Gallbladder Research Articles

Demographic and Clinicopathological Spectrum of Gallbladder Carcinoma in a Tertiary Care Centre in Jharkhand: A Retrospective Study.

Introduction Gallbladder carcinoma is a rare but aggressive cancer of adults that affects females more than males. Its occurrence is more common in the regions of South America and Asia. Chronic inflammation and cholelithiasis are frequently associated risk factors of gallbladder carcinoma. The incidental discovery of a gallbladder carcinoma during cholecystectomy, gross or microscopic examination of the unsuspected gallbladder specimens is termed incidental gallbladder carcinoma (IGBC). Considering the lack of extensive studies on gallbladder carcinoma in the Eastern region of India, especially in Jharkhand, this study has been done to present the demographic and clinicopathological characteristics of gallbladder carcinoma in this region. Methods A retrospective and descriptive study was done at Rajendra Institute of Medical Sciences (RIMS), Ranchi, a tertiary care center in Jharkhand. The study sample comprised 2386 gall bladder casesreceived in the Department of Pathology over five years, from December 2018 to December 2023. Results Of 2368 specimens, 25 cases (n=25) were reported as primary gallbladder carcinoma. The female-to-male ratio was 4:1. Pain was the most common complaint by the patients. Of the 25 cases, 12 were suspected intra-operatively or diagnosed microscopically (IGBC). Most showed a mass at the neck. In six cases, no gross mass/lesion was seen. Cholelithiasis is present in 19/25 cases.Most cases showed adenocarcinoma (not otherwise specified). Out of the adenocarcinoma cases, most were well differentiated. At the time of diagnosis, most were at the pT2 stage. Twelve cases of IGBC were found. Eight out of 12 IGBC were early-stage carcinoma when diagnosed. Conclusion Twenty-five cases of gallbladder carcinoma were diagnosed in the last five years in our center, with 19 (76%) of them associated with cholelithiasis. Twelve (48%) of the cases were incidentally diagnosed either preoperatively or during gross/microscopic examination, and eight (66%) of those were discovered early, out of which five (62.5%) were observed to be in the T1b stage. At this stage, there is a diversion from the general surgical management of gallbladder carcinoma for a better prognosis. This underscores the significance of routine histopathological examination of gallbladder specimens, even if there is no preoperative suspicion of gallbladder carcinoma.

A single institution’s experience with robotic resections of biliary tract cancers: an analysis of the short-term outcomes and long-term survival

IntroductionPerihilar cholangiocarcinoma, intrahepatic cholangiocarcinoma (IHCC), and gall bladder cancer are difficult malignancies to treat and are characterized by a tendency for local recurrence and a generally unfavorable prognosis. Surgical resection offers the only potential cure, conventionally performed via the open approach. Although minimally invasive approaches show promise, data remain limited. MethodsWith the institutional review board’s approval, we prospectively followed 100 patients between 2013 and 2023 who underwent robotic surgical resection for perihilar, IHCC, and gallbladder cholangiocarcinoma. Data are presented as median (mean ± SD). Significance was accepted at P ≤ .05. ResultsThe median patient age was 70 years, and the median operative duration was 333 min, with an estimated blood loss of 200 mL. Importantly, no unplanned conversions occurred, and only 1 intraoperative complication occurred within the IHCC cohort. The median length of stay was 4 days. There were a total of 19 postoperative complications and 19 readmissions within 30 days. Additionally, there were 3 in-hospital mortalities and 5 90-day mortalities. R0 resection was achieved in 87% of patients and R1 resection in 13%. At a median follow-up of 36 months, 62% of patients demonstrated disease-free survival, whereas 6% continued to live with the disease, and 32% did not survive. ConclusionOur experience demonstrates the feasibility and safety of robotic resection for these complex malignancies, yielding promising short-term outcomes. Further investigation is required to ascertain the long-term oncologic outcomes.

Computed Tomography Evaluation of Gall Bladder Mass with Histopathological Correlation

Background: In extrahepatic biliary carcinoma patients, unresectable disease is frequently discovered during exploration despite thorough preoperative assessment, leading to unnecessary laparotomy. Gallbladder carcinoma ranks fifth among gastrointestinal malignancies, following colorectal, pancreatic, gastric, and esophageal carcinomas. Aim of the study: The aim of the study was to establish the diagnostic usefulness of computed tomography (CT) in the diagnosis of gallbladder mass. Methods: This case-control study was conducted at the Department of Radiology and Imaging, Rajshahi Medical College Hospital, Rajshahi, Bangladesh from March 2018 to August 2018. The study included 65 patients diagnosed with a gallbladder mass, selected through purposive sampling. SPSS version 23.0 was utilized for data analysis. Results: CT scans accurately predicted various features of gallbladder mass, showing high sensitivity, specificity, and accuracy, with positive and negative predictive values of ≥95% for adenocarcinoma, squamous carcinoma, cholecystitis, metastases, GB polyp, and adenoma. Chronic cholecystitis sensitivity was over 83%. Overall, CT diagnosis performed at least 88.9% across all features. The histopathological assessment also detected nearly similar features of gallbladder mass. Conclusion: Computed tomography (CT) serves as a valuable diagnostic tool for distinguishing gallbladder neoplasms preoperatively. It is worth noting that CT scans aid in the rational management approach for patients with gallbladder neoplasms.

THU-187 Landscape of gall bladder cancers in India: a 25 years experience at a tertiary care cancer centre

THU-187 Landscape of gall bladder cancers in India: a 25 years experience at a tertiary care cancer centre

Establishing palliative care in tribal and rural Indian setting: A participatory action research approach.

e24085 Background: We established a palliative care center in the tribal area of Santhal Pargana, India, under a tertiary care facility, as a crucial step in addressing the palliative needs of oncology patients. This study assesses the center's inaugural year, focusing on referral patterns, morphine consumption, and pain management. Methods: Data from all patients visiting the palliative care outpatient department (OPD) in 2023 were prospectively collected and analyzed. The study focused on key palliative care indicators, including morphine consumption, patient referrals, and the mean Numeric Rating Scale (NRS) pain score after initial consultation. The PAR approach was utilized to tailor services to the community's needs. Results: The center observed an increase in patient referrals, from 8 new patients in January to 19 by December. The patient demographic primarily comprised individuals with head and neck cancer (43%), followed by breast cancer (28%) and gall bladder cancer (12%), alongside other types such as cervix, sarcomas, lung, and adult hematolymphoid malignancies. Bone metastasis was present in 46 (55.4%) patients at initial presentation. Morphine consumption demonstrated a notable rise, from 840 mg in May to 2860 mg in December, totaling 9800 mg for the year. The mean NRS pain score improved significantly from 6.5 in January to 4.3 post-initial consultation. The center maintained an overall median of 3 consultations per patient, and bereavement support was provided to 13 (15.7%) patients. Conclusions: The integration of the Participatory Action Research approach, specifically the CTC-5, was instrumental in the successful initiation and expansion of palliative care services within the center. The structured training, mentorship, and organizational restructuring, facilitated by the program, were crucial in establishing a modest palliative care infrastructure. This comprehensive approach not only enhanced care delivery but also ensured the sustainability and adaptability of palliative services, effectively addressing the gap in palliative care in rural, tribal settings.

A prospective observational role of magnetic resonance imaging and magnetic resonance spectroscopy in evaluation of choline levels in gall bladder carcinoma in tertiary care hospital in central India

Background Gall bladder carcinoma (GBC) is a challenging malignancy characterized by late-stage diagnosis and poor prognosis. Early detection and accurate staging are crucial for improving patient outcomes. Magnetic resonance imaging (MRI) and magnetic resonance spectroscopy (MRS) offer non-invasive imaging modalities that may aid in the evaluation of GBC. Choline, a metabolite detected by MRS, has been implicated in tumor growth and may serve as a potential biomarker for GBC. This study aims to investigate the role of MRI and MRS in evaluating choline levels as biomarkers for GBC. Method A prospective observational study will be conducted involving patients with suspected or confirmed GBC referred to the Department of Radiology, AVBRH, Sawangi. Patients meeting inclusion criteria will undergo MRI scans and MRS examinations to assess tumor characteristics and choline levels. Data collected will include MRI images, MRS spectra, histopathological results, and clinical outcomes. Statistical analysis will be performed to examine correlations between MRI findings, choline levels, and histopathological characteristics. Expected Outcome It is anticipated that MRI and MRS will demonstrate utility in evaluating choline levels as imaging biomarkers for GBC. Correlations between choline levels, tumor characteristics, and clinical outcomes are expected to provide valuable insights into the role of choline in GBC pathogenesis and prognosis. If successful, MRI and MRS could serve as non-invasive tools for early detection, staging, and treatment response monitoring in GBC, ultimately leading to improved patient outcomes and management strategies.

Gallbladder perforation: Diagnostic accuracy of new CT difficulty score in predicting complicated laparoscopic cholecystectomy.

To formulate and evaluate the diagnostic performance and utility of a new CT difficulty score in predicting difficult laparoscopic surgery in cases of gallbladder (GB) perforation. This prospective single centre study included a total of 48 diagnosed cases of GB perforation on CT between December 2021 and June 2023, out of which 24 patients were operated. A new 6-point CT difficulty scoring system was devised to predict difficult laparoscopic approach, based on patterns of inflammation around the perforated GB that were found to be surgically relevant. The pre-operative imaging findings on CT were studied in detail and correlation coefficients of various imaging findings were calculated to predict difficult surgery. On CECT, the type of perforation, according to the revised Niemeier's classification could be exactly delineated in all 48 patients. A CT difficulty score of ≥ 3 was found to a good predictor difficult laparoscopic approach, with statistical significance (p = 0.001), sensitivity of 94.44%, specificity of 83.33%, PPV of 94.44% and NPV of 83.33%. Inflammatory changes around duodenum showed maximum correlation coefficient of 0.744 (p = 0.0001), around colon showed a correlation coefficient of 0.657 (p = 0.0005), and in the omentum had a correlation coefficient of 0.5 (p = 0.013)). Inter-observer agreement was also calculated for various findings and it was found to have moderate to strong agreement (κ value 0.5-1.0). The CT difficulty scoring system can be an effective tool in predicting difficult laparoscopic surgery in cases of GB perforation in an emergency setting which can help in decision making and improved patient outcome.

Determining the patency of biliary tracts in dogs with gallbladder mucocele using near-infrared cholangiography with indocyanine green.

Cholecystectomy is indicated for gallbladder mucoceles (GBM). Evaluating the patency of the biliary duct and precise biliary tree visualization is crucial for reducing the risk of compromised bile flow after surgery. Therefore, intraoperative cholangiography (IOC) is recommended during cholecystectomy to prevent biliary tract injury. Although indocyanine green (ICG) cholangiography has been extensively reported in human medicine, only one study has been conducted in veterinary medicine. Therefore, this study aimed to demonstrate the use of ICG for IOC to identify fluorescent biliary tract images and determine the patency of the common bile duct during cholecystectomy in dogs. This study comprised 27 dogs, consisting of 17 with gallbladder mucoceles (GBM) and 10 controls, specifically including dogs that had undergone elective cholecystectomy for GBM. ICG injection (0.25 mg/kg) was administered intravenously at least 45 minutes before surgery. During the operation, fluorescent images from cholangiography were displayed on the monitor and obtained in black-and-white mode for the comparison of fluorescence intensity (FI). The FI values of the gallbladders (GBs) and common bile duct (CBD) were measured using FI analyzing software (MGViewer V1.1.1, MetapleBio Inc.). The results demonstrated successful CBD patency identification in all cases. Mobile GBM showed partial gallbladder visibility, whereas immobile GBM showed limited visibility. Additionally, insights into the adequate visualization of the remaining extrahepatic biliary tree anatomy were provided, extending beyond the assessment of CBD patency and gallbladder intensity. Our study demonstrates the potential of fluorescent IOC using intravenous injection of ICG for assessing the patency of the cystic duct and common bile duct during cholecystectomy in patients with GBM, eliminating the need for surgical catheterization and flushing of the biliary ducts. Further research is warranted to investigate and validate the broader applicability of ICG cholangiography in veterinary medicine.

Anatomy of Liver and Radiographic Study on Hepatic Duct in a South African Ostrich Struthio camelus australis

The South African Ostrich Struthio camelus australis, an acarinate flightless ratite bird, native to the African continent has been introduced in many countries including India in the recent past for meat as well as egg purpose. Although this largest extant bird is gaining popularity globally, the functional anatomy of this majestic giant has received relatively less attention. The liver, the largest gland in the body of an Ostrich (weighing approximately 1.5-2 Kg) is also the heaviest among all the birds. The Ostrich lacks gall bladder and thus, the bile needs to be produced continuously as in the case of certain mammals like horses and elephants. The present study aimed to investigate the gross morphological and radiographic characteristics of the liver of the Ostrich. The liver was divisible into two primary lobes: an undivided right lobe and a divided left lobe. The later consisted of dorso-cranial, intermediate, and ventro-caudal lobes. Notably, the ventro-caudal lobe was observed as the largest, while the intermediate lobe was the smallest. The right lobe, larger than the left, was connected to later by a thick isthmus at its cranial extremity. Using barium sulphate injection and positive contrast radiography, the intrahepatic course of the hepatic duct was visualized, revealing two distinct divisions and tributaries thereof for draining bile from the right and left lobes, respectively. A radiographic study of the intrahepatic course of the hepatic duct revealed a single right intralobar duct and two left intralobar ducts. The distinct isthmus was drained by the branch of the left intralobar duct.

Key postnatal magnetic resonance characteristics for differentiating cystic biliary atresia from choledochal cyst.

To analyze the ability of magnetic resonance (MR) to identify cystic biliary atresia (CBA) and choledochal cyst (CC). Infants (≤ 1 year old) who were diagnosed with CBA or CC type I/IV from January 2010 to July 2023 were retrospectively reviewed. Imaging characteristics on MR were compared between the CBA and CC groups. Binary logistic regression and the area under the receiver operating characteristic curve (AUC) were analyzed for the identification of CBA. Sixty-three patients with CBA (median age, 30 days) and 172 patients with CC (median age, 60 days) were included. Gallbladder (GB) wall thickness (cutoff, 1.2 mm) showed 98.4% sensitivity and 100% specificity (AUC, 0.998). MR-triangular cord thickness (MR-TCT) (cutoff, 4.1 mm) showed 100% sensitivity and 95.9% specificity (AUC, 0.986). The bile duct loop visualization showed 96.8% sensitivity and 100% specificity (AUC, 0.984). Proximal bile duct (PBD) diameter (cutoff, 1.3 mm) showed 92.1% sensitivity and 95.3% specificity (AUC, 0.977). Cyst wall thickness (cutoff, 1 mm) showed 77.8% sensitivity and 95.3% specificity (AUC, 0.942). The combination of GB wall thickness > 1.2 mm and MR-TCT > 4.1 mm, GB wall thickness > 1.2 mm and loop visualization, GB wall thickness > 1.2 mm, and cyst wall thickness > 1 mm showed 100% sensitivity and 100% specificity (AUC, 1.000). Imaging characteristics on MR might be used to identify CBA and CC, and the combination of GB wall thickness and MR-TCT, or loop visualization, or cyst wall thickness, has a perfect diagnostic value. Early and accurate differentiation of CBA and CC is essential, but current methods rely on inherently subjective ultrasound. Biliary features on MRI allow for an objective, accurate diagnosis.

Gall bladder carcinoma masquerading as bouveret syndrome as the initial presentation

Introduction: Gallbladder Cancer (GBC) is a rare yet serious condition that often presents diagnostic challenges due to its nonspecific symptoms, which are similar to other biliary disorders. Advanced stages of GBC can lead to rare complications like Cholecystoenteric Fistulas (CEF) or Bouveret Syndrome, where a gallstone migrates and causes Gastric Outlet Obstruction (GOO). We present a case of a woman who presented with symptoms of GOO but later led to the unexpected discovery of GBC.

Histopathological spectrum of gastrointestinal lesions - In a tertiary care centre

Gastrointestinal (GI) pathology is one of the largest sub- specialities in pathology. Histopathological evaluation of GI lesions is the gold standard for providing essential diagnostic and prognostic information to the clinicians for the best timely management of each patient. : This is an unicenter retrospective and prospective study of 510 patients with GI lesions over a period of 2 years from July 2021 to June 2023. Biopsies and resected specimens of gastrointestinal tract were fixed in 10% formalin. Those specimens were then processed in automatic tissue processor. Routine Haematoxylin and Eosin stain and special stains, including immunohistochemical stains were done, whenever indicated. Then slides were examined and data generated from observation and was used for statistical analysis. Out of total 2462 histopathological specimens received in 2 years, over 21% of specimens were GIT lesions of them 510 were GI specimens. Gall bladder was the most common specimen received [34.3%] followed by appendix specimens [18.6%] and gastric biopsies [13.9%]. Non neoplastic GI lesions [89.3%] were the most common followed by neoplastic lesions [10.7%]. Males outnumbered female patients having M: F ratio1.3:1. The peak incidence of non neoplastic lesions are found in the age group of 21-40 years and that for neoplastic lesions found in the age group of 50-70 yrs. Chronic cholecystitis was the most common GI pathology [34.3%] followed by appendicitis [18.1%]. Adenocarcinoma was the most common histopathological malignancy [52.7%] followed by squamous cell carcinoma [47.2%]. Most common lesion in the oesophagus and oral cavity was squamous cell carcinoma whereas adenocarcinoma was most common in colo-rectum. This study enables the overview of the spectrum of histopathological lesion encountered in the surgical pathology department and also reiterates that the histopathological evaluation is a valuable diagnostic tool for definitive and early diagnosis of GI lesions which has an impact on management of neoplastic lesions.

A rare case report ofIntracholecystic papillary-tubular neoplasm of the gall bladder

The understanding of Intracholecystic Papillary Neoplasm (ICPN) in the gallbladder is a recent development, hypothesized to have similarities in clinical and pathological traits with Intraductal Papillary Mucinous Neoplasm (IPMN) of the pancreas and Intraductal Papillary Neoplasm of the Bile Duct (IPNB). In this report, we present an uncommon instance of Intracholecystic Papillary-Tubular Neoplasms in a 38-year-old male. Although Intracholecystic Papillary Neoplasm (ICPN) is uncommon in the gallbladder lining, it typically presents a more favorable prognosis in contrast to gallbladder adenocarcinoma. Nonetheless, it still possesses the potential for metastatic spread to other organs. Our discussion delves into this patient’s case within the context of current literature on ICPN, while also delineating future avenues for enhancing clinical comprehension. Moreover, we emphasize the importance of implementing screening protocols, taking into account identified risk factors, to elucidate the natural course of the disease and deter its progression into invasive gallbladder carcinoma.

EVALUATING THE EFFECTIVENESS OF THE CRITICAL VIEW OF SAFETY IN LAPAROSCOPIC CHOLECYSTECTOMY AT BINH DAN HOSPITAL

Background: The aim of this study was to assess the safety of laparoscopic cholecystectomy using "The Critical View of Safety" (CVS) technique for the management of gallbladder stone disease. Subjects and methods: Prospective study, describing a series of cases of patients undergoing laparoscopic cholecystectomy with CVS applied to treat gallbladder stones at Binh Dan Hospital from January 2022 to October 2022. Results: We enrolled 89 patients and recorded the following outcomes: the success rate was high, at 97.8%. The failure cases were due to large stones blocking the gallbladder neck and severe adhesions in the hepatocystic triangle in necrotizing cholecystitis. There is a statistically significant difference in the success rate of achieving CVS between groups: gallbladder condition (p=0.02), degree of adhesion inflammation of the hepatocystic triangle (p=0.039). The overall bleeding complication rate was 10.3% (9 cases) and during CVS was 6.7% (6 cases). The overall gallbladder perforation complication rate was 8% (7 cases) and during CVS was 4.4% (4 cases), with no biliary tract injuries. The postoperative complications included fluid collection in the gallbladder bed in 10.3% of cases and surgical wound infection in 2.3% of cases. All were successfully treated with conservative measures. Conclusion: We concluded that CVS is a necessary, safe, and effective diagnostic method in laparoscopic cholecystectomy for gallbladder stone disease.

An Audit of Laparoscopic Cholecystectomy.

Objective: Gallstones is a common problem, particularly among women .In modern medicine, uncomplicatedgall stones are usually treated with Laparoscopic Cholecystectomy “Key-hole Surgery” .It carries significantlylower morbidity and mortality as compared to open surgery . At Muhammad Medical College Hospital (MMCH)we have started the procedure in recent years. .Aims: To look into various demographic and clinic aspects of Laparoscopic Cholecystectomy done at MMCH.Methods: Retrospective audit of record of last consecutive 99 patients undergoing Laparoscopic Cholecystectomy at MMCH. Research Ethics Committee approval was obtained (No.250811/REC/003).Results: 33 Men and 66 women underwent this procedure. Average age was 45 year (range 16 to 75). Commonest presenting symptoms were Nausea/vomiting (n=36) and abdominal discomfort /pain (n=36). All patientshad pre-procedure ultrasound scan showing gall stones .At surgery, 99/99 were confirmed to have gallstones .Although 9 also had adhesions, 6 were acutely inflamed and 3 had empyema gall bladder. There were 2conversions Average duration of stay in hospital after procedure was 9 days (range 3 to 20). 2 patients hadwound infection and 3 atelectasis. No mortality was seen.Conclusions: Laparoscopic Cholecystectomy is a safe procedure for gall stones disease.Keywords: Laparoscopic cholecystectomy, conversion rate morbidity.

The Association of Dyslipidemias with Cholelithiasis: A Case-Control Study Conducted at Pakistan Institute of Medical Sciences (PIMS), Islamabad

Objective: To find the association of lipid profile with early sign of cholecystitis (gall stones formation). Study Design: Case control study. Place and Duration of Study Methodology: The study recruited cholecystitis patients from 1st April 2022 to 30th September 2022 at Pathology Department, Pakistan Institute of Medical Sciences, Islamabad. Those patients having an age above 40 years and clinically diagnosed with gall bladder stone, went under ultrasonography examination, were included in the study. A total of 100 cases were compared with 100 controls in a case control study design. The lipid profile included serum concentrations of HDL cholesterol, Total Cholesterol, triglyceride, LDL cholesterol levels. Other tests as fasting blood glucose (FBG), total bilirubin (T-bil), alanine transaminase (ALT), aspartate transaminase (AST), creatinine (Cr), uric acid (UA), and urea nitrogen (UN) were also conducted. Results: The mean age of the gall stone patients and of normal controls was 51.71±13.48 and 42.00±13.14 years respectively. There was no variance in the BMI of both groups. The incidence of kidney stones was higher in the cases than controls while hypertension was more commonly reported in the 36% of the cases in comparison to the 19% of the controls. The logistic regression analysis presented a data where significant difference within lipid profile values of cases and controls could be seen having high values reported in cases than controls. The multivariant analysis of the lipid profile analyzed values presented a significant variance in the odds ration of high-density lipoprotein cholesterol levels and triglycerides of cases and controls. Conclusion: Low levels of high-density lipoprotein cholesterol and high levels of triglycerides are associated with the risk of gall bladder formation.

Dietary Considerations in Cholecystectomy: Investigating the Impact of Various Dietary Factors on Symptoms and Outcomes.

Cholecystectomy is commonly performed to address gallstone diseases, including the development of gallstones, which can lead to symptoms such as nausea, vomiting, and abdominal pain. Bile acids (BAs) produced by the liver are primarily stored and concentrated in the gallbladder (GB). After cholecystectomy, the body's ability to digest lipids isreduced due to the absence of the GB. Post-cholecystectomy syndrome (PCS) can occur when abdominal symptoms manifest after surgery. The purpose of this review is to look at the various effects of different dietary factors on patients undergoing cholecystectomy, how they affect their overall health after surgery, and how they contribute to symptoms of PCS. Some individuals may experience mild discomfort or alterations in bowel patterns, especially after consuming high-fat meals. The findings from the conducted studies suggest that, although dietary changes are a common recommendation, these measures are not sufficiently supported by evidence when it comes to alleviating symptoms and improving outcomes post-cholecystectomy. The studies found that subjects who consumed particular foods, such as processed meat and fried fatty foods, had exacerbated symptoms after cholecystectomy. Further studies are still required to understand the precise food factors that might affect post-surgical symptoms, as well as outcomes, and to develop tailored measures to enhance patient care and long-term prognosis after undergoing cholecystectomy.

Impact of Non-alcoholic Fatty Liver Disease on development of diabetes complications

Introduction. Non-alcoholic Fatty Liver Disease (NAFLD) shown frequent future in patients with type 2 Diabetes Mellitus (DM2). By affecting insulin metabolism, glucose production and gluconeogenesis liver disorders probably involved into DM2 clinical future and development of complications. We studied the role of the NAFLD in the development of diabetic complications such as retinopathy (DR), neuropathy (DPNP), nephropathy (DN). Material and methods. 62 patients with DM2 who were admitted into Republican Specialised Scientific Practical Medical Centre of Endocrinology named after acad. Y.Kh. Turakulov were observed. In all patient blood glucose, HbA1c, total blood count, urine test, blood lipids, AlT, AsT, alkaline and acid phosphatase, … were measured. Liver, pancreas, gall bladder were visualised by ultrasound. Results. Among patients with DM NAFLD were detected in 45% of patients with DM2. Patients average age, BMI, HbA1c, blood fibrinogen level were greater in NAFLD group, whereas there were no found any differences between ALT, AST, BUN, creatinine levels. Blood total platelets were decreased in NAFLD group (10.6%, p<0,05). Fib4 score was higher in NAFLD group by 1.5 times, where comparison of Fib4 score according to DN stages shown 2.57 times higher score in patients with DN4 and DN5. Patients with NAFLD diabetes complications were higher, especially DR by 1.2 times, DPNP 1.3 times and DN by 1.5 times than without NAFLD. Moreover, number of patients with NAFLD treated by insulin were 2 times more than without NAFLD. Conclusion. NAFLD is a frequent future among patients with DM2, have linkage with patients’ age, BMI, HbA1c level, depend from severity of DR, DPNP and DN. Blood platelets were lower in NAFLD group, where Fib4 score was 1.5 times higher. Results suggested about involving of NAFLD into diabetic complication development. NA. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.

18F]FDG PET/CT in Benign and Malignant Diseases Involving the Biliary Tract.

Role of FDG PET/CT in evaluation of biliary tract diseases remains relatively unexplored. PET/CT with FDG helps in evaluation of both infective / inflammatory as well as neoplastic diseases as increased glucose utilization is observed in both the conditions. In this article, we describe the spectrum of FDG PET/CT findings in various diseases affecting the biliary tract. Role of FDG PET/CT in neoplastic diseases involving the biliary duct has been described at the time of staging and response evaluation; in characterization of the intrahepatic mass (abscess v/s cholangiocarcinoma). In addition, we have discussed about the false positive FDG uptake along the biliary duct stent, which interfere with scan interpretation. Few of the benign conditions described are Langerhans cell histiocytosis and IgG4 related disease involving the biliary duct and adenomyomatosis and Xanthogranulomatous cholecystitis involving the gall bladder.

Enrofloxacin, Effective Treatment of Pseudomonas aeruginosa and Enterococcus faecalis Infection in Oreochromis niloticus.

Enrofloxacin is a broad-spectrum synthetic antimicrobial drug widely used in veterinary medicine. The present study aimed to determine the effective enrofloxacin dose for treating Pseudomonas aeruginosa and Enterococcus faecalis infection in Oreochromis niloticus. P. aeruginosa and E. faecalis isolates were verified using selective differential media and biochemically using the Vitek 2 test. Bacterial isolates were virulent for O. niloticus with LD50 equal to 2.03 × 106 and 2.22 × 107 CFU fish-1 for P. aeruginosa and E. faecalis, respectively. Infected fish suffered from decreased feed intake followed by off-food, tail erosion, darkening of the external body surface, exophthalmia, ascites, and loss of escape reflex. Internally, congested hemorrhagic hepatopancreas with engorged distended gall bladder were dominant. The posterior kidney was congested with enlarged spleen, and empty elementary tract. Pathologically, severe degenerative changes were dominant in the hepatopancreas, posterior kidney, spleen, stomach, and gills of infected fish. Antimicrobial sensitivity test indicated the high susceptibility of P. aeruginosa and E. faecalis to enrofloxacin with MIC estimated at 1 and 0.0625 µg/mL, respectively. Enrofloxacin effectively protected O. niloticus against E. faecalis and P. aeruginosa infection when used with medicated feed at doses of 10 and 20 mg kg-1 body weight.