Diseases Of Gastrointestinal Tract Research Articles

Collagen hydrogel protects intestinal epithelial cells from indomethacin-induced damage: results of an in vitro experiment

INTRODUCTION. Indomethacin is a derivative of indoleacetic acid and has anti-inflammatory, analgesic and antipyretic effects. However, the results of numerous studies show that indomethacin, like many other nonsteroidal anti-inflammatory drugs (NSAIDs), have an inhibitory effect on the viability and functional activity of enterocytes. In this regard, the search for new ways to reduce the severity of side effects from the use of NSAIDs remains relevant. One of these approaches may be to enrich patients’ diets with non-drug biologically active compounds, including proteins. However, the effect of dietary proteins and biologically active peptides on NSAID-induced damage to the wall of the small intestine and stomach has not been sufficiently studied. AIM. To evaluate the ability of a collagen-containing dietary supplement to protect human duodenal epithelial cells (HuTu-80 line) from indomethacin-induced damage. MATERIALS AND METHODS. The composite collagen-containing hydrogel was provided by «FIRST ALIVE COLLAGEN» LLC (Russia) and is a registered dietary supplement. The work used a commercial culture of human skin fibroblast cells and human duodenal epithelial cells (line HuTu-80). The viability of intestinal cells and fibroblasts was assessed using light and fluorescence microscopy and flow cytometry methods. RESULTS AND DISCUSSION. It has been established that indomethacin inhibits cell growth, causes apoptosis and death of enterocytes, and also leads to the accumulation of cells in the S-phase, which indicates a disruption in the regulation of the cell cycle. It was revealed that collagen hydrogel prevents cell death caused by indomethacin and reduces the number of apoptotic cells in the population. The protective effect of collagen hydrogel is characterized by normalization of the cell cycle of enterocytes and restoration of their growth and proliferative activity. CONCLUSION. Thus, collagen hydrogel, in vitro, is able to reduce the pathogenic effect of indomethacin on human intestinal epithelial cells. The protective effect of collagen hydrogel is characterized by maintaining viability, inhibiting apoptotic processes, and maintaining cell cycle stability. The results obtained indicate the prospects of using a dietary supplement based on a composite collagen hydrogel as a prophylactic agent to reduce the risk of NSAID-associated gastrointestinal diseases. However, to confirm the therapeutic effectiveness of the dietary supplement, further research is necessary, both using experimental animal modeling of NSAID-associated diseases of the human gastrointestinal tract, and clinical studies.

Intelligent Magnetic Microrobots with Fluorescent Internal Memory for Monitoring Intragastric Acidity

AbstractThis study investigates the dynamic fluctuations of pH caused by gastric acid secretion, a process of both biological and clinical significance, with microrobots. Abnormal patterns of acidity often indicate gastrointestinal diseases, underlying the importance of precise intragastric pH monitoring. Traditional methods using fluorescent probes face challenges due to their faint solid‐state fluorescence, limited target specificity, and accuracy. To overcome these obstacles, pH‐responsive fluorescent organic microparticles decorated with magnetite (Fe3O4) nanoparticles are engineered. These microrobots exhibit a unique fluorescence switching capability at a critical pH, enabling the monitoring of gastric acidity. The magnetic part of these microrobots ensures magnetic maneuverability to enable targeted navigation. The microrobots’ fluorescence switching mechanism is elucidated through comprehensive spectroscopy, microscopy, and X‐ray diffraction analyses, revealing molecular‐level structural transformations upon interaction with gastric acid and antacids. These transformations, specifically protonation and deprotonation of the microrobots’ fluorescent components, prompt a distinct fluorescence response correlating with pH shifts. In vitro and ex vivo experiments, simulating stomach conditions, confirm the microrobots’ efficacy in pH‐responsive imaging. The results showcase the promising diagnostic potential of microrobots for gastrointestinal tract diseases, marking a significant advancement in imaging‐based medical diagnostics at targeted locations.

Restraint Stress-Induced Neutrophil Inflammation Contributes to Concurrent Gastrointestinal Injury in Mice.

Psychological stress increases risk of gastrointestinal tract diseases. However, the mechanism behind stress-induced gastrointestinal injury is not well understood. The objective of our study is to elucidate the putative mechanism of stress-induced gastrointestinal injury and develop an intervention strategy. To achieve this, we employed the restraint stress mouse model, a well-established method to study the pathophysiological changes associated with psychological stress in mice. By orally administering gut-nonabsorbable Evans blue dye and monitoring its plasma levels, we were able to track the progression of gastrointestinal injury in live mice. Additionally, flow cytometry was utilized to assess the viability, death, and inflammatory status of splenic leukocytes, providing insights into the stress-induced impact on the innate immune system associated with stress-induced gastrointestinal injury. Our findings reveal that neutrophils represent the primary innate immune leukocyte lineage responsible for stress-induced inflammation. Splenic neutrophils exhibited elevated expression levels of the pro-inflammatory cytokine IL-1, cellular reactive oxygen species, mitochondrial burden, and cell death following stress challenge compared to other innate immune cells such as macrophages, monocytes, and dendritic cells. Regulated cell death analysis indicated that NETosis is the predominant stress-induced cell death response among other analyzed regulated cell death pathways. NETosis culminates in the formation and release of neutrophil extracellular traps, which play a crucial role in modulating inflammation by binding to pathogens. Treatment with the NETosis inhibitor GSK484 rescued stress-induced neutrophil extracellular trap release and gastrointestinal injury, highlighting the involvement of neutrophil extracellular traps in stress-induced gastrointestinal inflammation. Our results suggest that neutrophil NETosis could serve as a promising drug target for managing psychological stress-induced gastrointestinal injuries.

Role of Vitamin D in the Pathogenesis of Inflammatory Bowel Diseases: Literature Review

The pathogenesis of inflammatory bowel diseases still remains unclear nowadays. Genetic disposition, impaired immune regulation, disturbance in intestinal microbiota composition, exposure to environmental factors are associated with the development of inflammation in intestinal mucosa and increased epithelial penetrance that define disease's development and progression. There is a theory in scientific literature that vitamin D deficiency (among other environmental factors) increases the risk of inflammatory bowel disease. However, the role of vitamin D in the development of gastrointestinal tract diseases remains poorly studied. This article presents current data on the vitamin D effect on the intestinal mucosa barrier function, on the immune system and on the intestinal microbiota in the context of inflammatory bowel diseases pathogenesis.

Effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with inflammatory bowel disease: A protocol of a randomized controlled trial study.

Inflammatory bowel disease (IBD) is a chronic inflammatory gastrointestinal tract disease subdivided into Crohn's disease (CD) and ulcerative colitis (UC). There is currently no cure for IBD, and individuals with IBD frequently experience a lower health-related quality of life (HRQOL) than the general population. Gamification has become an increasingly popular topic in recent years. Adapting game design concepts to nongaming contexts represents a novel and potential approach to changing user engagement. This study will be conducted with the aim of evaluating the effect of a gamified mobile-based self-management application on disease activity index, quality of life, and mental health in adults with IBD. A multicenter, parallel, two-arm, exploratory randomized controlled trial with a 6-month follow-up per patient will be designed to compare the impact of the gamified mobile-based tele-management system on primary and secondary health outcomes and outpatient visits in 210 patients with all types of IBD which are divided equally into a control group with standard care and an intervention group which will use the developed mobile application named MY IBD BUDDY. All patients will attend study visits at baseline, 12 and 24 weeks, and routine IBD clinic visits or telephone consultations based on randomization group assignment. Disease activity or disease activity index, mental health (anxiety and depression) symptoms, quality of life, self-efficacy, and IBD-specific knowledge will be measured at baseline with two follow-ups at 12 and 24 weeks. In sum, the outcomes of our trial will demonstrate the impact of the gamified mobile-based self-management system on disease activity, quality of life, and anxiety and depression by means of interactive care and patient empowerment. IRCT: IRCT20200613047757N1. Registered November 16, 2021. Prospectively registered and visible at OSF (https://doi.org/10.17605/OSF.IO/AWFY9).

Pediatric Crohn's Disease in the Upper Gastrointestinal Tract: Clinical, Laboratory, Endoscopic, and Histopathological Analysis.

Crohn's disease (CD) is a progressive, multifactorial, immune-mediated disease characterized by chronic inflammation of any part of the gastrointestinal (GI) tract. Pediatric patients present with a more extensive form of the disease, especially in the upper GI tract with various histopathological inflammatory patterns. Our study aims to analyze the clinical, laboratory, endoscopic, and histopathological findings in children with diagnosed CD and compare results on the initial and follow-up tests. We have included 100 children and adolescents with CD, with performed endoscopic and histopathological (HP) procedures. The results of multiple biopsies executed in these 8 years were matched and compared. We found a statistically significant frequency reduction in stool changes (65.52% to 18.18%), weight loss (35.24% to 4%), and abdominal pain (41.86% to 6.67%) as presenting symptoms. There was an improvement in all laboratory values: fecal calprotectin (1000 to 60,8 μg/g), C-reactive protein (12.2 to 1.9 mg/L), and albumin (36 to 41 g/L). On esophagogastroduodenoscopy and ileo-colonoscopy 36.59% and 64.86% patients had specific findings, respectively. A total of 32 patients had evidence of Crohn's disease in the upper GI tract. Non-caseating granulomas were found on 9% of oesophageal, 18% of gastric, and 12% of duodenal biopsies. In the lower GI tract, we have observed a disease progression in the rectum (72.29 to 82.22%) and descending colon (73.49 to 80%). There was no registered disease progression in the upper GI tract. Our study demonstrated a significant decline in the frequency of symptoms and an improvement in laboratory values on the follow-up examinations. More than a third of our patients had specific endoscopic and HP findings in the upper GI tract, and an additional 23% had HP findings highly suggestive of CD. We demonstrated the importance of regular clinical, laboratory, endoscopic, and histopathological assessments of pediatric CD patients.

Combined effect of pantoprazole and mesenchymal stem cells on experimentally induced gastric ulcer: implication of oxidative stress, inflammation and apoptosis pathways.

Gastric ulcer (GU) is one of the most common diseases of the upper gastrointestinal tract that affects millions of people worldwide. This study aimed to investigate the possible alleviating effect of a combined treatment of pantoprazole (PANTO) and adipose tissue-derived mesenchymal stem cells (ADSCs) in comparison with each treatment alone on the healing process of the experimentally induced GU in rats, and to uncover the involved pathways. Rats were divided into five groups: (1) Control, (2) GU, (3) PANTO, (4) ADSCs and (5) ADSCs + PANTO. Markers of oxidative stress, inflammation and apoptosis were assessed. The current data indicated that PANTO-, ADSCs- and ADSCs + PANTO-treated groups showed significant drop (p < 0.05) in serum advanced oxidation protein products (AOPPs) and advanced glycation end products (AGEPs) along with significant elevation (p < 0.05) in serum TAC versus the untreated GU group. Moreover, the treated groups (PANTO, ADSCs and ADSCs + PANTO) displayed significant down-regulation (p < 0.05) in gastric nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB), tumor necrosis factor alpha (TNF-α), cyclooxygenase-2 (COX-2), intercellular adhesion molecule-1 (ICAM-1), matrix metallopeptidase 9 (MMP-9) and caspase-3 along with significant up-regulation (p < 0.05) in vascular endothelial growth factor (VEGF) and peroxisome proliferator-activated receptor gamma (PPARγ) genes expression compared to the untreated GU group. Immunohistochemical examination of gastric tissue for transforming growth factor β1 (TGF-β1), epidermal growth factor (EGF) and proliferating cell nuclear antigen (PCNA) showed moderate to mild and weak immune reactions, respectively in the PANTO-, ADSCs- and ADSCs + PANTO-treated rat. Histopathological investigation of gastric tissue revealed moderate to slight histopathological alterations and almost normal histological features of the epithelial cells, gastric mucosal layer, muscularis mucosa and submucosa in PANTO-, ADSCs- and ADSCs + PANTO-treated rats, respectively. Conclusively, the co-treatment with ADSCs and PANTO evidenced sententious physiological protection against GU by suppressing oxidative stress, inhibiting inflammation and reducing apoptosis with consequent acceleration of gastric tissue healing process.

CG‐Net: A novel CNN framework for gastrointestinal tract diseases classification

AbstractThe classification of medical images has had a significant influence on the diagnostic techniques and therapeutic interventions. Conventional disease diagnosis procedures require a substantial amount of time and effort to accurately diagnose. Based on global statistics, gastrointestinal cancer has been recognized as a major contributor to cancer‐related deaths. The complexities involved in resolving gastrointestinal tract (GIT) ailments arise from the need for elaborate methods to precisely identify the exact location of the problem. Therefore, doctors frequently use wireless capsule endoscopy to diagnose and treat GIT problems. This research aims to develop a robust framework using deep learning techniques to effectively classify GIT diseases for therapeutic purposes. A CNN based framework, in conjunction with the feature selection method, has been proposed to improve the classification rate. The proposed framework has been evaluated using various performance measures, including accuracy, recall, precision, F1 measure, mean absolute error, and mean squared error.

INDEX ASSESSMENT OF THE STATE OF THE ORAL CAVITY IN PATIENTS WITH GASTRO-ESOPHAGEAL REFLUX DISEASE

It has been established that diseases of the gastrointestinal tract, namely gastroesophageal reflux disease, affect the oral cavity. It should be noted that GERD is one of the most common diseases of the digestive tract in the world. The close relationship of the oral cavity, due to the similarity of functions, the common blood supply, innervation, and the morphological structure of the gastrointestinal tract leads to a violation of immunological reactivity, physical and chemical changes in saliva. SORP is a powerful receptor field that perceives the receptor influences of the whole organism. Numerous studies by clinicians confirm that 75% of patients with ENT pathologies are examined for gastrointestinal tract diseases. With increased acidity of gastric juice, there is hypersalivation, hypertrophy of the filiform papillae of the tongue in combination with foci of desquamation, pallor and swelling of the mucous membrane of the oral cavity, catarrhal gingivitis. With reduced acidity of gastric juice, there is a large number of plaques on the tongue, atrophy of filiform papillae, decreased salivation, dry lips, and angular cheilitis are observed. This is due to the weakening of the pharyngeal and cardinal valves of the stomach, as a result of which the contents of the stomach with its secretory component are thrown into the oral cavity, thereby affecting the taste buds. The index evaluation of the state of the oral cavity based on the index of plaque on the back of the tongue, the index of oral hygiene -OHI-S, the determination of the acidity of the oral fluid in patients with GERD indicates a dependence on the level of acidity of gastric juice. Gastroesophageal reflux disease negatively affects oral hygiene, the acid-alkaline balance of oral fluid, which leads to the formation of pathological processes in the oral cavity. Homeostasis of the oral cavity is maintained due to the acid-alkaline balance, the main indicator of which is the pH of the oral fluid. Oral fluid is considered an integral environment of the human body, therefore metabolic processes affect its composition.&#x0D; Aim. To study the indexes of the state of the oral cavity according to the indicators: index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.&#x0D; Materials and methods. To achieve the goal, 60 patients aged 25 to 55 years were examined. Of them, 30 are practically healthy people, 30 are patients with gastroesophageal reflux disease (of which 15 have increased acidity of gastric juice, and 15 have been examined with reduced acidity). IN THE RESEARCH PROCESS, WE STUDY INDICATORS index of plaque on the tongue according to (WTS); pH of oral fluid; hygiene index - OHI-S.&#x0D; Results. At the initial examination, plaque (W.T.C INDEX) was noted in patients with GERD. Thus, in the main group, the preference for a thick plaque on the back of the tongue was noted. Evaluating the state of oral hygiene (according to the Green-Vermillion index), it should be noted that, in general, hygiene was satisfactory in the main group of the examination. With increased acidity of gastric juice, at the age of 25-35, the satisfactory condition of the oral cavity according to the Green-Vermillion index was noted and was 1.4±0.1, and the group of female patients of the same category had an unsatisfactory state of oral hygiene and was 1.76±0 ,06. With low acidity, the hygienic index of the oral cavity in men aged 25-35 years was 1.3±0.1 and was satisfactory, while in women of the same age it was 2.0±0.4, which was unsatisfactory. Thus, in the 2nd group of women with reduced acidity aged 45-55 years, the indicator was 2.7±0.2, and in men of the same age, it was 2.3±0.3. Thus, when studying the pH of oral fluid in the main group, we noticed that the lower the pH level, the more acidic the environment. The acid-alkaline balance of the oral fluid is important for metabolism. Normally, the acidity of a person varies from 6.8-7.4 pH, and with a high rate of salivation it can reach 7.8 pH. With gastroesophageal reflux, which reaches the oral cavity, a decrease in the pH of saliva leads to pathological changes in the mucous membrane.&#x0D; Conclusion. So, the studied indices make it possible to assess the hygienic condition of the oral cavity, acid-alkaline balance in accordance with the level of acidity of gastric juice in GERD.

Applications of gastric peroral endoscopic myotomy in the treatment of upper gastrointestinal tract disease.

Gastric peroral endoscopic myotomy (G-POME) is an emerging minimally invasive endoscopic technique involving the establishment of a submucosal tunnel around the pyloric sphincter. In 2013, Khashab et al used G-POME for the first time in the treatment of gastroparesis with enhanced therapeutic efficacy, providing a new direction for the treatment of gastroparesis. With the recent and rapid development of G-POME therapy technology, progress has been made in the treatment of gastroparesis and other upper digestive tract diseases, such as congenital hypertrophic pyloric stenosis and gastric sleeve stricture, with G-POME. This article reviews the research progress and future prospects of G-POME for the treatment of upper digestive tract gastrointestinal diseases.

Antioxidant Activities and Phenolic Composition of Sarcococca saligna Leaves

Abstract: Sarcococca saligna (D. DON) Muel is a vital plant with several steroidal alkaloids and is effective against syphilis, liver diseases, gastrointestinal tract disease, infections, and inflammation. The present study aimed to investigate the in vitro antioxidant activities and phenolic profile of S. saligna. High-performance liquid chromatography (HPLC) analysis has shown the presence of twelve phenolics namely kaempferol-3-O-glucoside, proanthocyanidin B1, quercetin-3-malonylglucoside- 7-glucoside, kaempferol-3-O-sophorotioside, Isorhamnetin-3-O-glucoside-7-Orhamnoside, kaempferolhexoside, 4-O-Caffeoyl-5-O-p-coumaroylquinic acid, 3,4-Di-O-caffeoyl-5- O-feruloylquinic acid, 3,4-Di-O-feruloyl-5-O-caffeoylquinic acid, flavogalloyl-HHDP-gluconic acid (lagerstannin B), 3,4-di-O-caffeoylquinic acid and kaempferol-3-(caffeoyldiglucoside)-7-glucoside. The hot water extract showed the highest anti-lipid peroxidative activities. The IC50 value for 2,2- diphenyl-1-picrylhydrazyl (DPPH) radical scavenging activity was 71.5 ± 2.1 μg/mL. The extract could chelate the iron and possess reducing activities on phosphomolybenum assay. It is concluded that extracts of S. saligna are rich in antioxidants and contain essential phytochemicals. objective: The present study was aimed to investigate thein vitro antioxidant activities and phenolic profile of S. saligna. HPLC analysis has shown the presence of twelve phenolics namely kaempferol-3-O-glucoside, proanthocyanidin B1, quercetin-3-malonyl-glucoside-7-glucoside, kaempferol-3-O-sophorotioside,Isorhamnetin-3-O glucoside-7-O-rhamnoside,kaempferolhexoside, 4-O-Caffeoyl-5-O-p-coumaroylquinic acid, 3,4-Di-O-caffeoyl-5-O-feruloylquinic acid, 3,4-Di-O-feruloyl-5-O-caffeoylquinic acid, flavogalloyl-HHDP-gluconic acid (lagerstannin B), 3,4-di-O-caffeoylquinic acid and kaempferol-3-(caffeoyldiglucoside)-7-glucoside. method: The chemical used were 1,10-phenathroline, Thibarbituric acid, TRIS-HCl, amominium molybdate, Iron, sodium nitroprusside. HPLC standards were purchased from Sigma-Aldrich. All the reagents were of analytical grade. Double beam spectrophotometer was used for UV-VIS spectrophotometery. The HPLC system used was Agilent 1260 Infinity HPLC system which consists of quaternary pump, degasser, auto-sampler and diode array detector (DAD). conclusion: The results have shown that S. saligna antioxidant rich extract can be effectively utilized in food and pharmaceutical industries with additional income. However, more detailed understanding of utilization of extract against degenerative diseases is required. There is also need to find out the safety and bioavailability of the plant extract for its use as nutraceutical and as a plant products.

Third-party fecal microbiota transplantation for high-risk treatment-naïve acute GVHD of the lower GI tract

AbstractDisruption of the intestinal microbiome is observed with acute graft-versus-host disease (GVHD) of the lower gastrointestinal (LGI) tract, and fecal microbiota transplantation (FMT) has successfully cured steroid-refractory cases. In this open-label, single-arm, pilot study, third-party, single-donor FMT was administered in combination with systemic corticosteroids to participants with high-risk acute LGI GVHD, with a focus on treatment-naïve cases. Participants were scheduled to receive 1 induction dose (15 capsules per day for 2 consecutive days), followed by 3 weekly maintenance doses, consisting of 15 capsules per dose. The primary end point of the study was feasibility, which would be achieved if ≥80% of participants able to swallow ≥40 of the 75 scheduled capsules. Ten participants (9 treatment-naïve; 1 steroid-refractory) were enrolled and treated. The study met the primary end point, with 9 of 10 participants completing all eligible doses. Organ-specific LGI complete response rate at day 28 was 70%. Initial clinical response was observed within 1 week for all responders, and clinical responses were durable without recurrent LGI GVHD in complete responders. Exploratory analyses suggest that alpha diversity increased after FMT. Although recipient microbiome composition never achieved a high degree of donor similarity, expansion of donor-derived species and increases in tryptophan metabolites and short-chain fatty acids were observed within the first 7 days after FMT. Investigation into the use of microbiome-targeted interventions earlier in the treatment paradigm for acute LGI GVHD is warranted. This trial was registered at www.ClinicalTrials.gov as #NCT04139577.

Phytochemical and Pharmacological Potential of Ferula asafetida “Hing”

Abstract: Asafoetida, also known as Hing, is a resinous gum derived from the roots of Ferula species, specifically Ferula asafetida. From ancient times, it has been employed both in the kitchen as a seasoning and in the practice of traditional medicine. In terms of pharmacognosy, asafoetida is comprised of a number of active chemicals, the most notable of which are coumarins, volatile oils (17%), and ferulic acid (60%). Ferulic acid and coumarins (40%) are two of the components that contribute to the medicinal value of this plant. The volatile oils are responsible for the strong odour and flavour of this plant. It is used for a variety of applications in the medical field. It is not only used as spices and condiments for the goal of imparting taste in curries, but it is also utilised in the treatment of gastrointestinal tract diseases, asthma, whooping cough, hypertension, and a variety of other conditions. The herb has been used to extract a variety of phytochemical components, including sesquiterpene coumarins, coumarins, diterpene coumarins, and chemicals containing sulphur. This manuscript provides a synopsis of the facts concerning the pharmacological activities and bioactive components of Ferula asafetida.

Ciprofloxacin and Azithromycin Susceptibility in Salmonella Causing Bloodstream Infection in a Tertiary Care Hospital in South India

Enteric fever is a major health concern worldwide, especially in tropical countries. Enteric fever caused by Salmonella enterica is a gastrointestinal tract disease to begin with and later involving many systems,. After the advent of multidrug resistant Salmonellae, ciprofloxacin became the focus of its treatment. Azithromycin is widely being used for the prevention and treatment of Enteric fever. Of late, there are reports in literature to support that Salmonella have regained susceptibility to Ampicillin, Cotrimaxazole and Chloramphenicol. Therefore, this study undertaken aims to find out the antimicrobial susceptibility of Salmonella isolates to conventional drugs like Ampicillin, Cotrimaxazole and Chloramphenicol and find out susceptibility pattern of Ciprofloxacin that is over used for treatment of enteric fever and Azithromycin, most often used in children. As there is no disc diffusion method as per CLSI 2019 guidelines to detect the susceptibility to ciprofloxacin, ciprofloxacin resistance was determined by minimum inhibitory concentration(MIC)by E-test.Kirby-Bauer disk diffusion technique was used to monitor Azithromycin resistance among Salmonella entericaserovarTyphi as per CLSI 2019 guidelines. METHODS:The Prospective study was conducted over a period of 8 months (May 2019- December 2019) with the clinical samples yielding the growth of Salmonella from blood. These strains were screened for Ciprofloxacin susceptibility by E-test. Azithromycin,Ampicillin, Co-Trimaxazole and Chloramphenicol susceptibility were detected by Kirby-Bauer disc diffusion technique. RESULTS: Of the 80 isolates that were screened, 52 (65%) were resistant, 24 (30%) were intermediate susceptible and remaining 4(5%) were sensitive to ciprofloxacin by MIC detection. 69 (86.25%) of the isolates were sensitive and 11 (13.75%) were resistant to Azithromycin by disc diffusion technique. All isolates (100%)were found to be susceptible to Ampicillin, Co-Trimaxazole and Chloramphenicol CONCLUSION:The current study shows a high prevalence of resistance to ciprofloxacin in Salmonella species isolated in and around Mysuru district in southern India. Detection of ciprofloxacin resistance by the Kirby Bauer disk diffusion method is less effective, so it is advised that MIC of ciprofloxacin must be regularly done in the diagnostic laboratories for all strains. The findings from our study also showed low level resistance (13.75%) to Azithromycin. It is advised that Azithromycin can be used as a therapeutic agent only if it is reported to be sensitive by the susceptibility test. Conventional agents like Ampicillin, Co-Trimaxazole and Chloramphenicol can be reconsidered for treatment of Enteric fever.

Post-covid functional diseases of gastrointestinal tract

Aim. To assess the frequency of functional gastrointestinal diseases after COVID-19 and identify factors associated with the post-COVID esophageal syndrome.Materials and methods. The study included data from 72 (31 men and 41 women) patients over the age of 18 who had COVID-19. Patients were divided into two groups: with or without gastroenterological symptoms during acute coronavirus infection.Results and Discussion: After 6 months from the onset of the coronavirus infection, Irritable Bowel Syndrome (IBS) developed in 29% of patients with gastrointestinal symptoms and only in 7% of patients without symptoms in the acute stage of infection. The concurrent development of two digestive system diseases (more often a cross syndrome of Functional Dyspepsia and IBS) was 2.6 times more common in the first group of patients. Statistically significant risk factors for the development of post COVID functional digestive diseases were: diarrhea, abdominal pain, anorexia, anosmia, and agenesis.Conclusion. The presence of gastrointestinal symptoms at the baseline level of COVID-19 was more frequently associated with the development of functional gastrointestinal tract disorders during a six-month follow-up.

Cytomegalovirus Diseases of the Gastrointestinal Tract in Immunocompetent Patients: A Narrative Review.

Cytomegalovirus (CMV) is a potential pathogen that causes gastrointestinal (GI) tract diseases regardless of host immunity. In contrast to immunocompromised individuals, immunocompetent patients lack a comprehensive overview of the gastrointestinal manifestations. This study aims to provide a comprehensive summary of the current evidence regarding presentations, diagnostics, management, risk assessment, and outcomes in immunocompetent patients with CMV GI disease. A thorough literature search of English publications up to April 2022 was conducted across electronic databases to identify relevant articles, with eligible case series selected for detailed analysis. The majority of immunocompetent patients affected by CMV GI disease are typically elderly, critically ill, or burdened with comorbidities that compromise immunity. Clinical presentations range from subtle symptoms to severe surgical conditions, including instances of mortality. Specific clinical presentations, blood test results, or endoscopic features are lacking, necessitating reliance on histopathological tests such as immunohistochemistry staining for diagnosis. While antiviral therapy may offer benefits in improving outcomes, careful individual assessment is warranted due to diverse comorbidities and potential side effects. Mortality rates vary considerably based on underlying medical conditions and therapeutic approaches. It is imperative for clinicians to maintain vigilance for CMV GI disease among high-risk groups, despite their baseline immunocompetence, in order to enhance clinical outcomes.

The Association between Functional Dyspepsia and Metabolic Syndrome-The State of the Art.

Functional dyspepsia is a common functional disorder of the gastrointestinal tract that is responsible for many primary care visits. No organic changes have been found to explain its symptoms. We hypothesize that modern lifestyles and environmental factors, especially psychological stress, play a crucial role in the high prevalence of functional dyspepsia and metabolic syndrome. While gastrointestinal tract diseases are rarely linked to metabolic disorders, chronic stress, obesity-related metabolic syndrome, chronic inflammation, intestinal dysbiosis, and functional dyspepsia have significant pathophysiological associations. Functional dyspepsia, often associated with anxiety and chronic psychological stress, can activate the neuroendocrine stress axis and immune system, leading to unhealthy habits that contribute to obesity. Additionally, intestinal dysbiosis, which is commonly present in functional dyspepsia, can exacerbate systemic inflammation and obesity, further promoting metabolic syndrome-related disorders. It is worth noting that the reverse is also true: obesity-related metabolic syndrome can worsen functional dyspepsia and its associated symptoms by triggering systemic inflammation and intestinal dysbiosis, as well as negative emotions (depression) through the brain-gut axis. To understand the pathophysiology and deliver an effective treatment strategy for these two difficult-to-cure disorders, which are challenging for both caregivers and patients, a psychosocial paradigm is essential.

Plant-derived extracellular vesicles: A novel approach for gastrointestinal tract diseases

Exosomes, nanovesicles with diameters ranging from 30 to 150 nm are crucial for intercellular communication. They are produced by mammalian and plant cells to transport bioactive components such as proteins, nucleic acids, metabolites, and lipids, which vary based on their origin.

Design and development of artificial intelligence‐based application programming interface for early detection and diagnosis of colorectal cancer from wireless capsule endoscopy images

AbstractThe colorectal cancer (CRC) is gaining attention in the context of gastrointestinal tract diseases as it ranks third among the most prevalent type of cancer. The early diagnosis of the CRC can be done by periodic examination of the colon and rectum for innocuous tissue abnormality called polyp as it has the potential to evolve as malignant in future. The CRC diagnosis using wireless capsule endoscopy requires the dedicated commitment of the medical expert demanding significant time, focus and effort. The accuracy of manual analysis in identifying polyps is extensively reliant on the cognitive condition of the physician, thus emphasizing the requirement for automatic polyp identification. The artificial intelligence integrated computer‐aided diagnosis system could assist the clinician in better diagnosis, thereby reducing the miss‐rates of polyps. In our proposed study, we developed an application program interface to aid the clinician in automatic segmentation of the polyp and evaluation of its dimension by manual placement of four landmarks on the predicted polyp. The segmentation is performed by the proposed light weight Padded U‐Net for the effective polyp segmentation in the colorectal images. We trained and validated the Padded U‐Net with augmented images of Kvasir dataset and calculated the performance parameters. In order to facilitate image augmentation, a graphical user interface called Augment Tree was developed, which incorporates 92 augmentation techniques. The accuracy, recall, precision, IoU, F1‐score, loss achieved during validation of Padded U‐Net were 95.6%, 0.946%, 0.985%, 0.933%, 0.965% and 0.080% respectively. We demonstrated that accuracy was improved and loss was reduced when the model was trained with augmented images rather than only the limited original dataset images. On comparison of our Padded U‐net architecture with recently developed architectures, our model attained optimal performance in all the metrics except accuracy in which it attained marginal performance to the highest value.

Pelvic abscess treatment: A novel experience with UNICO drainage

Pelvic abscess can be a life-threatening condition due to infected fluid collection. Usually, pelvic abscess occurs as a complication of surgical procedures or pelvic organ tumors, inflammatory pelvic conditions, infectious gastrointestinal tract and gynecological diseases. Drainage is the standard treatment of pelvic abscess especially after failure of the antibiotic therapy. UNICO drainage is an innovative catheter for minimal invasive centesis and miscellaneous drainage procedures. In this report, it was used on three patients with pelvic abscess of different etiology: Pelvic inflammatory disease, Crohn disease, and endometriosis. In all cases, UNICO drainage was applied transrectally under loco-regional anesthesia. The procedure was well tolerated with rapid improvement of clinical conditions in all cases. The procedure was easy and rapid and there were no complications in any of the three cases reported. UNICO drainage is a simple and effective drainage tool and it can be a valid alternative for pelvic abscess drainage.