Incidence Of IBS Research Articles

Contribution of sex and gender roles to the incidence of post-infectious irritable bowel syndrome in a prospective study

Post-infectious irritable bowel syndrome (PI-IBS) occurs in about 10% of cases following gastroenteritis. The incidence of IBS is higher in females. However, it is not clear whether this is due to biological or psychosocial factors. We aimed to investigate the influence of gender roles on the incidence of PI-IBS, alongside traditional risk factors. Our study included 231 patients diagnosed with gastroenteritis who were hospitalized and treated with antibiotics between 2018 and 2021. The Korean Sex Role Inventory-Short Form (KSRI-SF), based on the Bem Sex Role Inventory (BSRI) was used to categorize patients (androgynous, masculine, feminine, and undifferentiated types). Six months after treatment, we conducted a telephone survey to confirm the presence of PI-IBS using the ROME IV criteria. Among the patients, 43.3% were female, and the mean age was 43.67 ± 16.09 years. After 6 months, 34 patients developed PI-IBS. Univariate analysis revealed that younger age, female sex, KSRI-SF undifferentiated type, and longer duration of antibiotic use independently influenced the occurrence of PI-IBS. Multivariate analysis showed that PI-IBS was associated with the KSRI-SF undifferentiated type and higher C-reactive protein (CRP) levels. Our study showed that the KSRI-SF undifferentiated type and high CRP levels at initial infection were associated with PI-IBS.

Effect of Vitamin D on Irritable Bowel Syndrome on Ain Shams University Medical Students

Abstract Objective Irritable Bowel Syndrome (IBS) can be divided into three subtypes according to bowel habits –IBS with diarrhea (IBS-D), IBS with constipation (IBS-C), and IBS with mixed bowel habits (IBS-M). Incidence of IBS has been increasing over last two decades. Recent studies have suggested a relationship between vitamin D and IBS. Vitamin D has a potential role as immune modulator, antiinflammatory, and anti-microbial agent that can explain its role in IBS. Method This study is part of The Nutritional Assessment of Medical Students of Ain Shams University (NAMS/ASU), the project was designed to evaluate the nutritional status of the undergraduate medical students. All participants were subjected to: Interview questionnaires including data: name, age, sex, study grade, past medical history and family history. Dietary recall: 24 hrs food recall, food frequency related iron intake. All data was analyzed using food composition table National Nutritional Institute (NNI). General clinical examination laying stress on: Systolic blood pressure & Diastolic blood pressure. This study was applied on 40 students who were diagnosed as IBS by ROME 4 criteria and vitamin D deficiency (<20 IU). They were advised to eat rich vitamin D food and vitamin D supplementation by vitamin D oral drops cholecalciferol 42000 IU per week for 12 weeks then vitamin D level was reevaluated again and check ROME IV criteria for IBS. Results Demographic data of Irritable Bowel Syndrome among Ain Shams University Medical Students according to their demographic data regarding age, sex and BMI shows that the ranged age 20-24 with mean 22.33±1.37, while female (65%) and male (35%), as well as ranged BMI 1930 with mean 23.75±3.02 and the ranged systolic blood pressure 95-130 with mean 113.13±10.23, also ranged diastolic 60-85 with mean 73.88±7.02 of blood pressure of demographic data. After three months of vitmin D intervention participants were divided into 2 groups according to IBS symptoms relief group 1 was with no symptoms (ROME IV criteria are not fulfilled), while group 2 are the candidates whom ROME IV criteria are fulfilled but with a less degree and improvement of Rome IV criteria.%. Conclusion Female sex is more liable for IBS, being a student in a medical college and lack of exercise. Our study indicated that Vitamin D supplementation could play a therapeutic role in the control of IBS in medical students.

HLA-DQ and alcohol in the pathogenesis of irritable bowel syndrome in college students: a case–control study

Some researchers have shown that genetics contribute to the incidence of IBS. However, no research has focused on the interaction between HLA-DQ and living habits in the pathogenesis of IBS. The present study explored the risk factors for IBS in college students of Guangxi Han nationality and explored the interaction between HLA-DQ and living habits on the pathogenesis of IBS. Univariate and multivariate analyses were used to determine the risk factors for IBS. Logistic interaction analysis and the Excel table made by Andersson were used to explore the interaction between genes and living habits in the context of IBS. We found that low expression of HLA-DQ2 and DQ8 were associated with the pathogenesis of IBS, while mild to moderate alcohol consumption was associated with the occurrence of IBS symptoms. Only the HLA-DQ8 gene and alcohol consumption had additive interactions in the context of the occurrence of IBS. In other words, for college students of Guangxi Han nationality, HLA-DQ2 and HLA-DQ8 might be protective against IBS, while alcohol consumption might be an independent risk factor. There was an additive interaction between HLA-DQ8 and alcohol consumption in the occurrence of IBS.

Effectiveness of Visual Inspection with Acetic Acid (VIA) Screening on Cervical Cancer Mortality and Incidence - A Systematic Review and Meta-Analysis.

Objectives:Despite being a cheap, easy, and commonly used technique for screening early development of cervical cancer, collective evidence on the effect of visual inspection with acetic acid (VIA) for reducing cervical cancer mortality and incidence are conflicting. We conducted a systematic review and meta-analysis to determine the effectiveness of VIA screening on cervical cancer mortality and incidence. Methods:We searched PubMed, Embase, Cochrane library (Cochrane Database of Systematic Reviews & Cochrane Central Register of Controlled Trials), World Health Organization’s (WHO) International Clinical Trials Registry Platform, and Google Scholar to identify studies conducted among women with no history of cervical cancer that assessed effectiveness of VIA on the cervical cancer mortality and incidence. Random effects model was used to estimate incident rate ratio and sensitivity analysis was conducted using Bayesian methods. Results:Of the included 4 studies, three were cluster randomized trials from India and one was quasi-experimental study done in Thailand. Duration of follow-up ranged from 7 to 12 years. Based on 3 trials, pooled rate-ratio for cervical cancer mortality and all-cause mortality was 0.68 (95% CI: 0.56–0.81, I2=0%) and 0.91 (0.85–0.97, I2=57%), respectively. Pooled rate-ratio of invasive cervical cancer was 0.94 (95% CI: 0.67 – 1.30, I2=84%). Likewise, there was non-significant reduction in incidence of stage IB, >=stage II, and unknown stage cervical cancer. Conclusions:VIA screening may lead to reduction in cervical cancer and all-cause mortality in long run. However, the effectiveness of VIA in preventing invasive cervical cancer is inconclusive.

Association between Helicobacter pylori infection and irritable bowel syndrome: A systematic review and meta-analysis.

Background:In recent years, the incidence of IBS has gradually increased, and it is considered as one of the most common functional gastrointestinal diseases. However, the etiology of IBS is still unclear, and expectations are rising for more targeted treatments. Many clinical trials have explored the link between Helicobacter pylori (H pylori) and IBS, with different conclusions. Therefore, we conducted a meta-analysis to explore whether there is an association between H pylori and IBS, which is of great significance for targeted treatment of IBS.Methods:We performed a systematic review and meta-analysis of the association between H pylori and IBS. We searched PubMed, EMBASE, Medline and the Cochrane Library to collect related studies. OR was used to describe the ratio of the probability of the H pylori infection occurring in IBS patients versus the controls. Heterogeneity was assessed by subgroup and meta-regression analysis.Results:Eight studies, including 1861 patients, assessed the association between H pylori infection and IBS. The OR of H pylori in IBS patients compared to controls was 1.32 (95% CI: 0.94–1.87; P = 0.11). Subgroup analyses showed a difference between IBS patients diagnosed with Roman III criteria and those diagnosed with non-Roman III criteria.Conclusions:Our study suggests that H pylori may have a positive effect on the development of IBS. Although the differences were not statistically significant, there were significant differences among subgroups of patients. Considering the limitations and heterogeneity, high quality studies are needed to further explore the effect of H pylori on the development of IBS.

Association between Brachyspira and irritable bowel syndrome with diarrhoea

ObjectiveThe incidence of IBS increases following enteric infections, suggesting a causative role for microbial imbalance. However, analyses of faecal microbiota have not demonstrated consistent alterations. Here, we used metaproteomics to...

Endometriosis and irritable bowel syndrome: a systematic review and meta-analysis.

Irritable bowel disease and endometriosis are two common diseases characterized by chronic inflammation state and recurrent abdominal pain. As a consequence of sharing of symptoms and chronic inflammation, endometriosis and IBS may coexist and be misdiagnosed and this leads to delays in diagnosis, mismanagement, and unnecessary testing. In recent years, some studies have found higher risk of IBS in women with endometriosis, compared to women without endometriosis. To provide a general overview, we performed a systematic review and a meta-analysis on published data on this issue. By a systematic literature search selection process, 11 studies were identified for the current study: 2 prospective and 2 retrospective cohort studies, 4 case-control studies, 1 cross-sectional study and 2 clinical series. When we meta-analysed data about the prevalence of IBS in women with endometriosis, the overall OR (95%CI), compared to women without endometriosis was 3.26 (1.97-5.39) with no statistically significant heterogeneity. All three studies considering the incidence of IBS in women with a previous diagnosis of endometriosis showed about twofold greater risk among women with endometriosis than women without. Likewise, in the random effects model of the meta-analysis, the overall OR of history of IBS in women with endometriosis was 3.10 (95% CI 2.06-4.67), with no heterogeneity between three studies considered. This meta-analysis provides epidemiological evidence of a link between endometriosis and IBS, highlighting two or more times higher risk of IBS in women with endometriosis compared to women without the condition.

Does prior antibiotic use increase the incidence of IBS within the following 12 months?

Evidence-Based Practice: March 2021 - Volume 24 - Issue 3 - p 35-36 doi: 10.1097/EBP.0000000000000928

Genetic characterization of GSD I in Serbian population revealed unexpectedly high incidence of GSD Ib and 3 novel SLC37A4 variants.

Glycogen storage disease (GSD) type I is inborn metabolic disease characterized by accumulation of glycogen in multiple organs. We analyzed 38 patients with clinical suspicion of GSD I using Sanger and next-generation sequencing (NGS). We identified 28 GSD Ib and 5 GSD Ia patients. In 5 patients, GSD III, VI, IX, cholesteryl-ester storage disease and Shwachman-Diamond syndrome diagnoses were set using NGS. Incidences for GSD Ia and GSD Ib were estimated at 1:172 746 and 1:60 461 live-births, respectively. Two variants were identified in G6PC gene: c.247C>T (p.Arg83Cys) and c.518T>C (p.Leu173Pro). In SLC37A4 gene, 6 variants were detected. Three previously reported variants c.81T>A (p.Asn27Lys), c.162C>A (p.Ser54Arg) and c.1042_1043delCT (p.Leu348Valfs*53) accounted for 87% of all analyzed alleles. Computational, transcription studies and/or clinical presentation in patients confirmed pathogenic effect of 3 novel variants: c.248G>A (p.Gly83Glu), c.404G>A (p.Gly135Asp) and c.785G>A (p.Ser263Glyfs*33 or p.Gly262Asp). In the cohort, hepatomegaly, hypoglycemia and failure to thrive were the most frequent presenting signs of GSD Ia, while hepatomegaly and recurrent bacterial infections were clinical hallmarks of GSD Ib. All GSD Ib patients developed neutropenia while 20.6% developed inflammatory bowel disease. Our study revealed the highest worldwide incidence of GSD Ib. Furthermore, description of 3 novel variants will facilitate medical genetic practice.

Inaccurate aortic stent graft deployment in the distal landing zone: incidence, reasons and consequences.

The aim of this study was to investigate the accuracy of stent graft deployment in the distal landing zone (LZ) during thoracic endovascular aortic repair (TEVAR). Currently, TEVAR focuses on accurate stent graft deployment in the proximal LZ. Data on landing in the distal LZ are lacking. Of 195 TEVAR patients (2005-16) with a non-dissected aortic pathology, 59 [median age 73 years (first quartile 68; third quartile 77), 20 women] patients had a distal LZ shorter than 40 mm. In all, the aim was to deploy the stent graft just above the target vessel (coeliac trunk, mesenteric superior or renal artery). Patients were divided into the accurate landing (n = 10) and inaccurate landing (IAL, n = 49) groups according to the distance to the target vessel ≤ 5 mm or > 5 mm after TEVAR, target vessel coverage and the need for a second stent graft in the distal LZ. We assessed the distal LZ, stent graft distance to the target vessel, apposition, migration and endoleak Ib on computed tomography. Median follow-up period was 23 months (5; 48). Distal LZ anatomy did not differ between groups. Overall stent graft distance to the target vessel was 10.0 mm (6.5 mm; 16.0 mm). Three patients required a second stent graft in the distal LZ, and in 3 others, the target vessel was accidentally covered. In patients of the accurate landing group primary endoleak Ib occurred less frequently than those in the IAL group (0% vs 33%; P = 0.049). Three (30%) accurate landing and 19 (39%) IAL patients (P = 0.73) presented with substantial stent graft wedge apposition. Accurate stent graft implantation in the distal LZ with the currently available deployment mechanism is often challenging. An inaccurate landing is associated with a higher incidence of endoleak Ib.

Do patients with longstanding IBD have higher cancer risk compared to the general population? Results from the IBSEN study.

1573 Background: Crohn’s disease (CD) and ulcerative colitis (UC) are chronic relapsing inflammatory bowel diseases (IBDs) that affect the gastrointestinal tract. The incidence and prevalence of IB...

G81(P) Impact of socio-economic position on incidence of Inflammatory Bowel Disease

BackgroundInflammatory bowel disease (IBD) is understood to result from the interaction of genetic, immunological and environmental factors. There has been a marked increase in the incidence of IBD over the...

Infant botulism in Andalusia (Southern Spain)

BackgroundInfant botulism (IB) is caused by the intestinal colonization by Clostridium botulinum in the first year of life and its subsequent production of neurotoxins. Traditionally, IB has been associated to honey consumption. IB cases tend to cluster in geographic regions. In Europe, IB is a rare disorder. From 1976 through 2006, 65 cases were identified in 13 European countries. In Spain, in the last 15 years, most of the cases have been reported in one region, Andalusia (Southern Spain). A specific treatment for IB type A and type B (BabyBIG) is available outside of the United States since 2005. Methodsand aims: We performed a retrospective review of IB cases detected in Andalusia since 1997 and compare them with the cases of IB reported in Europe. ResultsWe identified 11 confirmed cases of IB in Andalusia since 1997, and 14 cases in Spain. Nine out of 11 cases were detected since 2007; none of these infants had been exposed to honey consumption. One case in 1997 and another in 2000 were associated to honey. Two cases were treated with BabyBIG in 2007. In the period 2006–2012 the cases of IB reported in Europe were 54. ConclusionsWe identified a considerable increase in the incidence of IB since 2006. A tendency to a reduction in the number of cases of IB linked to honey consumption has also been identified. An increase in the exposure to these bacteria from the environment could be presumed. Clinicians should maintain a high index of suspicion for this treatable disorder.

Enhanced cold-tolerance in pineapple (Ananas comosus ‘Mauritius’) by combined cold- and heat-shock treatments or intermittent warming

SummaryInternal browning (IB) is a physiological disorder that develops in harvested pineapple (Ananas comosus) ‘Mauritius’ fruit during prolonged periods of cold storage. A brief exposure of fruit to low temperature (i.e., 4°C for 60 min) prior to cold storage at 10°C reduced the incidence of IB by 40% in both core and flesh tissues. When subjected to 4ºC for 60 min before or after a heat-shock (38°C for 60 min), pineapple fruit developed 88% and 40% less IB in the flesh and core areas, respectively, than in control fruit which were not subjected to 4ºC for 60 min. Intermittent warming (IW) involving the exposure of pineapple fruit to 28° – 30°C for 8 h every 6 d during 21 d of storage at 10°C and 85% RH, reduced the incidence of IB by ≥ 80% in the core, and by ≥ 50% in flesh tissue. Fruit subjected to IW showed only isolated areas of IB in their flesh tissue, and this was found in only 40% of the total fruit treated. Heat-shock (38°C for 60 min) before or after a low temperature (i.e., 4°C for 60 min) treatment, slowed fruit ripening slightly, but this effect was not observed in fruit subjected to IW. Cell damage was less in fruit tissues showing no symptoms of IB when fruit were given a heat-shock treatment, before or after a low temperature treatment.

An Outbreak of Acute Bacterial Gastroenteritis Is Associated With an Increased Incidence of Irritable Bowel Syndrome in Children

Acute bacterial gastroenteritis is associated with subsequent post-infectious irritable bowel syndrome (PI-IBS) in adults. Less is known about this relationship in children. In May 2000, contamination of municipal water by Escherichia coli 0157:H7 and Campylobacter species caused a large outbreak of acute gastroenteritis in Walkerton, Ontario. We assessed this association among a cohort of children enrolled in the Walkerton Health Study (WHS). WHS participants who were under age 16 at the time of the outbreak but who reached age 16 during the 8-year study follow-up were eligible for the pediatric PI-IBS study cohort. Eligibility also required no diagnosis of IBS or inflammatory bowel disease before the outbreak and permanent residency in the Walkerton postal code at the time of the outbreak. Validated criteria were used to classify subjects as having had no gastroenteritis (unexposed controls), self-reported gastroenteritis, or clinically suspected gastroenteritis during the outbreak. From 2002 to 2008, standardized biennial interviews used a modified Bowel Disease Questionnaire to diagnose IBS by Rome I criteria. Risk factors for IBS were identified by logistic regression. In all, 467 subjects were eligible for the pediatric PI-IBS study cohort (47.1% female; mean age 11.6+/-2.44 years at the time of the outbreak). Of these, 305 were exposed to GE (130 clinically suspected and 175 self-reported) and 162 were unexposed controls. The cumulative incidence of IBS was significantly increased among exposed subjects vs. controls (10.5% vs. 2.5%; odds ratio 4.6, 95% confidence interval (1.6, 13.3)). In an unadjusted risk factor analysis, IBS was associated with a shorter time interval from exposure to assessment of IBS symptoms, female gender, diarrheal illness lasting more than 7 days, weight loss >10 lb, and antibiotic use during the outbreak. In adjusted analyses, both female gender and time interval to assessment of IBS symptoms remained independent predictors of PI-IBS. Acute bacterial gastroenteritis is associated with subsequent IBS in children as in adults. Risk factors for PI-IBS in children are similar to those identified among adults. Confirmation of these findings in similar cohorts is needed.

T2051 Prognosis of Post-Infectious Irritable Bowel Syndrome (PI-IBS) Eight Years After the Walkerton Outbreak of Waterborne Gastroenteritis (GE)

Background and Aim: In May 2000, contamination of municipal water by E. coli 0157:H7 and Campylobacter species caused a large outbreak of acute GE in Walkerton, Ontario. The natural history of PI-IBS was assessed in a well-defined study cohort. Methods: TheWalkerton Health Study assessed participants annually from 2002 to 2008 (Gastroenterology 2006;131:445-50). Standardized interviews included a modified Bowel Disease Questionnaire to diagnose IBS by Rome I criteria. Subjects age > 16 and permanent residents of Walkerton in May 2000 with no prior diagnosis of IBS or inflammatory bowel disease were included in the study cohort. The prevalence, incidence and prognosis of IBS among participants with and without GE in 2000 were assessed. Risk factors for IBS in 2008 were identified by multiple logistic regression. Results: 2453 of 4561 participants enrolled in the Walkerton Health Study returned in 2008, including 1166 subjects eligible for the study cohort (59% female; mean age 57.4±15.5). Of these, 137 (11.7%) fulfilled Rome I criteria (35.8% IBS-D, 15.3% IBS-C). Independent risk factors for IBS after GE included younger age, female gender, fever and history of psychological disorder. The overall prevalence of IBS among returning subjects who suffered acute GE in 2000 declined from 210/742 (28.3%) at 2-3 years, to 159/742 (21.4%) at 4 years, 106/742 (14.3%) at 6 years and 114/742 (15.4%) at 8 years but remained higher than the prevalence of IBS among subjects who had remained well during the outbreak (23/424 [5.4%] at 8 years, p<0.0001). The proportion of subjects with vs. without exposure to GE who reported a new diagnosis of IBS in 2008 was (13/742 [1.8%] vs. 8/424 [1.9%], p=N.S.). Among 210 subjects with IBS 2-3 years after acute GE, only 105 (50.0%) at 4 years, 72 (34.3%) at 6 years and 73 (34.8%) at 8 years still fulfilled Rome I criteria. Over the same period, “sporadic” IBS (among subjects with no exposure to acute GE during the outbreak) persisted in (10/45 [22.2%]). Conclusion: Eight years after a waterborne outbreak of acute GE, most patients with PI-IBS have improved and the rate of new IBS diagnosis is no longer increased. However, the prevalence of IBS symptoms remains elevated, suggesting that PI-IBS can persist in some patients for longer than previously recognized. Funded by the Ontario Ministry of Health and Long-Term Care and the Crohn's and Colitis Foundation of Canada

Patients with irritable bowel syndrome in Swedish primary care

Background: IBS is the most common functional gastrointestinal disorders and affects approximately 10-20 % of the general population and is widespread in all societies and socio-economic groups. Although the disorder does not have a life-threatening course, it still seriously affects the patients in their everyday life. Aim: The general aims of this thesis were to estimate the occurrence of irritable bowel syndrome in the general population and to achieve a better understanding of present treatment of this disorder and impact on every-day life in those suffering from IBS. Material and methods: The LIPS study comprises two parts. Part I was a retrospective register study where the data collection was based on computerised medical records at three selected Primary Health Care centres in a defined region. Part II was a population based case-control study. The identified IBS cases from part I constitute the cases, while their control groups were randomly selected from the population census register in the same area as the cases. Data in part II were collected by means of a postal questionnaire to cases and controls. The study was conducted in Linkoping, a city located in the south-east of Sweden with 135 000 inhabitants. Results: The female IBS patients reported lower influence on planning their work and working hours as well as fewer opportunities to learn new things at their work compared to their controls, even after adjustments in multiple logistic regressions for potential confounders like; mood, sleeping problems and perceived health. The female IBS patients had considerably lower HRQOL in all dimensions compared to their controls, even when compared to male patients. Younger female IBS cases (18-44 years) reported lower mental health on the SF-36 scale than the older IBS female cases (p=0.015). In the multivariate analysis these variables, lack of influence on planning the work, family history of IBS, anxiety and sleeping disturbance displayed an association with being diagnosed with IBS in women. In men, lack of influence on working pace, family history of IBS was associated with an IBS diagnosis.The consultation incidence of IBS in part I was 3.4 (95% CI 3.20-3.70) per 1000 person-years for all IBS cases, among females; the incidence rate was 4.6 per 1000 person-years (95% CI 4.16-4.97) and males; 2.3 per 1000 person-years (95% CI 2.01-2.59). The dominating pharmacological treatment prescribed for abdominal complaints were fibre and bulking laxatives agents as well as acid suppressive drugs. These variables had an independent impact on the probability of a follow-up consultation; diagnosed co-morbidity besides the IBS diagnosis, rectoscopy ordered and laboratory tests ordered. Conclusions: IBS patients identified in primary care are significantly affected in their working-life compared to individuals in the general population. Especially female IBS-patients report lower decision latitude at work and they also appear to have a particularly impaired psychosocial functioning in their every day life and impaired HRQOL. Factors associated with IBS diagnosis among females are anxiety as well as family history of IBS and lack of co-determination at work. The incidence rate of IBS was 3.4 per 1000 person-years which increased with age and with an overrepresentation of females. IBS patients did not appear to be heavy utilisers of primary care and those who attended were treated by their GP without further consultation. The strongest predictors for having a follow-up consultation were diagnosed co-morbidity, rectoscopy and laboratory tests ordered

Ameliorating Internal Black Spot in Cranberry Bean Seed with Boron Application

A high incidence of “internal brown spot” (IBS) was found in the seed of the cranberry bean variety “Cardinal” when it was grown under commercial production. Boron deficiency has been reported to be associated with internal tissue breakdown in root crops, peanuts, and some bean varieties. Bean species, in general, tend to be sensitive to plant growth injury due to B application. Greenhouse and field studies were conducted to evaluate the effects of soil and foliar B application on plant growth and on IBS of the produced seed. Spraying a 0.05% B solution (0.5 g B/L) directly on the developing bean pods resulted in higher B concentration in the seed than spraying the whole plant or leaves only. Plants watered 2 wk before an thesis with water, 0.1% B solution (1 g B/L) and 1.0% B solution (10 g B/L) produced bean seed that had 88, 37, and 28% IBS, respectively. The 1.0% solution caused some marginal necrosis and bronzing of the leaves. Watering in the equivalent of 2.2 kg ha−1 at the first trifoliate stage caused severe marginal necrosis, bronzing of the leaves, and some leaf drop. Spraying a 0.1% B solution (sodium borate) on the whole plant at early pod set resulted in none of the seeds showing IBS, but some marginal necrosis, bronzing of leaves, and leaf drop. In a field study, 3 days after spraying 0.22 kg ha−1 B, some slight bronze speckling was observed on the leaves. The volume of water used had no effect on leaf injury. Four days later the new emerging leaves looked normal. Applying 0.44 kg/ha B caused severe bronze speckling near the leaf margins followed by yellowing of leaves. This amount of B resulted in reduced bean yield. Increasing the volume of water sprayed from 235 to 940 L/ha decreased the incidence of IBS from 25 % to 6%. Hence, coverage of the foliage and developing bean pods is important.

The histopathological predictor factors in the recurrence of cervical carcinoma stage IB - IIA after radical hysterectomy

The aim of this study is to know the incidence of cervical carcinoma stage IB - IIA recurrence after radical hysterectomy and the histopathologic factors which are related to it. This was a retrospective cohort study involving 68 patients with recurrence cervical carcinoma stage IB - IIA who underwent radical hysterectomy, However, there were only 58 cases which fulfilled the study citeria, and therefore were evaluated histopathologically. The histopathologic evaluation consisted of differentiation, inflammatory reaction, lymph-vascular permeation, invasion to the vagina incision margin, and to endometrium, lymph nodes metastasis, and the depth of stromal invasion. The incidence of the cervical carcinoma stage IB-IIA recurrence 2 years after radical hysterectomy was 30.8% (21 out of 68 cases). The recurrence occurred in nine (75%) out of 12 cases with lymph node metastasis, compared to 10 (21.7%) out of 46 cases without lymph node metastasis (P = 0.0004). In addition, eight out of 11 adenosquamous carcinoma cases had recurrence (p = 0.01). There was only one out of the 12 cases with the depth of stromal invasion of &lt; 5 mm that had recurrence compared to 18 out of 45 cases with stromal invasion of &gt; 5 mm (P = 0.02). The clinical factors such as parity, staging, size of the tumor were not statistically significant. The other pathologic factors such as differentiation, inflammatory reaction, and parametrial, vagina incision margin and endometrial invasion were not statistically signifcant. The incidence of the recurrence of cervical carcinoma within 2 years after hysterectomy was related to the pathological risk factors i.e. lymph node metastasis, adenosquamous cell carcinoma and the depth of stromal invasion. (Med J Indones 2001; 10: 79-83) Keyword: risk factor, cervical cancer