Dyspepsia Research Articles

Association Between Rapid Urease Test For H. Pylori Incidence And Non-Ulcer Dyspepsia In Bangladeshi Patients

Introduction: Dyspepsia is a fairly common group of symptoms including epigastric pain, epigastric burning, postprandial fullness, early satiation, bloating in the upper abdomen, nausea, vomiting and belching. Interestingly the majority of them are found to have no ulcer, and they are termed as non-ulcer dyspepsia (NUD). However. Different studies worldwide have found there is an association between H. Pylori infection and NUD. Objective: To evaluate the infection rates of H. pylori in patients, presenting with dyspepsia without any evidence of ulcer on endoscopy. Materials and methods: This cross-sectional study was conducted from June, 2022 to December, 2022. The study included 100 patients (46 males and 54 females) with NUD and recruited by convenient sampling method. Result: In the study, the prevalence of H. pylori infection in patients with NUD is 53% on the basis of (Rapid urease test) RUT. Gender-based prevalence was found to be 53.7% and 52.17% for women and men, respectively. The highest prevalence rate was found in the age group of 25-34 years. The prevalence of H. pylori infection was slightly higher for urban people. Conclusion: H.Pylori infection can be easily identified by RUT. The study has found significant correlation of H. pylori infection with NUD by using RUT. J Dhaka Med Coll. 2023; 32(1) : 4-8

Meloxicam-amino acids salts/ion pair complexes with advanced solubility, dissolution, and gastric safety

Amino acids have attracted attention as a potential functional excipient for optimizing biopharmaceutics characteristics of poorly soluble drugs. The amino acids are a diverse class with many functional groups, natural compounds, biocompatible and low molecular weight substances. Two amino acids serine and arginine were investigated with meloxicam. Meloxicam has extremely low solubility; being NSAIDs, gastric upset and ulcer are common side effects. Solid dispersions were produced by precipitation and physical mixing techniques. The produced combinations underwent in vitro dissolution, docking, DSC, FTIR, XRD, solubility and gastric ulcer formation studies. Docking indicated formation of ion pair/salt between the basic amino acid arginine and meloxicam. Both solubility and dissolution rates were increased by up to 3000- and 12-fold, respectively. DSC, FTIR an XRD supported these findings. Rats treated with meloxicam showed loss of surface gastric epithelium integrity and ulceration. The animal group received meloxicam: arginine showed intact gastric mucosa with the surface epithelium and gastric glands well organized and nearly similar to the untreated control. Arginine with the guanidine group that was capable of preserving gastric mucosa after repeated administration for 10 days. This study highlighted the role of arginine as a functional excipient that did not only improve solubility and dissolution rates but ameliorated the long-standing gastric side effects attributed to meloxicam.

Management of a Todani Type 1b Choledochal Cyst: Case report

This case report describes the management of a Todani Type 1b choledochal cyst in a 26-year-old woman who presented with chronic epigastric dyspepsia and acute epigastric pain. MRI revealed a cystic dilatation of the distal common bile duct. The patient underwent successful surgical excision of the cyst, cystic duct, and gallbladder, followed by reconstruction with a Roux-en-Y hepaticojejunostomy. The postoperative course was uneventful, with discharge on the sixth day. This case highlights the importance of timely diagnosis and surgical intervention to prevent complications such as biliary cirrhosis and malignancy.

Optimizing Mucoadhesive Film-Forming Spray for Efficient Oral Delivery of Fluconazole in Candidiasis Treatment.

Buccal candidiasis has become increasingly prevalent in recent years, with Candida albicans being the primary causative organism. While systemic fluconazole is an effective treatment, its use is associated with adverse effects such as gastric upset, hepatic failure, and potential drug interactions. Therefore, the development oflocal fluconazole treatment presents a promising solution to these challenges. This study aimed to formulate an efficient local mucoadhesive film-forming spray for the targeted delivery of fluconazole in the treatment of oral candidiasis. The investigation involved the use of three polymers (hyaluronic acid, polyvinyl alcohol, and xanthan gum) both individually and in combination to identify the most effective formulation. Various tests were conducted to characterize 13 formulations prepared using these polymers, including UV-vis spectroscopy, Fourier-transform infrared spectroscopy (FTIR), content assay, drying timeand film formation, viscosity determination, determination of the mucoadhesion strength by turbidimetric methods, drug release study, in-vitro anticandida activity, histological irritation analysis, and stability study. The optimum formula F11, comprised polyvinyl alcohol for its superior mechanical properties and film-forming capabilities, hyaluronic acid, and xanthan gum in combination, exhibiting synergistic mucoadhesive strength. This optimal formulation demonstrated maximum mucoadhesion, rapid film formation, an acceptable spray angle, and controlled release. Furthermore, the optimum formula underwent additional evaluations for in vitro anti-Candida activity, in vivo irritancy assessments, and stability studies, all of which yielded satisfactory results. These findings support the potential of the optimum formula as a straightforward and efficient spray formulation for the treatment of oral candidiasis.

Modified release, enriched biocompatibility, and enhanced oral bioavailability as precious features of nitrofurantoin-loaded polymeric nanoparticles

Nitrofurantoin (NTF) is a first-line therapy for treating urinary tract infections. However, gastric upset, short half-life, and poor bioavailability of NTF are major challenges for clinical use. Hence, the current work incorporated NTF in polymeric nanoparticles (NPs).NTF-loaded NPs (NTF-NPs) were prepared using Eudragit RS100 (RS100), DL-lactide/glycolide copolymer (PLGA), and their mixture at a ratio of 1:1 w/w (RS100/PLGA) as polymers. Pluronic F68, Tween 80, and polyvinyl alcohol (PVA) were applied as stabilizers. The particle size (PS), polydispersity index (PDI), zeta potential (ZP), and entrapment efficiency were determined. Three optimized formulations of NPs; F3, F13, and F29 were selected for further coating with Eudragit L100 (L100) and Eudragit S100 (S100). The optimized NPs and the corresponding coated ones were evaluated for solid-state characterization, morphology, and in vitro release. L100-coated F13 (LCF13) was further investigated for biocompatibility with normal oral epithelial cell (OEC) and Vero cell lines. A pharmacokinetic study using a rat model was also conducted.The results revealed that Tween 80 and PVA-stabilized NPs accomplished a nano-sized range with polymer- and stabilizer-dependent PDI and ZP. Optimized formulations: F3, F13, and F29 were selected for further coating where PS and PDI values not exceeding 260 nm and 0.502, respectively. The coated NPs had negative ZP ranging from −11.00 ± 2.70 to −40.20 ± 1.40 mV, attributable to the L100 or S100 coating. The solid-state characterization confirmed a transition of NTF to amorphousness. The spherical shape with the distinctive halo-like appearance of the coated NPs was proved. Additionally, the coating warranted a prolonged release of NTF especially for LCF13 avoiding the burst effect. Allowing enriched biocompatibility, LCF13 showed an IC50 value of 224.00 ± 9.20 μM for the OEC cell line, whereas a greater IC50 exceeding 300 μM was recognized for the LCF13-treated Vero cell line. After a single oral dose, LCF13 could provide a discernible increase in the extent of absorption (Du∞ = 863.31 ± 73.71 μg) with a significant extension of the absorption rate (tmax and t1/2 of 3 and 2.51 ± 0.317 h, respectively).LCF13 could be considered a controlled and safe nanocarrier that delivered significantly higher levels of NTF for a longer duration than NTF dispersion.

Outcomes of pediatric endoscopic ultrasound-guided celiac plexus block: A single center pilot study.

Celiac plexus blocks (CPB) using endoscopic ultrasound (EUS) guidance provide significant pain relief in adults with chronic pancreatitis. We present on EUS-guided CPB for pediatric patients with abdominal pain from chronic pancreatitis or severe functional dyspepsia necessitating clinically assisted nutrition and hydration. Patients who underwent EUS-CPB were included and followed prospectively at 2-, 4-, and 8-weeks postprocedure about pain, enteral tolerance, and school/activity attendance. Thirteen patients underwent EUS-guided CPB with a total of 21 procedures. In the pancreatitis cohort, mean pain relief was 11.7 weeks for those who responded. In the functional dyspepsia cohort, mean improvement (in either pain or enteral tolerance) was 4.8 weeks. Symptom improvement varied between the two cohorts. Acute recurrent/chronic pancreatitis patients demonstrated more sustained relief than the functional dyspepsia cohort. This study adds to the limited data investigating the utility of EUS-CPB as part of a multimodal treatment plan in pediatrics.

Clinical Significance of TNFSF14/LIGHT and CD160 in Gastric Cancer and Peptic Ulcer Dyspepsia.

Previous studies have reported the role of the Herpes Virus Entry Mediator (HVEM) in various cancer including gastric cancer. However, the expression level and clinical significance of CD160 and Tumor Necrosis Factor Ligand Superfamily Member 14 (TNFSF14) pathways in gastric cancer and gastric dyspepsia patients have remained unexplored. The study involved the collection of gastric tissue biopsies from 42 patients with non-ulcerative dyspepsia (NUD) as the control group, 43 gastric cancer (GC) patients, and 48 patients with peptic-ulcerative dyspepsia (PUD). All the patients were endoscopically examined at Imam Khomeini Hospital in Sari, Mazandaran, Iran. The expression levels of TNFSF14 and CD160 mRNA were assessed using quantitative real-time PCR (qPCR) with the SYBR Green method. Statistical analysis was performed to investigate the potential association between the clinical and experimental data. Among the 133 gastric endoscopic biopsies examined, LIGHT exhibited a significant overexpression in GC patients (p-value < 0.01). Moreover, the expression of TNFSF14 was higher in GC patients with stages I and II (p-value<0.05). Furthermore, GC patients with TNM stages III+IV were accompanied by high expression levels of LIGHT (p-value < 0.01) as well as CD160 (p-value<0.05). The expression of CD160 was also higher in younger adults with PUD (p-value<0.05). Whereas TNFSF14 exhibited higher expression in older adults with GC (p-value<0.05). Furthermore, this research provided insights into the potential biological pathways and significant gene enrichment of TNFSF14 and CD160, suggesting the potential role of CD160 and TNFSF14 in the regulation of immune system in GC and PUD. These findings suggest the possible role of LIGHT and CD160 expression in gastric cancer patients in immune dysregulation toward gastric cancer. Targeted immunotherapy that harnessing co-stimulatory molecules like LIGHT and CD160 could be a promising approach in the treatment of GC as well as potential GC tumor markers.

Oral Hygiene With Neutral Electrolyzed Water and Systemic Therapy Increases Gastric Helicobacter pylori Eradication and Reduces Recurrence.

Helicobacter pylori gastricinfection strongly correlates with gastric diseases such as chronic gastritis, functional dyspepsia, and complications such as peptic ulcers and gastric cancer. In developing countries, systemic therapies are not usually successful due to elevated antibiotic resistance. Additionally, oral H. pylori infection and periodontal disease correlate with gastric treatment failures. This study aimed to explore the effect of an integral therapy, comprising oral hygiene and concomitant systemic treatment, to increase the eradication of gastric infection and recurrences. A prospective, randomized, four-arm, parallel-group, open-label clinical trial was conducted to investigate the efficacy of integral therapy to eradicate gastric H. pylori infection and avoid recurrences in double-positive (real-time PCR oral and gastric infection) patients. Oral hygiene involved mouthwash with neutral electrolyzed water (NEW), with or without periodontal treatment.One hundred patients were equally distributed into four groups: NS, NS-PT, NEW, and NEW-PT. All patients had concomitant systemic therapy and additionally, the following oral treatments: mouthwash with normal saline (NS), periodontal treatment and mouthwash with normal saline (NS-PT), mouthwash with NEW (NEW), and periodontal treatment and mouthwash with NEW (NEW-PT). Gastric and oral infection and symptoms were evaluated one and four months after treatments. Integral therapy with NEW-PT increased gastric eradication rates compared with NS or NS-PT (84%-96% vs. 20%-56%; p < 0.001). Even more, a protective effect of 81.2% (RR = 0.1877; 95% CI: 0.0658-0.5355; p = 0.0018) against recurrences and 76.6% (RR = 0.2439; 95% CI: 0.1380-0.4310; p < 0.001) against treatment failure (eradication of infection and associated symptoms) was observed in patients from the NEW and NEW-PT groups. Implementation of oral hygiene and systemic treatment can increase the eradication of gastric infection, associated symptoms, and recurrences. NEW is recommended as an antiseptic mouthwash due to its efficacy and short- and long-term safety.

Role Of Endoscopic Gastric Biopsy in Patients With Chronic Dyspepsia For Diagnosis Of H. Pylori

Role Of Endoscopic Gastric Biopsy in Patients With Chronic Dyspepsia For Diagnosis Of H. Pylori

FREQUENCY OF HELCIOBACTER PYLORI AMONGST PATIENTS WITH GASTROINTESTINAL TRACT SYMPTOMS

Worldwide, H. pylori is recognised as a serious concern for public health that causes peptic ulcer disease, gastric cancer and chronic gastritis. The frequency of H. pylori infection ranges from 13% to 81%. Globally, H. pylori infection accounts for around 89% of stomach cancer. Objective: To determine the frequency of helicobacter pylori amongst patients with gastrointestinal tract symptoms. Methodology: The current cross-sectional study was carried out at the Department of Medicine General Hospital Peshawar from September 2023 to February 2024. The overall sample size of the current study was 150 patients. All the patients were assessed for the pylori SAT (Stool antigen test). All the information was gathered on a specialized proforma designed for our research. All the data was analysed using SPSS version 23.0. Results: In the current study, 150 patients were enrolled. Male patients were 100 (66.67%) while female patients were 50 (33.33%), with a ratio of males to females of 1:2. Among 150 patients, 129 (86%) individuals tested positive for H. pylori, whereas 21 (14%) patients tested negative. The enrolled patients' ages ranged from 15 to 85 years with a mean age (SD) of 50.3 (11.01). After analysing the endoscopic reports of patients, it was found that fifteen patients (25%) had chronic gastritis, thirty-five patients (58%) had duodenal ulcers, ten patients (16.6%) had stomach ulcers, and eight patients (13.3%) had non-ulcer dyspepsia. Conclusion: Our study concludes that Helicobacter pylori is the most prevalent problem among patients with gastrointestinal tract symptoms. Early diagnosis and timely treatment are fundamental to avoiding this severe problem.

Giant Gallstones – a Systematic Review

Giant gallstones are rare occurrences and measure 5 cm in any one dimension. They present unique set of features and complications. Due to their rarity, we conducted this systematic review to investigate the profile of patients with giant gallstones applying seven variables. For this study, we used the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. After an initial search of 111 peer reviewed articles from reliable sources, we included 29 articles for this study enrolling 30 patients with mean age of 66.7 years. Majority (97%) were symptomatic, reporting with cholecysto-enteric fistula/gallstone ileus (33%), acute cholecystitis (30%) and chronic dyspepsia (24%). The management options adopted included open cholecystectomy (48%), laparoscopic cholecystectomy (33%), endoscopic lithotripsy (6%) and conservative management (6%).

Family-based Helicobacter pylori infection control and management strategy and screen-and-treat strategy are highly cost-effective in preventing multiple upper gastrointestinal diseases in Chinese population at national level.

The overall benefits of the newly introduced family-based Helicobacter pylori (H. pylori) infection control and management (FBCM) and screen-and-treat strategies in preventing multiple upper gastrointestinal diseases at national level in China have not been explored. We investigate the cost-effectiveness of these strategies in the whole Chinese population. Decision trees and Markov models of H. pylori infection-related non-ulcer dyspepsia (NUD), peptic ulcer disease (PUD), and gastric cancer (GC) were developed to simulate the cost-effectiveness of these strategies in the whole 494 million households in China. The main outcomes include cost-effectiveness, life years (LY), quality-adjusted life year (QALY), and incremental cost-effectiveness ratio (ICER). When compared with no-screen strategy, both FBCM and screen-and-treat strategies reduced the number of new cases of NUD, PUD, PUD-related deaths, and the prevalence of GC, and cancer-related deaths. The costs saved by these two strategies were $1467 million and $879 million, quality-adjusted life years gained were 227 million and 267 million, and life years gained were 59 million and 69 million, respectively. Cost-effectiveness analysis showed that FBCM strategy costs -$6.46/QALY and -$24.75/LY, and screen-and-treat strategy costs -$3.3/QALY and -$12.71/LY when compared with no-screen strategy. Compared to the FBCM strategy, the screen-and-treat strategy reduced the incidence of H. pylori-related diseases, added 40 million QALYs, and saved 10 million LYs, but at the increased cost of $588 million. Cost-effectiveness analysis showed that screen-and-treat strategy costs $14.88/QALY and $59.5/LY when compared with FBCM strategy. The robustness of the results was also verified. Both FBCM and screen-and-treat strategies are highly cost-effective in preventing NUD, PUD, and GC than the no-screen strategy in Chinese families at national level. As FBCM strategy is more practical and efficient, it is expected to play a more important role in preventing familial H. pylori infection and also serves as an excellent reference for other highly infected societies.

Study of Prevalence of Gastritis Caused by H. pylori and Correlation of Urease Test with Serology (ELISA) Test.

H. pylori are a pathogen of global importance. Gram-negative curved flagellate bacilli are implicated as one of the most trivial complaints of and are associated with peptic ulcer disease gastritis ulcer and gastric malignancy. This study was performed to find out the prevalence of Helicobacter pylori (H. pylori) infection in patients presenting the symptoms related with gastritis with or without chemically known peptic ulcer. The study was undertaken with the help of the Christensen and quotes urease test on endoscopic biopsy specimen and correlated with the detection of immunoglobulin IgG in the serum against H. pylori by an ELISA technique. A total of 67 cases were analyzed in which 29 (43%) cases were positive for H. pylori. The endoscopic findings of acid peptic diseases show 21 (31.4%) cases of stomach ulcer, and 3 (4.5%) have esophagitis, whereas 43 (64.1%) have nonulcer dyspepsia. There is strong positive association between the urease tesr and ELISA test. The urease test is a quick and inexpensive test with high specificity and sensitivity, but since it is an invasive test, it has reduced patient compliance.

Supplementation of Crataegi fructus alleviates functional dyspepsia and restores gut microbiota in mice.

Functional dyspepsia (FD), also known as non-ulcerative dyspepsia, is a common digestive system disorder. In this study, an FD model was established using hunger and satiety disorders combined with an intraperitoneal injection of L-arginine. Indices used to evaluate the efficacy of hawthorn in FD mice include small intestinal propulsion rate, gastric residual rate, general condition, food intake, amount of drinking water, gastric histopathological examination, and serum nitric oxide (NO) and gastrin levels. Based on the intestinal flora and their metabolites, short-chain fatty acids (SCFAs), the mechanism of action of Crataegi Fructus (hawthorn) on FD was studied. The fecal microbiota transplantation test was used to verify whether hawthorn altered the structure of the intestinal flora. The results showed that hawthorn improved FD by significantly reducing the gastric residual rate, increasing the intestinal propulsion rate, the intake of food and drinking water, and the levels of gastrointestinal hormones. Simultaneously, hawthorn elevated substance P and 5-hydroxytryptamine expression in the duodenum, reduced serum NO levels, and increased vasoactive intestinal peptide expression in the duodenum. Notably, hawthorn increased the abundance of beneficial bacteria and SCFA-producing bacteria in the intestines of FD mice, decreased the abundance of conditional pathogenic bacteria, and significantly increased the SCFA content in feces. The mechanism by which hawthorn improves FD may be related to the regulation of intestinal flora structure and the production of SCFAs.

Grapefruit Seed Extract Reduces Gastrointestinal Symptoms

AbstractIn this explorative longitudinal survey, self-reported data was collected from persons suffering from chronic gastrointestinal symptoms, who were seeking relief employing self-medication with a grapefruit seed extract (GKE). This is not a clinical trial nor a non-interventional study, but an explorative longitudinal survey with self-reports. The data was collected online and there were no personal contacts with a physician or a study nurse. Participants followed their own decision to use GKE and to provide their data to a data retrieval system, following informed consent according to existing national regulations on data protection. The test product was provided by the sponsor to make sure that the correct product was used for the intended observation period.Drop in criteria were chronic gastrointestinal symptoms, including those of functional dyspepsia (FD, resp. non-ulcer dyspepsia NUD) and/or irritable bowel syndrome (IBS) for more than 4 weeks, resulting in a score of an expanded Nepean Index (‘total gastrointestinal score’) higher than 20. Symptoms were documented 4–12 days (VA) prior to GKE use on day 1 and then on day 1, days 28, 42 and 56 of continuous oral use. New symptoms, predominating symptoms, stool habits, amount of oral intake and global status was retrieved every day during the observation period. On day 56 some global assessments were additionally recorded.The evaluation cohort was intended to be at least 100, and within the survey cohort we were able to evaluate 100 subjects (15 m and 85 f). Total gastrointestinal symptom score decreased from a mean (±SD) of 78.7±36.9 points by 26.4% on day 14, by 53.1% on day 28, by 58.7% on day 42, and by 49.9% on day 56, when compared to day 1. Upper gastrointestinal symptoms like heartburn improved better compared to lower GI symptoms (by 57.9% versus 47.3% on day 56). Overall complaints were rated as “very strongly improved” by 30%, “strongly improved” by 42%, “somewhat improved” or “unchanged” by 20% and as “deteriorated” by 1%. GKE was tolerated well. Minor adverse events reported were judged as most probably unrelated by the authors. More than half of the participants rated the intake as “very pleasant” or “pleasant” and intended to continue GKE beyond the observation period.In this prospective uncontrolled survey, GKE seemed to improve GI-symptoms, based on users reports. These results need to be confirmed in controlled clinical trials proofing efficacy and tolerance of GKE in functional GI-diseases. Data collected from participants without any personal contact bear a high risk of bias. Evaluation of self-treatment as presented here is clearly restricted to marketed products and may report interesting details of self-treatment outside prescription settings.

Study of disinfectant activity against bee pathogenic enterobacteria in vitro

Dysbiosis is a pathological condition caused by violating the normal coexistence of bacterial organisms in one or more body systems. This disease arises due to the action of many ethological factors, the mechanisms of which arise from each other. Klebsiellosis of bee colonies is a relatively new disease of Apis mellifera, caused by pathogenic enterobacteria, which leads to the mass death of bees with signs of acute dyspepsia, particularly in the spring and autumn periods. To prevent klebsiellosis in bees, it is necessary to carry out veterinary and sanitary measures in apiaries every year, including disinfection. Modern beekeeping encourages the search for new antibacterial drugs to ensure the production technology of safe and high-quality beekeeping products suitable for sale. Preliminary laboratory assessment (in vitro) of the effectiveness of disinfectants against specific pathogens of specific diseases of bees will ensure an increase in the effectiveness of such agents in apiaries, which is economically effective for practical beekeeping. The purpose of the research was to determine the activity of different concentrations of the disinfectant (0.25 %, 0.5 %, 1.25 %, 2.5 %) with an active substance of an organic nature with covalent weakly polar bonds against pure cultures of pathogenic enterobacteria of bees of the species Klebsiella pneumoniae and Klebsiella (Enterobacter) aerogenes in vitro. The modified Kirby-Baur method on Mueller-Hinton agar was used for research. A bactericidal effect against a pure culture of Klebsiella pneumoniae species was registered after 24 hours with lysis zone diameters at 8.6 ± 0.27 mm (0.25 % concentration) – 15.0 ± 0.35 mm (2.5 % concentration). On the 3rd day of research, a bacteriostatic effect was registered with the largest diameter of the zone of growth retardation (24.4 ± 0.27 mm) at 2.5 % disinfectant concentration. Bactericidal and bacteriostatic effects were recorded on the culture of enterobacteria of bees of the species Klebsiella (Enterobacter) aerogenes for 24 hours of cultivation with zones of lysis – 6.8 ± 0.42 mm (0.25 %) – 11.8 ± 0.22 mm (2.5 %) and inhibition of bacterial growth at the level of – 21.8 ± 0.42 mm (0.25 %) – 25.8 ± 0.42 mm (2.5 %). At the same time, there was no significant difference between the zones of Klebsiella (Enterobacter) aerogenes growth retardation in concentrations of 0.5 % – 2.5 % on the 3rd day of research. The studied disinfectant has bactericidal and bacteriostatic effects on pure cultures of bee enterobacteria of the species Klebsiella pneumoniae and Klebsiella (Enterobacter) aerogenes in laboratory conditions, which is promising for further study of the drug.

Co-Morbidities of Irritable Bowel Syndrome in a Racially and Ethnically Diverse Population.

Introduction: Irritable bowel syndrome (IBS) is a disorder of gut-brain interaction (DGBI), and associated co-morbidities worsen quality of life. Research concerning IBS co-morbidities in different racial/ethnic groups is very sparse. This study aimed to determine the prevalence rates of co-morbidities and possible differences in a multiracial/ethnic IBS cohort. Methods: Based on ICD-9-coded IBS diagnosis, 740 outpatients (≥18 years) were included in this retrospective study at Boston Medical Center. Demographics and ICD-9-coded co-morbidities were extracted from electronic records. Descriptive statistics and multiple logistic regression were used for data analyses. Results: The most prevalent co-morbidities in this IBS cohort included gastroesophageal reflux disorder (GERD) (30%), depression (27%), anxiety (23%), (chronic obstructive pulmonary disease) COPD/asthma (16%), and obesity (10%). GERD was more prevalent in Hispanics and Blacks (p = 0.0005), and non-ulcer dyspepsia (NUD) was more prevalent in Blacks and Asians (p = 0.003). Higher rates of diabetes mellitus type 2 (DMT2) (p = 0.0003) and depression (p = 0.03), but not anxiety (p = 0.9), were present in Blacks and Hispanics. GERD was significantly associated with Hispanics (p = 0.003), dependent on age, overweight, and obesity. NUD was significantly associated with Blacks (p = 0.01) and Asians (p = 0.006), independent of sex, age, and BMI. Cancer of the thyroid, ovaries, and testis occurred at a five-fold higher rate than expected. Conclusions: Significant racial/ethnic differences exist for IBS co-morbidities in this study cohort, including depression, DMT2, GERD, and NUD. Certain cancers were found to be more frequent in this IBS sample as compared with the general population.

THE EFFECT OF DYSLIPIDEMIA ON THE INCIDENCE OF CORONARY HEART DISEASE IN WOMEN

Coronary heart disease (CHD) is one of the non-communicable diseases that causes the highest mortality in the world. Dyslipidemia is an important risk factor for CHD. This study aims to determine the relationship of dyslipidemia in detail including increased cholesterol, increased triglycerides, increased LDL cholesterol and decreased HDL cholesterol on the incidence of CHD in women at PKU Muhammadiyah Hospital Yogyakarta. This study used a case-control design involving 58 women as research subjects. The case group consisted of 29 women diagnosed with CHD and the control group consisted of 29 women diagnosed as non-CHD patients, including chronic lung disease, pneumonia, heart failure, dyspepsia and malignancy. Data tracing through medical records was carried out in March-September 2019. The results of this study the age range in the case group was 45-84 years and in the control group was 42-90 years. Based on the Chi-Square test, there was a significant relationship between dyslipidemia (RO = 7.04 (1.73-28.6), p = 0.003), high total cholesterol levels (RO = 5.14 (1.54-17.2), p = 0.012), high LDL cholesterol levels (RO = 9.286 (2.29-37.6), p = 0.001) and the incidence of CHD in women. From the Chi-Square test there was no significant relationship between high triglyceride levels (OR=2.16 (CI:0.62-7.49), p=0.358), low HDL cholesterol levels (RO=2,554 (0.83-7.84), p=0.167) and CHD incidence in women. The conclusion of this study is the effect of dyslipidemia including increased cholesterol and LDL cholesterol on the incidence of CHD in women at PKU Muhammadiyah Hospital Yogyakarta.

HPTLC Method Development and quantification of marker compound Gallic acid and Piperine in Ayurvedic Polyherbal formulations: Avipattikar Churna

Ayurvedic medications are becoming more and more well-liked and accepted globally because they are inexpensive and have no negative side effects. There is a chance that original medications will be adulterated with substances that chemically or physically mimic raw pharmaceuticals because of the increasing demand for herbal raw materials for the production of various classical as well as phytoformulation. Avipattikar Churna is an excellent Ayurvedic formulation for treating health issues resulting from an imbalance of Pitta dosha, such as acidity, heartburn, and indigestion. These issues might arise from bad eating habits, a sedentary lifestyle, or a lack of physical activity. Avipattikar Churna is also beneficial for ailments affecting the digestive and excretory systems' ability to operate normally. It counteracts the gastrointestinal tract's acid secretion and encourages the synthesis of digestive enzymes, which facilitate food absorption. Acid dyspepsia, often known as indigestion, is a condition marked by burning and sour vomit, nausea, heartburn (retrosternal burning), and burning in the throat. Avipattikar Churna is beneficial in treating these symptoms. The standardisation process, which can be carried out using a variety of methods and advanced techniques, conforms the identity, quality, and purity of herbal pharmaceuticals. The HPTLC method is superior to other methods since it may be used with herbal medications and is inexpensive, simple to use, and repeatable. For the purpose of evaluating the quality of Avipattikar Churna and identifying any changes made to the drug's composition, an HPTLC method has been devised. The existence and quantity of the marker compound in the sample are confirmed by the overlap of all relevant spectra with the marker. A gramme of Avipattikar Churna (AVC) methanolic extract contained 2.51 mg of piperine and 2.70 mg of gallic acid, the marker compounds.

Russell body gastritis: a case series and review of literature

Abstract Introduction/Objective Russell body gastritis is considered a rare finding characterized by Russell body-containing plasma cells in the lamina propria. Patients typically present with nonspecific findings. In this study, clinical and histopathological features of 3 cases with incidental findings of Russell body gastritis (RBG).&amp;lt;quillbot-extension- portal&amp;gt;&amp;lt;/quillbot-extension-portal&amp;gt; Methods/Case Report The Epic SlicerDicer tool was used to identify institutional cases between April 2022 to April 2023 using the keyword “Russell Body”. Using the PubMed database, we searched for articles published between January 2003 and April 2023, with the keyword "Russell body gastritis". Studies that described novel RBG cases were included.&amp;lt;quillbot-extension- portal&amp;gt;&amp;lt;/quillbot-extension-portal&amp;gt; Results (if a Case Study enter NA) The three cases were female with a mean age of 47 (42-51). Two patients were presented with chronic dyspepsia and one patient was being evaluated for right upper quadrant pain. The endoscopic finding for one patient was significant for multifocal erythematous gastric mucosa and the other two patients had unremarkable findings. Biopsies from the three patients revealed active gastritis in 2 cases and inactive chronic gastritis in 1 case. A dense accumulation of plasma cells with Mott cells and Russell bodies were identified in the lamina propria. Helicobacter pylori was identified on H. pylori stain in one case. Upon further investigation, CD138 highlights the plasma cells and kappa and lambda ISH demonstrated polyclonal plasma cells and cytokeratin AE1:AE3 was negative for a carcinoma A review of 64 previously reported cases of RBG shows that the average age of presentation is 63. Half of the cases were associated with Helicobacter pylori infection. Other associated conditions include multiple myeloma (3%) and HIV (6%). There have been 12 cases with monoclonal plasma cells with 10 cases of kappa-type monoclonality (including one case of duodenitis) and 1 case of lambda-type monoclonality.&amp;lt;quillbot-extension-portal&amp;gt;&amp;lt;/quillbot- extension-portal&amp;gt; Conclusion Most cases of RBG have been linked with helicobacter pylori. However, the underlying etiology is not well understood. Differentials include plasmacytoma, MALToma, and signet ring carcinoma. The clinical significance and its long-term effect remain unknown. Our report is the largest review of RBG. With its wide range of clinical presentations, additional cases are to define this entity better.&amp;lt;quillbot-extension-portal&amp;gt;&amp;lt;/quillbot-extension-portal&amp;gt;