Co-relation of Portal Vein Tumour Thrombus Response With Survival Function Following Robotic Radiosurgery in Vascular Invasive Hepatocellular Carcinoma.

Background/aims: The aim of this study was to prospectively evaluate stereotactic body radiotherapy (SBRT) with robotic radiosurgery in hepatocellular carcinoma patients with macrovascular invasion (HCC-PVT).

Materials And Methods: Patients with inoperable HCC-PVT, good performance score (PS0-1) and preserved liver function [up to Child-Pugh (CP) B7] were accrued after ethical and scientific committee approval [Clinical trial registry-India (CTRI): 2022/01/050234] for treatment on robotic radiosurgery (M6) and planned with Multiplan (iDMS V2.0).

Multi-center prospective survey of hepatocellular carcinoma in Kerala: More than 1,200 cases.

Background: Hepatocellular carcinoma (HCC) is considered uncommon in India. The aim of this study was to document the demographic characteristics and clinical aspects of HCC in Kerala, India.

Methods: A survey of HCC in Kerala was performed.

Deficiency of folate and vitamin B increases oxidative stress in chronic pancreatitis patients.

Background: Folate and vitamin B are involved in metabolic reactions for combating oxidative stress. We measured erythrocyte folate and plasma vitamin B and compared these with blood antioxidants - erythrocyte glutathione (GSH), glutathione peroxidase (GPx), superoxide dismutase (SOD), and plasma vitamin C - and marker of lipid peroxidation, thiobarbituric acid reactive substance (TBARS), in chronic pancreatitis (CP) patients.

Methods: One hundred and seventy-five CP patients (91 tropical, 84 alcoholic) and 113 healthy controls were recruited.

Correlation between insulin resistance and liver histology in patients with nonalcoholic steatohepatitis with and without obesity.

Introduction: Insulin resistance (IR) plays a central role in pathogenesis of nonalcoholic steatohepatitis (NASH). The aim of this study was to correlate histopathological grading and IR in overweight/obese patients with NASH as compared with lean NASH.

Methods: Patients with NASH who underwent liver biopsy between January 2012 and December 2012 were included.

Adrenal insufficiency in decompensated cirrhotic patients without infection: prevalence, predictors and impact on mortality.

Background: Relative adrenal insufficiency (RAI) is common in compensated and decompensated chronic liver disease in the presence of sepsis. This study was performed to find out the prevalence of RAI in decompensated cirrhotic patients presenting with hepatic encephalopathy and variceal bleeding without any evidence of infection.

Methods: The study prospectively included 75 cirrhotic patients with signs of decompensation.

Pancreas and Diabetes Mellitus: The Relationship between the Organ and the Disease.

Diabetes mellitus has been a fascinating disease from the dawn of medical history. The first breakthrough in its treatment came in 1922, with the discovery of insulin which was extracted from the pancreas of a dog. Even earlier, a relationship between pancreas and diabetes mellitus had been suspected by medical scientists.

Time trends in the etiology of chronic pancreatitis in South India.

Background: Recent reports indicate a decline in prevalence of classical tropical chronic pancreatitis (TCP). We studied the etiologies and risk factors over a 14-year period at a tertiary care university hospital.

Methods: We compared the etiology in chronic pancreatitis (CP) patients presenting and followed-up in our Pancreas Clinic over two time periods (2000-06 and 2007-13).

Embolization of portosystemic shunt for treatment of recurrent hepatic encephalopathy.

Hepatic encephalopathy in the setting of advanced chronic liver disease, occurs following a precipitating factor and generally responds to correction of the precipitating factor and anticoma measures. We report the case of a lady with Child A cirrhosis who presented with frequent episodes of hepatic encephalopathy without any precipitating factors. She was found to be having a large portosystemic shunt.

Diet, nutrient deficiency and chronic pancreatitis.

The aetiopathogenesis of chronic pancreatitis (CP) appears to be multifactorial with interplay of genetic and environmental factors such as alcohol, smoking and diet. Dietary factors in the form of a fat- and protein-rich diet are important cofactors in the aetiopathogenesis of alcoholic pancreatitis. Malnutrition used to be a hallmark in tropical pancreatitis.

Clinical profile of early-onset and late-onset idiopathic chronic pancreatitis in South India.

Background And Aim: Idiopathic chronic pancreatitis (ICP) is the most common form of chronic pancreatitis reported in India. There is paucity of literature on the prevalence and profiles of early- and late-onset forms of ICP in India.

Material And Methods: We compared the profile of early- and late-onset ICP in a patient population attending a tertiary care hospital in South India.

Alcoholic chronic pancreatitis and alcoholic liver cirrhosis: differences in alcohol use habits and patterns in Indian subjects.

Objectives: Alcohol abuse is a risk factor for both liver cirrhosis and chronic pancreatitis. However, less than 15% of heavy drinkers develop these complications. Coexistence of cirrhosis and pancreatitis in the same patient is considered uncommon.

Pancreatitis in the setting of the metabolic syndrome.

There is paucity of literature on the relation of obesity with recurrent and chronic pancreatitis. We recorded the clinical details and the outcome of five patients with recurrent pancreatitis who had components of the metabolic syndrome. Their age ranged from 8 to 20 years.

Strategy to differentiate autoimmune pancreatitis from pancreas cancer.

Autoimmune pancreatitis (AIP) is a newly described entity of pancreatitis in which the pathogenesis appears to involve autoimmune mechanisms. Based on histological and immunohistochemical examinations of various organs of AIP patients, AIP appears to be a pancreatic lesion reflecting a systemic "IgG4-related sclerosing disease". Clinically, AIP patients and patients with pancreatic cancer share many features, such as preponderance of elderly males, frequent initial symptom of painless jaundice, development of new-onset diabetes mellitus, and elevated levels of serum tumor markers.

Assessment of cassava toxicity in patients with tropical chronic pancreatitis.

Background And Aim: There have been conflicting reports on the role of cassava ingestion in tropical pancreatitis (TCP). In this study we aimed to estimate cyanogens detoxifying enzyme rhodanese, thiocyanate and sulfur containing amino acids in cassava consumer as well as cassava non-consumer TCP patients and healthy controls and compare the same.

Methods: Eighty-six TCP patients and 90 healthy controls were recruited.

Assessment of oxidative status in chronic pancreatitis and its relation with zinc status.

Background: Oxidative stress-induced free radicals have been implicated in the pathology of chronic pancreatitis (CP).

Aim: We aimed to estimate oxidative stress and antioxidant status in tropical chronic pancreatitis (TCP) and alcoholic chronic pancreatitis (ACP) and correlate with zinc status.

Methods: One hundred and seventy-five CP patients (91 TCP, 84 ACP) and 113 healthy subjects were prospectively studied.

Anthropometric, biochemical, clinical and dietary assessment for malnutrition in south Indian patients with chronic pancreatitis.

Background And Aim: Recent surveys suggest a change in nutritional status of population in Kerala along with a steep rise in alcoholism. We aimed to conduct a comprehensive assessment of anthropometric, biochemical, clinical and dietary parameters and study the association of nutritional status with dietary intake.

Methods: We compared the nutrient intake of a cohort of patients with chronic pancreatitis with a recent population survey.

Alterations in plasma amino acid levels in chronic pancreatitis.

Context: Dietary proteins and amino acids can modulate pancreatic function.

Objective: Our aim was to estimate the levels of plasma amino acids in chronic pancreatitis patients and study their relationship with disease characteristics as well as exocrine and endocrine insufficiency.

Patients: One hundred and seventy-five consecutive adult patients with chronic pancreatitis: 84 patients with alcoholic chronic pancreatitis and 91 patients with tropical chronic pancreatitis.

Fecal elastase1 and acid steatocrit estimation in chronic pancreatitis.

Background: Measurement of pancreatic exocrine function and steatorrhea in chronic pancreatitis in the clinical setting has not received much attention.

Aim: To assess pancreatic exocrine function and fecal fat excretion in a cohort of patients with chronic pancreatitis.

Methods: Stool elastase1 levels were measured in 101 patients using polyclonal ELISA and acid steatocrit was measured in 86 chronic pancreatitis patients.

Chronic pancreatitis is associated with hyperhomocysteinemia and derangements in transsulfuration and transmethylation pathways.

Objectives: Homocysteine has been implicated in vascular dysfunction and thrombosis, as well as inflammatory conditions. This study was aimed to find out whether chronic pancreatitis (CP) is associated with hyperhomocysteinemia and derangements of transmethylation and transsulfuration pathways.

Methods: We estimated homocysteine and its metabolites in 45 alcoholic CP patients, 45 tropical CP patients, and 48 healthy controls.

Zinc status in chronic pancreatitis and its relationship with exocrine and endocrine insufficiency.

Context: A major role of the pancreas in zinc homeostasis has been suggested.

Objective: To assess erythrocyte zinc status in chronic pancreatitis and to correlate it with pancreatic exocrine and endocrine insufficiency.

Patients: One hundred and one patients with chronic pancreatitis (34 alcoholic chronic pancreatitis, 67 tropical chronic pancreatitis) were prospectively studied.