Functional cure of chronic hepatitis B-hope or hype?

Chronic hepatitis B constitutes a substantial disease burden worldwide. The steps advocated by the World Health Organization in 2016 to eradicate hepatitis B by 2030 has failed to achieve significant progress, especially with respect to immunization coverage and linkage to care. The lack of governmental and public awareness regarding the long-term implications of hepatitis B burden cause underfunding of developmental projects.

Oral Commensals in Healthy Individuals: A Clinicocytological Study.

Background Each human being has a specific group of microorganisms that are necessary for both sustaining health and causing illness. Normally, these microorganisms maintain bio-communalism, do not harm the host, and lead to a state known as symbiosis or eubiosis. The commensal nature of these bacteria is always maintained in symbiosis and attains pathogenic potential when there is an imbalance between host immunity and microorganisms.

Epidemiology of Disorders of the Gut-Brain Interaction: An Appraisal of the Rome IV Criteria and Beyond.

Disorders of the gut-brain interaction (DGBIs) are presently classified into mutually exclusive anatomical area-related symptom-based categories according to the Rome IV criteria. The pathophysiology of visceral nociception, which contributes to the wide range of symptoms of DGBIs, involves complex psychobiological processes arising from the bidirectional interactions of multiple systems at the gut and brain levels, which affect symptom expression and illness behaviors. The attitude toward an illness and expression of pain and bowel habit vary across cultures with variable interpretation based on sociocultural beliefs, which may not tally with the medical definitions.

Applicability of Risk Scores to an Indian Cohort of Hepatitis B-Related Hepatocellular Carcinoma Patients.

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Long-term entecavir therapy of chronic hepatitis B in real-life setting-Importance of quantitative HBsAg level.

Background: The global burden of chronic hepatitis B remains high and the best possible treatment remains long-term viral suppression expecting cure.

Methods: Total 154 patients of chronic hepatitis B (48 HBeAg positive, e + ve) treated with oral entecavir (0.5 mg/1 mg per day) were recruited from June 2007 and followed prospectively until December 2022 for persistent HBV DNA negativity, HBeAg and HBsAg loss/seroconversion and other liver and drug-related events in real-life settings.

Amyand's hernia with a perforated appendix and an enterocutaneous fistula: A case report.

Introduction: Amyand's hernia is a rare finding accounting for less than 1 % of inguinal hernias. The appendix with its pathology within the hernia sac may become isolated from the gastrointestinal tract, which can cause further confusion in clinical diagnosis. Awareness of the possibility of such appendiceal isolation could aid in clinical diagnosis.

Incidence and outcome of gastrointestinal bleeding in patients receiving aspirin with or without clopidogrel over 10 years- An observational study.

Aims: To determine the long-term incidence and outcome of gastrointestinal (GI) bleeding in users of aspirin with (dual antiplatelet therapy, DAPT) or without clopidogrel.

Settings And Design: Prospective hospital based 12-year study.

Methods And Material: There were 1047 patients on either aspirin 150 md/day alone (n = 574, 54.

Management of liver diseases: Current perspectives.

There is increasing incidence and prevalence of acute and chronic liver diseases (CLDs) all over the world which influence the quality of life and can give rise to life threatening complications. The burden of advanced liver disease due to hepatitis B has been controlled by antivirals but its eradication is difficult soon. Highly effective directly acting antiviral therapy has reduced the burden of hepatitis C but is partially offset by increasing IV drug abuse.

Interrelation of the Risk Factors of NAFLD at various Stages of Progression of the glycemic Status on long-term Follow-up.

Background: Though the risk factors for nonalcoholic fatty liver disease (NAFLD) are the same in diabetic and nondiabetic patients, their exact interrelation and weightage in the pathogenesis are unclear Methods: A total of 130 nondiabetic and 170 diabetic patients with NAFLD [diagnosed on abdominal ultrasound and severity assessed by NAFLD fibrosis score (NFS)] were recruited from 2009 to 2018 and their baseline risk factors [body mass index (BMI), waist circumference (WC), blood pressure, presence of the metabolic syndrome (MS) and insulin resistance (IR) by Homeostasis Model of Assessment for Insulin Resistance (HOMA-IR), fasting blood glucose (FBG) and lipid levels, and hemoglobin A1c (HbA1c) levels] were noted and their interrelationship studied. The nondiabetic patients were prospectively followed up for alteration of glycemic status.

Results: There was presence of high BMI (>23) in 66%, central obesity in 86% (of whom 59% had normal body weight), low high-density lipoprotein cholesterol (HDL) in 51%, high triglyceride (TG) in 68%, high low-density lipoprotein cholesterol (LDL) in 46.

Sputum Protein Biomarkers in Airway Diseases: A Pilot Study.

Background: Chronic mucous hypersecretion (CMH or chronic bronchitis) per se or when associated with chronic inflammatory airway diseases such as asthma or chronic obstructive pulmonary disease (COPD) has several adverse clinical consequences. The sputum fluid phase has several candidate proteins including mucins which have the potential of being therapeutic targets, but has not yet been explored in-depth. This study aimed at exploring the profile of sputum proteins in various airway diseases.

Cloning and immunobiochemical analyses on recombinant chymopapain allergen Cari p 2 showing pollen-fruit cross-reaction.

Papaya is reported to trigger food and respiratory allergy. Here, we identified chymopapain Cari p 2 as an allergen that can sensitize atopic individuals through fruit consumption followed by respiratory hazards through pollen exposure. Recombinant Cari p 2 displayed IgE-reactivity with 78% of papaya allergic sera.

Kidney Disease in Type 2 Diabetes Mellitus and Benefits of Sodium-Glucose Cotransporter 2 Inhibitors: A Consensus Statement.

Diabetic kidney disease (DKD) occurs in approximately 20-40% of patients with type 2 diabetes mellitus. Patients with DKD have a higher risk of cardiovascular and all-cause mortality. Angiotensin-converting enzyme inhibitors or angiotensin receptor blockers and antihyperglycemic drugs form the mainstay of DKD management and aim to restrict progression to more severe stages of DKD.

Surgically assisted caudal anesthesia in a case of Ankylosing Spondylitis-An innovative approach.

Anticipated difficult endotracheal intubation and impossibility of conventional methods of neuraxial blocks in Ankylosing Spondylitis (AS) led to our search for an alternative technique of regional anesthesia for total hip replacement surgery in such a patient. The approach undertaken was, after infiltration of the area with a local anesthetic drug, an orthopedic surgeon drilled the posterior wall of sacral hiatus and surgically created a small opening on it. A nerve stimulator needle was then introduced through this opening to get muscle twitches of the great toe, which helped in identification of the sacral epidural space.

Molecular characterization of a fungal cyclophilin allergen Rhi o 2 and elucidation of antigenic determinants responsible for IgE-cross-reactivity.

Cyclophilins are structurally conserved pan-allergens showing extensive cross-reactivity. So far, no precise information on cross-reactive IgE-epitopes of cyclophilins is available. Here, an 18-kDa IgE-reactive cyclophilin (Rhi o 2) was purified from , an indoor mold causing allergic sensitization.

A STUDY OF METABOLIC PARAMETERS IN NON DIABETIC PATIENTS WITH NON ALCOHOLIC FATTY LIVER DISEASE - IMPORTANCE OF DYSLIPIDEMIA.

Background: Metabolic risk factors of non alcoholic fatty liver disease (NAFLD) in non diabetic teetotallers who constitute a definite group are not well defined.

Objective: To identify the metabolic risk factors of NAFLD if any in non diabetic subjects who do not consume alcohol.

Methods: In a cross sectional study the effect of metabolic parameters (BMI, individual lipid levels, hemoglobinA1c (HbA1c), HOMA IR and the metabolic syndrome components) of 150 consecutive non diabetic teetotallers (90 with normal glucose tolerance and 60 prediabetics) on their NFS (quantifiable severity parameter of NAFLD) was studied by linear regression analysis.

Overlap Syndrome and Myasthenia Gravis: An Uncommon Association With Unusual Features.

The author presents a rare case of overlap syndrome associated with myasthenia gravis in the absence of acetylcholine receptor antibody and thymoma. Various liver autoantibodies developed at different times later in the disease course and myasthenia occurred 5 years after the diagnosis of liver disease. The importance of repeating antibody panel later in the disease course for proper diagnosis and timely treatment is highlighted.

Clinical Presentation and Mortality Determinants of Alcohol-Related Liver Disease: A Single-Center Experience of the Rising Menace from Eastern India.

Objectives: Recently, the incidence of alcohol-related liver disease has been rising alarmingly in India with late presentation and short survival. Better delineation of factors affecting mortality is needed for optimal utilization of constrained resources like liver transplantation.

Methods: Baseline data of 395 patients with alcohol-related liver disease including age, clinical presentation, alcohol parameters (amount, duration, type), laboratory parameters for detecting organ failure, and prognostic scores were compared between survivor and deceased groups.

A Study of Hormonal Abnormalities in Chronic Liver Disease.

Background: The liver, being involved in multiple metabolic processes, not only impacts the endocrine system normally but also become an inevitable target during the course of endocrine disorders. The effects of this intricate relationship which may be disrupted in CLD can only be addressed by simultaneously studying all hormone profiles in such patients and also their relation to etiology and severity of CLD.

Methods: Serum fasting cortisol, insulin, prolactin, testosterone, estradiol, FSH, LH and thyroid hormones (TSH, free T4 & T3) were measured for any abnormality in 100 randomly selected patients of CLD in a cross sectional observational study and their relation to etiology and severity of CLD (estimated by MELD and CTP score) were studied.

Long-term outcome of endoscopic variceal band ligation of esophageal varices in patients with chronic liver disease.

Background: There are scanty data on the long-term outcome of endoscopic variceal band ligation (EVL) for esophageal varices.

Methods: Adult patients suffering from a chronic liver disease (CLD) undergoing EVL of esophageal varices of grade 2 and above between January 2006 and December 2015 were followed up for the recurrence of varices, worsening of portal hypertensive gastropathy (PHG), rebleeding, and mortality. EVL was done as primary prophylaxis of bleeding in 72 and as secondary prophylaxis in 175 patients.

Indian consensus on chronic constipation in adults: A joint position statement of the Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology.

The Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology developed this evidence-based practice guideline for management of chronic constipation. A modified Delphi process was used to develop this consensus containing 29 statements, which were generated by electronic voting iteration as well as face to face meeting and review of the supporting literature primarily from India. These statements include 9 on epidemiology, clinical presentation, and diagnostic criteria; 8 on pathophysiology; and the remaining 12 on investigations and treatment.

A Curious Case of Ankylosing Spondylosis and Motor Neuron Disease: A Mere Coincidence or Correlation?

Ankylosing spondylitis (AS) is a chronic (progressive) painful inflammatory rheumatic disease with genetic predisposition. Genetic susceptibility and common expression cause susceptibility to other inflammatory diseases such as psoriasis, ulcerative colitis, and Crohn's disease. However, cases of motor neuron disease (MND) in patients of biologically treated patients of AS have been rarely reported.

Spectrum of Allergens and Allergen Biology in India.

The growing prevalence of allergy and asthma in India has become a major health concern with symptoms ranging from mild rhinitis to severe asthma and even life-threatening anaphylaxis. The "allergen repertoire" of this subcontinent is highly diverse due to the varied climate, flora, and food habits. The proper identification, purification, and molecular characterization of allergy-eliciting molecules are essential in order to facilitate an accurate diagnosis and to design immunotherapeutic vaccines.

Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study: rationale and methods.

Despite a considerable number of international reports on allergic diseases among children, information about the prevalence and risk factors of asthma and allergy-related diseases among Indian adolescents is relatively sparse. The Prevalence and Risk Factors of Asthma and Allergy-Related Diseases among Adolescents (PERFORMANCE) study has been conceived to study the aetiology of asthma and allergic diseases including rhinoconjunctivitis, atopic eczema and food allergies among adolescents in West Bengal, India, using standardised methods and collaborations. The aims of the study are: 1) to estimate the prevalence and risk factors of asthma and allergic diseases among the adolescents residing in rural, suburban and urban areas of West Bengal; 2) to obtain information about the possible role of lifestyle factors (smoking, diet and physical activity) on the disease prevalence; and 3) to create a network for further investigation on social, environmental and genetic factors affecting the diseases.