Tropical pancreatitis differs in many respects from the chronic pancreatitis seen in Western countries. The present study was carried out to evaluate the role of ultrasonography in the diagnosis of tropical pancreatitis (TP) and to characterize the ultrasound findings in tropical pancreatitis. Patients referred with a suspected diagnosis of tropical pancreatitis formed the subjects for the study. Plain x-rays of the abdomen, ultrasonography, and endoscopic retrograde cholangio-pancreatography (ERCP) were carried out in all cases. Of the 25 cases, 17 patients had ERCP evidence of pancreatitis. Duct dilatation (82%) and demonstration of calculi were the most common ultrasound findings. Pancreatic atrophy (53%) was also a major feature of TP. Compared with ERCP, ultrasonography had a sensitivity of 94% and a specificity of 100%. Only one case with mild changes in ERCP was missed by ultrasonography. For the diagnosis and planning of surgery in TP, ultrasonography can replace ERCP. Even complications like cysts and malignancies are detected by ultrasonography.

Adult↗

PubMedDate not supplied

Lack of association between cassava consumption and tropical pancreatitis syndrome.

Previous studies suggesting an association between use of tubers of cassava and tropical pancreatitis have been weak and conflicting. To test a possible association the cassava consumption of 40 consecutive cases of tropical pancreatitis syndrome were compared with age-matched and sex-matched healthy hospital visitors. The sociodemographic characteristics of the two groups were comparable. There was no association between cassava consumption and tropical pancreatitis syndrome (odds ratio = 0.56; 95% confidence interval = 0.21-1.45). Controlling for the possible confounding effects of low socio-economic status and vegetarian diet did not alter the odds ratio. Testing for interaction also failed to show any effect modification of the association of cassava by economic status, chilli consumption or vegetarian diet. A significantly higher number of cases gave a positive family history of diabetes compared to the controls (odds ratio = 4.11; 95% confidence interval = 1.04-16.30; P = 0.04). In this case-control study which had sufficient power to detect an odds ratio > or = 3.5, there was no association between cassava consumption and tropical pancreatitis syndrome.

Adolescent↗

PubMedDate not supplied

A case-control study on risk factors for pancreatic diseases in Kerala, India.

BACKGROUND/AIMS: We simultaneously conducted case-control studies, in Kerala of South India, on chronic calcific pancreatitis of the tropics (CCPT), pancreatic ductal adenocarcinoma (PDA) with CCPT, and PDA alone to assess similarity of and difference between their risk factors. METHODOLOGY: Cases with one of these diseases were identified at the Trivandrum Medical College (TMC) Hospital, in Kerala, from 1994 to 1996. Controls were selected from healthy hospital visitors of the TMC Hospital by individual age (within +/- 3 years) and sex-matched with the index case. Odds ratios and their 95% confidence intervals for potential risk factors were calculated. RESULTS: Frequent consumption of cassava was positively associated with the risk of PDA with CCPT. Heavy cigarette smoking and drinking large amounts of coffee and/or tea everyday were positively related to the risk of PDA alone. Frequent consumption of vegetables and/or fruits was correlated to the decreased risk of PDA alone. CONCLUSIONS: Risk factors as well as preventive factors seem to be different between PDA with CCPT and PDA alone. Further study is necessary, especially to clarify the prognostic factors which would induce pancreatic malignancy in patients with CCPT.

Adolescent↗

PubMedDate not supplied

Ketotifen in prevention of indomethacin-induced gastropathy.

BACKGROUND: Therapeutic benefits of nonsteroidal anti-inflammatory drugs (NSAIDs) are offset by their gastrointestinal side effects. We evaluated whether oral ketotifen, which prevents experimental NSAID-induced gastric mucosal injury, is superior to placebo in preventing NSAID-induced gastropathy. DESIGN: Prospective, randomized, double-blind, placebo-controlled clinical trial. SETTING: Rheumatology clinic in a tertiary care hospital. PARTICIPANTS: A majority of the 53 subjects had rheumatoid arthritis (n = 36) or osteoarthritis (12). Those with comorbidity, gastrointestinal (GI) symptoms or abnormal endoscopic findings at entry were excluded. Persons on steroids or NSAIDs in the previous month were also excluded. The subjects were started on indomethacin 25 mg thrice daily. INTERVENTION: Subjects were randomly allocated to receive 2 mg ketotifen or placebo tablets. Compliance was measured by tablet count. OUTCOME MEASURE: At the end of every week a questionnaire was administered to elicit GI symptoms or adverse effects. Every patient underwent endoscopy after four weeks. RESULTS: Of 53 patients recruited (27 drug, 26 placebo), three (2 drug, 1 placebo) dropped out. The age, sex, NSAID use and clinical conditions were similar in the two groups. Eight in the drug group and 16 in the placebo group developed GI symptoms and/or endoscopic lesions (relative risk 0.51, 95% CI 0.27-0.95). The difference was significant on intention-to-treat analysis. CONCLUSIONS: Ketotifen significantly reduced the risk of GI side effects in patients on indomethacin.

Adult↗

PubMedDate not supplied

A trial of Phyllanthus amarus in acute viral hepatitis.

The study was done to know whether the powders of Phyllanthus amarus plants favourably influence the duration of disease in patients with acute viraus B hepatitis when compared to placebo. The powders of the plant were given in capsule form (300 mg capsules--3 capsules--3 capsules thrice daily) and an antacid powder in similar capsule was used as placebo. Persons with encephalopathy, preexisting medical conditions or serum bilirubin above 350 iu/l were excluded from the study. Fifty seven patients were randomized to receive either the placebo (28 cases) or the drug (28 cases). The two groups were comparable at the time of entry. Two cases from the placebo and one from the placebo and one from the drug group dropped out of the study. The duration of disease (time taken for bilirubin to come to below 2 mg%) was taken as the outcome measure. The duration of disease in the two groups was compared by Cox's proportional hazards analysis after adusting for the variables that influence the duration of jaundice. Only initial serum bilirubin was an independent predictor of duration of jaundice. The an analysis showed that Phyllanthus amarus powders did not significantly reduce the duration of jaundice in persons with virus B hepatitis.

Acute Disease↗

PubMedDate not supplied

Phenobarbitone in the treatment of dapsone induced hyperbilirubinaemia.

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Adult↗

PubMedDate not supplied

Medical colleges in India.

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Education, Medical, Undergraduate↗