Mysterious Gelly Belly: a Case Report of Pseudomyxoma Peritonei and Literature Review

Pseudomyxoma peritonei (PMP) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumors. Although appendix has usually been implicated as the primary site, some reports found no cause. This case also describes a PMP with no identifiable primary site. A 52-year-old male presented with an abdominal distension evolving for 3 months associated with diffuse abdominal pain, imaging techniques objective intra peritoneal mucoid materials with septated ascites but it failed to identify the primary site. Exploratory laparotomy with Biopsy confirmed PMP but also failed to found the original site.

Fast Induction of Hcc in Nash Rodent Model: A Simple Diet Associated with A Chemical Carcinogen

Introduction: Non-alcoholic fatty liver disease (NAFLD) have been increasing as an important cause of hepatocellular carcinoma (HCC). Experimental models are crucial to identify some pathways in the pathogenesis of HCC secondary to NAFLD. Objective: To systematize an experimental hybrid rodent model of HCC secondary to NAFLD. Material and Methods: Fourteen male Sprague-Dawley rats, weighting 350-500g, were fed with choline-deficient high-fat diet and diethylnitrosamine (DEN) in the drinking water for 16 weeks. The animals were separated into two groups: 7 received DEN in water (100mg/ml) associated to choline-deficient high-fat diet and 7 received only cholinedeficient high-fat diet. Histological and immunohistochemical analysis were also performed. Results: All animals had definitive diagnosis of NASH in both groups with hepatocellular ballooning, steatosis and inflammation. In the group that received high-fat choline deficient diet, only two animals had micro nodular cirrhosis. However, in DEN group with high-fat choline deficient diet, all animals had gross lesions, major nodulations and fibrosis, visible in macroscopy. Besides, according of Edmondson-Steiner classification, 71% of the animals that received DEN + Diet with positive CK19 and oval cells and developed some grades of dysplastic and tumoral lesions. Moreover, in this model we could identify beyond NASH progression, some tumor-development stages, which means this model shows different treatment and study targets. Conclusion: The model is accomplishable, promotes fast induction of HCC in NAFLD context without much complexity to be executed and will be implemented as an interesting model to study new drugs to HCC secondary a NASH.

Fast Induction of Hcc in Nash Rodent Model: A Simple Diet Associated with A Chemical Carcinogen

Introduction: Non-alcoholic fatty liver disease (NAFLD) have been increasing as an important cause of hepatocellular carcinoma (HCC). Experimental models are crucial to identify some pathways in the pathogenesis of HCC secondary to NAFLD. Objective: To systematize an experimental hybrid rodent model of HCC secondary to NAFLD. Material and Methods: Fourteen male Sprague-Dawley rats, weighting 350-500g, were fed with choline-deficient high-fat diet and diethylnitrosamine (DEN) in the drinking water for 16 weeks. The animals were separated into two groups: 7 received DEN in water (100mg/ml) associated to choline-deficient high-fat diet and 7 received only cholinedeficient high-fat diet. Histological and immunohistochemical analysis were also performed. Results: All animals had definitive diagnosis of NASH in both groups with hepatocellular ballooning, steatosis and inflammation. In the group that received high-fat choline deficient diet, only two animals had micro nodular cirrhosis. However, in DEN group with high-fat choline deficient diet, all animals had gross lesions, major nodulations and fibrosis, visible in macroscopy. Besides, according of Edmondson-Steiner classification, 71% of the animals that received DEN + Diet with positive CK19 and oval cells and developed some grades of dysplastic and tumoral lesions. Moreover, in this model we could identify beyond NASH progression, some tumor-development stages, which means this model shows different treatment and study targets. Conclusion: The model is accomplishable, promotes fast induction of HCC in NAFLD context without much complexity to be executed and will be implemented as an interesting model to study new drugs to HCC secondary a NASH.

Mysterious Gelly Belly: a Case Report of Pseudomyxoma Peritonei and Literature Review

Pseudomyxoma peritonei (PMP) is a rare clinical condition defined as extensive intraperitoneal spread of mucus associated with a variety of mucinous tumors. Although appendix has usually been implicated as the primary site, some reports found no cause. This case also describes a PMP with no identifiable primary site. A 52-year-old male presented with an abdominal distension evolving for 3 months associated with diffuse abdominal pain, imaging techniques objective intra peritoneal mucoid materials with septated ascites but it failed to identify the primary site. Exploratory laparotomy with Biopsy confirmed PMP but also failed to found the original site.

Increased Level of Serum Ceramides Correlate with Liver Steatosis, Hba1c and Cholesterol in Obese Patients

Objective: Sphingolipids including ceramides are biological active components of all cell membranes. They play a great role in cell interconnections in the process of proliferation, maturation, cell apoptosis and any fluctuations of their level can lead to development of metabolic diseases such as type 2 diabetes (T2D) and nonalcoholic fatty liver disease. Nevertheless, there is lack of information about what type of ceramides play a role in aforementioned diseases. Here we investigated the relationship between the serum level of some type of ceramides and parameters of metabolic syndrome that is commonly present in obese patients. Design: We performed cross-sectional study in two groups. One of them was control group – lean healthy people (n=10, body mass index, BMI 21, 2±1, 89) and the second group included patients with the obesity (n=24, BMI 33, 9±3, 1). We quantified the levels of serum ceramide by liquid chromatography-mass spectrometry, analyzed the parameters for insulin resistance, liver function and lipid metabolism by biochemical blood test. Results: The subjects with obesity had elevated level of ceramide C16:0, C18:0, C24:0 comparing with control group (p<0,001). As results of our study, we found correlation of the level ceramide C16:0, C18:0, C24:0 with the results of steatometry and some metabolic parameters (glycosylated hemoglobin (Hb A1C), cholesterol). Conclusion: These results demonstrate that obese subjects had increased level of ceramide C16:0, C18:0, C24:0 that correlated with some metabolic parameters supposedly recognizing them as new biomarkers of metabolic syndrome.

Microsphere: A Unique and Useful Drug Delivery System

Microsphere is one the novel technology that is used to deliver the drug to it targeted site. Microsphere they are micro particle in size. They are of natural and synthetic one. There are various approaches in delivering a therapeutic substance to the target site in a sustained controlled release fashion. For preparation of microsphere protein physiochemical property to be optimized this include optimal pH, protein stochiometry and protein concentration. Some of the important microsphere technology includes Ceformin microsphere technology Ceformin EI, Ceformin TI, Ceformin EA/CR, Silk microsphere and gelatin microsphere. Microsphere drug delivery system has gained enormous attention due to its wide range of application as it covers targeting the drug to particular site to imaging and helping the diagnostic features. Microsphere is excellent polymer used for buccal delivery. It is also used to deliver pacilitaxel at the tumor site. In the present study valuable and selective information on microsphere is enlightened with its important applications which will be beneficial for further newer drug development.

Side Effect of Antipsychotic Drugs on the Gastrointestinal Tract: A Review of the Literature

The antipsychotic preparations which are widely used in medical practice possess an extensive range of the negative side effects including operating on organs of system of digestion. In the offered review influence of antipsychotics on a digestive tract is considered.

Psychiatric Disorders in Patients with Irritable Bowel Syndrome at a Tertiary Care Centre in Bangladesh

Background/Aims: Irritable bowel syndrome (IBS) is one of the common functional gastrointestinal disorder. Psychosomatic illness is a common association with IBS. Although studies in both western and Asian countries showed significant coexisting psychiatric illness in IBS patients, such studies are scarce in south-east Asian countries like Bangladesh. So, the aim of this study was to find out the association of psychiatric co-morbidities in patients with IBS in a tertiary care center. Methods: This was a cross-sectional study conducted from July 2017 to January 2019. Patients were selected from the dedicated IBS clinic of a tertiary care center in Bangladesh. IBS population were enrolled according to the Rome-IV diagnostic criteria. Relevant history, physical examination and investigations were done to exclude organic diseases. A psychiatric assessment of all the study subjects was done by a clinical psychiatrist using the General Health Questionnaire (GHQ)-12. Results: Ninety-six IBS patients were enrolled in this study. The mean age was 33.51±9.87 years. Male outnumbered female (85.4% vs 14.6%). IBS diarrhea (83.3%) was predominant in this study. Approximately 60.41% of IBS patients had different psychiatric illnesses. Major depressive disorder (27.1%) and generalized anxiety disorder (15.6%) were the most common psychiatric illness in this study. There was no significant difference in psychiatric comorbidities among various IBS types. Conclusions: A significant number of IBS patients have co-morbid psychiatric disorders. So, IBS patients should meticulously be screened for such co-morbidities for effective and integrated management.

Side Effect of Antipsychotic Drugs on the Gastrointestinal Tract: A Review of the Literature

The antipsychotic preparations which are widely used in medical practice possess an extensive range of the negative side effects including operating on organs of system of digestion. In the offered review influence of antipsychotics on a digestive tract is considered.

Lack of Knowledge about Colonoscopy in High Risk Patients: Clinical and Public Health Challenges

In the United States and worldwide, public health officials are publishing guidelines for the management of high risk patients with biopsy proven colorectal polyps [1]. With respect to high risk patients with colorectal polyps , they have 20.6%risk of developing a recurrence in 3 years when compared with those without this diagnosis following an initial colonoscopy Further, such high risk patients who are diagnosed with advanced colorectal polyps have a 3 fold higher subsequent risk of developing colorectal cancer [2, 3]. These alarming increased rates of recurrence of colorectal polyps as well as colorectal cancer pose clinical and public health challenges.