Preoperative Factors Predicting Remission of Type 2 Diabetes Mellitus After Roux-en-Y Gastric Bypass Surgery for Obesity

Background  

Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. This bariatric procedure has also been noted to resolve hyperglycaemia in up to 70% of obese diabetics. We evaluated outcomes in diabetic patients undergoing RYGB in our institution, aiming to identify factors predicting diabetes remission.     

Replacement of tricuspid valve with homovital mitral homograft in infective endocarditis: a case report

An infected tricuspid valve was successfully replaced with a fresh antibiotic treated Homovital mitral homograft procured from recipient cardiectomy specimen of simultaneous cardiac transplant in our unit. This operation seems superior to valvectomy alone or the use of a stented prosthesis in terms of hemodynamics and resistance to infection.     

A missense mutation in PIK3R5 gene in a family with ataxia and oculomotor apraxia

Autosomal recessive ataxias are heterogeneous group of disorders characterized by cerebellar atrophy and peripheral sensorimotor neuropathy. Molecular characterization of this group of disorders identified a number of genes contributing to these overlapping phenotypes. Ataxia with oculomotor apraxia type 2 (AOA2) is an autosomal recessive form of ataxia caused by mutations in the SETX gene. We report on a consanguineous family with autosomal recessive inheritance and clinical characteristics of AOA2, and no mutations in the SETX gene. We mapped the AOA locus in this family to chromosome 17p12-p13. Sequencing of all genes in the refined region identified a homozygous missense mutation in PIK3R5 that was absent in 477 normal controls. Our characterization of the PIK3R5 protein and findings suggest that it may play a role in the development of the cerebellum and vermis.     

Characterization of a new begomovirus and a beta satellite associated with the leaf curl disease of French bean in northern India

Begomoviruses are emerging as serious threat to many crops throughout the world particularly in tropical and sub-tropical regions. A leaf curl disease with symptoms typical of infection by many begomoviruses was observed in French bean (Phaseolus vulgaris) at Kanpur, India, during 2010–2012. The disease caused downward leaf curling and made the plants unproductive. The disease was transmitted from infected to healthy plants through whitefly (Bemisia tabaci). The products of five samples digested with EcoRI yielded DNA fragments of about 2.7 kb. The complete sequence of the Fb1 sample comprised 2,741 nucleotides with genome organization typical of begomoviruses having two ORFs in virion-sense and five ORFs in complementary-sense separated by an intergenic region with begomovirus conserved nonanucleotide sequence, TAATATTAC. The complete DNA-A sequence homology was most closely related to Cotton leaf curl Bangalore virus with 80 % nucleotide sequence identity. Based on the demarcation criteria for identifying a begomovirus species, Fb1 is considered as a distinct begomovirus species, named French bean leaf curl virus and designated as FbLCV-[IN:Knp:12]. The complete sequence of associated satellite DNA-β comprises 1,379 nucleotides with single ORF and has 80 % identity with Papaya leaf curl beta satellite. There was no evidence of recombination in DNA-A of FbLCV and associated beta satellite DNA molecule.     

Molecular identification of enteroviruses associated with aseptic meningitis in children from India

We identified and characterized enteroviruses associated with aseptic meningitis in children between April 2009 and March 2010. Enterovirus RNA was detected in 51 (45.5 %) of 112 CSF samples. Molecular typing by RT-PCR and sequencing of a partial VP1 region revealed the predominance of echovirus (ECV) 32 (n = 20), followed by ECV 11 (n = 10), ECV 13 and ECV 14 (n = 5 each), coxsackievirus (CV) B3 and CV B6 (n = 3 each), CV A2, CV A10 and ECV 30 (n = 1 each). Phylogenetic analysis of ECV 32 showed 0 to 4 % sequence divergence among strains of the present study and 20-23 % from the prototype Puerto Rico strain at the nucleotide level. This is the first report of ECV 32 associated with an aseptic meningitis epidemic and identification of seven different enterovirus serotypes (CV A2, CV A10, CV B3, CV B6, ECV 13, ECV 14 and ECV 32) in meningitis cases from India.     

The Impact of Laparoscopic Gastric Bypass on Comorbidities and Quality of Life in the Older Obese Patients (Age > 60): Our UK Experience

Background

With population ageing, more older patients would benefit from the reduced comorbidities associated with laparoscopic Roux-en-Y gastric bypass (LRYGB). However, health care providers are still reluctant to offer bariatric surgery to older obese patients due to the perceived increased risk and possible reduced benefit. Here, we report the outcomes of first UK series of LRYGB in patients (>?60 years) with emphasis on quality of life (QoL).

Setting

University hospital.

Methods

Data was collected prospectively on all patients aged >?60 years undergoing LRYGB between 2006 and 2011. Patients had a minimum 1-year follow-up. Data related to weight loss, peri-operative complications and obesity-related morbidity (ORM) was collected. Patients’ QoL was assessed by postal questionnaire.

Results

Forty-six patients with a median age of 63 (60–71) underwent LRYGB with a median follow-up of 23 (12–55) months. There was a significant drop in patients’ BMI [mean (SD) 47.5 (6.2) to 31.2 (4.4) kg/m²]. Patients had an average 69% (SD 17%) excess weight loss and 34% (SD 10%) total body weight loss.The median hospital stay was 3 (1–16) with 13% peri-operative morbidity and no mortality. There was a 25% (30/123) resolution and 54% (66/123) ‘improvement’ in ORM. The QoL score increased significantly in several domains particularly physical performance (2.8 to 8.0, p?<?0.001), self-esteem (3.6 to 8.3, p?<?0.001) and mobility (2.9 to 7.5, p?<?0.001).

Conclusion

LRYGB in patients aged >?60 years can be performed safely and with weight loss comparable to younger patients. There is associated benefit in reducing ORM and substantial improvement in QoL.

     

A rare case of coexistent carcinoma of the colon with tuberculosis

This is a case report of a 35-year-old female who presented with acute intestinal obstruction initially diagnosed as ileocaecal tuberculosis. She was submitted to exploratory laparotomy with a right hemicolectomy for a non-passable ileocaecal mass. Histopathology showed colon cancer with tuberculosis both in the colon as well as the mesenteric lymph node. In addition to its pathological rarity, this case is of particular interest, because it highlights the diagnostic dilemma and therapeutic challenge associated with such a condition.