A ten year serological survey of hepatitis A, B and C viruses infections in Nepal

BACKGROUND: In 1987, we reported that the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection in Nepal was low, as compared to hepatitis A virus (HAV) infection, and that no human T-lymphotropic type-1 (HTLV-1) infection was found in Nepal. OBJECTIVES: To determine changes in the prevalence of HAV, HBV, and HCV infections between 1987 and 1996 in inhabitants of Bhadrakali (suburban) and Kotyang (rural) villages in Nepal. STUDY DESIGN: We did a cross-sectional survey of 458 inhabitants of two Nepalese villages, to assess the prevalence of antibody to HAV (anti-HAV), antibody to hepatitis B core antigen (anti-HBc), hepatitis B surface antigen (HBsAg), antibody to HCV (anti-HCV), and antibody to HTLV-I (anti-HTLV-I). RESULTS: Anti-HAV was detected in 454 (99.1%), HBsAg in 5 (1.1%), anti-HBc in 33 (7.2%) and anti-HCV in 8 (1.7%) of serum samples tested in 1996. Statistically significant differences by gender or age group were nil. The prevalence of HCV infection was significantly higher in 1996 than in 1987 after adjusting for age of subjects living in the two villages (p < 0.01). The prevalence of HBsAg was significantly higher in 1996 than 1987 in Bhadrakali after adjusting for the factor of age (p < 0.05). Between 1987 and 1996, evidence for HTLV-1 positive residents was nil. CONCLUSION: These results suggest that HAV has been endemic in Nepal for long time while not of HBV, and that HCV infection tends to be increased recently.     

Fasting concentrations of nesfatin‐1 are negatively correlated with body mass index in non‐obese males

Background We recently identified a novel anorexigenic protein, nesfatin‐1, which is processed from nesfatin/nucleobindin‐2 (NUCB2). However, the clinical importance of this protein has not been determined. Objective To investigate its clinical significance in humans, we have established a new specific enzyme‐linked immunosorbent assay (ELISA) for human nesfatin‐1 in peripheral blood and measured its circulating concentration in healthy subjects. Design The new sandwich‐type ELISA method was validated and then used to measure nesfatin‐1 levels in plasma samples, under overnight fasting conditions, followed by oral glucose tolerance and meal tests. Patients and measurements A total of 43 nonobese males (age: 24·5 ± 0·6 , body mass index (BMI); 21·1 ± 0·3 kg/m²) were recruited to the study for evaluating fasting concentrations of nesfatin‐1. In those, fifteen subjects underwent a 75‐ g oral glucose tolerance test (OGTT) and another 15 underwent a meal test. In addition, fasting concentrations of nesfatin‐1 were measured in nine males with high BMI (age: 32·4 ± 3·7 , BMI; 37·3 ± 3·8 kg/m²). Results Peripheral concentrations of nesfatin‐1 showed a significant negative correlation with BMI, percentage body fat, body fat weight and blood glucose (P < 0·05). Nesfatin‐1 concentrations were not significantly changed during OGTT and meal tests. Fasting nesfatin‐1 levels were significantly lower in subjects with high BMI compared to nonobese subjects (P < 0·05). Conclusions A new specific and sensitive ELISA for nesfatin‐1 was established. Further accumulation of clinical observations is necessary to clarify the role of circulating nesfatin‐1 in various metabolic disorders.     

Role of angiography in the diagnosis of pancreatic cancer

Endoscopic Retrograde Choledocho-Pancreatography, Ultrasonography and Computer Tomography can show dilated pancreatic duct in the patients with small resectable pancreatic carcinoma. However they can not predict the size of the tumor. Angiography is a complementary examination, being able to demonstrate the size of the tumor and predict its resectability.     

Intraarterial digital subtraction angiography in the diagnosis and treatment of gastrointestinal disorders

During a period of 18 months, intraarterial digital subtraction angiography (IADSA) was performed in 360 patients with various gastrointestinal disorders. This technique was useful both in diagnostic and interventional procedures. Due to increased contrast resolution, hepatic tumors and portal vein systems were better visualized than with the use of conventional angiography. Also, a significant reduction in the dosage of contrast medium resulted in markedly reduced patient discomfort. Small pancreatobiliary tumors were better evaluated on conventional angiograms due to the decreased spatial resolution of IADSA.     

Experience with percutaneous transhepatic cholangiography using the Japanese needle

Percutaneous transhepatic cholangiography using a very thin needle has been performed in 885 patients with a variety of underlying hepatic, biliary, and pancreatic disorders. The procedure was successful in 99% of the patients with dilated intrahepatic bile ducts and in 85% of those with non-dilated ducts. Complications which required surgical intervention occurred only in two cases (0.2%). In patients with obstructive jaundice, external bile drainage was performed immediately after visualization of the bile duct. Percutaneous transhepatic cholangiography is an extremely useful and safe method for investigating disorders of the biliary tract, for localizing the cause of obstructive jaundice, and for reducing the degree of jaundice and improving the general status of patients with obstructive jaundice.