Prevalence and patterns of diverticulosis in patients undergoing colonoscopy in a southern Indian hospital

The prevalence of diverticular disease of colon of colon is reportedly low in Asian compared to Western countries. We analyzed the prevalence of colonic diverticulosis in a selected cohort of patients undergoing colonoscopy. Retrospective study of records of patients undergoing colonoscopy in a tertiary hospital in southern India.     

Tobacco use among adults in Cambodia: evidence for a tobacco epidemic among women

Objective

To identify the demographic characteristics of current tobacco users in Cambodia, particularly women, and to explore the reasons for current tobacco use in demographic subgroups of the Cambodian population.

Methods

We used a stratified three-stage cluster sample of 13 988 adults aged 18 years and older from all provinces in 2005–2006. Participants completed an interviewer-administered survey that contained items on all forms of tobacco use and on health and lifestyle variables. Multivariable regression analysis was performed to identify demographic predictors of tobacco use.

Findings

Cigarette smoking occurred among 48.0% of men and 3.6% of women. We estimated that 560 482 women (95% confidence interval, CI: 504 783 to 616 180) currently chewed tobacco (typically as a component of betel quid) and that the prevalence more than doubles with each decade of adulthood up to the point that about half of all older women chew tobacco. Both men and women cited the influence of older relatives as their primary reason for starting to use tobacco. About one out of five rural women who used chewing tobacco started their habit for relief from morning sickness. The highest prevalence of chewing tobacco among women was seen among midwives (67.9%) and traditional healers (47.2%). High rates (66.8%) of cigarette and pipe tobacco use occurred among ethnic minorities who represent hill tribes found throughout south-east Asia.

Conclusion

The tobacco epidemic in Cambodia extends far beyond cigarette smoking in men. Tobacco control that focuses only on cigarettes will not address the health burden from smokeless tobacco use in women that may be an integral part of cultural, familial, and traditional medicine practices.     

Membranoproliferative glomerulonephritis in patients with cystic fibrosis: coincidence or comorbidity? A case series

Cystic fibrosis (CF) is perceived as a childhood illness. However, with advances in medical science, patients are enjoying lives extending well into adulthood. This article reviews two cases of membranoproliferative glomerulonephritis (MPGN) in adults with CF. One patient with severe CF pulmonary disease had concomitant renal failure during hospitalization for a pulmonary exacerbation. Subsequent evaluations, including complement levels, were consistent with MPGN. The second patient had been recently diagnosed with colon cancer and was found to be suffering from acute renal failure. Diagnostic evaluation likewise confirmed the MPGN diagnosis. Immunologic associations linking CF and MPGN, including derangements in the complement system and the effects of superantigen production, are reviewed.     

Non-ideality in vinyl polymerisation, 2. Free-radical polymerisation of styrene with azoisobutyronitrile

Polymerisation of styrene in benzene initiated by azoisobutyronitrile (AIBN) was carried out at 60°C covering a wide range of concentrations of both monomer and initiator. It is found that the monomer concentration has only little effect on the characteristic constant of primary radical termination, k_prt/(k_ik_p). This is explained on the basis of the fact that the secondary dissociation of the initial primary radicals occurs very quickly (ca. 10^?11 s), thus allowing no chance of competition for the initiation process. This is in sharp contrast to the secondary dissociation of the benzoyloxyl radical which has a much longer life-time (ca. 10^?9 s). However, it is found that the polymerisation constant 2f_kk_dk/k_t is dependent on monomer concentration and increases with the latter. The characteristic constant has also been determined at 40, 50, 70, and 80°C and the energy of activation corresponding to the initiation process obtained therefrom is about 66kJ/mol. This is appreciably higher than the value generally assumed (E_i≈E_p = 32,6kJ/mol) and could not be explained on the basis of experimental error. E_i is moreover very near to the value obtained for benzoyl peroxide initiated polymerisation of styrene determined earlier. Thus it seems that the initiation and propagation processes involve different activation energies and not the same as has hitherto been assumed.     

Laparoscopic Management of Colonic Diverticular Disease and its Complications: an Analysis

Dense inflammatory reactions, loss of tissue planes and sepsis make surgical treatment of diverticulitis complex and difficult. Experience with laparoscopic management of this disease is scanty in our country. This study aims to assess the pattern of presentation, the site of involvement and complications of diverticulitis coli. This study also aims to audit the results of laparoscopic approach for complicated colonic diverticulitis. A retrospective analysis of all patients who had laparoscopic management of complicated diverticulitis patients from August 2007 to October 2014 was done from the database. The site of involvement, extent and presence or absence of complications of diverticular disease was noted. The surgical approach, intraoperative parameters and short-term outcome measures were analysed. There were 38 (8.8 %) patients with diverticular disease out of 427 patients who had laparoscopic colorectal surgery in the study period with a median age of 59 years. Out of 38 patients, 50 % had comorbid conditions. Internal fistulae were seen in 9 (23.6 %) patients, 6 with colovesical and 3 with colovaginal fistulae. Elective laparoscopic colectomy with primary anastomosis was done in 34 (89 %) cases of which, and 10 (26 %) patients had abscess on presentation requiring drainage. Four patients required emergency laparoscopic surgery of which primary resection and anastomosis was done in 3 (7.8 %), and Hartmann’s operation was done in 1 (2.6 %) patient. Two patients required stoma. The morbidity was seen in 15 % cases, and the mean hospital stay was 9.54 days. Laparoscopic approach for diverticular disease and its complication is feasible and safe. Careful selection of patients, judicious use of diverting stoma and appropriate selection of the procedure help to achieve good results even in those with septic complications and fistulising disease.     

A new polyelectrolyte with acid-base indicating properties

Poly(styrene-co-acrylic acid) on sulfonation with concentrated sulfuric acid exhibits an unusual acid-base indicating property: an intense purple colour in alkali which changes sharply to yellow at the equivalence point. The acid-base indicating property of the polymer can not be explained by the simple structure of the sulfonated copolymer. On the basis of infrared and nuclear magnetic resonance studies it is suggested that the copolymer during sulfonation undergoes an internal Friedel Crafts acylation followed by cyclic dehydration leading to a conjugated structure. A possible mechanism is proposed for the colour change with change in pH. The copolymer was prepared also in form of spherical beads which can be used repeatedly as indicator in acid-base titrations.