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Eventration of the diaphragm is a rare anomaly of unknown origin characterized by a permanent high position of one or rarely both the leaflets of the diaphragm, providing a potential space for the displacement of abdominal viscera on the affected side(s). The etiology, diagnosis, and management of this condition remains a controversial subject. We report a rare case of infiltrating squamous cell carcinoma of the esophagus in a patient with eventration of the diaphragm and gastric volvulus who presented to us with retrosternal discomfort. To the best of our knowledge, this rare association has not been reported in the literature, although one case of esophageal adenocarcinoma arising from Barrett’s esophagus in association with eventration of the diaphragm has been reported previously. This case again emphasis the varied associations of an eventration of the diaphragm.

Colon preparation using polyethylene glycol (PEGLEC) and combination of bisacodyl and magnesium sulphate was compared in 74 patients. Type of preparation did not influence patient discomfort. The quality of preparation was excellent with PEGLEC in 63.6% as compared to 41.6% with combination preparation. The completion rates were similar in both groups. Good preparation was linked with shorter procedure duration (p = 0.001) and greater depth of examination. No major side effects were noted with both preparations. To conclude, polyethylene glycol is recommended for screening of right colon while combination of bisacodyl and magnesium sulphate is a good and cheap preparation modality to screen the left colon.

The effect of pinaverium bromide in controlling gastrointestinal symptoms in 61 patients with irritable bowel syndrome was studied, as an open trial. Individually, there was significant relief in abdominal discomfort/pain as well as in bowel symptoms in most of the patients. Abdominal pain was reduced in 49%, stool consistency improved in 74%, straining and urgency decreased in 71% and mucus decreased in 64%. Tolerance to the drug administered was good and side-effects reported were few.

Aim: To study the association of factors such as alcohol, smoking and vegetarianism with presence of gallstones amongst cirrhotics., Patients and Methods: Data on alcoholism, smoking and vegetarianism was collected from the case records of 669 cirrhotics with (76) or without gallstones (593) retrospectively. Relative risk for the factors was computed individually and in combination controlling for the effects of alcoholism and smoking on vegetarianism., Results: Alcoholism and smoking were of low relative risk [R.R-1.27 (95% CI 0.82 to 1.96), and 1.02 (95% CI 0.65 to 1.61) respectively] while vegetarianism was associated with high risk for gallstone formation in cirrhotics [R.R 2.74 (95% CI 1.65-4.53)]. Vegetarian men had a relative risk of 3.02 (95% CI 1.75-5.22) irrespective of their alcoholic status. If women were alcoholic the relative risk increased to 7.03 (95% CI 3.26-15.12). Controlling for effects of gender and alcoholism, vegetarian cirrhotics had a 3 times greater risk for gallstone formation [Mantel Haenszel Relative Risk 3.18 (95% CI MHRR 1.82-5.56)]., Conclusions: Cirrhotic, vegetarian women in South India have a much higher risk for gallstones, if they are alcoholic. Alcoholic men who are vegetarians are at a greater risk for gallstone disease.

The most common type of gastric carcinoma, namely the intestinal type, has been proposed to result from a precancerous process in which chronic gastritis, atrophy, intestinal metaplasia and dysplasia develop in a sequential manner. Helicobacter pylori is considered as the main cause of chronic atrophic gastritis and thus may play a role in the gastric carcinogenesis process. The present study was aimed at investigating the prevalence of H. pylori in the gastric carcinoma cases. Urease tests and ELISA developed in our laboratory and culture were used to assess the prevalence of H. pylori in the study group. The positivity of H. pylori by various tests ranged from 56.0 to 62.6% in the gastric carcinoma group and 37.3 to 46.6% in the control subjects, the difference being statistically significant. This suggests that H. pylori infection could be associated with an increased risk for gastric carcinoma, but only a very small percentage of the infected persons develops gastric carcinoma. Therefore, it is suggested that along with other critical risk factors, H. pylori may act as a cofactor in the pathogenesis of gastric carcinoma.