Search

We study the partial decay widths of charmonium (bottomonium) states to $D\bar D (B\bar B)$ mesons in magnetized (nuclear) matter using a field theoretic model of composite hadrons with quark (and antiquark) constituents. These are computed from the mass modifications of the decaying and produced mesons, including the nucleon Dirac sea effects within a chiral effective model. The Dirac sea contributions are observed to lead to an rise (drop) in the quark condensates as the magnetic field is increased, an effect called the (inverse) magnetic catalysis. In the presence of a magnetic field, there are mixings of spin 0 (pseudoscalar) and spin 1 (vector) states (PV mixing) The nucleon Dirac sea effects are observed to be significant and the anomalous magnetic moments (AMMs) of the nucleons are observed to play an important role. For $\rho_B$=0, there is observed to be magnetic catalysis (MC) without and with AMMs, whereas, for $\rho_B=\rho_0$, the inverse magnetic catalysis (IMC) is observed when the AMMs are taken into account, contrary to MC, when the AMMs are ignored. The magnetic field effects on the heavy quarkonium decay widths should have observable consequences on the production of the hidden and open heavy flavour mesons from ultra-relativistic peripheral heavy ion collision experiments, at RHIC and LHC, where the produced magnetic fields are extremely large., Comment: 32 pages, 10 figures. arXiv admin note: text overlap with arXiv:2208.14962

Introduction: Malabsorption occurs due to different causes and the clinical presentation varies with the underling etiology. Very few studies have been done to determine the etiological spectrum of malabsorption in northern India. Aim: To assess the etiology in patients presenting with malabsorption and to study clinical, haematological, biochemical, serological, endoscopic and histological features of these patients. Materials and Methods: Clinical assessment of 91 cases presenting with malabsorption complains in the gastro OPD was done along with vitamin B12 and fecal fat estimation. Relevant haematological, serological investigations, endoscopy was done. Duodenal biopsy was taken. Data was obtained and analysed. All patients clinically presenting with malabsorption were included in the study. The patients excluded were those, who refused for endoscopy or participation in the study. Results: The most common causes of malabsorption were non-specific duodenitis(42.8%), celiac disease (CD)(18.7%), tropical sprue (TS) (8.8%), giardiasis(3.3%), eosinophilic enteritis (2.2%), lymphangiectasia(1.1%), abetalipoproteinemia(1.1%) and 22% cases were normal histologically. The principal features differentiating celiac disease and tropical sprue were also noted. Patients with CD more often had anemia, scalloping of folds on endoscopy, moderate or severe villous atrophy and increased intraepithelial lymphocytes, in comparison to patients with TS. Conclusion: CD is commoner than TS. Though histology is gold standard for the diagnosis of CD, TS and other intestinal mucosal diseases, correlation of histological findings with clinical, hematological, endoscopic and serological findings is important as subtle histological changes may be missed depriving the patient of proper treatment. Keywords: Celiac disease, Diarrhea, Malabsorption, Tropical sprue, Villous atrophy, IELs.

Despite several recent advances in therapy in inflammatory bowel disease (IBD), 5-aminosalicylic acid (5-ASA) therapy has retained its place especially in ulcerative colitis. This consensus on 5-ASA is obtained through a modified Delphi process, and includes guiding statements and recommendations based on literature evidence (randomized trials, and observational stud ies), clinical practice, and expert opinion on use of 5-ASA in IBD by Indian gastroenterologists. The aim is to aid practitioners in selecting appropriate treatment strategies and facilitate optimal use of 5-ASA in patients with IBD. (Intest Res 2020;18:355-378)

IntroductionThese Asian Working Group guidelines on diet in inflammatory bowel disease (IBD) present a multidisciplinary focus on clinical nutrition in IBD in Asian countries.MethodologyThe guidelines are based on evidence from existing published literature; however, if objective data were lacking or inconclusive, expert opinion was considered. The conclusions and 38 recommendations have been subject to full peer review and a Delphi process in which uniformly positive responses (agree or strongly agree) were required.ResultsDiet has an important role in IBD pathogenesis, and an increase in the incidence of IBD in Asian countries has paralleled changes in the dietary patterns. The present consensus endeavors to address the following topics in relation to IBD: (i) role of diet in the pathogenesis; (ii) diet as a therapy; (iii) malnutrition and nutritional assessment of the patients; (iv) dietary recommendations; (v) nutritional rehabilitation; and (vi) nutrition in special situations like surgery, pregnancy, and lactation.ConclusionsAvailable objective data to guide nutritional support and primary nutritional therapy in IBD are presented as 38 recommendations.

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients suspected to have or having Crohn’s disease. The 29 consensus statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

We study the medium modifications of the spectral functions as well as production cross-sections of the strange vector mesons ($\phi$, $K^*$ and $\bar {K^*}$) in isospin asymmetric strange hadronic matter. These are obtained from the in-medium masses of the open strange mesons and the decay widths $\phi \rightarrow K\bar K$, $K^* \rightarrow K\pi$ and $\bar {K^*} \rightarrow {\bar K}\pi$ in the hadronic medium. The decay widths are computed using a field theoretic model of composite hadrons with quark/antiquark constituents, from the matrix element of the light quark-antiquark pair creation term of the free Dirac Hamiltonian between the initial and final states. The matrix element is multiplied with a coupling strength parameter for the light quark-antiquark pair creation, which is fitted to the observed vacuum decay width of the decay process. There are observed to be substantial modifications of the spectral functions as well as production cross-sections of these vector mesons due to isospin asymmetry as well as strangeness of the hadronic medum at high densities. These studies should have observable consequences, e.g. in the yield of the hidden and open strange mesons arising from the isospin asymmetric high energy heavy ion collisions at the Compressed baryonic matter (CBM) experiments at the future facility at GSI., Comment: 34 pages, 9 figures, version published in Eur.Phys.Jour.A

The masses and decay widths of charmonium states are studied in the presence of strong magnetic fields. The mixing between the pseudoscalar and vector charmonium states at rest is observed to lead to appreciable negative (positive) shifts in the masses of the pseudoscalar (longitudinal component of the vector) charmonium states in vacuum/hadronic medium in the presence of high magnetic fields. The pseudoscalar and vector charmonium masses in the hadronic medium, calculated in an effective chiral model from the medium changes of a scalar dilaton field, have additional significant modifications due to the mixing effects. The masses of the $D$ and $\bar D$ mesons in the magnetized hadronic matter are calculated within the chiral effective model. The partial decay widths of the vector charmonium state to $D\bar D$ are computed using a field theoretical model for composite hadrons with quark/antiquark constituents, and are compared to the decay widths calculated using an effective hadronic Lagrangian. The effects of the mixing are observed to lead to significant contributions to the masses of the pseusoscalar and vector charmonium states, and an appreciable increase in the decay width $\psi(3770) \rightarrow D\bar D$ at large values of the magnetic fields. These studies of the charmonium states in strong magnetic fields should have observable consequences on the dilepton spectra, as well as on the production of the open charm mesons and the charmonium states in ultra relativistic heavy ion collision experiments., Comment: 31 pages, 5 figures,to be published in Phys. Rev. C

The masses of the strange mesons ($K$, $K^*$ and $\phi$) are investigated in the presence of strong magnetic fields. The changes in the masses of these mesons arise from the mixing of the pseusdoscalar and vector mesons in the presence of a magnetic field. For the charged mesons, these mass modifications are in addition to the contributions from the lowest Landau energy levels to their masses. The decay widths, $\phi \rightarrow K\bar K$ and $K^* \rightarrow K\pi$, in the presence of the magnetic field are studied using a field theoretic model of composite hadrons with constituent quarks/antiquarks. The model uses the free Dirac Hamiltonian in terms of the constituent quark fields as the light quark antiquark pair creation term and explicit constructions for the meson states in terms of the constituent quarks and anitiquarks to study the decay processes. The study of the masses and decay widths of the strange mesons in strong magnetic fields can have observable consequences on the production of the open and hidden strange mesons in the peripheral ultra high energy collisions at LHC, where the created magnetic field can be huge., Comment: 20 pages, 3 figures. published in Int. Jour. Mod. Phys. E, Vol. 30, No. 3 (2021) 2150014. arXiv admin note: text overlap with arXiv:2005.00354

The Indian Society of Gastroenterology (ISG) Task Force on Inflammatory Bowel Disease and the Indian Radiological and Imaging Association (IRIA) developed combined ISG-IRIA evidence-based best-practice guidelines for imaging of the small intestine in patients with suspected or known Crohn's disease. These 29 position statements, developed through a modified Delphi process, are intended to serve as reference for teaching, clinical practice, and research.

The recommendations 31 which recommend "VSL#3®", refer only to the product used in the cited literature and equivalent products independent from the present product labelings. This product is now known by the generic name "De Simone Formulation".

The mass modifications of the open charm ($D$ and $D^*$) mesons, and their effects on the decay widths $D^*\rightarrow D\pi$ as well as of the charmonium state, $\Psi(3770)$ to open charm mesons ($\Psi(3770)\rightarrow D\bar D$), are investigated in the presence of strong magnetic fields. These are studied accounting for the mixing of the pseudoscalar ($P$) and vector ($V$) mesons ($D-D^*$, $\eta_c'-\Psi(3770)$ mixings), with the mixing parameter, $g_{PV}$ of a phenomenological three-point ($PV\gamma$) vertex interaction determined from the observed radiative decay width of $V\rightarrow P\gamma$. For charged $D-D^*$ mixing, this parameter is dependent on the magnetic field, because of the Landau level contributions to the vacuum masses of these mesons. The masses of the charged $D$ and $D^*$ mesons modified due to $PV$ mixing, in addition, have contributions from the lowest Landau levels in the presence of a strong magnetic field. The effects of the magnetic field on the decay widths are studied using a field theoretic model of composite hadrons with quark (and antiquark) consittuents. The parameter for the charged $D-D^*$ mixing is observed to increase appreciably with increase in the magnetic field. This leads to dominant modifications to their masses, and hence the decay widths of charged $D^*\rightarrow D\pi$ as well as $\Psi(3770)\rightarrow D^+D^-$ at large values of the magnetic field. The modifications of the masses and decay widths of the open and hidden charm mesons in the presence of strong magnetic fields should have observable consequences on the production of the open charm ($D$ and $D^*$) mesons as well as of the charmonium states resulting from non-central ultrarelativistic heavy ion collision experiments., Comment: 25 pages, 3 figures, version to be published in Int. Jour. Mod. Phys. E. arXiv admin note: text overlap with arXiv:2004.01007, arXiv:2006.03478

The in-medium partial decay widths of $\Upsilon (4S) \rightarrow B\bar B$ in magnetized asymmetric nuclear matter are studied using a field theoretic model for composite hadrons with quark (and antiquark) constituents. The medium modifications of the decay widths of $\Upsilon (4S)$ to $B\bar B$ pair in magnetized matter arise due to the mass modifications of the decaying $\Upsilon (4S)$ as well as of the produced $B$ and $\bar B$ mesons. The in-medium masses of the open bottom meson in magnetized nuclear matter are computed from their interactions with the nucleons and the scalar mesons within a chiral effective model. The mass modification of the $\Upsilon(4S)$ arises due to the medium modification of a scalar dilaton field, which is introduced in the model to simulate the gluon condensates of QCD. The charged $B^{\pm}$ mesons have additional contributions from the Landau energy levels, leading to positive shifts in their masses in the presence of a magnetic field. In the presence of an external magnetic field, there are contributions to the masses of the $B$, $\bar B$ mesons and $\Upsilon(4S)$ state (longitudinal component) due to the pseudoscalar meson-vector meson (PV) mixing ($B-B^*$, $\bar B- \bar {B^*}$ and $\Upsilon(4S)-\eta_b(4S)$ mixings), which are also considered in the present study. The PV mixing effects are observed to be the dominant contributions to the mass shifts of these mesons, which lead to appreciable modifications in the decay widths of $\Upsilon (4S)$ to the neutral ($B^0 \bar {B^0}$) and the charged ($B^+ B^-$) pairs in the presence of a magnetic field. These should have observable consequence in the production of open bottom mesons and bottomonium states at LHC and RHIC, where huge magnetic fields are produced in ultra-relativistic peripheral heavy ion collisions., Comment: 29 pages, 7 figures (to be published in Int.Jour.Mod.Phys.E

Introduction: Irritable Bowel Syndrome (IBS) is a functional gastrointestinal disorder which has a complex pathophysiology including the role of inflammation being recently studied. Aim: To assess the role of mast cells and Intraepithelial Lymphocytes (IELs) in IBS patients by morphometry. Materials and Methods: In this study, 148 cases of IBS using the Rome III criteria and 28 controls were taken. IBS patients were divided into two subgroups of Post Infectious (PI) and Non Post Infectious (NPI) subgroups on the basis of past history of episodes of gastroenteritis. All of them underwent full length colonoscopy and biopsy from the descending colon. Histopathology of these two were compared with special attention to morphometric count of IELs by “pin hole” method and mast cells using toluidine blue highlighting. Results: Biopsies were unremarkable in 23(15.54%) patients, whereas 125 (84.46%) patients were diagnosed as Non Specific Colitis (NSC). The difference in IEL counts and mast cell counts were extremely significant (p

The role of endoscopy in the diagnosis of dyspepsia is not clear and there are conflicting reports mainly from western countries.All patients presenting with dyspepsia to the gastroenterology department of the M.L.N. Medical College, Allahabad, between January 1989 and April 1990, were subjected to endoscopy. Patients were divided into two age groups: younger (≤45 years) and older (45 years).Ninety-two (16%) of 567 patients in the younger age group had endoscopic abnormalities and the majority had minor diseases such as peptic ulcer whereas 69 (42%) of 165 patients in the older age group had abnormalities (p0.001)and 15(9%) had gastric carcinomas.We suggest that in cases of dyspepsia, only patients above the age of 45 years should be subjected to routine endoscopy. This will considerably reduce the load on endoscopy units and make the procedure more costeffective.

Kantowski-Sachs plane symmetric models are investigated in bimetric theory of gravitation proposed by Rosen [1] in the context of bulk viscous fluid. Taking conservation law and the equation of state, two different models of the universe are obtained. It is observed that Kantowski-Sachs vacuum model obtained in first case and bulk viscous fluid model obtained in second case. It is also observed that the bulk viscous cosmological model always represents an accelerated universe and consistent with the recent observations of type-1a supernovae. Some physical and geometrical features of the viscous fluid model are studied.

Introduction: Helicobacter pylori (H. pylori) infection has been associated with increased levels of inflammatory cytokines and subsequent insulin resistance and epidemiologically linked to type 2 diabetes. Objectives: To study the prevalence rate of H. pylori infection in type 2 diabetes and its relation with HbA1C levels. Materials and Methods: In this cross-sectional case-control study, 80 patients (≥18 years) who met the Americans with Disabilities Act (ADA) criteria for diabetes were recruited. Similarly, 60 age, sex, and education matched healthy controls were taken. They were tested for H. pylori infection by rapid urease test, histological examination of antral endoscopic biopsy specimens and serology. The relationship between H. pylori infection and levels of plasma glucose and HbA1C was assessed. Results: Out of the 80 patients of type 2 diabetes, H. pylori infection was found in 62 (77.5%) while it was present in only 35 (58.3%) of 60 controls, which was found to be significant (Chi-square test: 5.919, df = 1, P value = 0.015). Mean HbA1C among diabetics with H. pylori infection was 8.19 ± 1.16% and without H. pylori infection was 6.9 ± 0.84% (t = 4.3872, P value = 0.0001). Conclusions: Prevalence of H. pylori infection was significantly higher in diabetes as compared to controls. Presence of H. pylori infection significantly correlated with the level of HbA1C.

In this paper,we investigate the non-static massive string magnetized barotropic perfect fluid cosmological models in Rosen's (Gen.Rel.Grav.Vol.4 (1973) 435) bimetric theory of gravitation. Using the relation isotropic pressure 'p' directly proportional to energy density 'ρ' ( i.e p = Є1 ρ , where -1 ≤ Є1 ≤ 1) , dust filled geometric string model and stiff fluid filled model of the universe are obtained. Some physical and geometrical behavior of the exhibited models are also discussed.

Thyroid abscess is a rare clinical entity and infrequently encountered. We hereby present a review of six cases-four in the paedriatic and two in the adult age group who presented to our hospital which is a Tertiary care referral centre with thyroid abscess and the management varying from serial aspiration to incision and drainage of abscess. A brief review of literature is also included. DOI: http://dx.doi.org/10.3329/bjo.v18i2.12019 Bangladesh J Otorhinolaryngol 2012; 18(2): 207-211

Hepatitis B virus (HBV) is a well known agent of acute and chronic hepatitis, liver cirrhosis and hepatocellular carcinoma. Around 400 million people worldwide carrier of HBV of which more than 250 million reside in Asia, and 1–2 million people have died from it. It has a partially double-stranded DNA, having 3.2-kb genome size and replicate via reverse transcription of RNA intermediate. In the natural history or during the antiviral therapy of chronic HBV infection, seroconversion from HBeAg to anti-HBeAg is usually accompanied by a decrease in viral replication and remission of liver disease. Based on genomic sequence data HBV is classified into eight genotypes A–H and four major serotypes ayw, ayr, adw and adr on the basis of complete genome and S gene sequence analysis. Genotypes and serotypes are useful tools in understanding the epidemiology of HBV infection. HBV genotypes have distinct geographical distributions. The HBV variants appear during HBeAg seroconversion and they bring mutations in the precore region (PC) that prevent HBeAg synthesis. Another common HBeAg variant is the basal core promoter mutant (BCP) characterized by point mutation in the promoter of both HBeAg mRNA and core protein mRNA. The most frequent core promoter mutation is the double A1762T and G1764A nucleotide exchange, which results in a substantial decrease in HBeAg expression but enhanced viral genome replication. The approved antiviral drugs such as Interferon, lamivudine, adefovir dipivoxil, entecavir and telbivudine for purpose of treating chronic HBV infection is to prevent or stop the progression of liver injury by suppressing viral replication or eliminating infection. Sustained losses of viral markers of active viral replication (HBeAg and HBV DNA) are the standard end point of the therapies.

Background: Patients with liver cirrhosis are susceptible to tuberculosis (TB) because of immune dysfunction. However, limited data is available regarding prevalence of TB in cirrhotics and its treatment. Aim: The aim of this study was to elucidate the prevalence and clinical characteristics of TB with liver cirrhosis and its treatment with different anti tubercular (ATT) regimens. Methods: Two eighty nine (289) patients with cirrhosis of liver were evaluated for evidence of tuberculosis during a period of 24 months (March 2011 to March 2013) in a tertiary care centre. Patients with evidence of tuberculosis were randomised into two different ATT regimens (Regimen A and B) after exclusion. Regimen A included initial phase of isoniazid (INH), rifampicin (RIF), and ethambutol (EMB) for 2 months followed by a continuation phase of INH and RIF for 7 months, for a total of 9 months and regimen B included EMB, a fluoroquinolone (ofloxacin), and RIF for 12 months. All drugs were given on weight based daily doses. Results: Forty two patients (14.5%) out of 289 with cirrhosis of liver were detected to have evidence of TB. Aetiological agents responsible for cirrhosis amongst these patients were alcohol (n=18, 42.8%), hepatitis B (n=11, 26.1%), hepatitis C (n=2, 2.6%) and other causes (11, 26.1%). The most common site of tuberculosis was pulmonary (n=20, 47.6%) followed by abdominal (n=11, 26.1%), peritoneum (n=8, 19.2%), intestinal (n=2, 4.6%) and small bowel (n=1, 2.3%). After exclusion of six patients, thirty Six (36) patients with cirrhosis of liver were randomised into two different groups (ATT regimen A and B). Two out of eighteen patients (11.11%) in Regimen A while none of 18 patients in regimen B developed ATT induced hepatotoxicity (p < 0.05). Conclusion: Prevalence of tuberculosis in patients with cirrhosis of liver in our study was 145.3 per 1000 patients (14.5 %) which was higher than the prevalence of all forms of tuberculosis in general population in India and alcoholic cirrhotic were highly vulnerable. Combination RIF, EMB and Ofloxacin (fluoroquinolone) was well tolerated in cirrhosis of liver, even in Child B cirrhosis.

BACKGROUND AND STUDY AIMS Injuries to the bile duct are not uncommon during cholecystectomy. While minor injuries are amenable to endoscopic therapy, major ones, such as complete transection of the duct, require surgical intervention. We report on the endoscopic management of such injuries. PATIENTS AND METHODS We included in the study ten patients who had persistent postoperative bile drainage (either through a surgically placed catheter or through a biliocutaneous fistula) after their cholecystectomy procedure had been complicated by complete transection of the bile duct. Plastic biliary endoprostheses were placed in the bilioma through the papilla of Vater. In one patient, both the right and the left hepatic ducts were opacified by injecting contrast material through the drainage catheter and it was possible to place stents in both the ducts. RESULTS All the patients improved clinically after the procedure. In one patient the stent became dislodged and an elective Roux-en-Y hepaticojejunostomy was performed, but it was possible to remove the stents from all the other patients. Two patients were referred for surgery but in both cases the bile flow through the bile duct was shown to be so good on nuclear imaging that they were not operated on. All the non-operated patients are well after a mean +/- SD follow-up of 22.3 +/- 5.5 months. CONCLUSIONS Placement of biliary stents in the bilioma is a useful adjunct to percutaneous drainage in patients with complete transection of the bile duct. After placement of a biliary stent in the bilioma the percutaneous drainage catheter may be removed. In one of our study patients it was also possible to place stents in the intrahepatic ducts and the bile duct was reconstructed. Long-term follow-up of these patients and further studies are required to assess the role of endoscopic management as an alternative to surgery in patients with this condition.

BACKGROUND AND STUDY AIMS Figures for the prevalence of anorectal varices and portal hypertensive colopathy have varied considerably in the available studies of patients with cirrhosis, and few studies have observed these changes in patients with extrahepatic portal vein obstruction (EHPVO). Our aim was to investigate the colonic changes, if any, in patients with EHPVO and to compare them with those seen in patients with cirrhosis of the liver. PATIENTS AND METHODS A total of 50 patients with cirrhosis and 35 patients with EHPVO, all of whom had a history of at least one episode of bleeding from esophageal varices, underwent both upper gastrointestinal endoscopy and colonoscopy. RESULTS Anorectal varices were seen more commonly in patients with EHPVO than in patients with cirrhosis (63 % vs. 38 %, P < 0.03). Of the patients with anorectal varices, large anorectal varices were also more common in patients with EHPVO than in patients with cirrhosis (73 % vs. 32 %, P < 0.01). Colopathy was noted in 40 % of patients with EHPVO and in 62 % of patients with cirrhosis (P < 0.05). Of the patients with EHPVO, colopathy was noted in 27 % of patients who also had anorectal varices and in 61.5 % of patients without anorectal varices (P < 0.05). Similarly, patients with both cirrhosis and anorectal varices were found to have a lower prevalence of colopathy than cirrhotic patients without anorectal varices (42 % vs. 74 %, P < 0.03). CONCLUSIONS Anorectal varices are more common in patients with EHPVO, while portal hypertensive colopathy is more common in patients with cirrhosis. Large anorectal varices are also more common in patients with EHPVO than in patients with cirrhosis and there is an inverse relationship between anorectal varices and colopathy in both cirrhotic patients and patients with EHPVO.

Background and study aims Although it is known that obliteration of esophageal varices following endoscopic variceal band ligation results in an increase in the incidence of portal hypertensive gastropathy, the effect of variceal ligation on hemorrhoids, anorectal/colonic varices and portal hypertensive colopathy is not known. The aim of this study was to investigate the effect of endoscopic variceal band ligation on hemorrhoids, anorectal/colonic varices and portal hypertensive colopathy. Patients and methods A total of 60 consecutive patients with cirrhosis of the liver and portal hypertension were prospectively studied. Upper gastrointestinal endoscopy and full-length colonoscopy were carried out before the patients underwent endoscopic variceal band ligation for esophageal varices and after obliteration of the varices following band ligation. Results Obliteration of esophageal varices by endoscopic variceal band ligation did not affect the incidence of hemorrhoids (37 % before and after), anorectal varices (40 % before and after), and portal hypertensive colopathy (57 % before and after). Conclusions It is concluded that esophageal variceal band ligation does not affect the incidence of hemorrhoids, anorectal varices or portal hypertensive colopathy in patients with cirrhosis of the liver.

Background and Aims: The topographic distribution and density of Helicobacter pylori and associated gastritis in the stomach were studied in order to determine which biopsy sites are likely to provide the maximum yield so as to reduce the fallacious results due to sampling error. Methods: Fifty patients with upper gastrointestinal symptoms were studied. Eleven gastric biopsies from predetermined sites were obtained and subjected to ultra-rapid urease test, imprint cytology and histology. Haematoxylin and eosin stain was used for defining gastritis and other associated histopathological details. Loeffler’s methylene blue stain was used to confirm the presence of H. pylori in imprint smears and histological sections. Results: All 50 patients had H. pylori infection and evidence of chronic gastritis at one or more of the 11 biopsy sites. Maximum and minimum percentage positivity were observed at A3 (antral lesser curvature) and B4 (corpus greater curvature), respectively. Various sites in decreasing order of percentage positivity were A3 > A2 > A1 > A4 > B3 > B1 > A5 > B6 > B5 > B2 > B4. Among the biopsies obtained from the corpus, B3 (corpus lesser curvature) was the site with maximum positivity. A3 and B4 had a statistically significant difference in percentage positivity (P < 0.0001) for H. pylori and gastritis. The maximum and minimum density scores of H. pylori and gastritis were found in A3 and the B4, respectively. A3 had a significantly higher (P < 0.0001) mean density score than any other site in the stomach. The difference in the grading of H. pylori between A3 and B3 (sites of maximum positivity in antrum and corpus) was statistically significant (P < 0.0001). A statistically significant (P < 0.001) positive correlation between increasing grades of H. pylori and gastritis was observed at the site of maximum density. Eighty per cent of the patients had antral predominant gastritis and in 82%, H. pylori was predominantly observed in antral biopsies. Conclusion: It is concluded that two biopsies taken from A3 are sufficient for confirmation of presence of H. pylori and associated gastritis for initiation of treatment. However, additional biopsies from B3 will help in deciding the topographic pattern of gastritis.

Summary Biliary ascariasis is common in certain geographical areas of the world. In India, it is common in the Kashmir valley and only stray cases have been reported from other parts of the country. Between January 1995 and May 1997, 14 patients with biliary ascariasis were seen at our centre, which is more than 1000 km from the Kashmir valley. The mean (± SD) age of the patients was 31.7 (± 6.1) years and all were females. None of them had been to a place known to be endemic for biliary ascariasis. Four patients presented with acute cholangitis, eight with acute abdominal pain and vomiting, and the remaining two were diagnosed incidentally during surgery for gallstone disease. Barring these two patients, ultrasound examination of the abdomen diagnosed the condition accurately. In 10 patients, a part of the worm was visible outside the papilla of Vater. The roundworm was caught in a Dormia basket and could be extracted in nine patients. In one patient the worm migrated inside the bile duct while it was being caught in a Dormia basket. In this and two other patients, in whom the worm had migrated completely inside the bile duct, worms were removed with the help of a Dormia basket after endoscopic sphincterotomy. There were no complications of endoscopic therapy. In the two patients in whom biliary ascariasis was detected during surgery, the worms were removed after choledocholithotomy. On a mean follow-up of 13.8 months, only one patient had a recurrence of biliary ascariasis. It is concluded that biliary ascariasis is not an uncommon disease and must be considered as a possibility in patients presenting with acute cholangitis and biliary pain even in a non-endemic area. Ultrasonography is an excellent diagnostic tool and endoscopic management is very effective and safe in the treatment of these patients.

During the last 4 years, 147 patients suffering from portal hypertension with acute upper gastrointestinal bleeding were subjected to emergency endoscopy soon after they were resuscitated. Seventeen (11.5%) patients were referred to us with a clinical diagnosis other than portal hypertension. The causes of bleeding as seen during endoscopy were: oesophageal varices ( n = 130; 88%), gastric varices ( n =11), gastric ulcer ( n = 2) portal hypertensive gastropathy ( n = 2) and erosive gastritis and duodenal ulcer in one patient each. All patient bleeding from oesophageal varices except one underwent emergency endoscopic sclerotherapy. One hundred and twenty-one (94%) stopped bleeding immediately. Rebleeding was seen in 11% and was effectively controlled by a second session of sclerotherapy in all but one patient. Twenty (14%) patients died. It is concluded that emergency endoscopy has a definite role in the management of patients with portal hypertension complicated by gastrointestinal bleeding.

Background and Study Aims : Conventionally, acute cholangitis is managed by placing a nasobiliary drainage catheter. We have attempted to place a biliary endoprosthesis in such patients as an alternative to using nasobiliary catheter drainage. Patients and Methods : Twenty-seven patients with acute cholangitis were managed by placement of 7-Fr straight biliary endoprostheses instead of using nasobiliary drainage catheters to decompress the biliary system. The procedure was carried out without sphincterotomy and without image intensification. Results : Biliary endoprosthesis placement was successfully carried out in all the patients. Definitive treatment was then provided to all but four patients, who either had inoperable cancers or were at high risk for surgery. Early stent occlusion occurred in one patient, and in another patient the Dormia basket became entrapped while stones were being removed from the common bile duct. There were no mortalities. Conclusions : Biliary endoprosthesis placement is safe, easy to perform, and is a cheaper alternative to endoscopic nasobiliary drainage.

We calculate the decay widths of the charmonium states, $J/\psi$, $\psi (3686)$ and $\psi(3770)$, to $D\bar D$ pairs, as well as the decay width of $D^* \rightarrow D\pi$, in isospin asymmetric strange hadronic matter, using a field theoretical model for composite hadrons with quark constituents. For this purpose we use the quark antiquark pair creation term of the free Dirac Hamiltonian written in terms of the constituent quark field operators, and use explicit charmonium, $D$, $\bar {D}$, $D^*$ and $\pi$ states to evaluate the matrix elements for the charmonium as well as $D^*$ decay amplitudes. The medium modifications of the partial decay widths of charmonium to $D\bar D$ pair, arising from the mass modifications of the $D(\bar D)$ and the charmonium states calculated in a chiral effective model, are also included. The effects of the isospin asymmetry, the strangeness fraction of the hadronic matter on the masses of the charmonium states and $D(\bar D)$ mesons and hence on the decay widths, have also been studied. The decay width of $D^* \rightarrow D \pi$ in the hadronic matter has also been calculated within the composite quark model in the present work, accounting for the medium modifications of the $D$ and $D^*$ masses. The density modifications of the charmonium states and $D(D^*)$ mesons, which are observed to be appreciable at high densities, will be of relevance in the compressed baryonic matter (CBM) experiments at the future facility of FAIR, GSI, where charmed hadrons will be produced by annihilation of antiprotons on nuclei. The interactions of the charmonium states and $D(D^*)$ with the nuclear medium could lead to the possiblility of the formation of exotic bound states of the nuclei with the (excited) charmonium states as well as with $D(D^*)$ mesons., Comment: 32 pages, 7 figures, version published in IJMPE (Journal Ref. IJMPE 24, 1550053 (2015))

Ascitic fluid total protein, albumin, cholesterol, their ascites/serum ratios, serum-ascites albumin and cholesterol gradients were measured for their ability to differentiate cirrhotic, malignant and tuberculous ascites in 76 patients. The mean +/- s.d. ascitic fluid total protein, albumin, cholesterol, their respective ascitic fluid/serum ratios in cirrhotic ascites were lower than malignant and tuberculous groups (P < 0.001 for each). The difference between malignant and tuberculous groups was significant for ascitic fluid/serum total protein (P < 0.05) and ascitic fluid/serum albumin (P < 0.01) only. Mean serum-ascites albumin gradient in cirrhotics was higher than in the malignant and tuberculous groups (P < 0.001 for each). The difference between malignant and tuberculous groups was significant (P < 0.01). Mean +/- s.d. serum-ascites cholesterol gradient in cirrhotics was higher than that in malignant and tuberculous groups (P < 0.001 for each). The difference between malignant and tuberculous groups was also significant (P < 0.01). Both serum/ascitic fluid total protein less than 0.5 and ascitic fluid cholesterol less than 55 mg/dL had 94% diagnostic accuracy for differentiating cirrhotic from malignant and tuberculous differentiating cirrhotic from malignant and tuberculous ascites. Serum ascitic fluid albumin gradient greater than 1.1 g/dL, ascitic fluid/serum albumin less than 0.65 and ascitic fluid albumin less than 2 g/dL had diagnostic accuracy of 92, 92 and 91%, respectively. Ascitic fluid total protein had diagnostic accuracy of 88%. None of the tests was able to differentiate between malignant and tuberculous ascites. Measurement of ascitic fluid cholesterol concentration is a simple method of differentiating cirrhotic from non-cirrhotic ascites.

The portal vein drains blood from the small and large intestines, stomach, spleen, pancreas, and gallbladder. The superior mesenteric vein and the splenic vein unite behind the neck of the pancreas to form the portal vein. Normal portal pressure is generally defined between 5 and 10 mm Hg. An increase in the blood pressure to 12 mm Hg or greater, within a system of veins is called portal hypertension (PHT). The most common cause of portal hypertension is cirrhosis of the liver. Other causes include portal vein thrombosis and a parasitic infection by Schistosomiasis. Sometimes the cause is unknown. Portal hypertension leads to hemodynamic disturbances throughout the gastrointestinal tract. McCormack et al (1985) coined the term congestive gastropathy to represent the mucosal changes in gastric mucosa of patients with portal hypertension and distinguished it histologically from inflammatory gastritis. (McCormack et al., 1985) The entity was attributed to alteration in gastric microcirculation.( Sarfeh et al., 1987 & Tarnawaski et al., 1988).Initial reports mainly focused on portal hypertensive gastropathy which demonstrated endoscopic and histologic changes seen in the gastric mucosa.(Baxter & Dobbs, 1988; Corbishley et al.,1988; Foster et al.,1989; SP Misra et al., 1990; Papazian et al., 1986 & Triger & Hosking,1989)The entity was renamed as ‘portal hypertensive intestinal vasculopathy’ with the evidence of small intestinal and colonic involvement. (Kozarek et al., 1991; Thiruvengadam & Gostout, 1989 & Viggiano & Gostout, 1992). The term portal hypertensive colopathy was initially described in the 1990, as a poorly defined entity by Naveau et al. (1991) In patients with liver cirrhosis and portal hypertension, vascular changes in upper gastrointestinal tract in the form of varices of the esophagus, stomach and portal hypertensive gastropathy and enteropathy are well described. (V Misra et al., 1997, 1998 & SP Misra et al., 1990). In present chapter various aspects of changes in colonic mucosa of the patients with portal hypertension are described in detail.

We consider here chiral symmetry breaking in quantum chromodynamics arising from gluon condensates in vacuum. Through coherent states of gluons simulating a mean field type of approximation, we show that the off-shell gluon condensates of vacuum generate a mass-like contribution for the quarks, giving rise to chiral symmetry breaking. We next note that spontaneous breaking of global chiral symmetry links the four component quark field operator to the pion wave function. This in turn yields many hadronic properties in the light quark sector in agreement with experiments, leading to the conclusion that low energy hadron properties are primarily driven by the vacuum structure of quantum chromodynamics., Comment: 25 pages, IP/BBSR/92-76, revtex

We study the vacuum structure in QCD in a nonperturbative manner using a variational approach with gluon condensates. We show that in Coulomb gauge as the coupling becomes moderately strong, the perturbative vacuum of QCD becomes unstable leading to gluon condensates and a gauge dependent effective mass for the gluons related to the gauge independent value of 〈vac‖GμνaGaμν‖vac〉 of Shifmanet al.

Hepatitis B virus infection continues to be a major global health problem with an estimated 350 million carriers. The response to available treatment modalities is not impressive. The advent of RNA Interference--a phenomenon of sequence-specific degradation of RNAs mediated by double-stranded RNA--holds promise as a potential therapy for chronic hepatitis B virus infection. Synthetic preparations of short RNA (21-23 bp long) can be used to mediate this process of gene silencing with a lower immune response. The duration of suppression can be further increased by using a vector delivery system. Small interfering RNA (siRNA) has several advantages over conventional therapy, which include fewer side-effects, a lower chance of developing escape mutants and non-requirement of viral replication for its action. A potent knockdown of the gene of interest with high sequence specificity makes RNA interference a powerful tool that has shown antiviral effect against hepatitis B virus. However, the 'off-target effect', i.e. suppression of genes other than the intended target, poor siRNA stability, inefficient cellular uptake, widespread biodistribution and non-specific effects need to be overcome. The problem of long-term toxicity of siRNA should be addressed and an ideal vector delivery system needs to be designed before it can be put to clinical use.