Manoj Kumar Sahu

Environmental factors associated with Crohn's disease in India.

BackgroundThe frequency of diagnosis of Crohn’s disease (CD) in India is increasing. This case-control study was designed to detect associations of environmental and dietary factors with the diagnosis of CD.MethodsIn 200 consecutive patients with CD and 200 control subjects without gastrointestinal disease, environmental hygiene exposures in childhood and in the past one year, and dietary preferences were recorded using a questionnaire. Univariate and multivariate analyses were done.ResultsIn univariate analysis, CD showed positive association with urban residence (at birth and current), availability of protected drinking water (childhood and current), availability of piped water in the house (childhood and current), and strict vegetarian dietary habit, and negative association with regular fish consumption and presence of cattle in the house compound. Multivariate analysis showed that regular fish consumption (OR 0.52, 95% CI 0.33–0.80, p = 0.003), and presence of cattle in the house compound currently (OR 0.57, 95% CI 0.35–0.92, p = 0.023) were significant protective associations, whereas use of safe drinking water was positively associated (OR 1.59, 95% CI 1.02–2.47, p = 0.042) with the disease.ConclusionOccurrence of CD was associated with dietary and environmental exposures, which indicate that diet and hygiene may influence the development of this disease.

High prevalence of significant endoscopic findings in patients with uninvestigated typical reflux symptoms.

High Prevalence of Significant Endoscopic Findings in Patients With Uninvestigated Typical Reflux Symptoms

Autoimmune pancreatitis with pancytopenia: A rare occurrence

Autoimmune pancreatitis (AIP) is considered a distinct type of pancreatitis with an autoimmune pathogenesis. Patients with AIP often develop extrapancreatic lesions such as biliary lesions, sialadenitis, retroperitoneal fibrosis, swelling of lymph nodes, chronic thyroiditis, and interstitial nephritis, suggesting that AIP may be a systemic disease. Moreover, several cases of immune thrombocytopenia and few with neutropenia complicated with AIP have been described. The pathogenesis of thrombocytopenia associated with AIP is still unclear; however, autoimmune processes are suggested. On the other hand, cases of pancytopenia complicated by AIP have not yet been reported. We herein report a very rare case of pancytopenia associated with AIP.

Pancreatic ascariasis with periampullary carcinoma

Ascarias lumbricoides infestation is endemic in tropical countries. Most infections are asymptomatic, but it can produce a wide spectrum of manifestations including hepatobiliary and pancreatic complications. There are reports of association of biliary ascariasis with bilary malignancies in the past, but same is not known for pancreatic ascariasis. We report a case of association of periampullary malignancy with pancreatic ascariasis.