Irritable bowel syndrome(IBS) is a chronic gastrointestinal disorder, common in clinic and in the community. It has a significant impact on both society and patients’ quality of life. The ...epidemiology, clinical presentation, and management of IBS may vary in different geographical regions due to differences in diet, gastrointestinal infection, socio-cultural and psychosocial factors, religious and illness beliefs, symptom perception and reporting. Although previous reviews and consensus reports on IBS in Asia have been published, Asia is quite diverse socio-demographically. In this context, India, Bangladesh and Malaysia share some similarities, including:(1) large proportion of the population living in rural areas;(2) rapid development and associated lifestyle changes in urban areas; and(3) dietary, cultural and religious practices. The present review explores the clinical and epidemiological data on IBS from these three major nations in South and South-East Asia. In-depth review of the literature revealed important differences between IBS in the East, as revealed by studies from these three countries, and the West; these include a predominantly rural profile, differences in bowel habit and symptom profile, raising concern with regards to diagnostic criteria and subtyping of IBS, higher dietary fiber consumption, frequent lactose malabsorption, parasitosis, and possible overlap between post-infectious IBS and tropical sprue. Moreover, the current perception on difference in prevalence of the disorder in these countries, as compared to the West, might be related to variation in survey methods.
Background and Aim
Because acute infectious gastroenteritis may cause post‐infection irritable bowel syndrome and functional dyspepsia and the severe acute respiratory syndrome coronavirus‐2 affects ...gastrointestinal (GI) tract, coronavirus disease‐19 (COVID‐19) may cause post‐infection‐functional GI disorders (FGIDs). We prospectively studied the frequency and spectrum of post‐infection‐FGIDs among COVID‐19 and historical healthy controls and the risk factors for its development.
Methods
Two hundred eighty patients with COVID‐19 and 264 historical healthy controls were followed up at 1 and 3 months using translated validated Rome Questionnaires for the development of chronic bowel dysfunction (CBD), dyspeptic symptoms, and their overlap and at 6‐month for IBS, uninvestigated dyspepsia (UD) and their overlap. Psychological comorbidity was studied using Rome III Psychosocial Alarm Questionnaire.
Results
At 1 and 3 months, 16 (5.7%), 16 (5.7%), 11 (3.9%), and 24 (8.6%), 6 (2.1%), 9 (3.2%) of COVID‐19 patients developed CBD, dyspeptic symptoms, and their overlap, respectively; among healthy controls, none developed dyspeptic symptoms and one developed CBD at 3 months (P < 0.05). At 6 months, 15 (5.3%), 6 (2.1%), and 5 (1.8%) of the 280 COVID‐19 patients developed IBS, UD, and IBS‐UD overlap, respectively, and one healthy control developed IBS at 6 months (P < 0.05 for all except IBS‐UD overlap). The risk factors for post‐COVID‐19 FGIDs at 6 months included symptoms (particularly GI), anosmia, ageusia, and presence of CBD, dyspeptic symptoms, or their overlap at 1 and 3 months and the psychological comorbidity.
Conclusions
This is the first study showing COVID‐19 led to post‐COVID‐19 FGIDs. Post‐COVID‐19 FGIDs may pose a significant economic, social, and healthcare burden to the world.
•A deep segmentation network based spine localization algorithm which outperforms the previous state-of-the-art by a large margin.•A novel spatial probability prediction deep convolutional network ...which achieves human-level performance in localizing vertebrae centers.•A novel shape-aware deep segmentation network for vertebrae segmentation.•A first of its kind fully automatic framework which combines the global localization, center localization and vertebrae segmentation in a single thread and provides a segmentation result for a real-life emergency room X-ray images without any manual input.
The cervical spine is a highly flexible anatomy and therefore vulnerable to injuries. Unfortunately, a large number of injuries in lateral cervical X-ray images remain undiagnosed due to human errors. Computer-aided injury detection has the potential to reduce the risk of misdiagnosis. Towards building an automatic injury detection system, in this paper, we propose a deep learning-based fully automatic framework for segmentation of cervical vertebrae in X-ray images. The framework first localizes the spinal region in the image using a deep fully convolutional neural network. Then vertebra centers are localized using a novel deep probabilistic spatial regression network. Finally, a novel shape-aware deep segmentation network is used to segment the vertebrae in the image. The framework can take an X-ray image and produce a vertebrae segmentation result without any manual intervention. Each block of the fully automatic framework has been trained on a set of 124 X-ray images and tested on another 172 images, all collected from real-life hospital emergency rooms. A Dice similarity coefficient of 0.84 and a shape error of 1.69 mm have been achieved.
Duodenal and plasma biomarkers of environmental enteric dysfunction that were identified through analyses of duodenal biopsy samples and the plasma of growth-stunted children were found to induce ...enteropathy of the small intestine in gnotobiotic mice.
Postinfection irritable bowel syndrome (PI-IBS) and functional dyspepsia (PI-FD), though reported from the temperate countries, have not been studied in the tropics; PI-malabsorption syndrome (MAS), ...which mimics PI-IBS, is reported from the tropics. No report till date on PI-IBS excluded PI-MAS. We studied: (i) the frequency of continuing bowel dysfunction after acute gastroenteritis (AG), (ii) its predictors, and (iii) PI-MAS among patients with PI-IBS.
345 consecutive subjects each, with AG and age- and gender-matched healthy controls were followed up 3-monthly for 12 months using a translated-validated questionnaire and functional gastrointestinal disorders (FGIDs) were diagnosed by Rome III criteria. Symptom duration >3 months but <6 months was diagnosed as chronic bowel dysfunction (CBD) and dyspeptic symptoms, respectively. MAS was diagnosed if 2/3 tests (D-xylose H
breath test, Sudan III-stained stool microscopy, and duodenal histology) were abnormal. Fecal microbiological studies were performed in 245/345 (71%) patients.
AG patients more often developed PI-IBS and PI-FD than controls (16.5 vs. 2.6% and 7.4 vs. 0.6%, respectively; p<0.001). Presence of FD was a risk factor for PI-IBS and IBS for PI-FD. On multivariate analysis, dyspeptic symptoms, CBD, and weight loss were the risk factors for PI-FGIDs. The frequency of PI-IBS following Vibrio cholera and other bacterial infection was comparable. Malabsorption was present among 2/23 (9%) patients with PI-IBS.
FGIDs are common after AG; dyspeptic symptoms, CBD, and weight loss were risk factors for PI-FGIDs. Vibrio cholerae infection caused PI-FGID, which was never reported. About 9 % patients fulfilling the criteria for PI-IBS had PI-MAS.
Although functional gastrointestinal disorders (FGIDs), now called disorders of gut-brain interaction, have major economic effects on health care systems and adversely affect quality of life, little ...is known about their global prevalence and distribution. We investigated the prevalence of and factors associated with 22 FGIDs, in 33 countries on 6 continents.
Data were collected via the Internet in 24 countries, personal interviews in 7 countries, and both in 2 countries, using the Rome IV diagnostic questionnaire, Rome III irritable bowel syndrome questions, and 80 items to identify variables associated with FGIDs. Data collection methods differed for Internet and household groups, so data analyses were conducted and reported separately.
Among the 73,076 adult respondents (49.5% women), diagnostic criteria were met for at least 1 FGID by 40.3% persons who completed the Internet surveys (95% confidence interval CI, 39.9–40.7) and 20.7% of persons who completed the household surveys (95% CI, 20.2–21.3). FGIDs were more prevalent among women than men, based on responses to the Internet survey (odds ratio, 1.7; 95% CI, 1.6–1.7) and household survey (odds ratio, 1.3; 95% CI, 1.3–1.4). FGIDs were associated with lower quality of life and more frequent doctor visits. Proportions of subjects with irritable bowel syndrome were lower when the Rome IV criteria were used, compared with the Rome III criteria, in the Internet survey (4.1% vs 10.1%) and household survey (1.5% vs 3.5%).
In a large-scale multinational study, we found that more than 40% of persons worldwide have FGIDs, which affect quality of life and health care use. Although the absolute prevalence was higher among Internet respondents, similar trends and relative distributions were found in people who completed Internet vs personal interviews.
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In this study, two bast fibers such as okra and jute were selected to manufacture composites taking polypropylene (PP) as matrix material by means of compression molding technique with maintaining ...40% fiber content on the total weight of the composites. Investigation was done on tensile properties such as tensile strength (TS), tensile modulus (TM), elongation at break (EB%), bending properties such as bending strength (BS), bending modulus (BM) and impact properties like impact strength (IS) and hardness (Shore-A) of the composites. From analyzed data, it was found that Okra/PP composites showed very competitive mechanical properties to Jute/PP composites. Non-irradiated okra composite showed the value of TS, TM, BS, BM, IS and hardness to be 32.2 MPa, 602 MPa, 55.6 MPa, 3.6 GPa, 19.54 kJ/m
2
and 95 (Shore-A), respectively, whereas that value for non-irradiated jute composite was 35.5 MPa, 629 MPa, 71.5 MPa, 4.5 GPa, 21.48 kJ/m
2
and 96 (Shore-A), respectively. The composite samples were exposed to different intensities of gamma radiation (250‒1000 krad) at a dose rate of 330 krad/h and changes in mechanical properties were examined. Both irradiated composites (500 krad) showed significant improvement of mechanical properties compared to that of the non-irradiated composites. Maximum TS, TM, BS, BM and IS value were found to be 41.9 MPa, 685 MPa, 72 MPa, 4.7 GPa and 22.6 kJ/m
2
, respectively for irradiated okra composite and 45.3 MPa, 717 MPa, 88 MPa, 6.7 GPa and 24.3 kJ/m
2
, respectively for irradiated jute composite. Fourier transform infrared spectroscopy was used to identify the surface groups of the composites. Water absorption, degradation behavior of the composites under soil and heat medium were also performed. Degradation tests revealed that okra composite retained its original mechanical properties higher than that of jute composite. The morphology of the composites was inspected by scanning electron microscope.
IntroductionEnvironmental enteric dysfunction (EED) is a subacute inflammatory condition of the small intestinal mucosa with unclear aetiology that may account for more than 40% of all cases of ...stunting. Currently, there are no universally accepted protocols for the diagnosis, treatment and ultimately prevention of EED. The Bangladesh Environmental Enteric Dysfunction (BEED) study is designed to validate non-invasive biomarkers of EED with small intestinal biopsy, better understand disease pathogenesis and identify potential therapeutic targets for interventions designed to control EED and stunting.Methods and analysisThe BEED study is a community-based intervention where participants are recruited from three cohorts: stunted children aged 12–18 months (length for age Z-score (LAZ) <−2), at risk of stunting children aged 12–18 months (LAZ <−1 to −2) and malnourished adults aged 18–45 years (body mass index <18.5 kg/m2). After screening, participants eligible for study provide faecal, urine and plasma specimens to quantify the levels of candidate EED biomarkers before and after receiving a nutritional intervention. Participants who fail to respond to nutritional therapy are considered as the candidates for upper gastrointestinal endoscopy with biopsy. Histopathological scoring for EED will be performed on biopsies obtained from several locations within the proximal small intestine. Candidate EED biomarkers will be correlated with nutritional status, the results of histochemical and immunohistochemical analyses of epithelial and lamina propria cell populations, plus assessments of microbial community structure.Ethics and disseminationEthics approval was obtained in all participating institutes. Results of this study will be submitted for publication in peer-reviewed journals.Trial registration numberClinicalTrials.gov ID: NCT02812615. Registered on 21 June 2016.
There is paucity of knowledge on the histological features of the intestinal mucosa in malnourished adults of Bangladesh. The purpose of the study was to explore the histological features of the ...intestinal mucosa in malnourished adults of Bangladesh and to compare the findings with their well-nourished counterparts. 64 adults (37 malnourished with body mass index, BMI < 18.5 kg/m
and 27 controls with BMI > 18.5 kg/m
) from the Bangladesh Environmental Enteric Dysfunction (BEED) study, who underwent upper-gastrointestinal endoscopy, were selected for this study. With a view to address the association of environmental enteric dysfunction (EED) with malnutrition, upper-gastrointestinal endoscopy was performed and mucosal biopsies from the distal duodenum were studied for histopathology. Villous height, crypt depth, and presence of inflammatory infiltrates in lamina propria were investigated. Bivariate analysis was performed to quantify the relation between malnutrition and the histological features. About 95% adults, irrespective of nutritional status, were diagnosed to have chronic non-specific duodenitis on histopathology. Malnourished adults suffered significantly more from chronic active duodenitis compared to their well-nourished counterparts (p = 0.003). Malnourished adults also had significantly higher frequency of subtotal villous atrophy, crypt hyperplasia and marked cellular infiltration in the lamina propria than the healthy controls (p < 0.05).
In the contemporary era of global and sustainable information management, blockchain has made a cutting-edge transformation in online learning. To apprehend this new trajectory, this current ...systematic review with bibliographic visualization aims to identify the thematic clusters of underlying aspects concerning the sustainable nexus of blockchain and online learning. Using the updated guidelines of the PRISMA flowchart, a total of 434 scholarly research papers from the mainstream research databases, i.e., Web of Science, Scopus, IEEE Xplore, and ScienceDirect, were inspected to be categorized into 15 relevant publications. Bibliographic data were assembled and analyzed accordingly to construct network visualization maps, such as co-authorship, citation, co-citation, bibliographic coupling, and term co-occurrence using VOSviewer 1.6.18. Significant terms were reported and later cross-mapped with those identified by critically reviewing the applicable 15 papers. Standardized scholarship, behavior pattern, and digital badging have been found and derived as themes from the connected clusters. Therefore, current research findings reveal these three broad clutches of themes concerning the sustainable nexus of blockchain and online learning.
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