Gastroenterology Centre

Name	Designation	Department	Email-ID
Prof. Kartar Singh, HOD	Professor	Gastroenterology	singh.kartar@pgimer.edu.in
Prof. D.K.Bhasin	Professor	Gastroenterology	bhasin.deepakk@pgimer.edu.in
Prof. S.V. Rana	Professor	Gastroenterology	rana.sv@pgimer.edu.in
Prof. B.R.Thapa	Professor	Gastroenterology (Paed.)	thapa.br@pgimer.edu.in
Prof. Rakesh Kochhar	Professor	Gastroenterology	kochhar.rakesh@pgimer.edu.in
Prof. Chetana Vaishnavi	Professor	Gastroenterology	vaishnavi.chetana@pgimer.edu.in
Dr. Usha V.Dutta	Additional Professor	Gastroenterology	dutta.ushavenkatac@pgimer.edu.in
Dr. S.K. Sinha	Additional Professor	Gastroenterology	sinha.sk@pgimer.edu.in
Dr. K.K. Prasad	Additional Professor	Gastroenterology	prasad.kaushalkishore@pgimer.edu.in
Dr. Arun Kumar Sharma	Associate Professor	Gastroenterology (Virology)	sharma.arunk@pgimer.edu.in
Dr. Sadhna Bhasin Lal	Assistant Professor	Gastroenterology	bhasin.sadhna@pgimer.edu.in
Dr. Surinder Rana	Assistant Professor	Gastroenterology	rana.surindersingh@pgimer.edu.in
Dr. Ravinder Goyal	Assistant Professor	Gastroenterology (Paed.)

1. Effect of predominant methanogenic flora on lactose hydrogen breath test in healthy and IBS patients.

This study indicates that fasting methane production was present in more number of healthy North Indians as compared to IBS patients. Lactose hydrogen breath test was positive in less number of healthy controls as well as IBS patients who were predominant methane producers as compared to low methane producers. History of symptoms of flatulence and diarrhoea was in less number of IBS patients

with predominant methanogenic flora as compared to low methanogenic flora. Symptoms of flatulence and diarrhoea that developed during the test were in less number of IBS patients and healthy controls with predominant methanogenic flora as compared to low methanogenic flora.

2. Effect of garlic and carotenoids on INH & RIF induced hepatotoxicity in rats

In conclusion, our data shows that garlic, carotenoids and NAC supplementation exerts protective effects in INH+RMP induced hepatoxicity in rats though partially. Histological evaluation also revealed a normal morphology of rat liver in hepatoprotective groups though partially. Moreover, a significant increase in antioxidant levels (both in liver and blood) in hepatoprotective groups is evident alongwith changes in lipid levels. Our results suggest the antioxidant and antilipemic action of these supplements, though partially. Partial protection by these antioxidants hypothesizes the existence of other mechanisms through which INH+RMP produces hepatic injury, which needs to be further studied.

Cooper binding protein was isolated and characterized for structure and function.

The biopsies from the duodenal bulb and second part of the duodenum in celiac disease can be equally representative of the underlying disease and a diagnosis of celiac disease can reliably be made even if biopsies are not taken from the distal duodenum or jejunum.

5. Histologic lesion variability of the duodenal mucosa in pediatric celiac disease.

The children with celiac disease showed high frequency of histological lesions with patchy distribution. Therefore, multiple endoscopic biopsies should always be obtained, not only from the distal duodenum, but also from the bulb.

6. Prevalence and speciation of faecal candida in antibiotic associated diarrhoea. One hundred and fifty consecutive diarrhoiec samples from hospitalized patients receiving antibiotics, negative for Clostridium difficile toxin and for other enteropathogens were cultured for prevalence and speciation of candida. Candida was isolated as pure growth from 26.6% patients. The predominant isolates were C. tropicalis and C. albicans. The other species isolated were C. krusei,C. glabrata and C. guilliermondii. Different candida species may thus play an important role in precipitating antibiotic associated diarrhoea.

Myeloperoxidase (MPO) activity was studied, in 728 diarrhoeic stool samples and 68 control samples. Of the patients’ samples studied, 32.0% were positive for MPO ranging from 0.07 units/ml to 3 units/ml. MPO estimation is a simple and rapid quantitative test that can be used as a measure of inflammation for inflammatory diarrhoeas.

8. Evaluation of serum C-reactive protein, faecal myeloperoxidase and lactoferrin in ulcerative colitis.

Serum C-reactive protein, faecal myeloperoxidase and lactoferrin were investigated in 50 patients with ulcerative colitis and an equal number of agematched healthy participants. All the three inflammatory parameters were found to be significantly raised in the patient population.

9. Prevalence and predictors of Gallbladder dysfunction in patients with gallstones.

50 patients were studied at 6 weeks postpartum for presence of gallstones, sludgeand gallbladder dysmotility. We found that gallstones were found in 20%, sludge in 10%, poor ejection fraction in 24% and sluggish response to fatty meal in 56% of patients. Low protein intake is associated with significant gallbladder dysmotility and gallstones. Protein deficient diet, iron deficient state in the presence of high fat intake is associated with increased risk for gallstones in the postpartum period.

34 patients with suspected esophageal motility disorder were studied. 67% of patients with dysmotility had neurotic traits and high stress scores in their lifes. The esophageal dysmotility improved on simple relaxation exercises and counseling. The study established that stress related esophageal dysmotility is very common and can be treated by simple measures rather than drugs.

11. Etiopathogenesis of vitamin B12 deficiency and predictors of B12 deficiency.

Prevalence of vitamin B12 deficiency among patients with peripheral neuropathy was 40%. The etiology of vitamin B12 deficiency was multifactorial. The etiological

factors identified were vegetarian diet (100%), pernicious anemia in 20%, H. pylori positivity in 17% and bacterial overgrowth in 20%. Among patients with low vit B12 (< 200 pg/ml ), 64% had parietal cell destruction in contrast to 18% in normal vit B12 group (p = 0.04). The predictors of low vitamin B12 levels are knuckle pigmentation (p = 0.003), cheilosis (p = 0.015), MCV > 100 (p = 0.004), macrocytosis (p = 0.001) and hypersegmented PMN ( p = 0.001).

12. Prevalence and predictors of Gallbladder stasis among patients with gallstones.

120 patients with symptomatic gallstones planned for cholecystectomy were studied. On HIDA, GB was non-visualized in 39 pts, GBEF was normal (>35% EF) in 64 pts and low (1-35% EF) in 17 pts. The mean EF was 39 ± 33 % . GB stasis is present in 47% of pts with GS. The independent predictors of GB stasis are presence of multiple GS, poor SES and postprandial discomfort and origin from non-Punjab Haryana Chandigarh states.

13. Non-visualized gallbladder on scintigraphy is associated with increased prevalence of precancerous lesions in the gallbladder mucosa of patients with cholelithiasis.

40 pts with gallstones were evaluated. On HIDA, 40% had normal GB contractility, 25% had decreased EF and in 35%, GB could not be visualized. Histological examination showed metaplasia in 72.5%, but none had dysplasia/ Ca-in-situ. Metaplasia was of incomplete intestinal type (IIM) in 35%, complete intestinal type (CIM) type in 15% and GM type in 22.5% pts. On logistic regression analysis, biliary colic (OR 20.4; p=0.030), non-visualized GB (OR 5.7; p=0.041) and age >50 years (OR 5; p=0.08) were found to be independent predictors for presence of IIM. Majority (72.5%) of patients with symptomatic GS in N India have mucosal metaplasia which is of IIM type in 33%. Non-visualized GB on HIDA, biliary colic and older age are independent predictors for presence of IIM.

There were 56 beds in Nehru Hospital for the gaestrology centre with the following distribution:

The Superspeciality of Gastroenterology provides following services to patients through special GE and Gut Clinics and Pediatric GE Clinic. It regularly runs General Medical OPD services twice a week. The department renders investigative facilities through its endoscopy, radiology, virology, biochemistry, enzymology, histopathology, microbiology, and manometry sections.

The department provides training to DM (Gastroenterology), MD (Internal Medicine), MD (Pediatrics), and Ph.D. students. DM residents are rotated through various sections in Clinical Gastroenterology, Pediatric Gastroenterology, GE Pathology, GE Radiology, GE Virology and GE Biochemistry/Enzymology, besides General Surgery, Microbiology, Parasitology, Pathology and Hepatology departments of PGI.

DM residents from different parts of the country come to our department as short term trainees and observers for training in department of Gastroenterology and GE Radiology during the year.