Serum Mucin1 and Cholesterol Ester Transfer Protein (CETP) Levels in Bangladeshi Cholelithiasis Patients and the Impact of Laparoscopic Cholecystectomy | Chapter 3 | Medical Science: Recent Advances and Applications Vol. 7

Background: Cholelithiasis, i.e., gallstone disease (GSD), is one of the most common gastrointestinal disorders. apolipoprotein A1 (ApoA1), In other studies, ApoE, Mucin1 and cholesterol ester transfer protein (CETP) were implicated with cholelithiasis. However, these results were variable and needed confirmation by further research.

 

Objective: This study evaluates the associations of Mucin1 and cholesterol ester transfer protein (CETP) between normal control subjects (NCs) and Cholelithiasis, i.e. gallstone disease (GSD) patients (Pts) preoperatively (I0) and postoperatively (II0) with laparoscopic cholecystectomy.

 

Methods: Adult Pts (N=55, Gender: 10 males, 45 females; Age range: 25-65 years, Mean age±SD: 45.5 ± 12.2 years) were those reported in our previous case-control prospective interventional studies carried out from October 2016 to March 2018 at MRU, MHWT, Uttara, Dhaka, Bangladesh. The patients with GSD were diagnosed as having cholelithiasis according to standard clinical and laboratory criteria as practised in the hospital. The lipid profile (TG, TC, LDL-C, HDL-C), Lp (a), ApoA1, ApoB100, ApoE, Mucin1 and CETP status in serum of NCs and Pts (I0, II0) and Pts-Bile (I0) were made by standard clinical laboratory methods using research/diagnostics kits from reputed companies and reported in the recent past. Recently, further advanced statistical analyses on these data were made according to the objectives of the present article, i.e. to obtain information regarding associations (correlations) between serum Mucin1 and CETP status among NCs and Pts (I0, II0) by using the SPSS programme version 26.

 

Results: Regarding associations (correlations) between Mucin1 and CETP status among NCs (I0) and Pts (I0) and Pts (II0), significant Pearson correlations were found for Pts-Mucin1 (I0) vs Pts-CETP (I0) (r=0.316, p=0.019), Pts-Mucin1 (Bile-I0) vs Pts-CETP (Bile-I0) (r=0.441, p=0.005), Pts-Mucin1 (II0) vs Pts-CETP (I0) (r=0.398, p=0.007), Pts-Mucin1 (I0) vs Pts-CETP (II0) (r=0.335, p=0.017) and NCs-Mucin1 (I0) vs Pts-CETP (Bile-10) (r=0.375, p=0.048). No significant correlations were observed between any of the other groups compared (P>0.05).

 

Conclusions: The observations on associations between Mucin1 and CETP among NCs and Pts (I0, II0) suggested their probable involvement in the aetiopathogenesis of the disease. Since GSD is one of the most prevalent diseases in gastroenterology, an appropriate diagnostic approach and management in clinical practice, such as medical treatment and surgical intervention depending on the patient’s condition, should be adopted. Considering the complexity of the molecular mechanisms in the formation of gallstones, further studies on GSD are certainly warranted, particularly involving a larger number of Bangladeshi patients in the future.

 

Author(s) Details

A. S. M. Giasuddin
Impulse Hospital, ImHS&RC Ltd, 304/E, Tejgaon Industrial Area, Dhaka-1208, Bangladesh.

 

K. A. Jhuma
Dhaka Medical College, Dhaka-1000, Bangladesh.

 

M. A. M. Choudhury
Department of Surgery, MCW&H, MHWT, Plot-4, Road-8/9, Sector-1, Uttara Model Town, Dhaka-1230, Bangladesh.

 

A. M. M. Haq
Department of Internal Medicine, MCW&H and Chairman of MRU, MCN&H, MHWT, Uttara, Dhaka-1230, Bangladesh.

 

Please see the book here:- https://doi.org/10.9734/bpi/msraa/v7/5598

 

A Review on Prevalence and Risk Factors of Gallstone Disease in Uganda | Chapter 7 | Advancement and New Understanding in Medical Science Vol. 4

Introduction: Globally, the burden and complications from gallstone disease are a major public health issue. It contributes significantly to health care costs and is a common cause of surgical intervention. Most sickle cell disease (SCD) patients have radiolucent stones, probably of pigment type, containing little or no calcium. While most patients with gallstones are asymptomatic, only 20% after 10 years become symptomatic. The prevalence of gallstone disease varies among different populations. The purpose of this review is to understand the profile of gallstone disease patients in Uganda which may facilitate better treatment options and may reduce the complications of gallstone disease.

Discussion: In Uganda, the prevalence of gallstone disease is high in patients presenting to hospital. The risk factors for gallstone disease include a previous history of biliary symptoms and the use of hormonal contraceptives. SCD in Sub-Saharan Africa is also a major health problem and a risk factor for gallstone disease. Acute abdominal pain in SCD patients was thought to be due to sickle cell crises until the advent of ultrasonography. Differentiating between acute cholecystitis and sickle cell crises may be difficult. An increased production of unconjugated bilirubin from a sickle cell crisis may precipitate acute cholecystitis. While in SCD patients with acute cholecystitis, a haemolytic crisis may occur.

Conclusions: While the prevalence of gallstone disease in Uganda from hospital-based studies is high the majority of patients are symptomatic at presentation. In the general population, the prevalence of gallstones may be determined using abdominal ultrasound as a screening tool. Any SCD patient who has an abdominal crisis should have an abdominal ultrasound to prevent missing any episodes of acute cholecystitis.

Author(s) Details:

Richard Wismayer,
Department of Surgery, Faculty of Health Sciences, Habib Medical School, IUIU University, Kampala, Uganda and Department of Surgery, Masaka Regional Referral Hospital, Masaka, Uganda.

Please see the link here: https://stm.bookpi.org/ANUMS-V4/article/view/13177