Non-alcoholic fatty liver disease (NAFLD) is closely associated with metabolic syndrome. Prevalence of metabolic risk factors including diabetes mellitus, obesity, etc. is rapidly increasing in India putting this population at risk for NAFLD. Patients with NAFLD are at increased risk for liver-related morbidity and mortality and also cardiovascular disease risk and increased incidence of diabetes mellitus on long-term follow-up. Management of patients with NAFLD may require a multi-disciplinary approach involving not only the hepatologists but also the internists, cardiologists, and endocrinologists. This position paper which is a combined effort of the Indian National Association for Study of the Liver (INASL), Endocrine Society of India (ESI), Indian College of Cardiology (ICC) and the Indian Society of Gastroenterology (ISG) defines the spectrum of NAFLD and the association of NAFLD with insulin resistance and metabolic syndrome besides suggesting preferred approaches for the diagnosis and management of patients with NAFLD in the Indian context.

The Indian Motility and Functional Diseases Association and the Indian Society of Gastroenterology developed this evidence-based practice guideline for management of chronic constipation. A modified Delphi process was used to develop this consensus containing 29 statements, which were generated by electronic voting iteration as well as face to face meeting and review of the supporting literature primarily from India. These statements include 9 on epidemiology, clinical presentation, and diagnostic criteria; 8 on pathophysiology; and the remaining 12 on investigations and treatment. When the proportion of those who voted either to accept completely or with minor reservation was 80% or higher, the statement was regarded as accepted. The members of the consensus team believe that this would be useful for teaching, clinical practice, and research on chronic constipation in India and in other countries with similar spectrum of the disorders.

Summary: We have encountered five cases of chronic iron deficiency anaemia due to bleeding from gastric antral vascular ectasia (watermelon stomach). Two cases were associated with a lymphoma and in three cases there was evidence of portal hypertension. Two patients were treated conservatively by blood transfusions. The other patients required either surgery or tranexamic acid or endoscopic laser therapy to control the chronic haemorrhage.

Fifty-two patients with rheumatoid arthritis taking nonsteroidal anti-inflammatory drugs were studied in order to assess the carriage rate of Campylobacter pylori (C. pylori) with reference to dyspeptic symptoms, endoscopic appearance and antral histology. All patients were interviewed using a standard gastrointestinal symptom scoring questionnaire and underwent endoscopy at which two antral biopsies were obtained. Sections were examined for the presence and severity of gastritis and of C. pylori. Forty-four of 52 patients (85%) had histological evidence of gastritis. Twenty-six of 44 (59%) patients with gastritis were positive for C. pylori. Twenty-six of 28 patients with 'active' (polymorph infiltration) chronic gastritis were positive for C. pylori (p less than 0.002). Sixteen of 26 bacteria-positive patients had gastrointestinal symptoms compared with eight of 26 bacteria-negative patients (p less than 0.05) and this may have therapeutic implications. There was no correlation between the presence of organisms and the appearances at endoscopy.

No abstract

The changing business environment in the service sector requires service providers to adapt to the ongoing changes that incorporate more adaptability with a higher quality of service. Teamwork is an important aspect of working in the service sector as nowadays teamwork is seen as a fitting response to the changes in the business environment. Effective teamwork can help the service organizations to provide better quality service to its customers. The current study is an attempt to highlight the influence of performance appraisal (PA), employee satisfaction (ES) and employee retention (ER) on team effectiveness (TE) in the service sector. The analysis of the data was carried out using statistical tools, like the confirmatory factor analysis, and the structural equation modelling for elucidating the validity of the design. The results of the study show that PA and TE have a significant relation. ER acts as a partial mediator between PA and TE, and, on the other hand, ES acts as a moderator between PA and ER. The article provides key practical implications for the service sector in the state of Uttarakhand.

The Indian Neurogastroenterology and Motility Association (INMA), earlier named the Indian Motility and Functional Diseases Association developed this evidence-based practice guidelines for the management of irritable bowel syndrome (IBS). A modified Delphi process was used to develop this consensus containing 28 statements, which were concerning diagnostic criteria, epidemiology, etiopathogenesis and comorbidities, investigations, lifestyle modifications and treatments. Owing to the Coronavirus disease-19 (COVID-19) pandemic, lockdowns and mobility restrictions, web-based meetings and electronic voting were the major tools used to develop this consensus. A statement was regarded as accepted when the sum of “completely accepted” and “accepted with minor reservation” voted responses were 80% or higher. Finally, the consensus was achieved on all 28 statements. The consensus team members are of the view that this work may find use in teaching, patient care, and research on IBS in India and other nations.

No abstract