Dietary Supplement

Pancreatic exocrine insufficiency (PEI) is an under-diagnosed condition. Untreated PEI can result in developing gastrointestinal symptoms and long-term complications including weight loss, nutrient deficiencies, sarcopenia and osteoporosis. Current best practice recommends testing for PEI in certain disorders including chronic pancreatitis, cystic fibrosis, pancreatic cancer and post-pancreatic surgery. However, there is increasing evidence that PEI is associated with a number of conditions in addition to the aforementioned diseases. These 'at-risk' conditions are a heterogeneous group of diseases, for example, diabetes mellitus, people living with human immunodeficiency virus, high alcohol intake, and coeliac disease. The pathophysiology of some of 'at-risk' conditions is becoming increasingly recognised; therefore, the list of associated conditions are in evolving process. We present a case of a 60-year-old male with Parkinson's disease and persistent abdominal pain who was found to have low faecal elastase levels indicative of severe PEI. His past medical history included none of the known risk factors for PEI. After examining the literature, we report a similar pathophysiological process underlying the development of pancreatitis and Parkinson's disease which is dysfunction of the Unfolded Protein Response. We suggest further research to assess the prevalence of PEI in the population of patients with Parkinson's disease.

Food fortification has always been an effective and proven practice for eradicating various nutrient deficiencies in Bangladesh. This study investigated different quality parameters of three types (soybean, sunflower, and palm) of extensively consumed fortified edible oils in Bangladesh. Vitamin A analysis has shown that the vitamin A fortification level of most of the oil brands (73 %) did not comply with the Bangladesh Standard and Testing Institution (BSTI) standards (1.5-3.0 mg/100 g). Vitamin A contents of soybean, sunflower, and palm oil brands ranged from 0.13 to 2.06, 0.92-1.34, and 0.99-1.31 mg/100 g, respectively. Inter-brand values of vitamin A were also significantly different (p < 0.05). The majority of the samples were found to be within the acceptable ranges of Codex and BSTI, taking into account the significant chemical quality parameters for soybean, sunflower, and palm oil, such as acid value (0.31-0.93, 0.31-0.56, 0.39-0.81 mg KOH/g), free fatty acid (0.15-0.46, 0.15-0.28, 0.2-0.41 %), saponification (188.64-196.35, 186.53-188, 197.05-199.86 mg KOH/g), and peroxide values (0.06-2.9, 0.65-1.58, 1.35-1.75 meq O₂/kg) respectively. All the brands' physical quality parameters (density, specific gravity, pH, viscosity, smoke point, color, and RI) complied with Codex standards. Various physical and chemical quality parameters were analyzed for significant correlations at 0.01 and 0.05 levels of significance. Remarkably, significant correlations were found between vitamin A and peroxide value (p < 0.01), iodine value and viscosity (p < 0.01), saponification value and viscosity (p < 0.01), pH and viscosity (p < 0.01), and saponification value and pH (p < 0.05). In conclusion, although the vitamin A status of most of the fortified edible oil brands was poor, the key quality indicators (except iodine value) of most of the oils were within the Codex and BSTI standard limits and were acceptable for human consumption.

Background. Obesity is a prevalent condition associated with various comorbidities, impacting mortality, fertility, and quality of life. Its relationship with type 2 diabetes mellitus (DMII) is well established, with nearly 44% prevalence. Bariatric surgery has proven crucial for treating both obesity and DMII. The comparison between surgical techniques, such as sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB), remains controversial in terms of glycemic control efficacy. This retrospective study aimed to assess DMII remission efficacy between SG and OAGB after 36 months. Methods. From January 2016 to September 2020, 201 patients who underwent SG and OAGB for morbid obesity associated with DMII were accurately followed-up with for 36 months, focusing on %HbA1c, DMII remission, anthropometric results, and nutrient deficiency. Results. Although DMII remission did not exhibit statistical significance between the groups (82% vs. 93%, SG vs. OAGB, p = 0.051), OAGB demonstrated a more robust association with glycemic control (Odds Ratio 0.51) throughout the entire follow-up and yielded superior anthropometric outcomes. Notably, nutrient deficiencies, excluding cholecalciferol, iron, and riboflavin, did not show significant intergroup differences. Conclusions. This study contributes valuable insights into the extended-term efficacy of SG and OAGB in DMII remission. The nuanced findings underscore the multifaceted nature of metabolic outcomes, suggesting that factors beyond weight loss influence diabetes resolution. Larger comparative studies are warranted to comprehensively address this issue.