The Importance of Clinical Reasoning in Pancreatic Insufficiency: A Case Report

Evidence-based medicine has demonstrated an extensive list of etiologies for exocrine pancreatic insufficiency (EPI). EPI is defined as inadequate pancreatic enzyme efficacy in digestion due to insufficient enzyme production, activation, or early enzyme degradation. Among the etiologies, acute pancreatitis secondary to chronic and excessive consumption of alcohol has been found to be one of the most common causes. In 2022, a 43-year-old male patient with a past medical history of polysubstance abuse, acute on chronic pancreatitis, alcohol dependence, pulmonary embolism, hypertension, hyperlipidemia and diabetes mellitus type 2 presented to the Emergency Department with three days of epigastric abdominal pain, nausea and non-bloody, non-bilious vomiting. Proper imaging confirmed the diagnosis of acute pancreatitis. The key to treatment and surveillance relies on proper identification of risk factors, pertinent imaging for diagnostic evaluation and appropriate treatment with electrolyte repletion. The patient developed persistent electrolyte deficiencies despite appropriate repletion, indicating high suspicion of pancreatic insufficiency. The treatment most importantly relies on a combination of repletion of electrolytes as well as pancreatic enzymes with a clear patient understanding of their chronic condition, the importance of reducing modifiable risk factors and compliance with medical therapy.

Potential of Amaranthus seeds in supplementary feed and its impact on growth in some carps

Amaranthus seeds were used at three different levels (20%, 35%, 50%) in fish diets under a semi-intensive fish culture system and their impact on the growth of common carp, Cyprinus carpio, and rohu, Labeo rohita, was studied. Growth in terms of body weight gain was maximum in fish fed on diets containing 20% Amaranthus seeds, that replaced rice bran and groundnut oil cake in the feed. Overall, the fish fed on diets containing Amaranthus seeds at different levels showed better growth than the control, because of the good-quality proteins available in Amaranthus seeds. In the two species used, L. rohita showed better growth performance than C. carpio.