Background/Objectives: Endometriosis represents substantial direct and indirect healthcare costs impacted by an absence of uniformly accurate, non-invasive diagnostic tools. We endeavored to demonstrate gastrointestinal myoelectrical activity (GIMA) biomarkers, unique to endometriosis, will allow non-invasive, uniformly accurate diagnosis or exclusion of endometriosis. Methods: Prospective open-label comparative study of 154 patients, age ≥ 18, with or without diagnosed endometriosis. Population included 62 non-endometriosis controls (Cohort 1), 43 subjects with surgically/histologically confirmed endometriosis (Cohort 2), and 49 subjects with abdominal pain and negative imaging (Cohort 3). Non-invasive electroviscerography (EVG) recorded GIMA biomarkers from three abdominal electrodes before and 30 min post water load protocol. Cohort 2 had postoperative EVG and Cohort 3 had preoperative EVG. Calculated specificity, sensitivity, negative predictive value (NPV), positive predictive value (PPV), and predictive probability or C-statistic used univariate, multivariate, linear, and logistical regression analyses of the area under the curve (AUC) at all frequency and time points, including age and pain covariants. Results: The non-endometriosis cohort differed significantly from the endometriosis cohorts (p < 0.001) for median (IQR) and AUC percent frequency distribution of power at baseline, 10 min, 20 min, and 30 min post water load at all frequency ranges: 15–20 cpm, 30–40 cpm, and 40–50 cpm. The endometriosis cohorts were statistically similar (p > 0.05). GIMA biomarker threshold scoring demonstrated 95%/91% sensitivity and PPV, 96%/95% specificity and NPV, and a C-statistic of >99%/98%, respectively, for age subsets. GIMA biomarkers in Cohort 3 predicted 47/49 subjects positive and 2/49 negative for endometriosis, confirmed surgically. Hormonal therapy, surgical stage, nor pain score affected diagnostic accuracy. Conclusions: EVG with GIMA biomarker detection distinguished participants with and without endometriosis based upon endometriosis-specific GIMA biomarkers threshold scoring.

Background: Increased demand of the serological biomarker test (GastroPanel^®) in non-invasive diagnosis of gastric cancer (GC) risk conditions, i.e., atrophic gastritis (AG) and Helicobacter pylori (Hp) infection, prompted the design of GastroPanel^® Quick test (GPQT) (Biohit Oyj, Helsinki, Finland) for point-of-care (POC) settings. Objective: This study validated the diagnostic accuracy (DA) of GPQT in diagnosis of AG and Hp among gastroscopy referral patients. Methods: Altogether, 266 patients were enrolled among the consecutive gastroscopy referrals at the Department of Gastroenterology, Fortis Hospital (Punjab, India). All patients underwent gastroscopy with biopsies (n = 249) classified using the Updated Sydney System (USS) and finger prick blood sampling for GPQT testing. Results: Biopsy-confirmed AG was found in 15.3% (38/249) of the patients. The overall agreement between the GPQT and the USS classification was 71.4% (95% CI 65.4–77.0%), with the weighted kappa (κ_w) of 0.823 (95% CI 0.773–0.862). In ROC analysis for moderate/severe AG of the corpus (AGC) endpoint, AUC = 0.990 (95% CI 0.979–1.000) and AUC = 0.971 (95% CI 0.948–0.995) for PGI and PGI/PGII, respectively. Hp IgG Ab test detected biopsy-confirmed Hp with AUC = 0.836 (95% CI 0.783–0.889). Conclusions: The GPQT favourably competes in accuracy with the ELISA test version (unified-GP) in diagnosis of AG and Hp in patients referred for diagnostic gastroscopy.

Background: Upper gastrointestinal (GI) motility disorders, such as gastroparesis and functional dyspepsia (FD), contribute significantly to morbidity, especially in populations at risk for type 2 diabetes. However, the prevalence and clinical manifestations of these disorders in India, and associated gastric dysrhythmias, are not well studied within this population. Methods: This retrospective, cross-sectional study analyzed 3689 patients who underwent electrogastrography with water load satiety test (EGGWLST) testing across multiple motility clinics in India. The prevalence of gastroparesis and FD-like symptoms, symptom severity, and their association with diabetes and other comorbidities were evaluated. Symptom severity was assessed using the Gastroparesis Cardinal Symptom Index (GCSI). EGGWLST findings were documented, including the gastric myoelectric activity threshold (GMAT) scores. Results: The study population had a mean age of 43.18 years. GCSI scores indicated that patients had symptoms that were mild (55%), moderate (33%), and severe (8%). Compared with the non-diabetic population, diabetic subjects had significantly higher rates of early satiety (56% vs. 45%, p < 0.0001), bloating (73% vs. 67%, p = 0.005), and reflux (28% vs. 24%, p = 0.029). WLST data analysis revealed that significantly more diabetic subjects ingested 0.59. Conclusions: Upper GI motility disorders are prevalent in India, particularly among diabetic patients. EGG is a valuable tool for characterizing these disorders, and may help in personalizing therapeutic approaches. Further research is required to optimize treatment strategies.

Gastropanel, serological ELISA test comprising of stomach biomarkers; serum pepsinogen I, pepsinogen II, gastrin-17, and Helicobacter pylori antibody depicts clearly the morphological and functional status of stomach mucosa in patients suffering from dyspepsia. Although the traditional system of medicine is a huge resource of efficient formulations useful in gastrointestinal disorders such as functional dyspepsia, lack of robust scientific evidence, and qualitative/subjective parameters like symptom scores do not suffice the need for the same. This study was thus planned to assess usefulness of gastropanel tests to validate efficacy of Avipattikar choorna, well-known antacid remedy in functional dyspepsia. A. choorna was given to patients of dyspeptic disorders following which gastropanel was performed pre- and post-treatment. The gastropanel findings obtained, prior and post-interventions were compared using Wilcoxon MPSR test and a level of P < 0.05 was considered for statistical significance. It was observed that although symptom scores showed improvement in all patients after treatment, change in pre- and post-values of gastropanel was seen only in few patients. Gastropanel could differentiate between true responders and non-responders, identification of which was difficult merely with symptom scores. Another highlight was that A. choorna proved more effective in H. pylori IgG positive cases. Gastropanel may be used as an effective tool to understand and validate the efficacy of traditional medicines in functional dyspepsia and gastric disorders along with its effect on stomach physiology and acid regulation. Need for employment of quantitative/objective parameters for traditional system drugs validation is also highlighted.

Background/Objectives: Endometriosis represents substantial direct and indirect healthcare costs impacted by absent accurate, non-invasive uniformly diagnostic tools. We endeavored to demonstrate gastrointestinal myoelectrical activity (GIMA) biomarkers unique to endometriosis allow noninvasive, uniformly accurate diagnosis or exclusion of endometriosis. Methods: Prospective open-label comparative study of 154 patients, age >18, with or without diagnosed endometriosis. Population included 62 non-endometriosis controls (Cohort 1), 43 subjects with surgically histologically-confirmed endometriosis (Cohort 2), and 49 subjects with abdominal pain and negative imaging (Cohort 3). Electroviscerography (EVG) recorded GIMA biomarkers from three abdominal electrodes before and 30-minutes post water-load protocol. Cohort 2 had postoperative EVG and Cohort 3 had preoperative EVG. Calculated specificity, sensitivity, NPV, PPV and predictive probability or C-Statistic used univariate, multivariate, linear and logistical regression analyses of the area under the curve (AUC) at all frequency and time points, including age and pain covariants. Results: Non-endometriosis cohort differed significantly from endometriosis cohorts (p0.05). GIMA biomarker threshold scoring demonstrated 95%/91% sensitivity and PPV, 96%/95% specificity and NPV and C-statistic of >99%/98% respectively for age subsets. GIMA biomarkers in Cohort 3 predicted 47/49 subjects positive and 2/49 negative for endometriosis, confirmed surgically. Hormonal therapy, surgical stage, nor pain score affected diagnostic accuracy. Conclusions: Non-invasive electroviscerography with GIMA biomarker detection distinguished participants with and without endometriosis based upon endometriosis specific GIMA biomarkers threshold scoring.

BACKGROUND: The Ayurvedic concept of Ama refers to the accumulation of incompletely digested or metabolized substances in the body due to impaired Agni (digestive fire). Ama is described as a pathological entity that disrupts systemic homeostasis, leading to chronic metabolic and immune disorders. Modern medical science recognizes similar pathological processes, such as endotoxin accumulation, gut dysbiosis, metabolic endotoxemia, and inflammatory responses driven by advanced glycation end-products (AGEs), damage-associated molecular patterns, and oxidative stress. Despite advances in research and clinical interventions, metabolic and immune disorders like diabetes, metabolic dysfunction-associated fatty liver disease, inflammatory bowel disease, and autoimmune conditions continue to rise globally. Expanding the scope of Ama and its subtypes in relation to these disorders may provide novel insights for disease prevention, diagnostics, and therapeutic approaches. EXISTING KNOWLEDGE AND GAP: Ayurvedic texts elaborate on Ama as a primary etiological factor in disease progression, classifying it based on its origins, affinity, and systemic translocation. However, there is a lack of standardized clinical assessment tools to evaluate Ama in the context of modern disease models. Current biomedical research highlights the crucial role of gut health, intestinal permeability, microbial dysbiosis, and metabolic endotoxemia in the development of chronic diseases. Despite these parallels, there is minimal integrative research correlating Ama with measurable biochemical or molecular markers. Moreover, the role of Ama in immune activation and inflammatory disorders remains largely unexplored within a scientific framework. PROPOSED CONCEPT: This paper proposes an expanded classification of Ama , integrating Ayurvedic epistemology with modern biomedical understanding. Ama can be characterized as a gut-derived response antigen complex or gut-associated molecular complex, which includes toxic metabolites, undigested peptides, microbial toxins, and inflammatory mediators resulting from impaired digestion and absorption. The subtypes of Ama can be categorized based on the site of expression, cause of origin, specificity or affinity, Kaal , and its movement or translocation. Modern tools such as metabolomics, proteomics, transcriptomics, and computational systems biology models can be employed to validate Ama and its subtypes. Biomarkers such as HbA1c (paralleling Ama in diabetes), lipid oxidation markers, gut microbiome alterations, and inflammatory cytokines may serve as objective correlates of Ama . WAY FORWARD: Future research should focus on developing standardized clinical scales for Ama assessment, incorporating radiological, biochemical, molecular, and genetic markers. Systems biology approaches, such as network pharmacology and artificial intelligence-based predictive models, should be utilized to map the progression of Ama in metabolic and immune disorders. Ayurvedic interventions, such as Deepana, Pachana , and Shodhana therapies, should be studied for their impact on gut barrier function, microbiome modulation, and immune homeostasis. Bridging Ayurvedic concepts with modern scientific methodologies will enable the development of personalized diagnostic and therapeutic strategies for chronic diseases.