Comparative evaluation of autologous platelet rich plasma and triamcinolone acetonide injection in the management of erosive lichen planus and oral submucous fibrosis: a clinical study

Background: It is need of an hour to establish an effective and efficient treatment modality for OLP and OSMF with lesser or no adverse effects. Platelet rich plasma can be used in mucosal lesions as it has a high concentration of various growth factors and anti-inflammatory properties. It could be a better novel substitute to the corticosteroid without any side effects. The present study is an effort to evaluate the therapeutic effects of intralesional injection of PRP in oral erosive lichen planus and OSMF compared to intralesional corticosteroids in the same patient. Methods: It was a randomized controlled clinical study consisting of 40 patients between the age groups of 18-60 years visiting dental OPD diagnosed clinically with either erosive lichen planus or OSMF. Triamcinolone 40 mg(1mg/ml) mixed with 2% (1:80,000) lignocaine hydrochloride was injected into the lesion on one side in case of erosive lichen planus and into the submucosal plane and fibrous bands in case of OSMF patients. Autologous PRP was prepared and injected on the other side in same patients. At every visit, all the patients were evaluated for pain and burning sensations, size, and severity of the lesion, and interincisal mouth opening (mm). The parameters were measured and recorded during the patient’s every visit. All the results were obtained and statically analyzed. Results: Intralesional injections of triamcinolone acetonide and PRP are effective in reducing pain and burning sensation in OSMF, but PRP is less effective in improving cheek flexibility as compared to triamcinolone acetonide. In OLP, both triamcinolone acetonide and PRP are almost equally effective in reducing the size of the lesion. However, PRP shows slightly better results in reducing the severity of the lesion and in pain and burning sensation in the patients of OLP as compared to intralesional triamcinolone acetonide. Conclusions: Thus, PRP is an effective modality in treating both OSMF and oral erosive lichen planus with no adverse effects.

The role of serum beta-human chorionic gonadotropin as a predictor for pregnancy induced hypertension in 12-20 weeks of pregnancy

Background: Pregnancy-induced hypertension occurs in approximately 3 to 5% of pregnancies and is still a major cause of both fetal and maternal morbidity and mortality worldwide. Pre-eclampsia is risk factor for stillbirth, intrauterine growth restriction (IUGR), low birth weight (LBW), preterm delivery, respiratory distress syndrome, and admission to neonatal intensive care unit. Overall, the incidence of preeclampsia ranges from 5 to 15% in India. This study conducted to assess the predictive value of raised beta-human chorionic gonadotropin (?-hCG) levels in development of pregnancy-induced hypertension in antenatal women and follow up the risk patients and reduce both maternal and perinatal morbidity and mortality.Methods: The present study was conducted in the department of obstetrics and gynaecology, L.L.R.M Medical College and associated SVBP Hospital, Meerut during the period of January 2021 to December 2021 on 400 antenatal women with 12 to 20 weeks of gestation. Estimation of serum beta hCG level was done by enzyme linked fluorescence immunoassay. The cases were followed up in antenatal clinics, 4 weekly till 28 weeks, fortnightly up to 34 weeks and thereafter weekly till delivery for the development of PIH.Results: From the study it was found that women with elevated beta hCG values in 12-20 weeks were at increased risk of developing PIH. The sensitivity of ?-hCG for development of PIH was found to be 90%. It was found that specificity, positive predictive value (PPV), negative predictive value (NPV) of ?-hCG for development of PIH was 82%, 41.7%, 98.3% respectively. However, p value of ?-hCG for development of PIH is 0.001 which is highly significant.Conclusions: From this study we found that that measuring second trimester serum beta-hCG levels is a good predictor of pregnancy induced hypertension and showed association with elevated levels of beta hCG with development and severity of PIH, but sensitivity and positive predictive value of beta hCG are low in this study to be useful for mass screening marker on its own.

Nimb (Azadirachta Indica): Validation of Classical Pharmacological Properties Through Reverse Pharmacology

Plants have been the main source of therapeutic agents in world’s most ancient system of medicine, the Ayurveda. Nimb (also known as Margosa tree) is one of the most commonly used plants in Ayurveda for the management of a large number of ailments. It is a member of the Meliaceae family, found commonly in India, Africa and America. Nimb has been used exclusively by mankind to treat various diseases since even before the availability of manuscripts that recorded the beginning of history. Nimb is well described in Charak Samhita, Sushrut Samhita, Ashtang Hridayam, Chikitsa grantha and Nighantus. It is having Laghu guna, Tikta kashaya rasa, Sheeta virya and Katu vipaka, due to which it has been considered as Kapha-pitta shamaka. Acharya Bhav Mishra considers it Tridosh Shamak. It is traditionally used in the treatment of various ailment i.e., Krimi, Kushtha, Jwara, Kandu, Shopha and many more. All the parts of the plant have been used in the preparation of therapeutic formulations. Nimb contains various bioactive compounds like Nimbinin and Nimbidin, due to which it shows antibiotic, antiulcer, anti-inflammatory, antihelmenthic, antifungal, diuretic, antihistaminic, nematicidal and spermicidal properties and other biological activities. Present paper is an effort to validate pharmacological properties of Nimb described in Ayurveda through reverse pharmacology.

Inter-laboratory testing as a strategy for external quality assessment for qualitative detection of SARS-CoV-2 by real-time RT-PCR testing in India

To implement the strategy of test, track and treat to tackle the ongoing COVID-19 pandemic, the number of real-time RT-PCR–based testing laboratories was increased for diagnosis of SARS-CoV-2 in the country. To ensure reliability of the laboratory results, the Indian Council of Medical Research initiated external quality assessment (EQA) by deploying inter-laboratory quality control (ILQC) activity for these laboratories by nominating 34 quality control (QC) laboratories. This report presents the results of this activity for a period of September 2020 till November 2020. A total of 597 laboratories participated in this activity and 86 per cent of these scored ?90 per cent concordance with QC laboratories. This ILQC activity showcased India’s preparedness in quality diagnosis of SARS-CoV-2.

Quality Characteristics of Chicken Meat Cutlets Incorporated with Finger Millet (Eleusine coracana) Flour

In view of continuously growing demand of snacks foods worldwide due to rapid changing lifestyle, industrialization and urbanization, the present study was conducted to standardize the incorporation level of finger millet flour for preparation of chicken meat cutlets. Chicken meat cutlets were prepared with different levels of finger millet flour viz. 5, 10, and 15%, and different levels by replacing the lean meat in chicken cutlets formulation. The optimum (mention) level of finger millet was standardized as 5% for incorporation in chicken meat cutlets. Crude fiber and calcium content of chicken cutlets prepared with finger millet flour was significantly higher as compared to control thereby depicting marked improvement in the desirable food trait with health benefits. The product yield of chicken meat cutlets with optimized level of finger millet flour was significantly higher as compared to control. It did not show significant effect on any of the sensory parameters. Storage stability of aerobically packaged chicken meat cutlets with optimum level (mention level) of finger millet flour along with control was further evaluated during refrigerated storage (4±1oC) at regular intervals of 0, 3, 6 and 9 days with respect to physico-chemical, microbiological and sensory characteristics. Chicken meat cutlets could be stored safely in aerobic packaging for 6 days at refrigeration condition (4±1oC).

Spectrum of findings on magnetic resonance imaging of the brain in patients with neurological manifestations of dengue fever / O espectro de achados de ressonância magnética do encéfalo em pacientes com manifestações neurológicas de dengue

Abstract Objective: To describe the spectrum of magnetic resonance imaging (MRI) findings in patients with neurological manifestations of dengue. Materials and Methods: We included nine patients with dengue fever (three females and six males; age range, 9-30 years), all of whom presented with neurological manifestations. The MRI examinations, performed in 1.5 T or 3 T scanners, included T1-weighted, T2-weighted, and fluid-attenuated inversion recovery (FLAIR) sequences. Diffusion-weighted imaging with apparent diffusion coefficient mapping was also employed. Fast low-angle shot and susceptibility-weighted gradient-recalled echo sequences, as well as contrast-enhanced T1-weighted scans, were also obtained in order to assess parenchymal enhancement. MRI scans were analyzed for lesion distribution and imaging features. Results: All patients showed areas of altered signal intensity that appeared as hyperintensity on T2-weighted and FLAIR sequences. The most commonly affected site was the basal ganglia-thalamus complex. Other affected sites were the cerebellum, cerebral cortex, white matter, and brainstem. In all cases, we observed patchy areas of restricted diffusion and focal areas of hemorrhage. Conclusion: Dengue encephalitis commonly affects the basal ganglia, thalamus, cerebellum, cerebral cortex, and white matter. Therefore, MRI should be an indispensable part of the evaluation of patients with neurological complications of dengue fever.

Resumo Objetivo: Descrever o espectro dos achados de ressonância magnética (RM) em pacientes com manifestações neurológicas de dengue. Materiais e Métodos: Foram incluídos nove pacientes com dengue (três do sexo feminino e seis do sexo masculino; faixa etária: 9-30 anos), todos com manifestações neurológicas. Os exames de RM, realizados em aparelhos de 1,5 T ou 3 T, incluíram sequências ponderadas em T1 e em T2, assim como fluid-attenuated inversion recovery (FLAIR). Também foi empregada a imagem ponderada em difusão com mapeamento de coeficientes de difusão aparente. Além disso, foram obtidas sequências gradiente-eco ponderadas por suscetibilidade e em fast low-angle shot, bem como imagens ponderadas em T1 pós-contraste, para avaliar o realce parenquimatoso. As imagens de RM foram analisadas quanto à distribuição de lesões e características de imagens. Resultados: Todos os pacientes apresentaram áreas de intensidade de sinal alteradas que apareceram como hiperintensidade em sequências ponderadas em T2 e sequências FLAIR. O local mais comumente afetado foi o complexo gânglios basais-tálamo. Outros locais afetados foram o cerebelo, o córtex cerebral, a substância branca e o tronco encefálico. Em todos os casos observamos áreas irregulares de difusão restrita e áreas focais de hemorragia. Conclusão: A encefalite por dengue geralmente afeta os gânglios basais, o tálamo, o cerebelo, o córtex cerebral e a substância branca. Portanto, a RM deve ser uma parte indispensável da avaliação de pacientes com complicações neurológicas da dengue.

Influenza A(H1N1)pdm09 cases in sub‑Himalayan region, 2014–2015 India.

Current influenza A(H1N1)pdm09 strain severely involved many parts of the country. The study was conducted to analyze the clinicoepidemiological trend of influenza A(H1N1)pdm09 cases from October 2014 to March 2015. Samples processing was done as per the Center for Disease Control guidelines. A total of 333 specimens were processed out of which influenza A(H1N1)pdm09 constituted 24% (81) of total, 5% (18) cases were seasonal influenza A virus strains. Mean age group involved was 49 years with case fatality rate of 20%. Patients died were 63% males and 44% had comorbidities, and among them, 38% patients died within 24 h of hospitalization. The mean age of comorbid patients who died was 59 years; whereas the mean age of patients died having no co‑morbidities was 41 years (P < 0.005). Mortality was seen among 81% (13) of patients who were on ventilator support. Added mortality in specific human group demands continuous surveillance monitoring followed by the detection of mutation, even in susceptible animal population.

Splenic Lymphoma with an Incidental Hemolytic Anemia: A Rare Association.

Splenic lymphoma with villous lymphocytes (SLVL) is a rare malignancy that comprises less than 1% of lymphoid neoplasms, characterized by the presence of small atypical lymphocytes in the peripheral blood and bone marrow and splenic infiltration in the white and red pulp. It must be distinguished from other chronic lymphoproliferative disorders that present with a similar clinical and hematological profile. Here, we report a case of SLVL in a 60-year-old male with leukocytosis, massive splenomegaly, and relatively few small sized leukemic cells presenting with a Coomb’s positive hemolytic anemia. It was initially diagnosed as chronic lymphocytic leukemia. The immunophenotyping studies and marrow examination indicated a diagnosis of SLVL. This case highlights the diagnostic pitfalls associated with this rare disorder.

Intraoral Myolipoma in a 6-Year-Old Child: A Rare Case Report.

Lipoma is the most common benign soft tissue mesenchymal neoplasm, which occasionally occurs in the oral cavity. It has many variants such as infiltrating lipoma, fibrolipoma, angiolipoma, spindle cell/pleomorphic lipoma, myxolipoma, chondroid lipoma, osteolipoma, and myolipoma. Myolipoma is a rare benign lipomatous soft tissue tumor which is diagnosed histologically because of presence of irregularly admixed mature adipose tissue and smooth muscle fibers. The most common site of its occurrence is retroperitoneum, abdominal and pelvic cavity, and the abdominal wall. Rarely myolipomas occur in the oral and maxillofacial region. Here, we present a rare case of intraoral myolipoma present in the buccal mucosa of a 6-year-old child.

Dental complications of herpes zoster: Two case reports and review of literature.

Herpes zoster (HZ) (shingles) results due to reactivation of varicella‑zoster virus. Unusual dental complications like osteonecrosis, exfoliation of teeth, periodontitis, and calcified and devitalized pulps, periapical lesions, and resorption of roots as well as developmental anomalies such as irregular short roots and missing teeth may arise secondary to involvement of 2nd or 3rd division of trigeminal nerve by HZ. Such cases pose both a diagnostic as well as a therapeutic challenge. We report two such rare dental complications of HZ‑spontaneous tooth exfoliation and osteonecrosis of the maxilla in a 70‑year‑old female patient; and multiple periapical pathoses affecting right half of the mandibular teeth in a 45‑year‑old female patient. Both the patients did not have any associated systemic illness. The aim of this paper was to compare the present cases with all the 46 cases of osteonecrosis and 6 cases of multiple periapical pathoses secondary to trigeminal zoster reported in literature till date The article also throws light that the occurrence of such dental complications of HZ is not entirely dependent on the immune status of the host.

Orodental findings in Hallermann-Streiff syndrome.

Hallermann-Streiff syndrome-also called occulomandibulofacial syndrome, Francois syndrome, oculomandibulodyscephaly with hypotrichosis, Aubry syndrome I, and Ullrich-Fremery-Dohna syndrome-is a rare genetic disorder, which comprisesmultiple congenital abnormalities affecting chiefly the head and face. It is characterized by bird-like facies, dental abnormalities, hypotrichosis, atrophy of skin, congenital cataracts, bilateral microphthalmia, and proportionate nanism. An interesting case of Hallermann-Streiff syndrome in a 23-year-old female patient is reported here, with the emphasis on the orodental findings.