Prevalence and correlates of dental caries among 2-5 years children with special reference to breastfeeding in Kamrup District, Assam.

Background: Dental caries among children is one of the most common health-related issues worldwide. Aim: To find out the prevalence of dental caries among 2-5 years old children in Kamrup district of Assam with reference to breastfeeding and associated variables. Materials and Methods: In this community-based cross-sectional study, 1439 children were examined from 15 wards of Kamrup Metro and four randomly chosen blocks of Kamrup Rural. Children were examined to assess the mean decayed/filled primary teeth (dmft) index, and a self-administered validated questionnaire was given to the mothers to collect data on the practice of breastfeeding initiation, its duration, and dental hygiene habits. Results: Dental caries prevalence was found to be higher in urban areas (54.6%) than rural areas (45.4%). The frequency of using toothpaste was highest among the tooth-cleaning materials. A significant difference in caries prevalence was observed among the children, those who brushed twice a day, and those who did not brush (P = 0.039). The difference was significant in the mean dmft of children from the upper socioeconomic class (P = 0.023) compared with the other classes. A significant difference was also observed between breastfeeding duration (P = 0.010), exclusive and nonexclusive breastfeeding, time of initiation of breastfeeding within 12 h (P < 0.001), and alternative feeding with caries prevalence (P < 0.001). Conclusions: Dental caries were higher in urban localities and upper socioeconomic classes. Breastfeeding initiation and duration may play an important role in the causation of dental caries. No significant association was found between colostrum, prelacteal feeding, and caries prevalence.

The cytological diagnosis of Pneumocystis jiroveci pneumonia in bronchoalveolar lavage.

Objectives: Immunosuppressed individuals are more prone for opportunistic infections. Pneumocystis jiroveci pneumonia (PJP), previously known as Pneumocystis carinii pneumonia (PCP), is the most common opportunistic infection affecting people living with HIV. As PJP can cause life threatening serious infection to a patient, treatment should not be delayed for these cases. To study clinico-cytomorphological spectrum of PJP. Material and Methods: We analysed the clinical and detailed cytological features of 15 patients with PJP who were diagnosed on examination of bronchoalveolar lavage (BAL) fluid. Results: The mean age of the patients was 38.4 years (range 13 - 61 years). A total of seven patients were HIV positive; five patients were post renal transplant, and one patient was a known case of acute leukaemia on immunosuppression. Presence of foamy alveolar casts (FACs) was the distinctive feature and was noted in 14 out of 15 cases. We detected 14 out of 15 cases accurately in BAL fluid cytology. Conclusion: BAL cytology is one of the important modes of investigations which can detect PJP infection. The history of fever, cough, immunosuppression, bilateral haziness in the radiography of lung and the characteristic alveolar cast indicate the possibility of PJP infection. Cytology can provide early diagnosis and can reduce the mortality of immunocompromised patients.

Oxidative stress-A key determinant of complications and negative outcome in hepatitis E virus infected pregnancies: A comprehensive account involving cases from northeast India.

Regulated oxidative stress (OS) is important during pregnancy. Sporadic studies suggest the significance of deregulated OS in hepatitis E virus (HEV) infected pregnancy, but with limited reactive oxygen species (ROS) or antioxidant markers. The present novel study, therefore, aimed to evaluate the significance of ROS-antioxidant imbalance and resulting altered OS in HEV infected pregnancy complications like preterm delivery (PTD) and outcome. Difference in serum levels of ROS and antioxidant panel of markers were evaluated by ELISA for HEV immunoglobulin M RNA positive genotype 1 cases (including acute [acute viral hepatitis, AVH] and fulminant [fulminant hepatic failure, FHF] cases) and healthy term delivery subjects, and analyzed statistically. Direct ROS marker H2 O2 levels and indirect OS marker for DNA damage 8-hydroxy-2'-deoxyguanosine was significantly increased in HEV-cases compared to controls, and was associated and prognostic factor for PTD and fetal death in HEV cases. A comparatively lower total serum antioxidant capacity was observed in the FHF cases compared to the control subjects and the AVH cases. Glutathione (GSH) levels and superoxide dismutase (SOD) activity were significantly associated with PTD in the FHF sub-cohorts (p = 0.017) and AVH sub-cohorts (p < 0.001), respectively, and was associated with poor prognosis in HEV cases. The serum H2 O2 levels were found to be negatively correlated with SOD activity (p = 0.016) and GSH levels (p = 0.001) in the HEV-AVH cases; and positively correlated with the viral load in HEV cases (p = 0.023). The ROS-antioxidant imbalance resulting OS plays a detrimental associative role in HEV infected pregnancy complications like PTD and adverse pregnancy outcomes; and holds therapeutic significance.

Increased homocysteine mediated oxidative stress as key determinant of hepatitis E virus (HEV) infected pregnancy complication and outcome: A study from Northeast India.

With the background of association of oxidative stress and Hepatitis E virus (HEV) infection in pregnancy complications the present novel study aimed to evaluate the significance of changes in maternal homocysteine levels and the related mechanism(s) in the pathophysiology of HEV related pregnancy complications and negative outcomes. Term delivery (TD, N = 194) and HEV-IgM positive pregnancy cases [N = 109] were enrolled. Serum and placental homocysteine levels were evaluated by ELISA and immunofluorescence and in turn correlated with serum Vitamin B12 levels. Distribution of variant MTHFR C➔T and TYMS1494del6bp genotyping were studied by PCR-RFLP. Differential folate receptor alpha (FR-α) expression in placenta was evaluated by real-time PCR and immunofluorescence respectively. The HEV viral load was significantly higher in both FHF and AVH cases. Higher serum homocysteine levels was associated with preterm delivery (PTD) and fetal death in HEV infected cases and was significantly inversely correlated with serum VitaminB12 levels in HEV cases. Placental homocysteine expression was upregulated in HEV cases, and in cases with negative pregnancy outcome. A Homocysteine level was associated with MTHFR C677T status. Genetic alterations in folate pathway was associated with increased risk of PTD in HEV infected pregnancy cases, disease severity, and negative pregnancy outcome in AVH and FHF groups. FR-α expression was downregulated in placental tissues of HEV infected pregnancy.Placental stress caused by HEV inflicted increased homocysteine due to alterations in maternal vitamin B12 levels and folate pathway components is detrimental mechanism in PTD and negative pregnancy outcome in HEV infected pregnancy cases and holds prognostic and therapeutic significance.

Prognostic, clinical, and therapeutic importance of RANTES-CCR5 axis in hepatitis A infection: A multiapproach study.

Fulminant hepatic failure (FHF) is a lethal manifestation of hepatitis A virus (HAV) infection, whose underlying mechanisms are poorly understood. We aimed to evaluate the importance of the modulation of the RANTES-chemokine receptor type 5 (CCR5) signaling axis and its immunomodulatory effects in directing hepatitis A disease pathogenesis using an in silico, in vitro and patient cohort-based approach. In silico interaction studies were performed using computation approaches with suitable software. Differential expression of relevant cytokines and immune cell markers were studied using real-time quantitative reverse transcription PCR (qRT-PCR), enzyme-linked immunosorbent assay, and flow-cytometry-based methods. In the HepG2 cell line, we studied inflammatory responses and susceptibility to HAV infection following RANTES stimulation and antibody blockade of CCR5. The HAV-VP3 region exhibited high interaction in CCR5: HAV complexes. RANTES levels were significantly increased in FHF cases. Reduced monocyte and T-cell activation were observed in FHF cases. RANTES expression inversely correlated with viremia but positively correlated with proinflammatory responses. Hyper Th1-biased immune responses, marked by high interleukin (IL)-12/IL-10 ratio were observed in FHF cases, which were also characterized by upregulated tumor necrosis factor-alpha (TNF-α) expression and reduced interferon-gamma expression. In vitro, RANTES was protective against HAV infection but resulted in upregulated TNF-α expression. Although viral load increased upon the regulation of inflammatory responses by CCR5 blocking, it was still significantly lower compared to control HAV-infected cells. Our study suggests the importance of RANTES-CCR5 signaling and linked-immunomodulation in HAV disease pathogenesis, as well as highlights the utility of CCR5 antagonists as a risk-reduction strategy in FHF patients. Our findings, therefore, have important implications for the management of high-risk HAV infections.

Alterations in XRCC1 gene profile in pathogenesis of oral cavity cancer: A population-based study from Kamrup Urban District of Assam, India.

XRCC1 gene is an integral component of the base excision repair pathway regulating DNA repair, the genetic alterations in which has been documented to be associated with cancers of multiple etiologies. The present study aimed to evaluate the key polymorphisms in XRCC1 gene for its association with pathogenesis of oral cavity cancer (OCC) in Kamrup Urban District of Assam, India. Tissue biopsies (N = 152) clinicopathologically characterized OCCs were collected along with whole blood samples (N = 190) from healthy controls with all clinical and habitual details. A PCR-RFLP approach was used to study the XRCC1 polymorphisms, and statistical associations with pathogenesis were studied with SPSSv13.0 statistical software. The XRCC1 codon 194 polymorphism was significantly associated with the risk of OCC (odds ratio [OR] = 1.878, P = 0.048) and severity (OR = 2.221, P = 0.031). The presence of XRCC1 280 variant genotype increased the risk of OCC in exclusive smokers (OR = 3.818, P = 0.006), exclusive alcoholics (OR = 3.144, P = 0.027), and in exclusive areca nut chewers (OR = 3.055, P = 0.034). Human papilloma virus cases with any other habitual risk factor carrying XRCC1 280 genotype showed 3-fold significantly increased risk compared to controls (OR = 3.341, P = 0.022). The presence of XRCC1 codon 399 polymorphism was also found to be associated with significantly increased risk of oral cavity carcinoma (OR = 1.566, P = 0.049). Distribution of altered XRCC1 gene haplotype was higher in OCC cases. Polymorphisms in XRCC1 gene is associated with OCC pathogenesis in Kamrup Urban District, Assam, India, and is of prognostic significance. It is also suggestive of the importance of base excision repair pathway alterations in OCC pathogenesis.

Significance of RANTES-CCR5 axis and linked downstream immunomodulation in Dengue pathogenesis: A study from Guwahati, India.

We aimed to evaluate the significance of the RANTES-CCR5 axis and resulting immunomodulatory status in Dengue pathogenesis involving a Guwahati, India based population where Dengue cases have increased alarmingly. An increased CC-chemokine receptor type 5 (CCR5) messenger RNA expression and CCR5 positive cell count profile was observed in Dengue cases, the highest being in severe cases. CCR5 ligand RANTES expression was significantly decreased in Dengue cases and inversely correlated with Dengue viremia fold change in severe cases. Monocytes are involved in Dengue virus homing and replication. Its levels and activation profile were higher in Dengue cases. A hyper Th1-biased immunomodulatory profile with upregulated tumor necrosis factor-α levels, and downregulated expression of antiviral cytokine interferon-γ and key regulatory Th2 anti-inflammatory cytokine interleukin 10 was observed in severe Dengue cases compared with mild Dengue cases and controls. The results, therefore, suggest the significance of RANTES-CCR5 axis deregulation and resulting altered immunomodulation in Dengue pathogenesis, and holds prognostic and therapeutic significance.

Oxidative stress and deregulations in base excision repair pathway as contributors to gallbladder anomalies and carcinoma - a study involving North-East Indian population.

Gallbladder cancer (GBC) is a fatal condition with dismal prognosis and aggressive local invasiveness; and with uncharacterised molecular pathology relating to non-specific therapeutic modalities. Given the importance of oxidative stress in chronic diseases and carcinogenesis, and the lacunae in literature regarding its role in gallbladder diseases, this study aimed to study the involvement of oxidative stress and deregulation in the base excision repair (BER) pathway in the pathogenesis of gallbladder diseases including GBC. This study involved patients from the North-East Indian population, where the numbers of reported cases are increasing rapidly and alarmingly. Oxidative stress, based on 8-OH-dG levels, was found to be significantly higher in gallbladder anomalies (cholelithiasis [CL] and cholecystitis [CS]) and GBC at the plasma and DNA level, and was associated with GBC severity. The expressions of key BER pathway genes were downregulated in gallbladder anomalies and GBC compared to controls, and in GBC compared to both non-neoplastic controls and gallbladder anomalies. Expression of XRCC1 and hOGG1 was significantly associated with both susceptibility and severity of GBC. The XRCC1 codon280 polymorphism was associated with disease susceptibility; and significantly higher oxidative stress was observed in hOGG1 genotypic variants. The genomes of GBC patients were found to be more hypermethylated compared to controls, with the promoters of XRCC1 and hOGG1 being hypermethylated and, therefore, being silenced. This study underlined the prognostic significance of the oxidative stress marker 8-OH-dG and BER pathway genes, especially hOGG1 and XRCC1, in gallbladder anomalies and GBC, as well as stated their potential for therapeutic targeting.

Genetic and expression changes in TNF-α as a risk factor for rheumatoid arthritis pathogenesis in northeast India.

Antitumour necrosis factor-alpha (TNF-α) therapy is used as a clinical intervention for rheumatoid arthritis (RA) but differences exist in response to the treatment which makes the candidature of the screening of TNF-α alteration(s) at genetic and expression levels an important agenda prior to treatment. This study aims to determine the associative role of TNF-α -308G/A polymorphism and differential expression of TNF-α in the pathogenesis of RA. A case-control study where a total of 126 RA patients were enrolled based on ACR-EULAR (2010) criteria, along with 160 community matched age and sex controls over a period of three years. The differential expression level of TNF-α mRNA and protein level was studied and TNF-α -308G/A polymorphism was screened by T-ARMS PCR assay. All statistical analysis was performed using SPSS software. mRNA expression level of TNF-α was upregulated in RA cases (avg. 15.85 ± 9.52 fold) compared to control. TNF-α protein level was found to be higher in RA cases (28.62±7.17 pg/mL) compared to control (23.14±6.91 pg/mL). TNF-α -308 variant GA genotype was higher in RA (46.03%) than in control (25%). The presence of TNF-α -308 variant A allele was associated with increased risk of RA susceptibility (odds ratio (OR) = 2.559 at 95% confidence interval (CI), P< 0.001) but not severity (OR = 1.617 at 95% CI, P = 0.571). The presence of -308 variant genotype was associated with a higher TNF-α mRNA and protein expression. The presence of TNF-α -308A allele is associated with increased risk of RA susceptibility and differential TNF-α expression, and has prognostic significance. Association of higher TNF-α pro-inflammatory cytokine levels with northeast Indian patients makes them suitable subjects for anti-TNF-α therapy.

Antibacterial property of Azadirachta indica, Ocimum sanctum, and Vitex negundo against oral microbes.

CONTEXT: Plant extracts are used in folklore medicine from time immemorial to treat different oral diseases. Chemical constituents extracted from these natural resources are gifted with huge opportunities. AIM: The aim of this study is to assess the antibacterial property of Azadirachta indica (Neem), Ocimum sanctum (Tulsi), and Vitex negundo (Pochotia) against oral microorganisms. MATERIALS AND METHODS: Plant extract was prepared with hot continuous extraction method by the Soxhlet Apparatus. Microorganisms isolated from the oral cavity and identified by Vitek-2. Bacterial inoculums poured and spread into Mueller Hinton plates. Plant extract was poured into prepared wells taking ciprofloxacillin as the positive control and dimethyl sulfoxide as the negative control. The experiment was performed in duplicates with two different concentrations of the extract and mean value of inhibition zone was calculated. STATISTICAL ANALYSIS: Paired t-test, analysis of variance, and regression analysis. RESULTS: Isolated microorganisms were Klebsiella oxytoca, Kochuria kristinae, Acinetobacter boumani, Sphingomonas paucimobilis, Pseudomonas fluorescens, Streptococcus gordonii, Enterococcus faecalis, and Bacillus subtilis. Higher zone of inhibition was observed against E. faecalis by V. negundo followed by A. indica. Among the aqueous and acetone group, in the aqueous group, the regression models of K. kristinae and B. subtilis have been found to be statistically significant (P= < 0.05), whereas, in the acetone group, the regression model of B. subtilis has been found to be statistically significant (P = < 0.05). CONCLUSION: All the three plants showed antibacterial potency against the isolated organisms. Acetone group showed better efficacy than the aqueous extract group.

Analysis of Epstein Barr Virus Encoded RNA Expression in Nasopharyngeal Carcinoma in North-Eastern India: A Chromogenic in Situ Hybridization Based Study.

INTRODUCTION: Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India. Though the role of environmental contributors of NPC in the North-Eastern part of India is firmly established, EBV as an etiological agent in the region remains unexplored. MATERIAL AND METHODS: Fifty-one patients, who presented at the department of ENT, NEIGRIHMS and were confirmed as NPC upon histopathological examination, were included in the study. Chromogenic in-situ hybridization (CISH) was used for the evaluation of EBER (Epstein Barr Virus Encoded RNA). Presence of nuclear signals was taken as positive for EBER expression. EBER status was correlated with various clinicopathological parameters like age, sex, dietary habits, histological types of NPC, and ethnicity of the patients. RESULTS: The age range of the study group was 25 to 70 years with a mean age of 44.64 years and a male:female ratio of 3:2. Non-keratinizing undifferentiated type of NPC was the most common histological type. EBV was positive in 59% (30/51) of our cases. It showed a statistically significant correlation with the Naga community (P=0.01), with consumption of smoked food (P=0.02), and cigarette smoking (P=0.02). There was no correlation of EBV with age, sex, lymph node metastasis, stage, and histology. CONCLUSION: Our result indicates that EBV may be an additional risk factor in the pathogenesis of NPC in this region of India. So apart from lifestyle modification, a future study for a screening test for EBV viral load even in asymptomatic patients may be considered, for determination of disease susceptibility, early diagnosis, and proper management.

Caries prevalence of school-going boys and girls according to cleaning methods and soft drink-taking frequency in different localities, in and around Guwahati City.

BACKGROUND: Dental caries is a multifactorial disease, causes of which are mostly understood nowadays. This disease is not only treatable but also preventable, if detected in its initial stage. In a developing country like India, facility of dental treatment is available mostly for urban population, whereas a very common approach of dental disease treatment is still traditional for the rural people. OBJECTIVE: The objective of this study was to find out the prevalence of dental caries, teeth cleaning methods, and sweet and soft drink-taking frequency among boys and girls of Guwahati City and its nearby semi-urban and rural areas. MATERIALS AND METHODS: Cross sectional study was carried out among school going boys and girls of 3-17 years group, using the modified WHO oral health survey form. The number of population was 2396 from urban locality, 2370 from semi-urban, and 2467 from rural. RESULTS: Caries prevalence is much higher in urban (62.77%), contrary to rural where 76% of the sample is caries free. Those who take sweet occasionally suffered less or almost caries free (7.93% in urban and 0% in rural) than among those who consume it more than five times a day (90.75% in urban, 100% in semi-urban, and 99.33% in rural). DISCUSSION AND CONCLUSION: Urban localities are two times and semi-urban areas are 1.64 times more at risk of dental caries than rural areas. The odds ratio for cleaning frequency shows that the effect of cleaning by brush on caries is less (78%, not significant) than chewing stick while the risk associated with finger and charcoal use is about 19.63 times and 7.11 times, respectively.

Evaluation of Sealing Ability of Biodentine as Retrograde Filling Material by Using two Different Manipulation Methods: An In Vitro Study.

BACKGROUND: The study was aimed to evaluate the microleakage of Biodentine using two different manipulation methods by dye penetration. MATERIALS AND METHODS: A total of 60 single-rooted human maxillary permanent teeth were cleaned and obturated with gutta-percha using lateral condensation method. Standardized root-end cavities were prepared after apical resection. All teeth were divided randomly into two groups of 30 specimens and were filled with Biodentine by trituration and hand manipulation methods. The samples were coated with varnish and immersed in 1% methylene blue dye for 72 h. Then the teeth were sectioned longitudinally and observed under a stereomicroscope. The depth of dye penetration was measured in millimeters. RESULTS: There was highly statistical significant difference observed between Group I and Group II (P < 0.001) when dye penetration scores were compared. CONCLUSION: More microleakage was seen when Biodentine was manually manipulated as compared to machine trituration.

Molecular epidemiology of HBV infection in chronic hepatitis B virus infected patients in northeast India.

The present study aimed to evaluate the molecular epidemiology of HBV in chronic HBV infected cases from northeast India (NEI), since scanty data are available from the region which has a predominant ethnically distinct tribal population. A total of 523 clinically diagnosed index chronic HBV infected cases and 172 asymptomatic patients (based on family screening) were enrolled with informed consent. Patients were stratified based on serology, imaging, pathology, and clinical data and grouped as chronic HBV and cirrhotic cohorts. Analysis for serum HBV DNA levels and HBV genotyping was performed, and was statistically co-related with disease severity. Males were more prone to chronic HBV infection. Majority of the patients who had Chronic HBV infection based on family screening were females (59.88%), majorly wives of index patients. Mean viral load in Chronic HBV patients was almost 4.5-folds higher than cirrhosis patients, and was significantly associated with e-antigen positive status(P < 0.001) in both groups. HBV genotype D was the most prevalent genotype (62.30%) in NEI. Mixed genotype infection of A + D was found from Assam, along with C + D cases (1.29%) cumulatively. There is a high prevalence of HBV genotype C (13.96%) in our studied cohort which was found to be associated with higher viral load(P = 0.018), e-antigen positivity(P = 0.043), and increased cirrhosis risk compared to Chronic HBV cases [OR = 1.670]. Family contacts in NEI are prone to infection with HBV and development of Chronic HBV. Higher presence of e-positive cases and genotype C along with the mixed genotypes in NEI is unique and of significance with reference to predisposition to disease severity and even response to antiviral therapy.

Prognostic relevance of human telomerase reverse transcriptase (hTERT) expression in patients with gall bladder disease and carcinoma.

BACKGROUND: Gallbladder carcinoma (GBC) has been stated as an Indian disease, with the highest number of cases being reported from certain districts of northeast India, which has an ethnically distinct population. Unfortunately there are no scientific reports on the underlying molecular mechanisms associated with the pathogenesis of the disease from this region. AIM: The present study evaluated the role of differential expression of human telomerase reverse transcriptase (hTERT) in the development of gall bladder anomalies. MATERIALS AND METHODS: Blood and tissue samples were collected from patients undergoing routine surgical resection for clinically proven cases of gallbladder disease {cholelithiasis (CL, n=50), cholecystitis (CS, n=40) and GBC (n=30) along with adjacent histopathologically proved non-neoplastic controls (n=15)} with informed consent. Whole blood was also collected from age and sex matched healthy controls (n=25) for comparative analysis. Differential hTERT mRNA expression was evaluated by semi-quantitative rt-PCR and real-time PCR based analysis using ß-actin as an internal control. Evaluation of differential hTERT protein expression was studied by Western blot analysis and immunoflourescence. Statistical analysis for differential expression and co-relation was performed by SPSSv13.0 software. RESULTS: Gallbladder anomalies were mostly prevalent in females. The hTERT mRNA and protein expression increased gradiently from normal

Molecular epidemiology of hepatitis A virus infection in Northeast India.

The present study was undertaken to screen the molecular epidemiology of Hepatitis A virus (HAV) in Northeast India (NEI) who are ethnically distinct, tribal dominated and of lower socio-economic status with almost no information available from NEI on these aspects. Briefly, 3 ml blood was collected from 324 random liver disease cases with jaundice, receiving care at Central Hospital, N.F. Railway, Guwahati, Assam with informed consent. The patients detected with HAV-IgM positive status were included and were stratified as acute viral hepatitis (AVH) and fulminant hepatitis (FHF) based on clinical profile. Viral RNA was isolated and HAV-RNA was detected by Real-time PCR using primers for the VP3-VP1 region. HAV genotyping was studied by PCR-direct sequencing-phylogenetic analysis approach using the VP1/2A region of HAV isolates. Statistical analysis was performed using SPSS13.0 software. A total of 69 cases were HAV infected with two HBV co-infected cases (n = 69 + 2 = 71), 62 cases and two co-infected cases were AVH and others were FHF cases. HAV infection was predominant in especially in the young and adult age group. HAV-RNA was detected in 28 cases, out of which 19 cases could be genotyped (12 AVH, 7 FHF); which showed the prevalence of genotype IIIA or IA only. Although HAV genotype IIIA was the major genotype in both the AVH (10/12, 83.33%) and FHF (5/7, 71.43%) group, but the difference in distribution of genotypes in AVH and FHF cases was statistically non-significant (P = 0.550). HAV genotype IIIA is associated with the majority of HAV infected cases and severity in NEI.

Role of CYP2E1 gene polymorphisms association with hepatitis risk in Northeast India.

AIM: To investigate hepatitis virus, genetic and environmental factors, and their interactions in predisposing patients to liver diseases in Northeast India. METHODS: A total of 104 jaundice patients and 124 community controls were included. Serological analysis was performed by routine enzyme-linked immunosorbent assay, and nucleic acid testing for hepatitis viruses was done by polymerase chain reaction (PCR), followed by PCR direct sequencing for viral genotyping. Cytochrome P450 2E1 (CYP2E1) polymorphism was studied by PCR-restriction fragment length polymorphism. Nitrite and volatile nitrosamines in indigenous foods consumed routinely by the Northeast Indian ethnic population were estimated by Griess's reagent and GC-MS, respectively. RESULTS: Hepatitis A virus (HAV) infection was predominantly prevalent (36.5%) in our cohort, followed by hepatitis B virus (HBV), hepatitis E virus (HEV) and hepatitis C virus. HBV genotype D and HEV genotype 1 were the most dominant. CYP2E1 c1/c2 genotype frequency was comparatively higher in alcoholic (P < 0.0001, OR = 30.5) and cryptogenic (P = 0.014, OR = 8.714) patients, and was associated with significantly higher hepatitis risk (P = 0.0.007, OR = 6.489). Mutant C allele of Cyp2E1 DraI frequency was comparatively higher in HAV (P = 0.006), alcoholic (P = 0.003) and cryptogenic (P = 0.014) cases, and was associated with overall hepatitis risk (P = 0.026, OR = 5.083). Indigenous foods, Gundruk, Kharoli, betel leaf and nuts were found to have the highest nitrite content. CONCLUSION: Apart from viral factors, CYP2E1 polymorphism might be associated with increased risk of liver diseases in Northeast India. Indigenous foods that contain nitrite and nitrosamine might be an associated risk factor.