Richa Gupta

Role of horizontal transmission in hepatitis B virus spread among household contacts in north India.

Objectives: Familial clustering of HBV provides epidemiological evidence for the different modes of spread of the virus. Though the majority of the studies have addressed the issue of perinatal transmission in India, only a few reports have dealt with other modes of transmission. Methods: The study was prospectively designed and data were collected from a total of 265 household contacts of 91 index patients with HBV-related chronic liver disease between January 2006 and July 2007. The prevalences of HBsAg and various antibodies; anti-HBs, anti-HBc and anti-HBe, were estimated in all household contacts using ELISA and VIDAS. Results: Among the various household contacts, the highest prevalence of HBsAg was seen in the pediatric age group (kids 1–15 years: 37.0%) and especially in siblings (48.3%), with statistical significance (p < 0.001). Hepatitis B virus (HBV) serological markers were found more commonly in contacts of female (68.8%) index patients as compared to males (p > 0.05). The development of anti-HBV antibodies showed an increasing trend with age (p < 0.001), with the highest prevalence in parents. Conclusion: Horizontal transmission plays an important role in contributing to the high prevalence of HBsAg especially in young children. Hence, this age group needs to be targeted for primary prevention and effective vaccine.

Chronic neutrophilic leukemia with V617F JAK2 mutation

Chronic neutrophilic leukemia (CNL) is a rare disease grouped under World health organization classification as chronic myeloproliferative disease. It is a diagnosis of exclusion in patients with sustained mature neutrophilia and splenomegaly with no evidence of other myeloproliferative disease or reactive neutrophilia. V617F JAK 2 mutation has been described in classical myeloproliferative diseases, but its association with CNL has been reported in a few cases. Here in, we describe three cases of CNL with presence of V617F JAK 2 mutation. To distinguish CNL from secondary neutrophilia can be difficult. Detection of the V617F JAK 2 mutation in such scenario can provide a useful diagnostic test to establish the neoplastic nature of the neutrophilia.

Specific determination of azathioprine in solution by a spectrophotometric method and its application to a tablet assay

A previously reported spectrophotometric method for the determination of azathioprine in the presence of 6-mercaptopurine was evaluated for its specificity in the presence of other major degradation products. A three-pronged validity test proves that the method is stability indicating under all pH conditions. The method is simple, rapid, does not require specialised equipment and produces accurate and reliable results.

Coexistence of scleroderma with multiple myeloma: a rare association

Coexistence of scleroderma with multiple myeloma (MM) is an unusual finding with unclear significance. Only 13 cases of MM with scleroderma have been reported until now. We report a case of a 24-year-old man with 8-year history of progressive thickening of skin all over the body. Histopathology of skin lesion was consistent with scleroderma. Bone marrow biopsy showed interstitial and focal increase in plasma cells and increased bone marrow fibrosis. Skeletal survey showed osteopenia, but no osteolytic lesion or fracture. The patient was diagnosed as scleroderma with coexistence of immunoglobulin A, κMM. The patient recovered with improvement of skin lesions after 9 months of therapy with thalidomide and dexamethasone.

Necessity of oral health intervention in schizophrenic patients – A review

Individuals with mental illness often cannot perform day to day activities due to a psychiatric or emotional disorder. Schizophrenia is one such psychiatric disorder characterized by worsening self-care ability with progressing mental illness. This disease may potentially deteriorate oral health by affecting the subjects ability to perform oral hygiene measures. Literature on oral disease manifestations in schizophrenia is limited. Lack of desire for oral health care as well as generally poor awareness of oral health issues in these patients, compounded further by side effects of medications, may complicate dental management in schizophrenic patients. The present review explores clinical features and possible factors associated with oral health status among those with Schizophrenia.

Mucosal Substitutes for Periodontal Soft Tissue Regeneration

Periodontal plastic surgery would be defined as the surgical procedures performed to prevent or correct anatomic, developmental, and traumatic or disease induced defects of the gingiva, alveolar mucosa or bone. The introduction of oral mucosal equivalents also called as mucosal substitutes or mucosal fillers, composed of the structured triad of scaffold, cells and signaling molecules could be considered the essence or a culmination of the notion of periodontal regeneration. For the purpose of soft tissue augmentation, various mucogingival surgical procedures that are usually performed are: connective tissue grafts (gold standard) and its modifications, lateral pedicle flap, free gingival grafts, semilunar flaps, coronally positioned flaps. Several mucosal substitutes have been fabricated and tried with varying results. Tissue engineered mucosal constructs owe their origin to the treatment of ulcers, diabetic foot and burns. There is an increasing interest in the field of dentistry too. Mucosal substitutes are made of cell sources that have not caused acute and chronic tissue reaction and have self-renewal properties that can re-grow and differentiate to a new tissue. With all the advantages of reproducible tissue engineering technologies, these mucosal substitutes/ oral mucosal equivalents appear to be the imminent hope for tissue repair, replacement or regeneration in regenerative medicine in the treatment of lost tissues, impaired functions and soft tissue defects that are caused by congenital abnormalities, trauma, diseases or aging processes.