Bactericidal Effect of GaAIAs Laser on Anaerobic Photosensitized Periodontopathics- An In Vitro Study

Background: The mainstay of periodontal therapy remains the physical removal of subgingival plaque. The present study was conducted to determine bactericidal effect of GaAIAs laser on anaerobic photosensitized periodontopathics. Materials & Methods: The present study was conducted on 60 adult patients of both genders of chronic periodontitis (Group I). Equal number of controls was also selected (Group II). In all patients subgingival plaque samples were collected. Samples were cultured anaerobically for 72 h at 37°C on blood agar, Brewer's agar culture plates. Bacteria were identified based on colony characteristics, hemolysis, pigmentation, and fluorescence. Results: The mean P. gingivalis count (CFU/ml) during undilution in group I was 302.4 and in group II was 401.5, at 1:10 was 204.5 in group I and 328.2 in group II, at 1:50 was 115.2 in group I and 276.3 in group II, at 1:100 was 27.8 in group I and 132.8 in group II. The difference was significant (P< 0.05). The mean F. nucleatum count (CFU/ml) during undilution in group I was 212.4 and in group II was 291.5, at 1:10 was 125.5 in group I and 217.2 in group II, at 1:50 was 68.2 in group I and 150.3 in group II, at 1:100 was 17.8 in group I and 94.8 in group II. The difference was significant (P< 0.05).Conclusions: Authors found that GaAIAs laser found to be effective in reducing periodontal pathogens.

Association of homocysteine and methylene tetrahydrofolate reductase (MTHFR C677T) gene polymorphism with coronary artery disease (CAD) in the population of North India

The implications of the methylene tetrahydrofolate reductase (MTHFR) gene and the level of homocysteine in the pathogenesis of coronary artery disease (CAD) have been extensively studied in various ethnic groups. Our aim was to discover the association of MTHFR (C677T) polymorphism and homocysteine level with CAD in north Indian subjects. The study group consisted of 329 angiographically proven CAD patients, and 331 age and sex matched healthy individuals as controls. MTHFR (C677T) gene polymorphism was detected based on the polymerase chain reaction and restriction digestion with HinfI. Total homocysteine plasma concentration was measured using immunoassay. T allele frequency was found to be significantly higher in patients than in the control group. We found significantly elevated levels of mean homocysteine in the patient group when compared to the control group (p = 0.00). Traditional risk factors such as diabetes, hypertension, smoking habits, a positive family history and lipid profiles (triglyceride, total cholesterol, HDL-cholesterol, LDL-cholesterol, VLDL-cholesterol), were found significantly associated through univariate analysis. Furthermore, multivariable logistics regression analysis revealed that CAD is significantly and variably associated with diabetes, hypertension, smoking, triglycerides and HDL-cholesterol. Our findings showed that MTHFR C677T polymorphism and homocysteine levels were associated with coronary artery disease in the selected population.

Genetic predisposition of E-selectin gene (S128R) polymorphism in patients with coronary artery disease (CAD).

Background & objectives: A surface glycoprotein molecule, E-selectin is involved in adhesion of circulating leukocyte to the activated endothelium and plays a fundamental role in pathogenesis of atherosclerosis. The present study was undertaken to document the status of S128R polymorphism of E-selectin gene in angiographically proven coronary artery disease (CAD) patients from Uttar Pradesh. Methods: Genotype of the S128R polymorphism was done by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) in 329 angiographically proven CAD patients [n=83 acute myocardial infarction (AMI) and n= 246 AMI-free] and 331 age and sex matched control individuals (angiographically proven not to have CAD). Results: This pilot study revealed a significant association of R allele in coronary artery disease patients in univariate analysis [allele frequency 9.6% in patients vs. 5.6% in control (P = 0.031, OR = 1.57, 95% CI = 1.05 – 2.47)]. However, after binomial logistic regression the significant determinants of CAD were: presence of diabetes (OR: 2.26, P=0.001) hypertension (OR = 2.61, P=0.001), smoking habit (OR=2.038, P=0.001), elevated serum triglycerides (OR=1.967, P=0.001) and low HDL-C (high density lipoprotein cholesterol) (OR=1.107, P=0.001). Interpretation & conclusions: The interaction of classical risk factors for CAD with S128R polymorphism in our study population showed that the significant determinants of coronary artery disease were presence of diabetes, hypertension, smoking habit, elevated serum triglycerides and low HDL. S128R polymorphism in E-selectin gene was not an independent predictor of CAD in our population.

Induced mild hypothermia in post-cardiopulmonary bypass vasoplegia syndrome.

The state of vasoplegia in immediate post-cardiopulmonary bypass period is characterized by severe hypotension, supranormal cardiac output, low systemic vascular resistance (SVR), and resistance to vasoconstrictors. We could successfully use induced mild hypothermia to increase SVR, and could avoid very high doses of nor-epinephrine (>0.3 mcg/kg/min) in the background of severe pulmonary hypertension (systolic pulmonary pressure> 90 mmHg). Its effects such as decreased oxygen demand, positive inotropy and better right ventricle performance probably helped to improve oxygenation in presence of pulmonary oedema.

Gabapentin for refractory idiopathic trigeminal neuralgia.

Trigeminal neuralgia is sudden, usually unilateral, severe, stabbing, brief recurrent pain in the distribution area of one or more of the branches of trigeminal nerve. Various pharmacological agents including carbamazepine, oxcarbazepine, phenytoin, lamotrigine, baclofen and clonazepam have been tried with variable success rate. Here a case of idiopathic trigeminal neuralgia is presented. The patient presented in the emergency room with severe pain in the distribution area of maxillary branch of trigeminal nerve, resistant to conventional pharmacotherapy, managed successfully with gabapentin without untoward side-effects.

Self-extubation in intensive care and re-intubation predictors: a retrospective study.

To find out the incidence of self-extubation in intensive care, to evaluate the factors responsible for it and to identify the predictors of need for re-intubation, a retrospective analysis was conducted among 350 patients who were admitted to the intensive care unit over a two-year period and required ventilatory therapy for more than 48 hours. In all patients who self-extubated, the demographic data, ventilatory parameters before self-extubation (mode of ventilation, inspired oxygen concentration, positive end-expiratory pressure), partial pressure of oxygen in arterial blood and inspired oxygen fraction ration (PaO2/FiO2), and the event of re-intubation were noted. These values were compared among patients who were re-intubated and those who were not. Twelve patients out of 350 self-extubated. Of these 12 patients, 7 required re-intubation while 5 did not. Of these 7 patients, 3 died within 48 hours of the episode of self-extubation and one patient's death was directly attributable to self-extubation. Of the remaining 4 patients, 3 died within a span of 7 days. Re-intubation after self-extubation should not be considered mandatory. Patients who required re-intubation had lower PaO2/FiO2 than patients who did not.