Ethics of the use of dead human bodies in anatomy teaching in India

The study of the human anatomy predominantly requires the use of remains of the dead. Unclaimed bodies are easily available in India; however, there is a lack of clear ethical guidelines governing their transport and exchange. We raise pertinent questions about the ethical implications of using unclaimed bodies in teaching anatomy, their transport, transfer and storage, ethical and legal issues regarding the voluntary donation of bodies and dry human bones, as well as the commercial aspects of body donation. We also examine existing practices in anatomy departments in India, and explore the available legal safeguards. We detail practical and ethical challenges in the existing practices and safeguards and attempt to provide solutions.

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.

Spectrum of malignancies in human immunodeficiency virus – positive patients at a tertiary care centre in South India.

CONTEXT: India has a very large number of patients living with human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome. Opportunistic infections in these patients are commonly encountered. However, malignancies in such patients also do occur. AIM: The aim was to study the spectrum of malignancies in HIV‑positive patients at a tertiary health care center. SETTINGS AND DESIGN: Retrospective study. MATERIALS AND METHODS: The cases were retrieved from pathology record files at our Institute from January 2003 to December 2008. The follow‑up was obtained from Medical oncology records. The morphology of each case was reviewed along with immunohistochemistry wherever done. RESULTS: There were 61 such cases (51 males, 10 females). The age range was 7–78 years with a median of 35 years. The clinical presentation varied according to the malignancy. The largest group was non‑Hodgkin lymphoma (18 nodal, 23 extra‑nodal). The others included carcinoma breast (4), chronic myeloid leukemia (3), Burkitt Leukemia (2), squamous cell carcinoma anal region (2), multiple myeloma (2) and one each of miscellaneous malignancies (7). CONCLUSION: Malignancies in HIV positive individual occurred in younger individuals. Non‑Hodgkin lymphomas, especially extra‑nodal lymphomas, were the most common malignancy. There were no cases of proven Kaposi’s sarcoma or invasive cervical carcinomas. There were two cases of multiple myeloma which are infrequently reported.

A rapid and low-cost microscopic observation drug susceptibility assay for detecting TB and MDR-TB among individuals infected by HIV in South India.

Background: The converging epidemics of HIV and tuberculosis (TB) pose one of the greatest public health challenges of our time. Rapid diagnosis of TB is essential in view of its infectious nature, high burden of cases, and emergence of drug resistance. Objective: The purpose of this present study was to evaluate the feasibility of implementing the microscopic observation drug susceptibility (MODS) assay, a novel assay for the diagnosis of TB and multi-drug-resistant tuberculosis (MDR-TB) directly from sputum specimens, in the Indian setting. Materials and Methods: This study involved a cross-sectional, blinded assessment of the MODS assay on 1036 suspected cases of pulmonary TB in HIV-positive and HIV-negative patients against the radiometric method, BD-BACTEC TB 460 system. Results: Overall, the sensitivity, specificity, positive predictive value, and negative predictive value of the MODS assay in detecting MTB among TB suspected patients were 89.1%, 99.1%, 94.2%, 95.8%, respectively. In addition, in the diagnosis of drug-resistant TB, the MODS assay was 84.2% sensitive for those specimens reporting MDR, 87% sensitivity for those specimens reporting INH mono-resistance, and 100% sensitive for specimens reporting RIF mono-resistance. The median time to detection of TB in the MODS assay versus BACTEC was 9 versus 21 days (P < 0.001). Conclusion: Costing 5 to 10 times lesser than the automated culture methods, the MODS assay has the potential clinical utility as a simple and rapid method. It could be effectively used as an alternative method for diagnosing TB and detection of MDR-TB in a timely and affordable way in resource-limited settings.

Role of bitewing in enhancing the assessment of DMFS index in a group of Indian adolescents.

Context: Caries epidemiological studies based on clinical examination alone tend to underestimate proximal caries. Aims: This study aims to determine the additional value of radiographic examination (bitewings) compared to clinical examination in assessing posterior proximal caries. It also aims to determine the radiographic multiplication /adjusting / correction factors by which a clinical decayed surface (D-S) and decayed-missing-filled surfaces (DMFS) score could be multiplied, to obtain an actual D-S and DMFS score Materials and Methods: Two groups of 100 subjects each, in the age range of 16-20 years, were examined clinically for caries and their DMFS index recorded. Both groups were subjected to bitewing radiographs to detect the clinically undiagnosed posterior proximal caries. The radiographic adjusting factors were determined for group A. To check its repeatability and thus its usefulness, radiographic correction factor was determined for Group B. Statistical Analysis: The results were statistically analyzed with the use of means, standard deviations, regression equation and "Z" test. Level of significance was determined at P > 0.05. Results: A significant number of clinically undetected proximal caries was diagnosed with the help of bitewing radiographs. The difference between the radiographic adjusting/correction factor for D-S and DMFS score for the two groups was statistically not significant (P > 0.05) thus verifying the repeatability of the radiographic correction factors. Conclusion: The radiographic correction factors can be used to obtain a more precise estimate of true caries prevalence in a particular study population without having to subject all individuals to radiographic examination.