Risk Factors for Erythema Nodosum Leprosum: A Case Control Study in a Tertiary Hospital of Western Odisha, India

Erythema nodosum leprosum (ENL) is a serious, often recurring and disabling, immunologically mediated reaction occurring in leprosy which often requires hospitalization. There are published several studies of ENL, but systematic studies regarding the risk factors associated with ENL in the post elimination era are few. The aim of the study was to determine the risk factors associated with ENL in a tertiary care centre in Western Odisha. This is a case control study involving 292 patients of leprosy who attended the Dermatology OPD of this tertiary care centre. These constituted 97 patients with ENL and 195 patients without ENL who attended the OPD during this period. Detailed history, clinical examination, slit skin smears were done. These included gender details, age, area of residence (rural/urban), education and socioeconomic status. The most common subtype of leprosy observed in ENL was lepromatous leprosy followed by borderline lepromatous type. Patients diagnosed with initial high BI and lepromatous leprosy were found to be significant risk factors for development of ENL. Skin diseases, Anaemia and Diabetes Mellitus were found to be more prevalent in ENL patients

Malignant Melanoma Infiltrating the Bone Marrow.

Malignant melanoma with infiltration into the bone marrow is seldom reported in the literature, for they are exceedingly rare. The primary site is not always apparent and a sizeable number of cases have been attributed to an occult primary. Metastasis to bone marrow is a terminal event usually occurring in stage IV of the disease and can be a focus of residual tumor cells which can cause a relapse.The current documentation is of a case of melanoma occurring as a rectal primary with anemia, thrombocytopenia, and leukoerythroblastic reaction. The marrow aspirates and trephine biopsy showed round to spindle-shaped malignant cells with intracytoplasmic brown-black coarse pigment, suggestive of melanin. The patient was diagnosed with stage IV melanoma but was lost for follow-up. The recognition of such an entity is important for both pathologists and clinicians alike. This case is being reported for the novelty of such an occurrence.

Clinico-epidemiological Profile of Erythema Nodosum Leprosum Cases in Western Odisha

This study was carried out in a hospital setting in Odisha to find out the epidemiological profile and clinical spectrum of ENL and their association with bacillary load, clinical types of leprosy and comorbid conditions of leprosy patients. Out of 1352 cases of leprosy, 97 were diagnosed with rd th ENL. Male patients outnumbered the females (4.3:1), and leprosy patients in their 3 and 4 decade were more commonly found to be having ENL. Majority of the patients belonged to the lepromatous leprosy (LL) spectrum (74.22%). A positive family history of Leprosy was obtained in 7.21% of cases. Diabetes mellitus followed by hypertension was the most common comorbid condition. Whether these conditions have any direct link with ENL needs to be investigated by proper prospective studies. 79.38% of cases had arthritis whereas glomerulonephritis and peripheral edema were observed in 29.89% of cases each. Observations of this study will be useful for planning field based studies in population from Odisha.

Potency dependent activity of homeopathic nanomedicine- classical and quantum electrodynamical approach

The effect of homeopathic medicine on biological and physical system is directly related to its potency [1]. However, from physico-chemical point of view it is difficult to explain this effect at such high dilution, as then the existence of even trace amount of particle is questionable. It has been reported that during the process of potentization, a large amount of mechanical energy gets transferred to the medium due to succussion [2]. This energy in all probability reduces the size of the drug aggregates. The drug then penetrates easily through the membrane barrier, and thereby gives rise to enhanced activity of the medicine. It has been experimentally proved by us and supported by others that indeed a reduction of size of the aggregates takes place with increase in potency [3]. Using five different homeopathic medicines, their sizes at three different potencies have been estimated and a general mathematical expression relating the size of the particle (Y) and the corresponding potency (X) has been derived as follows Y = a X -n. (AU)

Transmission Blocking of Year Round Resistant Malaria in Koraput (India) by OMARIA – A New Antimalarial Phytotherapy.

Background: Globally, in resistant malaria endemic zones, even the latest lines of MDTs (multi drug therapes) are yielding chaotic results. These include unacceptable side effects/contraindications, with poor prognosis in juveniles/adolescents. Juvenile stage is intensely humoral and up-regulate infestation. MDTs are more unpredictable in the juveniles, and fail in the geriatric group. Pharmacies are also failing. Tropical-equatorial conditions necessitate frugal body cover cum bare foot life style. Typical geomorphology, orography, meteorology, flora and fauna provide year round conducive conditions for vector bionomics and for other types of infections. OMARIA (Orissa Malaria Research Indigenous Attempt) is a new anti-malaria phytotherapy that has been in mono station use (Koraput, India) since 1998 in drug resistant core endemic regions, also well known for tertian type. It transpired out of Koraput Model to Fight Malaria at Home with OMARIA. Materials and Methods: OMARIA is composed of the dry rind of the Indo-year round fruiting Punica granatum (Dalimba). Principal drug moieties are: (i) ellagic acid; (ii)punicalagin (iii) punicalin and (iv) potassium (K+). Are physiologically compatible and has never been used before. All the moieties being non alkaloids offer a paradigm shift among anti-malarials. Results: OMARIA kills and clears hemoprotozoas of all spp., at all stages (including gametocytes) in patients of all ages and chronicity. Is potently anti-inflammatory vis-a-vis WBCs; blocks transmission; prevents relapse and non- recrudescence; and is very useful in severe/acute/complicated/refractory malaria and in sickle cell patients. No development of resistance. Potassium (K+) probably acts as the drug’s efficacy upregulator. Conclusion: OMARIA is prophylactic and therapeutic in target groups. Is useful in numerous forms of malaria, being active against key stages of the parasite (complicated or systemic status); and in patients having multiple infections. It has synergistic and possibly buffering roles. Koraput Model has been of much help to the afflicted communities and to the administrations.

Prevalence of goitre among school children in Belgaum District.

Objective. A school survey was conducted to estimate the prevalence of goitre among schoolchildren in Belgaum district. Methods. A cross-sectional study was conducted in primary, middle and high schools of villages selected. All the children of the selected schools were examined for the presence of goitre and the salt samples obtained from their homes were tested for iodine content. Results. Overall prevalence of goitre was 16.7%. Prevalence of palpable goitre was 16.4 % and visible goitre was very low (0.3%). Higher prevalence was found among females (21.1%) when compared to that of male children (12.8 %). Prevalence of goitre increased significantly with advancement of age until 16-yr. 72.1 % children were consuming rock salt and only 27.9 % were consuming powdered salt at their homes. Estimation of Iodine content in the salt samples showed that 68.7 % of the sample had inadequate iodine content. Prevalence of goitre was significantly high among children who consumed rock salt (16.2%) as compared to those who used powdered salt (11%). Conclusion. Strict implementation of salt codization and marketing in rural area is desired. Also health education programme be showed.

Periodontal infections and cardiovascular disease: is it a mere association?

The oral cavity is a major site of chronic infection and inflammation, particularly periodontal or chronic gum diseases. In recent years there has been increasing interest in the "periodontal systemic connection" between periodontal health parameters and risks of cardiovascular disease. Given that poor oral health and cardiovascular disease are major worldwide health problems, their association are potentially important. The article summarizes the evidences from epidemiologic studies and studies that focused on potential contributing mechanisms to provide an insight of this association.

Nucleic acid probes in periodontal diagnosis.

Periodontal Disease is considered as an infection caused by a variety of microorganisms. Considering the vast range of microbial species involved in the causation of periodontal diseases, a specific diagnostic procedure, to identify the various organisms involved is a major necessity. A number of diagnostic procedures, including microbiological and immunological have been utilized in the diagnosis of periodontal disease. The DNA probe technology provides both a sensitive and specific assay and also alleviates concern for transport of the fastidious microorganisms in clinical samples, fulfills the need for a specific and rapid test, that does not require the preservation of viable microorganisms. DNA probes are now being used to identify the various putative pathogen's including; A. actinomycetemcomitans, P. gingivalis, P. intermedia, B. forsythus, etc. Besides DNA probes have also been proven an advantage over the various other available procedures in periodontal diagnosis.

Enamel matrix derivative in periodontal reconstructive surgery. A new approach in periodontal regeneration.

True periodontal regeneration is the goal of any periodontal regenerative techniques. Cementum formation is a key event in the development of root and supporting periodontium. Due to its distribution, acellular cementum is the type most affected by early to moderate periodontitis. Studies over the past twenty years demonstrated that, enamel matrix proteins from the root sheath are involved in the formation of acellular, during tooth development. Thus the adjunctive use of enamel matrix derivatives in conjunction with regenerative periodontal surgery could possibly lead to true periodontal regeneration. The purpose of this article is to review the use of enamel matrix derivative in true periodontal regeneration.

Pathology of temporal lobe epilepsy: An analysis of 100 consecutive surgical specimens from patients with medically refractory epilepsy.

The neuropathological features of temporal lobe epilepsy were studied utilising 100 consecutive surgical specimens from patients with medically refractory complex partial seizures. A wide spectrum of neuropathological changes was recorded in 98 specimens. Fifty-eight specimens showed features of Ammon's horn sclerosis. Diffuse accumulation of corpora amylacea were demonstrated in the resected temporal lobes from 54 patients. Six patients had neoplastic lesions of temporal lobe. One unique case of dysembryoplastic neuroepithelial tumour showed a melanotic component within the tumour. The neuropathological features were regarded as nonspecific in 31% of cases. Our results indicate that a majority of patients with medically intractable epilepsy of temporal lobe origin reveal significant neuropathological features. Careful documentation of the neuropathological features and its correlation with radiological, electrophysiological and pre- and post-surgical clinical features will help in predicting the seizure outcome after temporal lobectomy for medically refractory epilepsy.

Septal splint with wax plates.

To pack or not to pack, has always been a debate, especially after septal and functional endoscopic sinus surgery. The authors have studied the symptoms of packing versus not packing in their series of 100 patients having undergone nasal surgery. They advocate the use of dental wax for the fashioning of septal splints, since they are easy to introduce, cheap and malleable. The patients postoperative comfort is greatly enhanced with the use of dental wax plate splints instead of nasal packing.