An Overview On Platelet Rich Plasma

Platelet rich plasma (PRP) is a platelet concentrate obtained from autologus whole blood. After its first application by Ferrari et al in 1987, use of PRPhas increased in various fields. PRPis a promising alternative to promote healing in dental and oral surgical procedures. Since it is obtained from patients blood risk of immunogenic reactions can be avoided. This article reviews PRPas an emerging treatment modality in oral region .

Behavioral and emotional problems in school children: teachers and parents perspective

Background: The present research was carried out with an objective to study the behavioral problems and emotional problems of school children as perceived by their parents and teachers.Methods: This cross sectional observational study was conducted on parents and teachers of 304 secondary school children of a metropolitan city. A pre formed semi structured questionnaire was used to assess the socio-demographic profile of the students. Parents and teachers rated Strength and difficulties questionnaire was used to assess their child’s /students behavioral and emotional problems as perceived by their parents & teachers. The analysis was done using Microsoft Excel and SPSS software.Results: Regarding the perception of teachers and parents it was found that parents were not much concerned as the response rate for parent reported SDQ was only 64.8% and response rate among teachers was 100%. Out of 304 study subjects, 22 (7.2%) were having borderline total difficulties on teachers reported total difficulty scale of SDQ and 11 (3.6%) were reported to be abnormal. Parent reported SDQ showed that out of 197 parents, who filled the SDQ, 24 (7.9%) study subjects were having borderline total difficulties, while 33 (10.9%) were found to be abnormal on SDQ scale.Conclusions: Parents, child-care givers, teachers and health care professionals if made aware of symptoms of mental health problems in their children’s, we can restore their mental health conditions in time

Platelet count – a diagnostic aid in fever.

Introduction: Vivax Malarial infection. Dengue Viral fever is also emerging as a Febrile conditions to have reduced platelet count. The absence of the normal platelet count on peripheral smear in case of fever is a clue to the presence of Malaria and Dengue fever. Material & Method: Present study we have tried to study the pattern of thrombocytopenia in these febrile conditions and their diagnostic and prognostic implications. The study was conducted at GMERs Medical College, Gandhinagar. This study group consisted of 146 Patients of Fever treated at Pediatric Department, Malaria diagnosed by thick & thin smear examination. The platelet count was done by Abascus Junior B- Blood Cell counter. Dengue Fever was diagnosed by NS1 Antigen Test. The Mean Platelet counts in P. Falciparum are 69852 cells/mm3, P.Vivax 1,15,580 and Dengue Fever 53,100. Statistically the difference between P. Falciparum & Vivax is significant for differentiating Malarial type. Result: Platelet count <20,0000 cells/mm3 was observed in both the types of Malaria and not seen with Dengue Fever. Profound thrombocytopenia still remains the distinguishing, feature of P. Falciparum Malaria. Platelet count more than 1,00,000 cells/mm3 favours the diagnosis of P.Vivax & Moderate reduction in Platelet Count (between 20,000 to 1,00,00) is clue to P. Falciparum and Dengue Fever. In this segment other diagnostic criteria like pFHrp Antigen and N.S.Antigen should be applied to differentiate these two grave conditions. Thrombocytopenia (Platelet count <150000 cells/mm3) can be considered as a predictor of Malaria and in combination with Anemia (Hb<10gm/dl) is a next best parameter. Unlike Malaria, in Dengue fever thrombocytopenia is usually associated with normal Hemoglobin.

The determination of Q192R polymorphism of paraoxonase 1 by using non-toxic substrate p-nitrophenylacetate.

CONTEXT: The human serum paraoxonase 1 (PON1) is calcium-dependent esterase and associates with the high density serum lipoproteins. PON1 plays a major role in oxidation of high density lipoprotein and low density lipoprotein and prevention of atherogenesis in coronary heart disease. PON1Q and R allele hydrolyses number of substrates like paraoxon (PO) (diethyl p-nitrophenyl phosphate) and phenylacetate. AIMS: The aim of the study is to the determination of Q192R polymorphism of PON1 by using non-toxic substrate p-nitrophenylacetate and compares it with the phenotype determined by using PO as substrate. MATERIALS AND METHODS: The study group consists of 60 healthy normal patients. Paraoxonase activity was measured using the procedure described by Eckerson (Reference method) and for phenotyping; the ratio of hydrolysis of PO in the presence of 1 M NaCl (salt-stimulated PON1, SALT) to the hydrolysis of phenylacetate (PA) is calculated. In new method (Haagen et al.) arylesterase activity measured using p-nitrophenylacetate and for phenotyping arylesterase, the ratio of inhibition of enzymatic hydrolysis of p-nitrophenylacetate (substrate) by phenyl acetate to non-inhibited hydrolysis of p-nitrophenylacetate (inhibited arylesterase activity (IA-IA0)/non-inhibited arylesterase activity (NIA). RESULTS: It was found that paraoxonase activity is trimodally distributed in both the methods. There is no significant difference in the distribution of PON1 phenotypes of both reference method and new method being frequencies 0.946 and 0.376 respectively and there was no significant difference for phenotypic polymorphism for an individual by both methods (χ2= 0.15 and P = 0.9262). CONCLUSION: The Q192R polymorphism of PON1 by using non-toxic substrate p-nitrophenylacetate showed trimodal distribution of QQ (homozygous), QR (heterozygous), and RR (homozygous) phenotype and it is comparable with reference method. This method can be used for PON1 phenotype in different pathological and complex disease conditions.

Thrombocytopenia in p. vivax malaria.

Backgroud: Plasmodium Falciparum and P. Vivax are endemic infections in India and commonly associated with Hematological Abnormalities. Severe thrombocytopenia is frequently noticed with P. Falciparum Malaria, but its occurrence is less reported and studied with P. Vivax Malaria. In present study we have tried to evaluate severity & prognostic implications of thrombocytopenia in cases of P Vivax Malaria. The study was conducted in Department of Pediatrics, GMERS Medical College, Gandhinagar.Method: The study group consisted of 92 Pediatric Patients diagnosed on thick & thin blood smear examination having thrombocytopenia. The platelet counts were done by Abacus Junior B Blood Cell Counter. Result: Platelet Count <150000 Cell/mm3 (thrombocytopenia) was observed in 73.92% patients of P. Vivax Malaria. The mean platelet count 1,16,520 is significantly low and the range being 18000 cell/mm3 to 5,10,000 cells/mm3. Anaemia with mean Hemolobin level 8.8 gm/dl. was reported in the patients with P. Vivax Malaria with thrombocytopenia. Discusssion: In our view, this statistically low platelet count in P.Vivax Malaria is having significance & should be kept as differential diagnosis in Acute Febrile conditions. Unnecessary Platelet transfusions can be prevented as noticed in the study. Platelet transfusion was not required in the patients having severe thrombocytopenia (platelet count <20000 cells/mm3)as bleeding tendencies and systemic complications were not observed as compared to Falciparum Malaria. Platelet count and clinical recovery were immediate on 2nd day after initiation of treatment and complete recovery within 7 day without any complications and mortality suggest a good prognosis. Conclusion: Anaemia with severe thrombocytopenia in P. Vivax Malaria required further study to differentiate other febrile conditions with low platelet count and unaltered hemoglobin levels.

Outcome of optical penetrating keratoplasties at a tertiary care eye institute in Western India.

Aim: To study the indications, risk factors, postoperative course, and long-term survival of corneal transplants done for optical purposes. Design: Retrospective case series. Materials and Methods: Data were obtained by reviewing the records of 181 patients operated at our institute (H.V. Desai Eye Hospital) between October 2005 and October 2007 for optical penetrating keratoplasty. Patients with less than one year of follow up, pediatric cases, therapeutic, tectonic, and lamellar keratoplasties were excluded. Kaplan Meier survival analysis was used to calculate median survival time of grafts and to see correlation between nine variables viz. age, gender, corneal vascularization, previous failed grafts, previous Herpes Simplex keratitis, post-perforation corneal scars, donor tissue quality, graft size, type of surgery and follow-up. These variables were also used for univariate and multivariate analysis using Cox Proportional Hazard Regression Modeling. Results: Median survival of the cohort was 27 months (95% confidence interval: 20.47-33.52). One- and two-year survival rates were 65% and 52.5%, respectively. Median survival was significantly lower in poor prognosis cases (14 months) than good prognosis cases (27 months, P = 0.0405). Graft survival was lower in vascularized corneas (18.55 months, P = 0.030) and in post-perforation corneal scars (17.96 months, P = 0.09, borderline significance). Multivariate analysis showed that the same factors were predictive of graft failure. Conclusion: Long-term survival of grafts at our center is different from centers in western world. More high-risk cases, paucity of excellent quality donor corneas, and differences in patient profile could be the contributory factors.

Pattern of histo pathological changes of liver in poisoning.

Increasing trend of poisoning in rural as well as urban set up for committing suicides must drive attention of law enforcing agencies to restrict its use and providing better methods for pest control. One of the organs suffered by such poisoning is liver, which is studied in detail in this study with special reference to histopathological finding. Out of total 140 autopsies 78 cases revealed histopathological finding in liver which varies with treatment, duration of survival, death autopsy interval. This may be helpful to conclude cause of death in obscure autopsies or even at each poisoning autopsy where opinion is reserved till viscera report is available. This may cut short time required for court proceeding, insurance claims based on these opinions.

Serum copper in rural women taking combined oral contraceptive.

This prospective case-control study included 78 women between 15 to 45 years of age from rural area to see changes in serum copper level as a consequence of oral contraceptive use. Among the subjects, 34 women were included as controls because of not taking any form of hormonal contraceptives neither during the time of selection nor during one-year period prior to the study. Women in the control group were motivated to consume oral pill (Sukhi) for 3 consecutive cycles. At the 3(rd) month, 25 such women became available and henceforth included as cases on longitudinal basis. Another 44 women were randomly selected as cases on the basis of using combined oral contraceptives (Sukhi) for a duration of 4 months onwards. Considering different duration of oral contraceptive (OC) use, subjects were grouped as follows: Group I (n=34)--> controls, Group II (n=25)--> 3 months, Group III (n=17)--> 4 months - 2 years and Group IV (n=27)--> >2 years. Finally, 103 samples of blood (34 from controls and 69 from oral contraceptives users) were collected for estimation of Serum Copper (mgm/dl) by Atomic Absorption Spectrometry using UNICAM-AA Spectrometer. Mean+/-SD of Serum Copper significantly increased in all 3 contraceptive groups in comparison to controls (p<0.001). Further study including larger population from rural area was recommended to see correlation among serum copper and other trace elements with side effects of hormonal contraceptives. This preliminary study tried to explore the possibility of establishing biochemical monitoring of serum trace elements in OC users.