Role of Periodontist in Screening Diabetes- A Correlation of Clinical and Biochemical Parameters

The increased prevalence and severity of periodontitis seen in patients with diabetes, especially those with poor metabolic control, has led to the designation of periodontal disease as the “sixth complication of diabetes” and successful periodontal therapy in diabetic patients entails the stabilization of blood glucose to a normal range. Hence, present study evaluates whether the noninvasive method of testing gingival blood glucose, is a reliable tool for screening diabetes in chronic periodontitis patients. Methods: The study sample comprised of 75 patients with probing pocket depth of > 4mm and clinical attachment loss of >3mm. Under aseptic measures and proper isolation, after gently probing the gingival sulcus the blood was drawn onto the glucometer strip and the readings were recorded. At the same visit blood was also collected from the index finger onto the glucometer strip. The statistical methods applied were Student's t-test (unpaired) to compare mean values between the two groups and Pearson's correlation for Means and Standard Deviation of the different parameters were calculated. Results: There is a positive correlation between GCBG and CFBG with all the clinical parameters. Fasting blood glucose level is negatively associated with age, plaque index and clinical attachment level (r=0.083, r=0.22 and p=0.042, respectively) whereas Post prandial blood glucose level is negatively associated with age, plaque index and probing pocket depth (r=0.117, r=0.099 and r=0.06, respectively). CFBG is slightly positively correlated with age, plaque index and clinical attachment whereas GCBG is strongly associated with probing pocket depth. Conclusion: The gingival crevicular blood glucose levels also found a positive correlation with the fasting blood glucose levels and post prandial blood glucose levels, suggesting the use of gingival crevicular blood as a screening marker for diabetes. Also a correlation was found between the gingival crevicular blood glucose levels and the clinical parameters suggesting that the treatment of periodontal disease can be considered as an important factor, which can help in improvement of the blood glucose levels in periodontitis subjects.

Phenotypic characterization and susceptibility of gram negative bacteria from surgical site infections in a tertiary care hospital

Background: Gram negative bacteria are the common isolates among the cases of Surgical Site Infections (SSI). Resistant and specially Multi Drug Resistant (MDR) Gram negative isolates are a serious challenge for the treatment to clinicians. Present study was undertaken for phenotypic characterization and susceptibility pattern of Gram negative bacterial isolates from cases of surgical site infections in a tertiary care institute.Methods: This descriptive cross sectional hospital based study was conducted in a tertiary care teaching hospital over a period of one and half year from January 2012 to June 2013. Centers for disease control and prevention (CDC) SSI case definitions were used to label a case as SSI. Only culture proven cases, out of clinically suspected was included in the study for evaluation.Results: During the study period a total of 5949 patients were operated and screened for SSI in the wards under surveillance. Out of which 556 were clinically suspected as a case of SSI. With 408 culture proven cases of SSI the rate of SSI in present study was (6.86%). Rates of SSI were more in dirty (22.54%) and contaminated (13.78%) type of wounds. Among Gram negative bacterial isolates (n=343) from SSI, E. coli (45.18%) was the commonest followed by Pseudomonas aeruginosa (16.03%) and Klebsiella pneumoniae (13.42%). Unpleasant trend in antimicrobial resistance observed during study is a serious concern.Conclusions: The data presented in this study clearly indicate the continuous need of surveillance of SSI. This will clearly help health care personnel in curtailing down the incidences of SSI.

Advances in human papilloma virus vaccines: a review.

Cervical cancer is the second most common cancer among women and third leading cause of cancer death. Approximately 500,000 women worldwide develop new cases of cervical cancer annually, with 80% of these new cases occurring in developing countries. Human papilloma virus (HPV) infection is the main factor associated with the development of cervical cancer. The currently available HPV vaccines, gardasil and cervarix, can prevent infection by certain HPV types, but not all. At present, research efforts are being devoted to developing broader spectrum preventative vaccines, as well as therapeutic vaccines. To confer additional therapeutic activities, chimeric vaccines have been developed. Multivalent vaccine technologies employ strategies for addressing a broader spectrum of HPV types or for combining HPV with other pathogens. Edible vaccines are also disclosed. For needleless immunization, jet gun, gene gun and microneedles have been developed. Biodegradable and mucoadhesive polymer-based vaccine formulations have been developed to deliver vaccines through the mucosa and enhance immunogenicity. Various viral vectors of recombinant HPV DNA vaccine are disclosed.

Posterior mediastinal mass: Do we need to worry much.

Anesthetic management of mediastinal masses is challenging. There is abundant literature available on anesthesia management of anterior mediastinal mass. Anesthetic management of posterior mediastinal mass lesions normally have uneventful course. We describe airway collapse and difficult mechanical ventilation in the postoperative period in a patient with posterior mediastinal mass.