Cardiovascular risk markers in premature canities

Background: An elevated cardiovascular risk has been demonstrated in middle-aged individuals with onset of hair greying before the age of 30 years. Increased serum levels of pro-inflammatory cytokines, interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-?), indicate an ongoing state of chronic inflammation that is correlated with cardiovascular risk but have not been studied earlier in patients with early onset of hair greying. Aim/Objective: To study various cardiovascular risk markers including pro-inflammatory cytokines interleukin-6 (IL-6) and tumour necrosis factor-alpha (TNF-?) in patients with premature canities. Methods: This was a hospital-based case-control study of 40 patients with premature canities (age between 19 and 25 years; >5 grey hair) and an equal number of age and gender-matched healthy controls. The blood pressure, pulse rate and body mass index were recorded, and investigations including fasting blood sugar, serum insulin, fasting lipid profile, high sensitivity c-reactive protein (hs-CRP), IL-6 and TNF-? were performed. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated for all the participants. Results: The mean blood pressure, fasting blood sugar, serum insulin, hs-CRP and HOMA-IR were all significantly elevated in patients with premature canities and the serum HDL levels were significantly lower. A greater number of patients with premature canities had significantly elevated IL-6 as compared with the controls. Limitations: The sample size was small. A subjective scale was used for grading the severity of premature canities. Trichoscopic evaluation of severity of greying or modified phototrichogram could not be used in this study. Conclusion: Abnormalities in cardiovascular risk markers were found in patients with premature canities. Screening and counselling of patients with premature greying of hair is recommended in order to prevent future cardiovascular disease.

A study of serum vascular endothelial growth factor in infantile hemangiomas

Background: Though infantile hemangiomas are the most common benign tumor of infancy, their etiopathogenesis is not fully understood. Some studies report a diagnostic role for vascular endothelial growth factor (VEGF), but such studies are lacking from India. Aims: To study the clinicoepidemiological profile of infantile hemangiomas, to estimate and compare the serum levels of VEGF in infantile hemangiomas and controls, and to determine correlations between serum levels of VEGF and growth characteristics of infantile hemangiomas. Methods: A hospital-based, cross-sectional study was carried out on 30 clinically diagnosed cases of infantile hemangioma and 30 controls presenting with other disorders. VEGF levels were recorded for both cases and controls by the sandwich enzyme-linked immunosorbent assay (ELISA) technique. Results were analyzed using SPSS version 20.0, and their significance determined using appropriate tests. Results: Mean serum VEGF level in the cases was 216.8 ± 49.2 pg/ml while in the control group it was 115.1 ± 43.1 pg/ml (P < 0.0001). There were no statistically significant correlations between serum VEGF levels and sex or size, phase of growth, morphological variants or ulceration of lesions. Limitations: Our sample was not large enough to draw clinically applicable conclusions. An adequate sample size could not be achieved because of low incidence of the disease, and resource and time constraints. Conclusions: The mean value of serum VEGF in the study group was significantly higher than that in the control group, suggesting that serum VEGF can serve as a diagnostic marker of infantile hemangiomas. Mean serum VEGF was higher in proliferative lesions than in involuting lesions, indicating that it may also be useful as a prognostic serological marker in cases of infantile hemangioma.

Direct Immunofluorescence Profile Of Lichen Planus - A Fresh Look On Old Disease. A Study Of 15 Cases

Introduction: Lichen planus (LP) is a chronic inflammatory mucocutaneous diasease that is often diagnosed on the basis of clinical &/or histopathologic findings. However, it has some characteristic direct immunofluorescence (DIF) findings that can help in diagnosing confusing cases.Aim:We analyzed DIF findings in skin biopsy in LP compared to histopathology. Materials & methods: A skin biopsy of lesion was taken from 15 cases of LP(13 classic LP & 2 LP pigmentosus) & subjected to histopathology & DIF examination. Results:The sensitivity of histopathology and DIF was found to be 100% & 93.3% respectivelyfor the diagnosis of LP & LPP.

Fecal Contamination of Drinking Water Supplies in and around Chandigarh and Correlation with Acute Gastroenteritis.

The study evaluated drinking water from localities in and around Chandigarh for fecal coliforms, V.cholerae and Enterotoxigenic E.coli and correlate with occurrence of acute gastroenteritis occurring from the same region. Drinking water sample were collected from various sources from the defined area. Samples were tested for fecal coliforms and E.coli count by multiple tube method and pathogens by membrane filtration technique. E. coli were screened for heat labile toxin (LT) by the reverse passive agglutination method and heat stable toxin (ST) by ELISA. Stool samples from cases of acute gastroenteritis from the same region and time were collected and processed for V. cholerae, Enterotoxigenic E coli (ETEC) and others like Salmonella, Shigella and Aeromonas spp. Of 364 water samples examined, 116 (31.8%) samples were contaminated with fecal coliforms (58.5% rural, 33.4% semi-urban and 11.1% from urban areas). E. coli were grown from 58 samples. Ninety-two isolates of E. coli were tested for enterotoxins of which 8 and 24 were positive for LT and ST respectively. V. cholerae were isolated from 2 samples during the outbreak investigation. Stored water samples showed a significantly higher level of contamination and most of Enterotoxigenic E. coli were isolated from stored water samples. A total of 780 acute gastroenteritis cases occurred; 445 from semiurban, 265 rural and 70 from urban areas. Out of 189 stool samples submitted, ETEC were the commonest (30%) followed by V. cholerae (19%), Shigellae (8.4%), Salmonellae (2.1%) and Aeromonas (2.6%). ST-ETEC (40/57) were commoner than LT- ETEC(17/57). In the present study, high levels of contamination of drinking water supplies (32.1%) correlated well with cases of acute gastroenteritis. Majority of cases of acute gastroenteritis occurred in the semi-urban area corresponding with high level of contamination (33.4%). The highest level of water contamination was seen in rural areas (58.5%) but the number of acute gastroenteritis cases were lesser (33.9%) as ponds were infrequently used for drinking purpose. Safer household water storage and treatment is recommended to prevent acute gastroenteritis, together with point-of-use water quality monitoring.

Mucocutaneous manifestations in children with human immunodeficiency virus infection.

Skin is one of the most frequently involved organs in human immunodeficiency virus (HIV) infection, and mucocutaneous manifestations may be one of the earliest markers of AIDS. The prevalence of cutaneous abnormalities in HIV approaches nearly 90%. Mucocutaneous manifestations may also act as a prognostic marker of HIV infection. Children are increasingly being affected by HIV infection and it is important to realize the presence of the infection early in the disease process as their immune status is not mature enough to handle the stress of various infections. Skin manifestations can serve as early markers and prognostic indicators of HIV infection. This review highlights the epidemiology, transmission, pathogenesis, and the mucocutaneous manifestations of HIV infection in children.