Evaluation of platelet derived growth factor-BB levels in injectable platelet rich fibrin coated graft using gingival pedicle split thickness tunnel technique for isolated gingival recession: A randomized controlled trial.

Background: Use of injectable-platelet rich fibrin (i-PRF) in the field of periodontal regeneration is quite well known due to its efficacy. The study was aimed to evaluate the platelet derived growth factor-BB (PDGF-BB) levels in cases of isolated gingival recession using gingival pedicle split thickness tunnel technique (GPST) and de-epithelialized gingival graft (DGG) with or without coating it with i-PRF. Methodology: 20 patients exhibiting Miller's class I/II isolated gingival recession were selected for this parallel arm randomized controlled trial. Recipient site was prepared using GPST technique, free gingival graft was harvested and de-epithelialized, further graft was coated with i-PRF and wound fluid samples from surgical site were collected at baseline, 3rd day and 7th day for group A. The same procedure without coating the graft in i-PRF was carried out for group B. Clinical parameters like probing depth, recession depth, recession width, width of keratinized gingiva, wound healing index (WHI), complete root coverage was recorded at baseline and after 4 months. Results: Significant intergroup difference was seen in WHI and the levels of PDGF-BB from baseline to the last estimated time point (p < 0.05). Conclusion: The study emphasizes on the use of novel GPST technique in conjunction with DGG coated with liquid PRF, which has shown sustained release of PDGF-BB resulting in better wound healing.

Prevalence of HIV infection and high-risk characteristics among leprosy patients of south India; a case-control study.

With the observation of the occurrence of the human immunodeficiency virus (HIV) infection among leprosy patients in our pilot study carried out in Tamil Nadu, South India, a case-control study was planned to explore whether HIV infection is a risk factor for leprosy and to understand the characteristics of HIV infection and high-risk behaviors among leprosy patients. We screened 556 patients and 1004 nonleprosy controls (matching 502 cases for age, sex and area of residence) for HIV-1 and HIV-2 antibodies. They also were interviewed for personal information on history of blood transfusion, intravenous drug abuse, high-risk sexual behavior, and sexually transmitted diseases. Of the 1019 total cases screened (of both pilot and extended studies), 5 were found to be position for HIV antibodies (HIV-1 = 4, HIV-2 = 1); of the 1019 nonleprosy controls, 6 were positive for HIV-1 antibodies. An analysis by odds ratio revealed no association between leprosy and HIV infection (OR = 0.824, 95% CI = 0.201-3.593). A strong association was found only between high-risk behavior and HIV infection (OR = 5.186, 95% CI = 1.717-15.667). However, unmarried, unmarried after 30 years of age, exposure to spouses of the leprosy patients, and a history of surgery were all observed to be significantly more common among leprosy patients than the controls.

HIV infection amongst leprosy patients in south India.

In a pilot study, 463 leprosy patients (374 males and 89 females) were investigated for HIV-1 and HIV-2 antibodies by screening tests. Sera positive by the screening tests were subjected to confirmatory tests. Three cases were confirmed to be positive for HIV, two for HIV-1 and one for HIV-2. All the three positive cases were young males, who had visited commercial sex workers. No correlation was found between the type of leprosy and HIV infection. This is the first report of HIV infection amongst leprosy patients from South India.

PIP: Screening for HIV-1 and HIV-2 was performed on 463 leprosy patients (374 males and 89 females) from south India because of concerns about the possible adverse effects of HIV infection on the clinical course of leprosy as well as on leprosy vaccine trials. The first ELISA test was positive in sera from 30 patients. HIV was detected in 14 of these by a second ELISA, but confirmation was found for only three cases (two by gelatin particle agglutination test, solid phase enzyme immunoassay, and Western blot tests and the third by Immunocomb test). These three cases were all young adult men whose only risk factor was that they frequented prostitutes. The presence of HIV-1 in two patients and HIV-2 in the third points to the necessity to screen for both types of infection. No correlation appeared between type of leprosy and infection. These findings have led to the initiation of a larger study.

Indeterminate leprosy: a seroimmunological and histochemical evaluation.

An effort was made to differentiate indeterminate (IND) leprosy from other types of the paucibacillary (PB) group of leprosy and to identify among indeterminate leprosy cases those which may evolve to multibacillary (MB) leprosy, using serological, immunological and histochemical parameters. A total of 92 untreated, histologically classified (TT-19, BT-30, IND-32) patients, including 11 cases diagnosed as nonspecific dermatitis (NSD), which were clinically strongly suspected to be leprotic, were screened for antibodies against PGL-I, 35-kDa and LAM antigens. Lepromin tests and antigen demonstration in tissue by indirect immunoperoxidase staining were also carried out. Though a qualitative analysis did not differentiate, a quantitative analysis in terms of a cumulative index (CI) showed a higher antibody level amongst the indeterminate group of patients than the other groups included in PB leprosy. Also, the lepromin negative indeterminate group patients showed a higher CI than the lepromin positive cases, indicating that perhaps these may be the cases which may develop into MB leprosy. Thus, the semiquantification of antibody levels in the form of a CI may be a useful parameter to predict the possible evolution of a given case of indeterminate leprosy. Interestingly 64% of NSD cases had either antigen or antibody which indicated that they were probably cases of leprosy.

Clinical and laboratory predictors of invasive diarrhoea in children less than five years old.

Five hundred and thirty-three children < 5 years of age with acute watery diarrhoea were followed for appearance of blood in their stools to evaluate various clinical and laboratory predictors of dysentery. The statistical analysis was performed in two steps. Firstly, clinical and laboratory variables were evaluated as 'predictors' for isolation of invasive bacterial enteropathogens from stool culture. Secondly, all the variables, including isolation of invasive bacterial enteropathogens, were analyzed for predicting bloody diarrhoea. Presence of mucus (sensitivity = 57.4%, specificity = 83.1%, positive predictive value = 24.8%, negative predictive value = 95.3%, p = 0.0000) was the only significant clinical predictor of bloody diarrhoea. Polymorphonuclear leucocytes (PMN) > 10/hpf (sensitivity = 55.3%, specificity = 92.4%, positive predictive value = 41.3%, negative predictive value = 95.5%, p = 0.0000) and red blood cells, regardless of their number, (sensitivity = 78.7%, specificity = 93%, positive predictive value = 52.1%, negative predictive value = 97.8%, p = 0.0000) on light microscopy of fresh stool samples were two significant laboratory findings. Isolation of invasive bacterial enteropathogens was also a significant predictor of bloody diarrhoea (sensitivity = 19.1%, specificity = 89.5%, positive predictive value = 15%, negative predictive value = 92% p = 0.0077) but ranked lower than the other 3 variables. Our results indicated that it is the severity of invasion caused by offending enteropathogens, clinically manifesting as mucoid stools and/or presence of PMN or RBC, which may be a better indicator of the invasive process and subsequent development of dysentery rather than mere isolation of invasive enteropathogens from the stools.

Prevalence of copper resistant salmonellae in India.

Sixty eight of 330 strains of Salmonella belonging to three different serotypes, S. typhi, S. typhimurium and S. bareilly, referred to at the National Salmonella and Escherichia Centre, Central Research Institute, Kasauli, between 1989-1991 were found to be copper resistant. Maximum number of strains (39.1%) were resistant in S. bareilly serotype, followed by S. typhimurium (21.7%) and least in S. typhi (17.4%). Of the 15 States/Union Territories (UTs) from where Salmonella strains were received, copper resistance was observed in strains from 10 States/UTs. This resistance was maximum among the strains from Goa (85.7%).

Serological response of leprosy patients to Mycobacterium leprae specific and mycobacteria specific antigens: possibility of using these assays in combinations.

The serological response of 147 leprosy patients to 3 mycobacterial antigens, PGL-I, 35 kDa (Mycobacterium leprae-specific) and LAM (which is a common mycobacterial antigen) were analysed. A stronger serological response was seen amongst the MB patients than the PB patients in all the assays. The 3 antibody levels correlated positively with each other in both MB and PB cases. An overlap of seropositivity was seen between anti-PGL-I and anti-LAM (p > 0.05). A progressive increase in seropositivity and a significant difference of absorbance or titre in antibody levels in all 3 assays over increasing grades of BI were seen in the MB patients (p < 0.05). A significant difference in seropositivity between untreated and treated groups of patients was observed for anti PGL-I (p < 0.05) and antiLAM (p < 0.01) antibodies. The sensitivity, specificity and efficiency of antiPGL-I (50%; 99%; 70%), antiLAM (43%; 95%; 64%) and anti35 kDa (66%; 100%; 80%) assays taken individually were less than that of combinations of antiPGL-I/anti-35 kDa (74%; 99%; 84%) or antiPGL-I/anti-35 kDa/antiLAM (80%; 94%; 86%). The difference in the efficiency of both sets of combination of assays were not statistically significant (p > 0.05).

Salmonella choleraesuis subsp. indica serovar bornheim causing urinary tract infection.

An unusual Salmonella species, S. choleraesuis subsp. indica serovar bornheim, was isolated from the urine of a patient with aplastic anemia, diabetes mellitus, and a healed urethral injury. An immune response to this isolate was demonstrated by whole-bacterial-cell agglutination.

Surveillance of salmonellae in India for drug resistance.

Out of 3001 salmonella received during 1984-85, 2985 strains were tested for antibiotic resistance and R-pattern transfer. Multidrug resistance was observed in 73% of diarrhoeal and 43% of non-diarrhoeal isolates. Antibiotic resistance markers were transferable in 46.6% of diarrhoeal and 41.1% of non-diarrhoeal isolates. Two out of 4 salmonella sero-types isolated for the first time in India during this period were multidrug resistant.

Characteristics of Escherichia coli isolates from infantile and childhood diarrhea.

Seventy-five strains of Escherichia coli from cases of infantile and childhood diarrhea were serogrouped and analysed in terms of hydrophobicity, mannose resistant haemagglutination and enterotoxigenicity. The strains were distributed over 21 serogroups of which 54.6% were hydrophobic, 37.3% were haemagglutinating and 66.5% were enterotoxigenic. EPEC strains were less than ETEC strains. LT producers were more than LTST or ST producers. MRHA activity was found to be well correlated with hydrophobicity.

A study of the epidemiology of Salmonella bareilly in India using a new phage-typing system.

A total of 637 strains of Salmonella bareilly received from different parts of India between 1959 and 1985 were phage typed using five locally isolated wild phages. The overall typability was 94.5% and 11 different phage types could be defined. Phage types 10 and 1 were the most prevalent and the geographical and source distribution is described.

A new Salmonella serovar S.III b 58:z10:z53:Rz50.

A new Salmonella serovar S.III b 58:z10:z53:Rz50 was isolated from the water samples of Ashida river, Fukuyama city, Japan. Its antigenic structure is described.

A new scheme for phage typing Salmonella bareilly and characterization of typing phages.

A new phage typing scheme using wild bacteriophages isolated from sewage for phage typing Salmonella bareilly is described. Six hundred and thirty-seven strains of Salm. bareilly could be separated into 11 different phage types using five wild phages. Overall typability was 94.5%. These phages belonged to two different morphotypes. A1 and B1, and showed varying host range.