Interrelationship between Diabetes and Periodontitis- A Review

Evidence for the link between periodontal disease and several systemic diseases is growing rapidly. Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life causing morbidity and mortality. Periodontitis, one of these complications, is a chronic infection associated with substantial morbidity in the form of tooth loss and that affects the quality of life directly. The association between diabetes and inflammatory periodontal disease has been studied extensively. The relationship between these two conditions appears bidirectional. The presence of one condition tends to promote the other and the meticulous management of either may assist treatment of the other. It also provides a perfect example of a cyclical association, whereby a systemic disease predisposes the individual to oral infections, and once the oral infection is established, it exacerbates the systemic disease. This review focuses to explain the interrelationship between the two based on information in the literature and the potential common immunoregulatory connections involved, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes. Keywords: Diabetes mellitus; inflammation; insulin resistance; periodontitis.

Interrelationship between diabetes and periodontitis: a review

Evidence for the link between periodontal disease and several systemic diseases is growing rapidly. Diabetes mellitus is a systemic disease with several major complications affecting both the quality and length of life causing morbidity and mortality. Periodontitis, one of these complications, is a chronic infection associated with substantial morbidity in the form of tooth loss and that affects the quality of life directly. The association between diabetes and inflammatory periodontal disease has been studied extensively. The relationship between these two conditions appears bidirectional. The presence of one condition tends to promote the other and the meticulous management of either may assist treatment of the other. It also provides a perfect example of a cyclical association, whereby a systemic disease predisposes the individual to oral infections, and once the oral infection is established, it exacerbates the systemic disease. This review focuses to explain the interrelationship between the two based on information in the literature and the potential common immunoregulatory connections involved, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes.

Preliminary investigation of test-retest reliability of a robotic assessment for Parkinson's disease

Several systems have been proposed to objectively quantify the motor signs of Parkinson's disease. While validity has been investigated for a subset of these systems, test-retest reliability of automated assessments has been more neglected. We have created a protocol that uses a robotic system to measure force and position as the user performs tracking tasks with and without a simultaneous cognitive or motor task. We present preliminary results for test-retest reliability with eight individuals with early to moderate PD. Based on this data, we identified variables with large, significant correlations between the test and retest data. A total of 21 reliable variables were identified with all portions of the assessment protocol producing reliable variables.

Impalement injury to the heart

Cardiac impalement injury is rare and one of the most severe penetrating chest injuries, often fatal. The management of penetrating cardiac injuries is a challenging one. The success in management of impaling cardiac trauma requires stabilization of the impaling object, expeditious transfer to a facility for open heart surgery, rapid imaging, access to blood and blood products and a ready surgical team. We report a case of impalement injury to the heart by a stick, transfixing the right ventricle and its successful treatment.

Anterior cingulate and cerebellar GABA and Glu correlations measured by ¹H J-difference spectroscopy

Gamma-aminobutyric acid (GABA) and glutamate (Glu) levels, normalized to total creatine (tCr), were measured in the anterior cingulate and cerebellar vermis in healthy adults (n=19, age=24.6±6.4 years) using ¹H MRS at 3 T, and metabolite correlations across regions and subjects were determined. Mean anterior cingulate and cerebellar GABA/tCr ratios were 0.31 (0.08) and 0.23 (0.06), respectively, while corresponding Glu levels were 1.16 (0.10) and 0.70 (0.07), respectively. Anterior cingulate and cerebellar glutamate levels were correlated (r=0.6103, P=.0140), although it is noted that when adjusted for multiple comparisons, all correlations reported here cluster to a P value of .0583. It is unlikely that this correlation is driven by correlations in tCr, since interregional correlations were not observed for other metabolites referenced to tCr. Correlations were also observed among metabolites in both the anterior cingulate and cerebellar vermis. In the former, N-acetylasparate was linearly dependent on glutamate (r=0.6577, P=.0063) and, at or below this significance threshold, four metabolites were correlated in the cerebellar vermis (Ins/tCh: r=0.6261, P=.0109. NAA/tCh: r=0.6426, P=.0082. NAA/Glu: r=0.6412, P=.0085. tCh/Glu: r=0.6193, P=0.0122).

Immunoglobulin IgG Fc-receptor polymorphisms and HLA class II molecules in Guillain-Barré syndrome

OBJECTIVE

To analyze host genetic factors immunoglobulin G Fc receptors (FcgammaRs) and human leukocyte antigen (HLA) class II in GBS patients.

METHODS

FcgammaRIIA, IIIA and IIIB polymorphisms were studied in 80 each GBS patients and healthy controls by allele specific PCR. HLA class II DRbeta1 and DQbeta1 typing was performed at the two-digit level by PCR in randomly selected 54 GBS patients and 202 controls.

RESULTS

FcgammaRIIA-H/H (56% vs 9%; P < 0.0001) and FcgammaRIIIA-V/V (40% vs 13%; P < 0.0001) genotypes, H131 allele frequencies (0.73 vs 0.26, P < 0.0001) and HLA DQbeta1*060x (OR, 1.96; 95% CI, 1.26-3.04; P < 0.01) were significantly increased in GBS than controls. DRbeta1*0701 alone (OR, 10; 95% CI, 45.90-2.25; P < 0.001) and together with FcgammaRIIA-H/H (OR, 11.03; 95% CI, 2.63-46.20; P < 0.001) was significantly associated with GBS patients having microbiological evidence of recent infection.

CONCLUSIONS

The study indicates that homozygous FcgammaRIIA and FcgammaRIIIA genotypes and FcgammaRIIA H131 allele are associated with GBS. HLA class II molecule DRbeta1*0701 is identified as novel genetic risk factor for development of GBS in patients with preceding infection.

Nitrogen reduction in wastewater treatment using different anox-circulation flow rates and ethanol as a carbon source

We studied the optimization of nitrogen reduction from municipal wastewater in a laboratory-scale modified Ludzack-Ettinger activated sludge wastewater treatment plant (WWTP). The unit consisted of primary denitrification, secondary nitrification, a sludge clarifier and a post-denitrification unit. The process simulates the Kuopio WWTP, which provided the influent utilized. We describe the effect of varying anox-circulation schemes on the nitrogen removal efficiency. We further compare the denitrification efficiencies of ethanol and methanol applied in the post-denitrification unit, and compare the properties and costs of these chemicals as carbon sources. Maximum efficiency of total nitrogen removal (70.8%) was obtained with 256% anox-circulation. The process was, however, not very sensitive, as a wide range of 150-400% of anox-circulations gave good results for nitrogen reduction. The unit achieved high BOD, and COD reductions of wastewater also when nitrogen reduction was moderate. The addition of 40 mg/L/day of ethanol to the post-denitrification tank meant that the nitrate-levels of effluent could be controlled to below 10 mg/L of nitrate nitrogen. Methanol and ethanol were equally effective for denitrification. The use of ethanol instead of methanol could reduce treatment costs by 30% to 0.02 E/m3 of treated wastewater according to 2008 market prices.

Feature selection for classification based on fine motor signs of Parkinson's disease

Effective evaluation of potential neuroprotective interventions for Parkinson's disease (PD) requires precise quantification of the motor signs associated with this disease. We have created a protocol that uses force tracking in a simultaneous task paradigm to quantify the fine motor control deficits in individuals with PD. We have used this protocol to collect data from 30 individuals with early to moderate PD and 30 age-matched controls. Based on this data, we computed 60 variables. We generated all possible combinations of three of these variables, and we then computed the classification accuracy of a support vector machine (SVM) trained on each variable combination. We were able to correctly classify 85% of subjects as with or without PD. We found that root-mean-square error variables were the most important features for classification and that utilizing a simultaneous task paradigm improves classification accuracy.

Role of the oestrogen receptor (ESR1 PvuII and ESR1 325 C->G) and progesterone receptor (PROGINS) polymorphisms in genetic susceptibility to migraine in a North Indian population

We aimed to explore the single-locus, haplotype and epistasis patterns and the contribution of oestrogen receptor [ESR1 PvuII (rs2234693), ESR1 325 C→G (rs1801132)] and progesterone receptor [PROGINS (rs1042838)] polymorphisms in genetic susceptibility to migraine by analysing 613 subjects consisting of 217 migraine patients, 217 healthy controls (HC) and 179 patients with tension-type headache (TTH). Entire data were analysed by taking the Bonferroni corrected P-value into account. We found significant association of TT genotype [odds ratio (OR) 3.458, confidence interval (CI) 1.757, 6.806; P = 0.0003] and T allele (OR 1.729, CI 1.309, 2.284; P = 0.0001) of ESR1 PvuII single nucleotide polymorphism with migraine when compared with HC. Significant association was seen only in female migraine patients at both genotype (P = 0.002; OR 3.834, CI 1.625, 9.043) and allele level (P = 0.002; OR 1.721, CI 1.228, 2.413). Moreover, higher risk was limited to migraine with aura (MA) (in case of TT genotype, P = 0.002; OR 4.377, CI 1.703, 1.246; in case of T allele, P = 0.001; OR 1.888, CI 1.305, 2.735) rather than migraine without aura (MoA) (P-value of TT genotype = 0.003; OR 3.082, CI 1.465, 6.483; P-value T allele = 0.002; OR 1.630, CI 1.188, 2.236). In case of a recessive model, risk was seen with migraine patients (P = 0.0003; OR 2.514, CI 1.635, 3.867), MA (P = 0.0001; OR 3.583, CI 1.858, 6.909) and MoA patients (P = 0.002; OR 2.125, CI 1.304, 3.464) when compared with HC. No risk was observed when TTH patients were compared with HC. No significance of ESR 325 G→C polymorphism was seen in any of the models under study. Significant differences in genotypic (P = 0.0001) and allelic frequency (P = 0.0002) were seen in case of PROGINS polymorphism when migraine patients were compared with HC, showing a protective effect (for A1A2 genotype, OR 0.292, CI 0.155, 0.549; for A2 allele, OR 0.320, CI 0.174, 0.589). Moreover, significance was seen only in case of female migraine patients at genotype (P = 0.002; OR 0.344, CI 0.176, 0.684) as well as allele levels (P = 0.004; OR 0.379, CI 0.198, 0.727) in case of PROGINS polymorphism. ESR1 PvuII TT*ESR1 325 C→G CG genotype, PROGINS A1A2*ESR1 325 C→G CG genotype and ESR1 PvuII CT*PROGINS A1A2 interacted significantly, but significance was lost after Bonferroni correction. In conclusion, ESR1 PvuII polymorphism is a significant risk factor for migraine particularly in women and MA patients, but ESR 325 C→G polymorphism is not associated with migraine susceptibility. PROGINS polymorphism seems to play a protective role in genetic susceptibility to migraine in the North Indian population.

Investigation of TNFA 308G > A and TNFB 252G > A polymorphisms in genetic susceptibility to migraine

We aimed to look for the association of tumor necrosis factor (TNF) gene polymorphisms (TNFA 308G > A, and TNFB 252G > A) in genetic susceptibility to migraine. The pathogenesis of migraine involves many immune-mediated mechanisms in the vascular endothelium. TNF, being a potent immunomodulator and pro-inflammatory cytokine, is suggested to be involved in inflammatory reactions leading to migraine attacks. A total of 216 normotensive migraine patients, 160 tension type headache (TTH) patients and 216 healthy controls (HC) were recruited in the study. The genetic polymorphisms were investigated through SNP association analysis using a matched case control migraine population. Genotyping of TNFA 308G > A polymorphism and TNFB 252G > A was done using ARMS PCR and PCR-RFLP, respectively. A borderline association was observed in TNFA 308GA genotype in migraine patients versus HC (p = 0.043; OR = 1.763; 95% CI = 1.019-3.051). After sub-grouping migraine into migraine with aura (MA) or without aura, significant difference at genotypic (p = 0.015; OR = 2.293; 95% CI = 1.172-4.487) as well as allelic (p = 0.035; OR = 1.955; 95% CI = 1.047-3.651) level was evident. The difference was even more significant in female MA at genotypic (p = 0.006; OR = 2.901; 95% CI = 1.361-6.181) and allelic level (p = 0.017; OR = 2.318; 95% CI = 1.159-4.635) as well as for A allele carriers in MA [p value = 0.020; OR = 2.205 (1.132-4.295)] and female MA (p value = 0.008; OR = 2.741; CI = 1.297-5.792). No association of TNFB252G > A was observed in migraine patients or any subgroups. We did not find any association of TNFA or TNFB gene polymorphisms with TTH. In conclusion, the TNFA 308G > A polymorphism was found to be associated with MA, particularly in females, whereas we could not find any association of TNFB 252G > A polymorphism in genetic susceptibility to migraine on comparing the migraine patients with HC or TTH patients.

Role of ultrasound in early pregnancy in differentiating normal and abnormal pregnancies

A prospective study was carried out from November 2006 - December 2008 in which a total of 304 patients with early pregnancy were examined by ultrasound (US). Of these, 203 (66.8%) cases were normal pregnancies (including 8 cases of twin pregnancy), 32 (10.5%) missed abortions, 19 (6.3%) incomplete abortions, 14 (4.6%) complete abortions, 12 (4.0%) blighted ovums, 11 (3.6%) without sonographic evidence of pregnancy, 7 (2.3%) ectopic pregnancies and 6 (1.9%) molar pregnancies. US in early pregnancy gave a reliable and accurate differentiation between a viable normal pregnancy and an abnormal/pathological pregnancy.

Gingival enlargement in antihypertensive medication

INTRODUCTION

Drug-induced gingival enlargement is a well documented side effect with the use of phenytoin, cyclosporine and calcium channel blockers. The prevalence of gingival enlargement induced by calcium channel blockers is uncertain. Several studies show conflicting results ranging from 20% to 83%. This study was conducted to determine the prevalence of gingival enlargement in patients taking antihypertensive medication.

METHODS

All consecutive patients on antihypertensive agents attending the Dental OPD were studied. The prevalence of drug induced gingival enlargement was determined. The periodontal condition of all subjects were assessed including plaque index and probing depth.

RESULTS

Total 81.2% of subjects taking antihypertensive were seen to have significant enlargement. Among them 71.1% were taking calcium channel blocker, 21.5% were taking ACE Inhibitors, and 7.4% were taking beta-blockers.

CONCLUSIONS

Patients taking antihypertensive agents are at increased risk for gingival enlargement and inflammation is an important cofactor for the expression of this effect.

No association of ABCB1 polymorphisms with drug-refractory epilepsy in a north Indian population

Multiple drug resistance is a common problem in the treatment of epilepsy, and approximately 30% of patients continue to have seizures despite all therapeutic interventions. Among various classes of drug transporters, genetic variants of P-glycoprotein (P-gp) encoded by the ABCB1 (ATP-binding cassette subfamily B member 1) gene have been associated with drug-refractory epilepsy. Our aim was to investigate the effect of the 1236C>T(rs1128503), 2677G>T/A(rs2032582), and 3435C>T(rs1045642) single-nucleotide polymorphisms of ABCB1 (or MDR1) on drug resistance in north Indian patients with epilepsy. Genotyping was performed in 101 control subjects and 325 patients with epilepsy, of whom 94 were drug resistant and 231 drug responsive. Therapeutic drug monitoring for phenytoin, carbamazepine, phenobarbital, and valproate was also performed to confirm compliance in 20% of the patients. Genotype and haplotype frequencies of these polymorphisms did not differ between drug-resistant and drug-responsive patients. Our results demonstrate ABCB1 polymorphisms are not associated with drug resistance in north Indian epileptic patients.

Biological-chemical treatment of soils contaminated with exploration and production wastes

Oil-gas exploration and production (E&P) soils contaminated with total petroleum hydrocarbons (TPHs) have been tested for degradation by two different treatments: biological and chemical. Biological treatment includes the use of native microorganisms for transformation of the various hydrocarbons found in E&P soils. Degradation of TPH of 80 and 86%, was achieved for two different soils, respectively in control experiments. The effect of growth stimulants such as glucose, acetic acid, and valeric acid was examined on TPH degradation. Incorporation of inducer (valerate) enhanced the degradation up to 89 and 93%, for the two soils, respectively. A large portion (> 41%) of contaminant in one soil was comprised of compounds in the carbon range of C10-C16 and < 7% constituted carbon range of C24-C28. The degradation of C10-C16 compounds was higher (> 98%) as compared to C24-C28 compounds (< 75%). Likewise, the degradation rate was also higher (58 mg/kg/d) for lower compounds as compared to higher carbon range compounds (6.7 mg/kg/d). Experiments conducted on chemical treatment included the effect of chelators on stabilization of H2O2, comparative studies between buffer and water (used for soil preparation), and the effect of pH on TPH degradation. The rate of oxygen evolution from H2O2 was significantly reduced with use of either chelated iron or phosphate buffer using naphthelene as a model compound. Chemical treatment demonstrated a higher degradation of TPH from contaminated soils at pH 4.0 as compared to a pH of 7.0. More degradation was obtained with slurry prepared in phosphate buffer as compared to deionized water.

Reye Syndrome – A Case Report with Review of Literature

Here we describe a case of Reye syndrome diagnosed at postmortem liver biopsy of a three-year oldgirl who presented with vomiting, low grade fever for three days and loss of consciousness for 18hours. Clinically, the differential diagnoses were meningitis, encephalitis and septicemia. No historyof past illness or any drug ingestion including aspirin were present. Laboratory investigationsindicated a diagnosis of Reye syndrome. The child was given supportive treatment but died aftertwo days of admission and postmortem needle-biopsy of the liver showed microvesicular steatosisconsistent with Reye syndrome.Key words: Microvesicular steatosis, mitochondrial hepatopathy, Reye syndrome, Reye-like syndrome

Measurement of temperature of laser cooled atoms by one-dimensional expansion in a magneto-optical trap

We discuss a simple time of flight technique for measurement of temperature of a cold cloud in a magneto-optical trap (MOT). The technique is based on spatiotemporal fluorescence imaging of the cloud that is allowed to undergo one-dimensional expansion in the presence of the orthogonal two-dimensional configuration of laser beams by temporal modulation of a pair of counterpropagating trapping beams in the MOT. We show that, in the time scale 0< or =t<5 ms, the expansion of the cloud is ballistic and the temperature can be extracted from the time variation of the rms size of the cloud in the expansion direction. The reliability of the technique has been established by comparing the results with release and recapture method, and also by fitting them to the known temperature scaling law.