The aim of this study was to evaluate the efficacy of combination therapy of diode laser and photodynamic therapy (PDT) as an adjunct to scaling and root planing (SRP) on interleukin-17 (IL-17) levels in gingival crevicular fluid (GCF) in patients with chronic periodontitis. Thirty subjects with chronic periodontitis were included. All teeth received periodontal treatment comprising of SRP. Using a split mouth study design, the test group was additionally treated with a combination therapy of diode laser and PDT. GCF was collected to evaluate IL-17 levels at baseline and 3 months. There was no difference in baseline values for levels of IL-17 in GCF in the test group and the control group. A significant decrease in GCF levels of IL-17 was observed in both treatment groups 3 months after treatment ( < 0.001). However, the treatment groups showed no significant difference ( > 0.05). Based on the results of the present study it was concluded that, GCF levels of IL-17 changed significantly after treatment regardless of treatment modality.

Transfusion usage greatly exceeds that in the Jamaican Sickle Cell Clinic. Transfusion therapy carries risks and cost and more detailed investigation and diagnosis of anemic episodes is necessary to define the role of transfusion among other potential therapies. Eventually, guidelines evolved by Indian specialists should determine the indications for transfusion in sickle cell disease.

Sickle cell disease (SCD) poses considerable public health problems in India. This study was undertaken to understand the clinical course of SCD among children identified during newborn screening programmes in Gujarat and Madhya Pradesh where the frequency of the HbS gene is high. A total of 8,916 newborn babies 8,411 from Gujarat and 505 from Madhya Pradesh were screened over 6 years (2010–2016) using HPLC and the diagnosis was confirmed by molecular analysis in a subset. A total of 128 babies (122 Gujarat, 6 Madhya Pradesh) were identified with sickle cell disease, of whom 87 (69 HbSS, 18 HbS-β thalassemia) from Gujarat were followed for 0.5–6.6 years. Acute painful events, severe anemia and fever with infections were the major complications and 23 babies required hospitalization. Severe to moderate clinical presentation was found in 13.8% babies with SCD whereas, 86.2% babies had a milder presentation. Presence of ameliorating factors (α-thalassemia and Xmn 1 polymorphism) did not have a discernible effect on the clinical severity. Parents of babies with SCD were educated and counseled for home care. Distribution of mobile phones to 44 families having babies with SCD was beneficial as it allowed regular contact with patients and their families. Genetic counseling to the affected families has increased the awareness and acceptance for prenatal diagnosis and 18 couples opted for prenatal diagnosis in subsequent pregnancies. SCD is not always mild among tribal groups in India. Therefore, facilities for early diagnosis and prophylactic treatment in the tertiary care centers should be made available. The difficulties in regular follow up of the babies in remote rural areas have also been highlighted.

Background: Pyrexia in association with hepatic dysfunction is commonly found in clinical practice with varied etiologies like malaria, dengue, typhoid, scrub typhus, viral hepatitis, etc. The liver is frequently involved in systemic infections, resulting in various types of abnormal liver function tests. It is very important to know the frequency and pattern of abnormal liver function tests in each infection for its appropriate management.Methods:  A complete data of all the patients admitted in medicine wards and medicine ICU from January to December 2018 were studied. One hundred and ten patients with fever with abnormal liver function tests were interviewed and presenting complaints were noted. Demographic data such as age and sex were noted. These patients underwent a thorough general physical examination and systemic examination. The findings were noted on a predesigned and pretested proforma. The selected patient underwent blood investigations related to liver functions.Results: Most of the patients were of age group of 21 to 50 years (65 patients), 67 patients (60.91%) were males and 43 (39.09%) were females. Malaria (25.45%) and dengue (26.36%) were major etiologies. Hepatomegaly (46.36%), icterus in (45.45%) and splenomegaly (42.73%) were most common clinical signs.Conclusions: Present study will help clinicians to identify etiological factors and clinical picture in patients of pyrexia with hepatic dysfunction.

Cardiac metastasis due to primary lung lesion is a rare entity. The involvement of endocardium is very unusual. Moreover, cardiac metastasis may present is different ways. Here we present a case of a male in his sixth decade who presented with right ventricular outflow tract ventricular tachycardia. On examination, a cardiac metastasis in endocardium of primary lung origin was observed. A 62-year-old male was admitted with history of recurrent episodes of palpitation, perspiration and chest pain since 2 months. On admission, electrocardiogram was done which showed monomorphic ventricular tachycardia with LBBB and inferior axis was suggestive of right ventricular outflow tract ventricular tachycardia (RVOT-VT) (Figure 1). Immediately synchronised DC shock was used to cardiovert to normal sinus rhythm. He had no family history of QT prolongation, arrhythmia or sudden cardiac death. He was evaluated with 2D-Echocardiography which showed large echogenic mass on right ventricular wall extending up to RVOT. It was adherent to myocardium, sessile with rough borders. It raised a suspicion of tumour or metastasis of right ventricle. In view of RVOT-VT we started metoprolol 25 mg twice daily. Chest X-ray and ultrasonography was normal. Coronary angiography was normal. Cardiac MRI showed a 62 x 26 mm well defined lesion with central necrosis involving anterior wall of right ventricle with post contrast enhancement which was suggestive of neoplastic mass (Figure 2). There was an ill-defined soft tissue lesion with post contrast enhancement in left lower lobe of lung which was likely to be primary or secondary neoplastic lesion. As RV free wall mass was easily approachable to endomyocardial biopsy, we planned the same and took multiple endomyocardial biopsies which were sent for histopathology and immunohistochemistry. Histopathological report showed intermediate grade fibrosarcoma or malignant fibrohistiocytic tumour. When the patient was informed about his condition, he denied treatment for metastasis and subsequently he succumbed after one month of diagnosis.