Changing clinico-laboratory profile of encephalitis patients in the eastern Uttar Pradesh region of India

A cross-sectional study was done on 100 consecutive paediatric patients presenting with acute encephalitis syndrome. The clinico-laboratory features of all patients were recorded in a prestructured performa. Cerebrospinal fluid and serum samples were tested for: Japanese encephalitis (JE) virus; Chandipura virus; coxsackie virus; dengue virus; enterovirus 76; and West Nile virus. Twenty-two (22.0%) patients were confirmed JE cases and 17% had parasitic or bacteriological aetiology. The remaining 61 cases (61.0%) in which no viral aetiological agent was found were grouped as non-JE cases. Peripheral vascular failure, splenomegaly and hypotonia were distinguishing clinical features found in the non-JE patients. A high mortality of 26.5% was seen in patients with confirmed or presumptive viral encephalitis (22/83). A fatal outcome was independently associated with peripheral vascular failure and pallor at the time of admission. Early recognition of these signs may help clinicians to manage these cases.     

Bone Regeneration in Extraction Sockets with Autologous Platelet Rich Fibrin Gel

Aim

To evaluate the effects of autologous platelet rich fibrin gel (PRF gel) on bone regeneration following extraction.

Materials and Methods

The study design was approved by the Institutional Ethical Committee. Study sample consisting of a total of 22 patients requiring bilateral transalveolar third molar extractions were included after written informed consent. One side was randomly chosen as case and the other side was the control. Autologous PRF gel was prepared from Fresh blood obtained from the patient. The PRF gel was placed in the extraction site and primary closure was obtained. The patient was called for a follow up on the first post op day, 1st week, one month, three month and six months post op. Regeneration of bone was measured using serial radiographs (RVG) at immediate post op, one, three and six months. This was then compared with the bone regeneration seen in the control group, with the radiographs taken at same intervals, to estimate the difference in bone regeneration if any. RVGs were assessed for amount of radiologic bone filling by the method described by Matteo Chiapasco et al.

Results and Conclusion

Higher mean pixels was recorded in cases compared to controls at all the time intervals viz., immediate post op, 1 month post op, 3 months post op and 6 months post op. However, the difference in the mean pixels recorded between the two groups was not statistically significant (P > 0.05). For complete analysis, further follow up of the present patients and a larger sample size is required to obtain a conclusive result of the Bone Regeneration in extraction sockets with PRF gel.     

Analysis of mutational status, SNP rs16754, and expression levels of Wilms tumor 1 (WT1) gene in acute promyelocytic leukemia

Overexpression, polymorphisms, and mutations of the WT1 gene have been reported in several human tumors including acute myeloid leukemia (AML) and variably correlated with prognosis. Acute promyelocytic leukemia (APL) represents the AML subset disclosing higher WT1 expression levels; however, no WT1 studies specifically focused on APL have been conducted. We screened for the presence of mutations, SNP rs16754, and expression levels of WT1 gene in 103 adult patients with newly diagnosed APL. Fms-like tyrosine kinase (FLT3) mutations were analyzed as well. WT1 mutations were identified in four (4?%) patients. At least one copy of the minor SNP rs16754 allele (WT1 ^AG or WT1 ^GG) was detected in 30 (29?%) patients. Six patients (6?%) were homozygous for the minor allele (WT1 ^GG ) and this genotype was associated with higher WT1 mRNA copies (p?=?0.018). FLT3 mutations were found in 37?% of patients and correlated with high WT1 mRNA expression (p?=?0.004). Patients heterozygous or homozygous for the minor allele and patients homozygous for major (WT1 ^AA) allele did not differ in terms of presenting features. In adult APL, WT1 gene mutational and polymorphic profile shows similarities with pediatric AML rather than with adult AML.     

Cystic cochleovestibular anomaly presenting with congenital deafness and recurrent bacterial meningitis in childhood

Recurrent bacterial meningitis (RBM) in many instances is associated with identifiable anatomical defects. Presence of congenital deafness with recurrent meningitis should alert clinician for presence of middle and inner ear malformation. These defects can be demonstrated by various neuro imaging techniques and can be surgically corrected. In this case report we describe a child seen at our institute with congenital deafness and recurrent meningitis, discuss the approach to RBM and briefly describe inner ear malformation associated with the same and how to differentiate them.