Association Of Systemic Diseases Research Articles

An Update on Noninfectious Retinal Vasculitis.

Retinal vasculitis (RV) signifies the inflammation of various retinal vessels. Noninfectious RV differs from infectious RV with regard to its pathogenesis and treatment. It can have varied clinical presentations and may be associated with systemic vasculitic diseases. Noninfectious RV can be caused due to type-III hypersensitivity reactions, increased expression of intracellular adhesion molecules, and genetic susceptibility. Noninfectious RV is primarily classified on the basis of the type of retinal vessels involved. It can be further classified as an occlusive or nonocclusive. RV can be a major association of systemic diseases like Behcet's disease, sarcoidosis and systemic lupus erythematosus. Newer modalities, like ultra-widefield fundus fluorescein angiography, can help in the management of RV. Effective treatment of noninfectious RV requires anti-inflammatory and immunosuppressive therapy. The patients may require treatment with high-dose corticosteroids and biological agents. Anti-vascular endothelial growth factor injections and laser photocoagulation may be indicated to treat the occlusive disease. Prompt treatment may prevent complications like vitreous hemorrhage, neovascular glaucoma, and tractional retinal detachment. The treatment more often requires a multidisciplinary approach. This review provides a comprehensive update on the various causes of noninfectious RV, including both systemic and isolated ocular conditions. It also details various complications and management strategies for this condition.

Salivary Trefoil Factor (TFF3) in Stage I–II Periodontitis: A Prospective Clinical Study

Abstract Objective This article evaluates the salivary trefoil factor levels using enzyme-linked immunosorbent assay and clinical parameters in stage I to II periodontitis subjects. Materials and Method A total of 44 subjects with periodontitis and healthy periodontium were enrolled for the study as per the inclusion criteria. The subjects were selected and categorized as group A (control group) and group B (test group). Scaling was performed on healthy subjects at baseline and 1 month if necessary and scaling and root planing was performed for periodontitis subjects. Trefoil factor 3 (TFF3) levels was analyzed at first and post-nonsurgical periodontal therapy followed by clinical parameters, respectively. Statistical Analysis Inferential statistics were performed using independent t-test and repeated measures of analysis of variance (ANOVA) test. Independent t-test was used for the intergroup comparison of all the variables. Repeated measures of ANOVA test along with post hoc Bonferroni test was used for the intragroup comparison and the level of statistical significance was set at 0.001. Results Difference in TFF3 levels and clinical parameters was seen between groups A and B, which was statistically significant. Conclusion Within the constraints of the study, it can be stated that TFF3 is a relevant biomarker to determine the activity and association of periodontal and systemic diseases, gastrointestinal disorders, and inflammatory bowel diseases.

The role of the immune response in the development of pneumonia arising from oral periodontitis: a literature review

Link of Video Abstract: https://youtu.be/Cgi15seZAw4 A growing evidence links periodontitis, a chronic inflammatory disease of the oral cavity, to the development of systemic inflammation. One of the most commonly reported is pneumonia, arising from aspiration of the periodontal pathogens into the lung tissue. In high-risk individuals, the morbidity and mortality rate is high, raising the concern for prevention measures. Secondary systemic effects are proposed to arise from both direct periodontal pathogens spread and through leakage of bacterial byproducts and local inflammatory cytokines to the bloodstream. The association of periodontitis and systemic diseases is bi-directional, as systemic diseases may, in turn, increase the incidence and severity of periodontal diseases. Here, the conflicting roles of the immune system in both limiting pathogen growth and its potential catastrophic inflammatory activation is further discussed. In addition, possible approaches to prevent periodontitis from spreading into the respiratory organs are also proposed. Given the large number of the population affected by periodontitis, a comprehensive understanding of the pathomechanisms of the development of systemic diseases, notably pneumonia, as well as the discovery of prevention and therapeutic approaches, is urgently needed.

Association of systemic diseases with chronic pruritus

Background/Aim: Pruritus is an unpleasant sensation that provokes the desire to scratch. It is one of the most common reasons why patients consult a dermatologist. Aim of this study was to determine the association of chronic pruritus with skin and systemic diseases, as well as the age and sex distribution in the studied population. Methods: The cross-sectional study included 120 patients of both sexes who, in the period from January 2017 to January 2021, received outpatient and inpatient treatment at the Skin and Venereal Diseases Clinic of the University Clinical Centre of the Republic of Srpska diagnosed with pruritus. Through the Clinical Information System insight was gained into the medical history and other documentation of the subjects from which data were taken on the age and sex of the subjects, onset, course and duration of pruritus, daily or seasonal variations in intensity, as well as the presence of associated skin and systemic diseases. Results: Out of a total of 120 subjects, a larger number (53.3 %) of subjects with chronic pruritus were male, and 46.7 % were female, the difference was statistically significant (p < 0.05). The analysis of the distribution of subjects according to their age revealed that the largest number of subjects (62.6 %) was over 65 years of age, while 38.4 % of subjects were under 65 years of age. The difference in the age structure was statistically significant (p < 0.05). In subjects older than 65 years pruritus was most frequently (47.3 %) associated with diabetes and in subjects under 65 years of age with skin diseases and conditions. The difference was statistically significant (p < 0.05). Conclusion: In people aged over 65 years, pruritus was most frequently associated with systemic diseases (diabetes mellitus) and in people aged under 65 years with dermatological diseases (Dermatitis atopica).

North India Childhood Cataract Study - The real scenario and causes of surgical delay of pediatric cataract.

Purpose:The study sought to describe the clinical presentation pattern of pediatric cataracts and factors leading to delay in surgery at a tertiary care center in North India.Methods: A cross-sectional, interview-based study was conducted from January 2020 to October 2020, that included pediatric patients <12 years, with unilateral or bilateral congenital or developmental cataract. A pre-validated questionnaire was used to record data. The parameters recorded were age at first symptoms, age at diagnosis of cataract, age at surgery, laterality of cataract, first symptom, first family member noticing the abnormality, the morphology of cataract, association of perinatal complications, family history, systemic diseases, and cause (s) of delay in surgery.Results: A total of 89 patients were included. The mean age of subjects was 4.75(±3.51) years. A white pupil was the most common symptom (64.04%) and appeared in infancy in 30.3% of cases. Parents first detected the problem in 60.67%, and the pediatrician was the first medical contact in 11.23% of cases. The median (IQR) delay period between diagnosis of cataract and cataract surgery was 4 (3–6) months, the major causes were long GA waiting (30.33%), and delay due to systemic ill health (14.61%).Conclusion: Parental education on cataract detection is recommended to help in the timely detection and hence, improved outcomes of pediatric cataract surgery. Pediatricians, consulted for any systemic illness, have the role of the second most important contact in the detection of pediatric cataract.

Interrelationship between cardiovascular and periodontal diseases

In the recent times studies relating the association of Oral and Systemic diseases has gained immense importance because the high occurrence of oral diseases is an extremely common source of infection. Periodontitis is ranked as the sixth most prevalent disease affecting humans affecting 740 million people worldwide. Periodontitis and cardiovascular disease have a complex etiology and genetics and share some common risk factors (i.e., smoking, age, diabetes, etc. The aim of this review is to look at the link between these two diseases. PD is a potential risk factor that may initiate the development, maturation, and instability of atheroma in the arteries. Two mechanisms were proposed to explain such association, either periodontal pathogens directly invade bloodstream or indirectly by increasing systemic level of inflammatory mediators. Interestingly, According to the current literature, it is concluded that there is a strong relationship between these chronic disorders. Improvement in the condition of one disease positively impact the condition of the other one emphasizing the association between these two diseases.

Can Improved Periodontal Health Be a Key Factor in Preventing Severe COVID-19 Complications: An Evidence-Based Review

COVID-19 is now recognized as a pandemic throughout the world and the severity of the disease has been attributed to many patient-related medical risk factors, which include diabetes, hypertension, respiratory diseases, cardiovascular disease and chronic kidney diseases due to exaggerated immune response associated with these diseases. However, in recent decades, there has been a renewed interest in the association of systemic diseases with periodontal health as the severity of these diseases increases in patients having compromised periodontal health. Therefore, it is suggested that there could be a possible link between the status of periodontal health and the severity of the disease in patients suffering from COVID-19. The purpose of this review article is to explore and highlight the various common mechanisms between periodontal disease and COVID-19 and further explore the role of periodontal disease as a contributing factor for COVID-19 related complications.

Association of Systemic Diseases With Surgical Treatment for Obstructive Sleep Apnea Compared With Continuous Positive Airway Pressure

The efficacy of surgical treatments for obstructive sleep apnea (OSA) is variable when considering only the Apnea Hypopnea Index as the treatment end point. However, only a few studies have shown an association between these procedures and improved clinically relevant outcomes, such as cardiovascular, endocrine, and neurological sequelae of OSA. To evaluate the association of surgery for OSA with clinically relevant outcomes. This retrospective cohort study used the Truven MarketScan Database from January 1, 2007, to December 31, 2015, to identify all patients diagnosed with OSA who received a prescription of continuous positive airway pressure (CPAP), were 40 to 89 years of age, and had at least 3 years of data on file. Data were analyzed September 19, 2019. Soft tissue and skeletal surgical procedures for the treatment of OSA. The occurrence of cardiovascular, neurological, and endocrine complications was compared in patients who received CPAP alone and those who received surgery. High-dimensionality propensity score matching was used to adjust the models for confounders. Kaplan-Meier survival analysis with a log-rank test was used to compare differences in survival curves. A total of 54 224 patients were identified (33 405 men [61.6%]; mean [SD] age, 55.1 [9.2] years), including a cohort of 49 823 patients who received CPAP prescription alone (mean [SD] age, 55.5 [9.4] years) and 4269 patients who underwent soft tissue surgery (mean [SD] age, 50.3 [7.0] years). The median follow-up time was 4.47 (interquartile range, 3-8) years after the index CPAP prescription. In the unadjusted model, soft tissue surgery was associated with decreased cardiovascular (hazard ratio [HR], 0.92; 95% CI, 0.86-0.98), neurological (HR, 0.49; 95% CI, 0.39-0.61), and endocrine (HR, 0.80; 95% CI, 0.74-0.86) events. This finding was maintained in the adjusted model (HR for cardiovascular events, 0.91 [95% CI, 0.83-1.00]; HR for neurological events, 0.67 [95% CI, 0.51-0.89]; HR for endocrine events, 0.82 [95% CI, 0.74-0.91]). Skeletal surgery (n = 114) and concomitant skeletal and soft tissue surgery (n = 18) did not demonstrate significant differences in rates of development of systemic complications. In this cohort study, soft tissue surgery for OSA was associated with lower rates of development of cardiovascular, neurological, and endocrine systemic complications compared with CPAP prescription in a large convenience sample of the working insured US adult population. These findings suggest that surgery should be part of the early treatment algorithm in patients at high risk of CPAP failure or nonadherence.

Knowledge and attitude of dental practitioners regarding the association of oral health and systemic diseases; a survey-based study in Riyadh

Dental specialists in Saudi Arabia see an expanding number of patients with systemic conditions. The association between dental conditions and systemic diseases is a known factor, and the knowledge in treating such systemically compromised patients due to the changes occurring in the oral cavity is needed for better diagnosis and treatment. Hence this cross-sectional survey was conducted to know the knowledge and attitude of dental practitioners regarding the association of oral health and systemic diseases in Riyadh. Keywords: Knowledge, Oral health, Systemic diseases.

Association of Systemic Diseases with Periodontitis among Patients Attending A Private Dental College in Chennai - A Record based Study

Oral cavity works as a continuous space of infectious agents and its condition reflects in progression ofsystemic diseases. Recent studies state that periodontal disease may be a potential marker to systemicdiseases. Aim of the study was to determine the association of periodontitis and systemic disease amongpatients attending a private dental college. Russell’s periodontal index was used to measure the periodontaldisease.This study included all periodontal index patient records from 18- 80 years old who visited thedental college in the month of January 2020 and a total of 136 records were reviewed. Descriptive statisticsand chi square tests were used for statistical analysis. In the sample population (N= 136), 64.71% males and35.29 % females were present. Age distribution of the records showed that 16.91 % of the study populationwere 18-35 years old; 36.03% were 36-50 years and 47.06% were 51-80 years. It was found that 0.74% ofthe study population had normal gingiva; 8.09% had simple gingivitis; 23.53 % had beginning destructiveperiodontitis; 53.68% had established destructive periodontitis and 13.97 % had terminal periodontaldisease. Results revealed that 35.56 % of the study population reported to have systemic disease. Significantassociation was found between age and periodontal disease; age and systemic disease (p&lt;0.05). Results ofthe present study showed that there was no significant association between periodontal status and systemicdisease condition of the study population (X2 = 5.826a;; p&gt;0.05)

Medical Conditions and Oral Diseases in Elderly Thai Dental Patients in Lower Northern Thailand Patients in Lower Northern Thailan

The World Health Organization (WHO) aims to strengthen oral health promotion and disease prevention around the globe. The prevalence and association of systemic diseases and oral diseases has been reported. Objectives: The objectives of this study were to investigate prevalence of medical conditions and oral diseases in elderly Thai dental patients. Methods: Three hundred dental records of patient aged 60 years old and older were retrospectively reviewed. Data were analyzed using Pearson’s Chi-square and Fisher›s exact test with the significant level at p < 0.05. Results: All of them were Thai of 142 males (47.3%) and 158 females (52.7%). Their age ranged between 60 and 85 years old with an average age of 66.1 ± 5.4 years old. Two third of patients had the history of systemic diseases (66.3%) and hypertension (10.3%) was the predominant one. Eighty-nine percent of patients had oral health problems. Fifteen percent were currently on antiplatelet and anticoagulant drugs, and 15.4% had the history of drug allergy. The most prevalent oral diseases were tooth loss (87.7%) followed by periodontal diseases (80.0%), tooth wear (66.0%), dental caries (65.3%) and pulp diseases (54.0%). The prevalence of oral mucosal lesions, temporomandibular disorder and orofacial pain were 23.7%, 1.6% and 1.6%, respectively. Conclusion: The present study provides the information of medical conditions and oral diseases in a group of older Thai dental patients in the lower northern Thailand.

Epidemiological Association Between Systemic Diseases and Keratoconus in a Korean Population: A 10-Year Nationwide Cohort Study.

To investigate the association of systemic diseases with keratoconus in the general Korean population. This is a nationwide population-based retrospective cohort study using the Korean National Health Insurance Service-National Sample Cohort database from 2002 to 2015, involving 1,108,369 individuals. Patients with keratoconus were identified using the Korean standard classification of diseases code H18.6. The prevalence and annual incidence rates were estimated. To examine the risk factors, 5 controls were matched per patient with keratoconus by propensity score matching using age and household income. Univariate and multivariate regression analyses were performed to assess the association between relevant factors and keratoconus. A total of 613 subjects were identified as patients with keratoconus from the cohort database. The prevalence rate was 55.31 cases per 100,000 people [95% confidence interval (CI): 51.01-59.86]. The annual incidence rate, calculated using a predate 1-year washout period, was 4.47 cases per 100,000 person-years (95% CI: 4.11-4.85). People with allergic conjunctivitis had a 37% increased odds of being diagnosed with keratoconus [odds ratio: 1.37 (95% CI: 1.12-1.67), P = 0.002] compared with those without allergic conjunctivitis. By contrast, people with allergic rhinitis had a 52% reduced odds of being diagnosed with keratoconus [odds ratio: 0.48 (95% CI: 0.38-0.59), P < 0.001]. Atopy and eczema, asthma, connective tissue disorders, diabetes mellitus, sleep apnea, and inflammatory bowel disease had no significant association with a positive keratoconus diagnosis. Allergic conjunctivitis may increase the risk of developing keratoconus in Koreans.

CLINICAL EVALUATION OF THE TOOTH LOSS IN PERIODONTAL DISEASE IN DIABETIC PATIENTS

Help in detecting diabetes may come from an unlikely source like a dentist as an allied health team, as it is rightly said ‘oral cavity is the mirror of the body system’. They may diagnose undetected cases of diabetes and may refer to a physician for further evaluation and treatment. Research studies have found a link between periodontal (gum) disease and diabetes. Symptoms of the disease often appear in the mouth, while almost one-third of people with diabetes have severe periodontal disease. This is believed to be a result of the diabetic patient’s greater susceptibility to developing infections. Conversely, severe periodontal disease may increase the risk of developing diabetes, and may make it more difficult to manage blood sugar levels. However, studies have found that patients who receive treatment for periodontal disease may be able to control the condition with less insulin. Dentists often detect symptoms of diabetes during routine oral health examinations. Foamy saliva, unusually dry and irritated tissue, poor periodontal conditions inside the mouth are tell-tale signs of the condition. And, diabetic patients often lose more teeth compared to patients without the disease. Proper and effective management of patients with diabetes requires that the practice evaluate all aspects of patient interaction. Systems need to be customized so that all procedures and patient communication scripts are implemented consistently to meet the distinct needs of patients with diabetes. Hence based on above findings the present study was planned for clinical evaluation of the tooth loss in periodontal disease in diabetic patients.&#x0D; The present study was planned in Department of Public Health Dentistry, Buddha Institute of Dental Sciences, Patna ,Bihar for a period of six months from January 2019 to June 2019. Total 40 patients were evaluated during this period . Out of that 20 cases are of Diabetic patients were enrolled in first group and another second group consist of 20 control patients without any diseases.&#x0D; The data generated from the present study concludes that there is significant difference in teeth loss amongst diabetics and non-diabetics. People with diabetes should be aware about the periodontal complications associated with it and should go for regular dental visits. Therefore it is the need of the hour to educate the dentists, general physicians and specialists about the association of systemic diseases with oral health and vice versa as many of the systemic diseases may be prevented and improved by improving oral hygiene.&#x0D; Keywords: Tooth Loss, Periodontal Disease, Diabetic Patients, etc.

The Immunological Association between Alopecia Areata and Respiratory Diseases: A Systematic Review

Background: While alopecia areata (AA) has been associated with atopy, the immunological relationship is unclear, with the association of specific atopic and systemic respiratory diseases not established. The relationship between T-helper (Th)1-mediated AA and Th2-mediated atopy challenges the conventional Th1/Th2 paradigm of autoimmune disease categorization. Objectives: To determine the association between AA and atopic respiratory diseases in adults and children, and respiratory diseases in general. Method: All primary literature, excluding case reports, were identified within PubMed/MEDLINE, CINAHL, and Web of Science in May 2018 using the following search terms: “(alopecia OR hair loss) AND (respiratory OR pulmonary OR lungs OR asthma OR rhinitis OR bronchitis OR COPD OR atopy OR atopic).” Information from 32 articles meeting the inclusion and exclusion criteria was reviewed. Results: Among the 32 articles identified for inclusion, the prevalence of AA was more strongly associated with allergic rhinitis compared to asthma among pediatric and adult populations. While a significant association was identified between AA, allergic rhinitis, and a late age of onset, the association of AA and asthma remains controversial despite asthma’s prevalence among AA patients. No significant difference was identified with regard to the association of AA and non-atopic respiratory diseases between adult and pediatric patients. Conclusions: Adult and pediatric patients with AA warrant further workup for atopic respiratory diseases such as allergic rhinitis. AA may have an underlying Th2-mediated immunological component, which supports its association with atopic respiratory diseases and provides a new avenue for targeted therapies in select cases.

Diesel exhaust particles induce autophagy and citrullination in Normal Human Bronchial Epithelial cells

A variety of environmental agents has been found to influence the development of autoimmune diseases; in particular, the studies investigating the potential association of systemic autoimmune rheumatic diseases with environmental micro and nano-particulate matter are very few and contradictory. In this study, the role of diesel exhaust particles (DEPs), one of the most important components of environment particulate matter, emitted from Euro 4 and Euro 5 engines in altering the Normal Human Bronchial Epithelial (NHBE) cell biological activity was evaluated. NHBE cells were exposed in vitro to Euro 4 and Euro 5 particle carbon core, sampled upstream of the typical emission after-treatment systems (diesel oxidation catalyst and diesel particulate filter), whose surfaces have been washed from well-assessed harmful species, as polycyclic aromatic hydrocarbons (PAHs) to: (1) investigate their specific capacity to affect cell viability (flow cytometry); (2) stimulate the production of the pro-inflammatory cytokine IL-18 (Enzyme-Linked ImmunoSorbent Assay -ELISA-); (3) verify their specific ability to induce autophagy and elicit protein citrullination and peptidyl arginine deiminase (PAD) activity (confocal laser scanning microscopy, immunoprecipitation, Sodium Dodecyl Sulphate-PolyAcrylamide Gel Electrophoresis -SDS-PAGE- and Western blot, ELISA). In this study we demonstrated, for the first time, that both Euro 4 and Euro 5 carbon particles, deprived of PAHs possibly adsorbed on the soot surface, were able to: (1) significantly affect cell viability, inducing autophagy, apoptosis and necrosis; (2) stimulate the release of the pro-inflammatory cytokine IL-18; (3) elicit protein citrullination and PAD activity in NHBE cells. In particular, Euro 5 DEPs seem to have a more marked effect with respect to Euro 4 DEPs.

Brief review of the diagnostics of pyoderma gangraenosum

The diagnosis of pyoderma gangraenosum was previously made as adiagnosis of exclusion. For this reason repeated attempts have been made in recent years to develop new diagnostic scores, whereby the typical clinical and anamnestic aspects were usually taken into account and the relevant differential diagnoses were excluded. With the PARACELSUS score an evaluated diagnostic score was presented for the first time. The main diagnostic criteria of this score are arapidly progressing disease, the assessment of relevant differential diagnoses and reddish-violaceous wound borders. If these criteria are or were present 3points are given for each criterion. Secondary criteria with ascore of2 for each of the aspects are amelioration by immunosuppressant drugs, characteristically irregular (bizarre) ulcer shape, extreme pain of >4 on a visual analog scale and localization of the lesion at the site of trauma (pathergy phenomenon). Additional criteria worth one point are suppurative inflammation in histopathology, undermined deep wound borders and the association of relevant systemic diseases. An additive score of ≥10 makes the diagnosis of pyoderma gangraenosum very likely. The newly developed and evaluated PARACELSUS score is an easy to use clinical tool to objectify securing the diagnosis of pyoderma gangraenosum.

Association of risk factors with primary open angle glaucoma in adults over the age of 40

To determine the association of systemic diseases, as well as smoking and alcohol with primary open-angle glaucoma (POAG) in adults over 40 years age. A revision of the records of patients older than 40 years aged who had been diagnosed with glaucoma, which were selected at the outpatient care dept. Information was obtained through the automated hospital information system, which included socio-demographic and clinical variables. Data base was created and was processed by SPSS V20 program. 1,020 patient, 548 (53.7%) with a diagnosis of POAG, mean age of patients 73.2 ± 11.16 years, of which 193 (35.2%) were male and 355 (64.8%) female. A significant relationship was found between POAG and increasing age (p = 0.000), diabetes mellitus (p = 0.056) and hypertension (p = 0.098). While no relationship was found between POAG and cancer, smoking and alcohol intake was found. These results display the need of carrying out more specific studies of causal type to establish best possible partnerships and thus carry out prevention programs for early diagnosis.

Presence and Types of Systemic Diseases among Patients with Periodontitis in Suva, Fiji

Objectives: Periodontitis is an infection which is caused by micro-organisms like Porphyromonas gingivalis. Periodontitis patients can have one or more systemic diseases such as heart diseases, diabetes, renal diseases, respiratory diseases etc. Due to lack of study in Fiji, this study is aimed to determine the presence and types of systemic diseases among patients with periodontitis in Suva, Fiji. Methods: This is a descriptive study on periodontitis patients with complete self-reported systemic disease history carried out in two dental clinics operated by the Fiji National University. Periodontitis patients with or without self-reported systemic disease history were included in this study. Patients without periodontitis were excluded from this study. The patient clinical records are recorded from 1st January 2013 to 31st December 2014. SPSS was used to analysis the data and all the categorical variables were presented by numbers and percentages. Results: The total number of periodontitis patients who reported having at least one type of systemic diseases was 35.5% (n=131). The most common types of diseases were heart disease 55.7% ~ 56% (n=73) and diabetes 45% (n=59). The age group 40-64-year-old periodontitis patients showed the highest number of heart diseases and diabetes, (68.1%) and (79.3%), respectively. Amongst all the ethnic groups, the Fijians of Indian Descent showed the highest number of heart diseases (49.1%), and the I-Taukei Fijians showed highest number of diabetes (42.4%). The use of tobacco was 39.7%, alcohol was 38.4% and betel-nut was 5.6% among periodontitis patients with heart diseases. And the use of tobacco was 33.9%, alcohol was 39% and betel-nut was 3.4% among periodontitis patients with diabetes mellitus. Severe periodontitis patients showed high percentages of diabetes (50.9%) among the mild periodontitis and moderate periodontitis patients. However, the occurrence of heart diseases was the same, (40.6%) among moderate and severe periodontitis patients. Conclusion: The study concluded that the number of periodontitis patients with any one type of systemic disease was 35.5%. And the most common types of systemic diseases seen among the periodontitis patients were heart disease and diabetes. Further research studies in future will provide more insight to the association of periodontitis and systemic diseases.

Functional and structural abnormalities of the kidney and urinary tract in severely malnourished children - A hospital based study.

Objectives:The association of malnutrition and systemic diseases like chronic kidney disease (CKD) is well known. Various urinary tract abnormalities may be associated with malnutrition. So objective of current study was to determine the frequency of functional and structural urinary tract abnormalities in severely malnourished children admitted in Nutritional Rehabilitation Unit (NRU) of a tertiary care facility, Karachi.Methods:This descriptive cases series of 78 children was conducted in NRU from October 2014 - March 2015. All newly admitted children aged 2-60 months, diagnosed as Severe Acute Malnutrition (SAM) were studied and children with known kidney and urinary tract disorders were excluded. Detailed history, examination and investigations like serum creatinine, ultrasound kidney and urinary tract in addition to routine tests for SAM, were done. A proforma was used to collect demographic data, clinical history, physical findings, and radio-imaging and biochemical investigations. Glomerular filtration rate (GFR) was calculated using Schwartz equation. Data was analyzed using descriptive statistics.Results:Among 78 children, male to female ratio was equal. Mean age was 18±15.53 months and majority (79.48%) of children were below 24 months. Majority (82%) of children with SAM had marasmus whereas 18% had edematous malnutrition. Out of 78, 57 (73%) children had either functional (80.7%) and or structural (19.3%) abnormalities whereas 21(36.84%) had normal functional and structural status. Most common functional abnormality was subnormal GFR (<90ml/min/1.73 m2) found in all 46 children. Functional abnormities were more common in children below 24 months. Other functional disorders were Bartter syndrome, renal tubular acidosis and urinary tract infection (UTI) found in two cases each. Common structural abnormalities were echogenic kidneys (n=4, 36%), hydronephrosis (n=3, 27%), hypoplastic kidneys (n=3, 27%) and calculi (n=1, 9%). Subnormal GFR was also found in all cases with structural abnormalities. UTI was observed exclusively in two children among 11 with structural abnormalities.Conclusion:A high frequency of functional abnormalities and noticeable proportion of structural abnormalities of urinary tract were detected in children with SAM. Current finding suggest that multicenter study at national level may be undertaken to generate better data about prevalence of renal diseases in SAM.

Factors associated with geographic tongue and fissured tongue

Objectives: The primary objective of this study was to investigate the association of systemic diseases, use of medications, allergies and tobacco habits with geographic tongue (GT) and fissured tongue (FT) lesions. The secondary objectives were to evaluate the clinical characteristics of tongue lesions and to compare the overall results for referred and non-referred patients.Methodology: Non-referred patients with GT (GTgp; n = 130) and FT (FTgp; n = 62) were examined by general practitioners (gp) and compared to a control group without oral mucosal lesions (C; n = 1029). Referred patients with GT (GTs; n = 166) and FT (FTs; n = 15) were examined by oral medicine specialists (s) and compared to GTgp and FTgp. Statistical analyses were performed using unpaired t-test or Fisher’s exact test. A multiple logistic regression model was developed to control for age and gender as confounders.Results: Compared to the C group, GTgp patients used more anti-hypertensive medications and Swedish snus (p < 0.01). The GTgp group consisted of older males (p < 0.001) compared to C. Compared to the GTgp group, the GTs group was younger, more likely to have symptomatic lesions (p < 0.0001) and comprised of more females. Among the groups examined, FT patients had the highest mean age.Conclusion: This study identified an association between GT and anti-hypertensive medications, as well as the use of Swedish snus. It also found differences in the activities and symptoms of the lesions between referred patients and their counterparts who were seen in general dental practice; these parameters influenced the results when these conditions were taken into account.