King George's Medical University Research Articles

Comparative evaluation of topical application of turmeric gel and 0.2% chlorhexidine gluconate gel in prevention of gingivitis.

Introduction:Turmeric commonly known as “Haldi” is a popular spice frequently used in Indian foods and curry. Turmeric holds a high place in Ayurvedic medicine as a “detoxifier of the body,” and today, science has documented several diseased conditions that can be healed by the active ingredients of turmeric. Curcumin is the most active constituent of turmeric curcuminoids obtained from the rhizome of Curcuma longa. Curcumin has been found to have antioxidant, anti-tumor, anti-inflammatory, antiviral, antibacterial, antifungal, analgesic, anti-allergic, antiseptic properties and thus has a potential against various diseases. Due to these properties it was felt that promotion of turmeric in dental practice may prove beneficial.Materials and Methods:The study was conducted in the Department of Periodontology, Faculty of Dental Sciences, King George's Medical University, Lucknow, India. A total of 40 subjects of both the sexes from age group 20-35 years. Simple random sampling was followed and the participants were assigned to two groups ‘A’ and ‘B’ of 20 participants each. Group A subjects were advised 0.2% chlorhexidine gluconate gel. Group B 30 subjects were advised experimental (turmeric) gel.Statistical Analysis:Data were summarized as mean ± SD. Pre and post outcome measures of two groups were compared by repeated measures analysis of variance (RM ANOVA) using general linear models (GLM) and the significance of mean difference within and between the groups was done by Bonferroni post hoc test after adjusting for multiple contrasts (comparisons).Conclusions:Based on the observations of our study, it can be concluded that chlorhexidine gluconate as well as turmeric gel can be effectively used as an adjunct to mechanical plaque control in prevention of plaque and gingivitis. chlorhexidine gluconate gel has been found to be more effective when antiplaque and anti-inflammatory properties were considered. The effect of turmeric observed may be because of its anti-inflammatory action. The antiplaque action of chlorhexidine gluconate is due to its substantivity. Substantivity of tutmeric is required to be further studied.

Traumatic Thoracolumbar Spine Injury –A Demographic Study

Abstract Study design and subjects Cross-sectional descriptive analysis of data of patients with thoracolumbar SCI admitted for rehabilitation at a tertiary care centre from January 2011 to September 2014. Objectives To identify the demographic pattern of TLSCI admitted to this centre. Setting Department of PM&R, King George's Medical University, Lucknow. Methods One hundred and thirty-three consecutive patients of traumatic TLSCI admitted for rehabilitation were included in the study. Detailed demographic, clinical, neurological evaluation as per ASIA scale and radiological assessment done and analyzed. Results Mean age of our sample was 29.62±5 years. There were 21.05% females and 78.95% males. A significant percentage (36.84%) was farmers/labourers, followed by students 26.31%. Majority (67.67%) had fall from height followed by road traffic accidents (21%). Only 3.76% received ambulance for transport and majority (87.22%) of the cases transported by hired four wheelers. Only 18.78% cases came to tertiary center within 2 hours and majority (70%) came after 8 hours of injury. Ratio of complete and incomplete injuries being 1.7:1. Most common vertebral involvement in 58.64% cases were of T12 and L1. Conclusions Majority of Indian population live in rural areas which have minimal accessibility to even primary care. This disparity should be removed by even distribution of specialty hospital and trauma care centres in rural areas with better transportation with trained staff for trauma care. A national SCI registry system is needed and SCI case should be reported from all hospitals so that rehabilitation programme planning can be done accordingly.

Department of Neurology, King George's Medical University, Lucknow: The journey continues.

King George Medical University is one of the oldest and most prestigious medical universities of India. The Department of Neurology has trained many illustrious neurologists who are offering yeoman's service to the nation. This brief review traces the history and milestones of the department and its current areas of focus.

Publication performance and research output of neurology and neurosurgery training institutes in India: The true picture of King George's Medical University

Publication performance and research output of neurology and neurosurgery training institutes in India: The true picture of King George's Medical University

Dengue myocarditis presenting with mitral valve involvement

We admitted a case of dengue fever who was positive for dengue serotype 2 in the Department of Medicine, King George's Medical University (K.G.M.U.), Lucknow, Uttar Pradesh, India. The patient had developed erythematous rashes with thrombocytopenia and bleeding manifestation in the form of microscopic hematuria. While he was recovering from the illness, he developed a sudden onset of breathlessness. On examination, his chest was full of crepitation bilaterally and his x-ray was suggestive of pulmonary edema. His troponin T (Trop T) and prohormone brain natriuretic peptide (proBNP) levels were elevated. Two-dimensional echo showed global left ventricular (LV) hypokinesia with mitral regurgitation (MR) and tricuspid regurgitation (TR). A diagnosis of myocarditis was made and the patient was managed in an intensive care unit (ICU) setting. The patient recovered from the illness and after a follow-up period of 6 weeks, showed no residual cardiac abnormality.

Role of diarrhoeagenic Escherichia coli in children <5 years of age hospitalised for acute/persistent diarrhoea at a tertiary care hospital in Lucknow

Background and Objectives: Diarrhoea is one of the leading causes of morbidity and mortality among children under 5 years. Study was aimed to evaluate the role of different categories of diarrhoeagenic Escherichia coli (DEC) in children <5 years of age hospitalised for acute/persistent diarrhoea, by multiplex polymerase chain reaction assay for simultaneous detection of five categories of DEC using eight virulent genes and antibiotic susceptibility pattern of DEC. Materials and Methods: Faecal samples from 355 children with and 150 children without diarrhoea were collected from 2011 to 2013 from King George Medical University and Balrampur Hospital of Lucknow district, Uttar Pradesh, India and were tested for enteric pathogens using conventional diagnostic methods and molecular methods. Results: DEC was detected in 152 (42.81%) children with and 14 (9.33%) in children without diarrhoea respectively. The most common pathotype was enteroaggregative E. coli (EAEC) in cases and controls (16.05% and 5.33%), followed by enteropathogenic E. coli (12.67% and 2.66%), enterotoxigenic E. coli (8.73% and 1.33%), enteroinvasive E. coli (5.35%/and nil) in cases and controls respectively, enterohaemorrhagic E. coli was not detected in any of the diarrhoeal samples. DEC isolates showed a low rate of sensitivity to Ampicillin (07.89%), Amoxycillin-Clavulanic acid (06.57%), Trimethoprim/Sulphamethaxazole (20.39%), Nalidixic acid (24.34%,), Ciprofloxacin (34.34%), Ceftriaxone (23.68%)), Chloramphenicol (33.55%) and Cefoxitin (30.26%) while they were more sensitive to Amikacin (65.78% sensitive), Piperacillin/Tazobactam (61.84% sensitive) and Gentamicin (61.84% sensitive). Interpretation and Conclusions: DEC strains are a significant cause of diarrhoea in children. EAEC was the most frequent pathotype in the study. The high level of antimicrobial resistance in our study raises a broader discussion about the indiscriminate use or misuse of antibiotics and the risks of empirical antibiotic therapy in children of a very young age.

Comparative study of preinvasive and invasive lesions of the cervix in HIV-positive and HIV-negative women

Background: Evidence suggests that Human Immunodeficiency Virus (HIV) infection is a risk factor for preinvasive and invasive lesions of cervix but confusion regarding pathogenesis and progression of cervical neoplasia in HIV-positive women still prevails. Aims : To find the incidence of cervical neoplasia in HIV positive and HIV-negative women and to study the impact of CD4 counts, duration of HIV infection, and treatment with highly active antiretroviral therapy (HAART) on the incidence of cervical lesions in HIV positive women. Materials and Methods : It was an observational case control study carried over a period of one year at the Department of Obstetrics and Gynaecology and Department of Medicine, King George Medical University, Lucknow. Cases were HIV-positive women and controls were HIV negative women. Those with previous diagnosis or treatment for cervical neoplasia, history of total hysterectomy or coexistent immunosuppressive conditions were excluded. All subjects had cervical screening by Pap smear. Colposcopy and cervical biopsy were done if indicated. Statistical Analysis Used : Chi square test, univariate, and multivariate analysis. Results: The incidence of cervical lesions in HIV-positive women (159.66 per 1000 screened women) was higher compared to HIV-negative women (15.15 per 1000 screened women) ( P 3 were associated with an increased incidence of cervical neoplasia ( P P Conclusions: Seropositivity is associated with an increased incidence of cervical lesions. This risk is further enhanced by CD4 counts less than 500/mm 3 and duration of HIV infection of more than two years.

Need of Revision of Lower Limb Amputations in a North Indian Tertiary Care Centre.

Amputation of the extremity is a big challenge to mankind. Revision rate of primary amputations stands high despite of maximum care at tertiary care centres. The purpose of this study was to establish cause for the revision, identify preventable cause and to assess outcome of revision amputation surgery. We performed a retrospective study on lower limb revision amputations in Department of Physical Medicine and Rehabilitation and Department of Orthopaedic Surgery, King George Medical University between Jan 2012 to Jan 2015. All patients of any age group and gender admitted for revision amputation were included in the study population. A total of 32 patients who required revision amputation of lower limbs was included in the study, out of these 62.50 % were male and 37.50 % were female. Age of the patients ranged from 5 to 72 years with mean of 42 years. Most common level of initial amputation was below knee (56.25 %) followed by above knee amputation (31.25%). Most common indication for initial amputation was trauma (43.75%) followed by infection, vascular diseases, malignancy and leprosy. Poor stump formation was found to be most common indication for revision amputation (37.50%) followed by infection (25%), recurrent ulceration (18.75%), stitch abscess (6.25%), neuroma (6.25%), and necrosis (6.25%). All patients were treated successfully. Revision amputation increases morbidity. Poor stump formation at the time of initial amputation and infection are the most common indication for revision surgery. These are the preventable causes and every effort should be made to alleviate these as well as other preventable causes.

Direct (presenting primarily to trauma center) versus indirect (referred or transferred) admission of patients to the Trauma Centre of King George Medical University: One-year prospective pilot study

Background:India does not have a trauma registry. There is lack of base line demographic data of trauma victims that present directly to the trauma center and those that are transferred to the trauma center.Aim:To compare the clinical and demographic profile of directly admitted (presenting primarily to the trauma center) and referred (transferred to trauma center) patients at the trauma centre of King George Medical University.Materials and Methods:The demographic and clinical profiles of patients admitted on thirty-three consecutive Mondays were collected and compared. In addition, the demographic data of patients admitted on Mondays and eight randomly selected Wednesdays and Saturdays were analyzed to ascertain the representativeness of the studied sample.Results:Of the 572 patients in the study, 327 were referred and 245 were directly admitted. There was 27% mortality in the referred group and 22% mortality in the directly admitted group, the difference been statistically insignificant (P value 0.20). Patients referred from peripheral hospitals were more severely injured with a lower GCS and a higher TRISS, and had a higher proportion of multi system major trauma and severe head injury.Conclusion:Referred admitted (transferred) patients at the KGMU trauma center are more seriously injured than the patients presenting directly. Yet there is no statistically significant difference in the overall mortality. A future study focusing on certain sub-categories of patients such as those demonstrating subdural hematoma, GCS less than 9 or ISS more than 15 may yield interesting data.

199. Expression of non conventional hormonal receptors in breast cancer with special relation to response to neoadjuvant chemotherapy in Indian women

S S85 199. Expression of non conventional hormonal receptors in breast cancer with spec ia l re lat ion to response to neoadjuvant chemotherapy in Indian women A.Agarwal, A.A. Sonkar, P. Saxena, K.R. Singh, J.K.Kushwaha, N. Husain 1 King George Medical University, Surgery, Lucknow, India 2 RMLIMS, Pathology, Lucknow, India Background: Breast cancer (BC), a heterogeneous disease comprises different tumour subtypes associated with varied clinical characteristics. Prognostic factors including age, tumour size, histological subtype and grade, lymph node status and the expression of estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor 2 (HER2) currently assist routine clinical management. The role of the androgen receptor (AR) and Vitamin D receptor (VDR) in breast carcinomas has drawn great attention in recent years. Breast cancer has long been associated with vitamin D receptor downregulation. This study evaluates the potential correlations of AR and VDR with BC and possible role as predictors response to neo adjuvant chemotherapy. Methodology: Between June 2011 and Jan 2013, 116 breast cancer patients were enrolled. Tissue sections were immunostained for ER, PR, Her2 Neu, AR and VDR with immunoreactive (IRS) scoring. Patients with fibroadenoma (n1⁄430) served as controls for VDR receptor status. The age of the patients ranged between 32 and 70 years. n1⁄472 patients were subjected to neoadjuvant taxane and/or anthracycline based chemotherapy according to standard treatment guidelines. Clinical response was evaluated using WHO criteria. Results: 31.5% of cases belonged to young age group ( 0.5 cm in 20.6% of tumors and understimated tumor size by > 0.5 cm in 29.4%. MRI performed better than MU to correlate with tumor size in final pathology (R1⁄40,748 Vs R1⁄40,710; p1⁄40.001). MRI showed 3/70(4,3%) occult lesions in the contralateral breast. Analysing only women that were initially proposed to conservative surgery (n1⁄453), we defined three groups, after MRI: 1) 7(13,2%) patients in which MRI did not differ from MU; 2)

Morphometric Study of Metopic suture in Adult North Indian skulls

Background: A suture is a type of fibrous joint which only occurs in the skull or cranium. They are bound together by sharpey”s fibre. A tiny amount of movement is permitted at sutures, which contributes to the compliance and elasticity of the skull. Sutures are junctions or line of articulation between adjacent bones of skull.Methods: The present study was carried out in the department of anatomy on Adult North Indian 100 Skulls of unknown age and sex which were obtained from the osteology section of Integral Institute of Medical Sciences and Research & King George medical university. 20 damaged and diseased skulls were excluded from the study and 80 skulls were observed.Results: In our study we observed 66 (82.50%) skulls who had neither complete nor incomplete metopic suture. 14 skulls (17.5%) had metopic suture either in the form of complete or incomplete. Complete metopic suture was found in two skulls (2.50%) and incomplete suture was observed in twelve skulls (15%). Among the incomplete metopic sutures, the incidence of linear incomplete metopic suture was 9/80 (11.25%), inverted 'U' shaped incomplete metopic suture was 1/80 (1.25%) and 'V' shaped incomplete suture was 2/80 (2.5%).Conclusions: Knowledge regarding persistent metopic suture is essential in studying the radiographs to avoid misinterpretation as fractures. It is also useful in evaluating various medico legal cases.

Comparison of third generation ELISA and conventional nested RT-PCR for detection of HCV among hemodialysis patients

Shantanu Prakash , S.N. Sankhwar *, Amita Jain , Kausar Usman , Narayan Prasad , D. Saha , K.P Singh , Parul Jain 2 and Desh Deepak Singh 2 1 Department of Urology, 2 Department of Microbiology, 3 Department of Medicine, King George's Medical University, Chowk, Lucknow, U.P. KGMU, Lucknow, India. 4 Department of Nephrology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India. 5 Department of Nephrology, Vivekanand Polyclinic, Lucknow.

Flying high as a kite

Some of my happiest memories are from my childhood. Part of it was spent in Lucknow where my mother had her ancestral home. An important city in Northern India, Lucknow was the seat of the Nawabs who built many beautiful palaces. One of these has a labyrinth, which many have entered only to get lost within its many chambers. Another, the Chhota Imambara is pictured on the cover. Lucknow is also famous for its cuisine with street vendors selling tasty kebabs. Above all, I remember many hours perched on the roof top of our home in the old town, flying kites, with my family. The sky above became a riot of colours. Today there is even a touring company offering nostalgic kite flying holidays in this ancient city http://www.tornosindia.com/kiteflying.php In May, our Article of the Month comes from the King George Medical University, Lucknow. In a prospective, longitudinal comparison over six years, of a large number of patients undergoing urinary diversion after radical cystectomy, the authors demonstrate better quality of life after orthotopic neobladder rather than ileal conduit formation 1. The mean age of the patients was in the mid 50s, which is perhaps why a significant number underwent neobladder formation. This article and the accompanying editorial from Urs Studer 2 are must reads for anyone involved in the management of bladder cancer. In the UK many of our patients are generally older with multiple co-morbidities and end up having ileal conduits. For the younger patients it is perhaps time for a rethink? We also feature an excellent multi-institutional collaboration reporting on PCNL outcomes in England from the Hospital Episode Statistics (HES) database over a five year period. Mortality is rare after this procedure but 9% of patients have a readmission within 30 days 3. While the HES like most other databases has its inherent limitations, the authors should be congratulated for analysing complex outcomes on nearly 6000 patients; in particular John Withington who is writing his thesis on the subject. And finally – an invitation. If you are attending the AUA, we are again having a BAUS–BJUI–USANZ session on the afternoon of the 18 May. The faculty is international and the program even more exciting than it was last year (http://www.aua2014.org/program/courseinfo/event_1022.cfm). This is a further testament to the strong friendship that exists between our organisations and the AUA. The Coffey–Krane prize for the best paper published in the BJUI by a trainee, will be presented at the end of this session followed by the BJUI reception. Many of you have loved our new design, layout and quality although this has led to a precipitous drop in our acceptance rate in favour of only the very best papers. Thank you for your support, which has given us the strength and resolve to fly high. The sky is the limit.

Program and AbstractsThirty-fourth Annual Meeting of the Surgical Infection SocietyBaltimore, MarylandMay 1–3, 2014

Program and AbstractsThirty-fourth Annual Meeting of the Surgical Infection SocietyBaltimore, MarylandMay 1–3, 2014

Hospital outbreak of human respiratory syncytial virus (HRSV) illness in immunocompromised hospitalized children during summer

The human respiratory syncytial virus (HRSV) is a community-acquired virus that mainly causes acute respiratory tract infection in infants and children. HRSV is increasingly recognized as an important nosocomial pathogen causing morbidity in immunocompromised patients. Here, we are reporting a hospital outbreak of HRSV during summer in children receiving chemotherapy for haematological malignancies. Prompt detection and timely preventive measures could abort the devastating outbreak. In the month of June 2013, seven children from paediatric oncology Ward at King George Medical University presented with respiratory signs and symptoms in span of 3 days. Nasal and throat swabs of children were tested for the presence of HRSV, human metapneumovirus and their subtypes A and B, influenza A and B, measles, parainfluenza virus (1, 2, 3 and 4), adenovirus, and human bocavirus by real-time polymerase chain reaction. A segment of F gene of HRSV was amplified and sequenced for phylogenetic analysis. The demographic, clinical profile, underlying diseases, clinical diagnosis and seasonal distribution were studied and analyzed. Of the total seven cases, six tested positive for HRSV A, which were genetically similar to each other. Children with respiratory symptoms were segregated from other patients, and strict implementation of restricted visiting policy was adapted, which led to control of widespread outbreak. HRSV A outbreak was detected in immunocompromised patients; the wider spread of which was prevented by prompt detection and application of preventive measures.

Electroconvulsive therapy pre-treatment with low dose propofol: Comparison with unmodified treatment

BackgroundWhilst electroconvulsive therapy (ECT) is routinely administered under anesthesia in developed nations, in many developing countries, ECT is still administered unmodified. This practice has attracted considerable scrutiny with calls to ban unmodified ECT. However, there are no affordable alternatives for many poor, acutely ill psychiatric patients. We evaluated whether administration of intravenous propofol 0.5 mg/kg for sedation by the ECT psychiatrist just prior to otherwise unmodified treatment improved acceptance of and reduced anxiety surrounding the treatment. MethodWe conducted an open label trial at The King George's Medical University in Lucknow, India. Forty-nine patients received propofol pre-treatment and 50 patients received unmodified treatment as usual. ResultsSocio-demographic profiles, diagnoses and clinical responses were comparable. Patients who received propofol experienced less anxiety monitored by the State-Trait Anxiety Inventory just prior to ECT (p < 0.001), and had a more favorable attitude towards treatment assessed by an established questionnaire (Freeman and Kendell, 1980). Propofol patients were less likely to experience post-ictal delirium monitored by the CAM-ICU (p = 0.015) and had fewer cognitive side-effects on the MMSE (p = 0.004). There were no adverse events associated with propofol administration. ConclusionWhilst unmodified ECT should never be used when modified ECT under anesthesia is available, we have found low dose propofol can be safely administered by the ECT psychiatrist to sedate patients pre-treatment who would otherwise receive completely unmodified treatment. The intervention was associated with reduced anxiety and a more positive attitude towards ECT, without compromising efficacy. A randomized double blind controlled study is necessary to confirm these benefits.

Elevated Expression of Maspin mRNA as a Predictor of Survival in Stage II and III Gallbladder Cancer Cases

Maspin expression is a potential prognostic factor for various malignancies but its relation with gallbladder cancer is unknown and needs to be investigated needs to be investigated. We therefore here focused on maspin mRNA expression in normal, gall stone disease and gallbladder cancer subjects, with particular attention to prognostic importance in individuals with malignancies. This study was carried out at the Department of Surgical Gastroenterology, King George's Medical University, Lucknow, India. Gallbladder samples from normal (n=25), gall stone disease (n=25) and cancer patients (n=38) were analysed for maspin mRNA expression by semi-quantitative reverse transcriptase PCR and quantitative real time PCR. Statistical analysis was carried out using the Students t test or ANOVA. Survival analysis was conducted according to the Kaplan-Meier method and correlations were assessed using the Pearson correlation method. p<0.05 was considered statistically significant. Significant increase (p=0.028) in expression of maspin mRNA was observed in gallbladder cancer as compared to gall stone disease, whereas no expression was found in normal tissues. Significant correlation (Pearson's coefficient(r)=-0.798, p<0.0001) was observed between relative quantification of maspin mRNA and survival of cancer patients after surgery, with significantly shorter (p=0.002) survival in patients having relative quantification >1.5 as compared to those having relative quantification <1.5. Similarly, significant differences in patient survival for maspin mRNA expression was observed for stage II (p=0.025) and III (p=0.011) cancer. Higher expression of maspin mRNA in gallbladder cancer has prognostic significance for stage II and III cancer, which needs to be investigated further.

Establishment of sexual dimorphism in north indian population by odontometric study of permanent maxillary canine teeth

Aim: To investigate whether sexual dimorphism can be established by odontometric study of permanent maxillary canine teeth as well as inter-canine width in north Indian population. Study Design: The study was carried out at department of oral and maxillofacial pathology, King George's Medical University, Lucknow, India on students and patients reporting at OPD. Out of total 180 subjects examined 90 subjects were female and 90 were male. Impressions of the upper arch were made using alginate and casts poured in dental stone. The mesiodistal diameter (MD) of the crown of permanent maxillary canine both on right and left sides and inter-canine width were measured. From these measurements, maxillary canine index was calculated. The percentage of sexual dimorphism (SD) was assessed for all the parameters. Results: In the present study, the MD of maxillary canine for both right (P = 0.001) and left side (P = 0.005) was significantly higher among male subjects than females, Similar observation was found for inter-canine width too (P = 0.0001). However, the maxillary canine index for right and left was almost similar (P > 0.05) for both male and female subjects. The SD in right and left MDs of maxillary canine was 4.2% and 3.6% respectively. For, inter-canine width it was maximum (13.7%). However, SD in right and left canine index showed negative values (−2.1% and -0.9% respectively). Conclusion: There was SD in MD and inter-canine width of permanent maxillary canine teeth. SD was more on right permanent maxillary canine teeth than left permanent maxillary canine.

Role of CYP2E1 genetic polymorphism in the development of oral leukoplakia among tobacco users in North Indian population.

The aim of the study to find out role of CYP2E1 genetic polymorphism in development of oral leukoplakia among tobacco users in North Indian population, this study was carried out at Department of Oral and Maxillofacial Pathology, King George's Medical University, Lucknow, UP. Study include a total of 105 leukoplakia patients were genotyped for CYP2E1 polymorphism (93 males and 12 females; mean age ± SD: 47.5 ± 10.6) and 96 unrelated healthy controls (85 males and 11 females; mean age ± SD: 49 ± 11.1). All the patients had either reported for treatment of leukoplakia or were diagnosed with leukoplakia during routine oral examination. A total of 105 leukoplakia patients and 96 controls were included in the study. The mean age of leukoplakia patients and control were 47 ± 10 and 51 ± 10 years respectively. The exclusive smokers comprised 62 (59%) leukoplakia patients and 53 (53%) controls. The exclusive smokeless tobacco users were 16 (15%) in leukoplakia patients and 27 (28%) in controls groups, while 27 (26%) leukoplakia patients and 16 (17%) controls have both types (smoking as well as smoke less) of tobacco habits simultaneously. Range of life time smoking exposure in leukoplakia and controls were (5-80 PY in both groups) but the mean smoking exposure in both groups were (leukoplakia: 28 ± 21.8 PY, control: 27: ±17 PY). But the mean smokeless tobacco dose in two groups were (leukoplakia: 150 ± 175 CY, controls: 137 ± 110 CY). All the results demonstrate an association between CYP2E1 genetic polymorphism and leukoplakia risk, premalignant lesion. It indicates that the CYP2E1 polymorphism, singly showed a protection towards the oral leukoplakia. Independent confirmation of this finding is required, and additional examination of the joint effect of CYP2E1genotype and other non-tobacco-related exposures is needed before more conclusive interpretation of our results can be made. This study demonstrates the importance of genetic variations in CYP2E1genes in susceptibility towards oral leukoplakia and it is conceivable that these variants will interact with environmental carcinogens and possibly some combinations of these genotypes will be at a high risk to oral leukoplakia.

Impact of yoga on biochemical profile of asthmatics: A randomized controlled study.

Background:Asthma is a chronic inflammatory disorder of the airways. The chronic inflammation causes an associated increase in airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing at night or in the early morning. Most of the studies have reported, as the effects of yoga on bronchial asthma, significant improvements in pulmonary functions, quality of life, and decrease in medication use, but none of the studies has attempted to show the effect of yoga on biochemical changes.Objective:To evaluate the effect of yoga on biochemical profile of asthmatics.Materials and Methods:In the present study, 276 patients of mild to moderate asthma (FEV 1> 60%) aged between 12 to 60 years were recruited from the Department of Pulmonary Medicine, King George's Medical University, U.P., Lucknow, India. They were randomly divided into two groups: Yoga group (with standard medical treatment and yogic intervention) and control group as standard medical treatment (without yogic intervention). At completion of 6 months of the study period, 35 subjects were dropped out, so out of 276 subjects, only 241 subjects completed the whole study (121 subjects from yoga group and 120 subjects from control group). Biochemical assessment was carried out at baseline and after 6 months of the study period.Results:In yoga group, there was significant improvement found in the proportion of hemoglobin and antioxidant superoxide dismutase in comparison to control group and significant decrease was found in total leukocyte count (TLC) and differential leukocytes count in comparison to control group. There was no significant change found in TLC, polymorphs, and monocytes in between group comparison.Conclusions:Yoga group got significantly better improvement in biochemical variables than control group. Result shows that yoga can be practiced as adjuvant therapy with standard inhalation therapy for better outcome of asthma.