South Indian Patient Population Research Articles

MTHFR (C677T) CT genotype and CT-apoE3/3 genotypic combination predisposes the risk of ischemic stroke

The predisposition to ischemic stroke (IS) might involve interactions of several genes and environmental factors. The present study was aimed to evaluate the influence of polymorphisms in methylenetetrahydrofolate reductase (MTHFR-C677T) and apolipoprotein-E (apo-E) as risk factors for IS patients in south Indian population. 200 IS patients and 193 age and sex matched controls were genotyped for MTHFR-C677T and apoE by Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method. Statistically significant association was observed for MTHFR CT genotype (IS-Pooled: OR=4.29; p=5.01×10−5; IS-Males: OR=4.13; p=0.001; IS-Females: OR=8.62; p=0.027; IS-Large Vessel Disease (LVD)- Pooled: OR=4.14; p=0.0002) and T allele (IS-Pooled: OR=4.82; p=1.49×10−5; IS-Males: OR=4.33; p=0.0002; IS-Females: OR=7.99; p=0.031; IS-LVD-Pooled: OR=4.13; p=0.0001). Further, reduced frequencies of CC genotype (IS-Pooled: OR=0.20; p=9.80×10−6; IS-Males: OR=0.25; p=0.001; IS-Females: OR=0.12; p=0.027; IS-LVD-Pooled: OR=0.23; p=0.0001) and C allele (IS-Pooled: OR=0.21; p=1.49×10−5; IS-Males: OR=0.23; p=0.0002; IS-Females: OR=0.13; p=0.031; IS-LVD-Pooled: OR=0.24; p=0.0001) were observed in IS patients than the controls. No association was observed for apoE genotypes/alleles in IS/LVD cases. Our study demonstrated the presence of risk for MTHFR CT genotype/T allele and ‘CT-3/3’ (n=33 vs. 5; OR=7.42; p=0.001) genotypic combination in the development of IS in south India. Further, follow-up study of these stroke cases i.e., in later stages of the disease whether they are developing the neurological disorders such as Alzheimer's Disease (AD) and vascular dementia (VaD) is needed to draw a fruitful conclusion in connection between neurological disorders and with these two polymorphisms, before translating it into clinical practice.

Missense FokI variant in the vitamin D receptor gene in primary knee osteoarthritis patients in south Indian population

Osteoarthritis (OA) is a common and multifactorial skeletal disabling disease in the adult/elder population. Vitamin D was involved with multiple diseases including OA. Based on the prior studies, the single nucleotide polymorphism in the vitamin D receptor (VDR) gene might be a risk factor for the development of autoimmune diseases. However, we aimed to investigate whether FokI polymorphism and serum vitamin D levels are in association with primary knee OA in south Indian population. In this case–control study we have selected 100 OA cases and 100 healthy controls from Kamineni Hospitals in Telangana and India. The collected blood samples were used for estimation of serum vitamin D levels and isolation of genomic DNA. PCR was carried out with specific primers. The FokI enzyme was used to perform RFLP and followed by electrophoresis and analysis. The clinical data has been calculated separately between the OA cases and controls. The biochemical analysis performed with ELISA method revealed that 44% of cases were vitamin D deficient, 28% had in sufficient vitamin D levels and 28% had sufficient vitamin D levels. We have performed the statistical analysis between the OA cases and controls and we could not find any significant association either with allele and genotype frequencies (p>0.05). The gender association analysis also failed to disclose the significant difference between males and females (p>0.05). The results of our present study concludethat genetic missense variant of FokI in VDR gene does not associate with primary knee OA in the south Indian population.

GSTM1 null polymorphism prevalence in tobacco users, oral leukoplakia and oral squamous cell carcinoma patients in South Indian population: A polymerase chain reaction study.

Tobacco abuse is a well-known risk factor for potentially malignant disorders as well as oral squamous cell carcinoma. Factors that influence tobacco-exposed individuals developing a malignancy may include the combination of total tobacco exposure and genetic susceptibility. This study was undertaken to determine the prevalence of the glutathione S-transferase M1 (GSTM1) null polymorphism in oral leukoplakia and oral squamous cell carcinoma patients in South Indian population. This case-control study was conducted in hospital setting on South Indian population. About 280 subjects with history of tobacco use, oral leukoplakia, oral squamous cell carcinoma were included in this study. Three milliliter of blood was collected and transported under cold cycle and taken for evaluation of GSTM1 null polymorphism using multiplex polymerase chain reaction. On comparing the prevalence of GSTM1 null polymorphism among the group with subjects with habits and no oral lesions, oral leukoplakia, and oral squamous cell carcinoma, it was observed that there was a statistically significant association between GSTM1 null polymorphism and the different groups (P < 0.01). The lack of GSTM1 activity would make the oral tissues more susceptible to action of tobacco carcinogens and to the development of a high-grade level of dysplasia in oral leukoplakia and thereby increases the susceptibility of lesion to undergo malignant changes.

A molecular and genetic basis study in POLG mutation of MtDNA in Parkinson patients in South Indian population

A molecular and genetic basis study in POLG mutation of MtDNA in Parkinson patients in South Indian population

Body Image and Sexual Problem in Young Breast Cancer Patients in South Indian Population

The purpose of this study was to determine the frequency of body image and sexual problems after 12 month of follow up among women diagnosed with breast cancer at age 35 or younger. Types of breast cancer treatment effect physical appearance as loss of the body part, disfigurement, scars or skin changes. The goal of this paper is to comprehend the body image and sexual distress of newly diagnosed younger survivors. A multi-ethnic population-based sample of 72 out of 124 women aged 21–35 who were married or in a stable unmarried relationship were interviewed with in situ, or regional breast cancer. The women participating in this study were underwent treatment from 2003 to 2013 at 2 different hospitals located in south India. Body image and sexual problems were experienced by a substantial proportion of women after diagnosis or treatment. Different type of treatment patterns were used as 59 (81.94%) women underwent surgery, 39 (54.1%) were treated with CMF chemotherapy, 54 (72.2%) women underwent hormonal therapy and remaining with radiotherapy. The Hopwood Body Image Scale was used for the assessment of the body image perception which shown less physically attraction in most of the patients with self-consciousness, seeing themselves naked in mirror and dissatisfied with scars on their body. The Female Sexual Distress Scale (FSDS) was used to assess the sexual distress in women with breast cancer. The mean score was 24.4 (47%) which relatively shows higher sexual distress with the major sexual problem; distress about sex life, Frustration by the sexual problems, Dissatisfaction with sex life and inferiority because of sexual problem among the women. Difficulties related to body image and sexuality were common and occurred soon after surgical and adjuvant treatment. Addressing these problems is essential to improve the quality of life of young women with breast cancer.

Review of Results of QuantiFERON TB Gold Test in Presumed Ocular Tuberculosis in a South Indian Patient Population

Aim: To review the results of QuantiFERON TB gold (QFT-G) in our patient population of presumed ocular tuberculosis and the effect of antitubercular therapy (ATT) on the QFT-G result.Materials and methods: Retrospective review of 82 cases of presumed ocular tuberculosis with a successful response to ATT and 6 months follow-up post-ATT. Appropriate statistical analysis was done for associations between QFT-G and independent variables. Pre-ATT QFT-G values were also compared to the post-ATT value.Results: There were no statistically significant differences in the results of QFT-G with age (0.635), gender (0.096), history of oral steroids (0.171), or type of uveitis (0.664). There was a statistically significant association between a positive QFT-G and serpiginous-like choroiditis (0.048). The majority of our patients had positive QFT even after completion of ATT but with a significant drop in the mean values post ATT (0.010).Conclusions: Our study shows significant association of positive QFT with serpiginous-like choroiditis and persistent positivity even after completion of ATT in majority of cases in our population. There was, however, a drop in the mean values of QFT-G post-ATT.

Prevalence of eight putative periodontal pathogens in atherosclerotic plaque of coronary artery disease patients and comparing them with noncardiac subjects: A case-control study.

The study was aimed to assess the prevalence of periodontal pathogens namely Tannerella forsythia (T.f), Campylobacter rectus (C.r), Eikenella corrodens (E.c), Porphyromonas gingivalis (P.g), Treponema denticola (T.d), Prevotella nigrescens (P.n) ,Aggregatibacter actinomycetemcomitans (A.a), P.g (fi mA gene) and Prevotella intermedia (P.i), in the subgingival and the atheromatous plaque of patients with coronary artery disease (CAD), and comparing them with the noncardiac subjects thereby indicating the role of periodontal pathogenic bacteria in the progression of atherosclerosis in south Indian population. 51 cardiac and non cardiac subjects within the age group of 40-80 years,who met the eligibility criteria, were selected and categorized as the experimental and control group respectively. Total number of teeth was recorded, and oral hygiene was evaluated using Plaque Index and Oral Hygiene Index (OHI). Periodontal pocket depth and clinical attachment level were also assessed as a part of periodontal examination. Subgingival plaque samples were collected with the help of with Gracey's curette in both the groups. In experimental group, biopsy was obtained from the atherosclerotic plaque during Coronary artery bypass grafting CABG procedure. Both, subgingival and the coronary atherosclerotic plaque samples were subjected to polymerase chain reaction (PCR) analysis for identification of the periodontal bacteria. Mean, standard deviation and test of significance of quantitative variables such as periodontal parameters were compared between experimental group and control group. Kappa measures of agreement was done to analyze the relationship between the presence/absence of microorganisms in the subgingival and atherosclerotic plaque samples in the experimental group. The mean Plaque Index, Gingival Index, Russel's Periodontal Index, OHI, clinical attachment level, Pocket Depth Index was statistically significant in both the groups. Association of T.f, E.c, C.r, P.g, P.g (fi mA), T.d, P.i, P.n was significantly associated. A.a was absent in the control group, whereas only one patient in the experimental group was positive for the bacteria. Kappa analysis showed the significant association of periodontal bacteria T.f, C.r, P.g, P.g (fi mA), P.i and P.n in subgingival plaque and atherosclerotic plaque of the same patients of the experimental group. It is concluded that CAD subjects had higher prevalence of periodontal pathogens in subgingival biofilms as compared to the non cardiac subjects. Further, the number of bacteria was significantly associated between the subgingival and atherosclerotic plaques of the cardiac patients in south Indian population.

Comparative Analysis of Visual Field Plotting by Octopus Interzeag 1-2-3, Humphrey Field Analyser II and Frequency Doubling Perimetry in Glaucoma Patients in South Indian Population.

Standard achromatic perimetry tests the differential light sensitivity whereas the frequency doubling technology tests the contrast sensitivity. The aim of this study was to compare and correlate the visual field indices with three different types of perimeters namely frequency doubling perimetry (FDP), Humphrey field analyser (HFA) and Octopus Interzeag 1-2-3 (OI) for detecting glaucomatous field defects. Prospective cross-sectional observational study. Hundred eyes of 50 glaucoma patients were studied. All the patients underwent visual field examinations by Octopus Interzeag 1-2-3, Humphrey field Analyser II and Frequency Doubling perimetry (FDP). The correlations of the global indices were compared. The time taken to perform the test with the three perimeters was analysed. The visual field plotting by the perimeters were comparable and significant positive correlation was observed. The time taken to perform visual field test by Octopus Interzeag 1-2-3 was shorter than the other two methods. The visual field plotting by Octopus Interzeag 1-2-3, Humphrey field analyser and frequency doubling technology perimetry were comparable and Octopus field plotting takes lesser time than the rest two methods.

Prevalence of glutathione S-transferase M1 null polymorphism in tobacco users, oral leukoplakia and oral squamous cell carcinoma patients in South Indian population: A polymerase chain reaction study.

Context:Tobacco abuse is a well-known risk factor for potentially malignant disorders as well as oral squamous cell carcinoma (SCC). Factors that influence tobacco-exposed individuals developing a malignancy may include a combination of total tobacco exposure and genetic susceptibility.Aim:This study was undertaken to determine the prevalence of the glutathione S-transferase M1 (GSTM1) null polymorphism in oral leukoplakia and oral SCC patients in South Indian population.Settings and Design:This case-control study was conducted in hospital setting on South Indian population.Materials and Methods:Totally, 280 subjects with a history of tobacco use, oral leukoplakia, oral SCC were included in this study. Three milliliter of blood was collected and transported under cold cycle and taken for evaluation of GSTM1 null polymorphism using Multiplex Polymerase Chain Reaction.Results and Discussion:On comparing the prevalence of GSTM1 null polymorphism among the group with subjects with habits and no oral lesions, oral leukoplakia and oral SCC, it was observed that there was a statistically significant association between GSTM1 null polymorphism and the different groups (P < 0.01).Conclusion:The lack of GSTM1 activity would make the oral tissues more susceptible to action of tobacco carcinogens and to the development of a high-grade level of dysplasia in oral leukoplakia and thereby increases the susceptibility of lesion to undergo malignant changes.

Clinical characteristics, angiographic profile and in hospital mortality in acute coronary syndrome patients in south indian population

Aims: The aim was to study the clinical profile, risk factors prevalence, angiographic distribution, and severity of coronary artery stenosis in acute coronary syndrome (ACS) patients of South Indian population. Materials and Methods: A total of 1562 patients of ACS were analyzed for various risk factors, angiographic pattern and severity of coronary heart disease, complications and in hospital mortality at Sri Jayadeva Institute of Cardiovascular Research and Sciences, Bengaluru, Karnataka, India. Results: Mean age of presentation was 54.71 ± 19.90 years. Majority were male 1242 (79.5%) and rest were females. Most patients had ST elevation myocardial infarction (STEMI) 995 (63.7%) followed by unstable angina (UA) 390 (25%) and non-STEMI (NSTEMI) 177 (11.3%). Risk factors; smoking was present in 770 (49.3%), hypertension in 628 (40.2%), diabetes in 578 (37%), and obesity in (29.64%) patients. Angiography was done in 1443 (92.38%) patients. left anterior descending was most commonly involved, left main (LM) coronary artery was least common with near similar frequency of right coronary artery and left circumflex involvement among all three groups of ACS patients. Single-vessel disease was present in 168 (45.28%) UA, 94 (56.29%) NSTEMI and 468 (51.71%) STEMI patients. Double-vessel disease was present in 67 (18.08%) UA, 25 (14.97%) NSTEMI and 172 (19.01%) STEMI patients. Triple vessel disease was present in 28 (7.55%) UA, 16 (9.58%) NSTEMI, 72 (7.95%) STEMI patients. LM disease was present in 12 (3.23%) UA, 2 (1.19%) NSTEMI and 9 (0.99%) STEMI patients. Complications; ventricular septal rupture occurred in 3 (0.2%), free wall rupture in 2 (0.1%), cardiogenic shock in 45 (2.9%), severe mitral regurgitation in 3 (0.2%), complete heart block in 11 (0.7%) patients. Total 124 (7.9%) patients died in hospital after 2.1 ± 1.85 days of admission. Conclusion: STEMI was most common presentation. ACS occurred a decade earlier in comparison to Western population. Smoking was most prevalent risk factor. Diabetic patients had more of multivessel disease. Complications and in hospital mortality was higher in females and elderly population.

Orbital and adnexal tuberculosis: a case series from a South Indian population.

BackgroundOrbital tuberculosis (OTb) is rare and may be regarded as a manifestation of extrapulmonary tuberculosis. We report an interesting case series of six patients with varied presentations of orbital and adnexal tuberculosis in a South Indian patient population.ResultsA retrospective, interventional case series of six patients diagnosed with orbital and adnexal tuberculosis on the basis of clinical, radiological and histopathological evaluations between 2010 and 2013 was performed. Among the six patients with histopathologically proven OTb, five were women. The varied presentations included tubercular dacryoadenitis (two cases), classical periostitis (two cases), OTb with bone involvement (one case) and ocular adnexal tuberculosis (one case). Systemic involvement was seen in one case. All cases were treated with a regimen of antitubercular therapy (ATT).ConclusionsOTb, though rare, should form a part of the differential diagnosis of orbital lesions in a high tuberculosis (TB) endemic country like ours. Biopsy still remains the mainstay of diagnosis.

Clinical Profile of Isolated Viral Anterior Uveitis in a South Indian Patient Population

Aim: To analyze the clinic profile of polymerase chain reaction proven viral anterior uveitis in a south Indian patient population.Materials & Methods: Retrospective, nonrandomized study between January 2009 and July 2012.Results: Out of the 36 patients with polymerase chain reaction (PCR)-positive viral anterior uveitis, 24 patients had varicella zoster virus (VZV) anterior uveitis, 7 patients had HSV anterior uveitis, 3 patients had cytomegalovirus (CMV) anterior uveitis, and 2 patients had chikungunya virus related anterior uveitis. Corneal involvement was seen in 21 cases (58.33%). An altered iris pattern was seen in 14 cases (38.89%). Increase in intraocular pressure (IOP) at the time of inflammation was seen in 10 cases (27.78%). Reactivations were seen in 22 cases (61.11%). A comparison of herpes simplex virus (HSV)- and VZV-related anterior uveitis did not reveal any significant factors except for a previous history of herpes zoster in VZV-associated uveitis.Conclusion: We see isolated viral anterior uveitis related to HSV, VZV, CMV, and chikungunya viruses in our patient population. Corneal involvement, pigmented keratic precipitates, an abnormal iris pattern, increase in IOP, and reactivations are seen as a spectrum of viral anterior uveitis in our patient population as well.

Early Stage Oral Tongue Cancer among Non-Tobacco Users - An Increasing Trend Observed in a South Indian Patient Population Presenting at a Single Centre

Oral tongue squamous cell carcinoma (OTSCC) is the most common cancer diagnosed within the oral cavity worldwide. Many studies in India report OTSCC ranking among the top two most common subsites within the oral cavity. India is often labeled the oral cancer capital of the world. The incidence of tongue cancers in the population-based cancer registry (PBCR) of Chennai is showing an increasing trend. A majority of the oral cavity cancers (85%) in our cancer center present in advanced stages (III and IV). In contrast, early tongue cancers (stages I and II) constitute nearly 45% of all OTSCCs. The aim of this study was to analyze the clinical profile and epidemiological trends in our early stage tongue cancer patients with an emphasis on tobacco and alcohol habits. This retrospective analysis was based on a prospectively collected database of 458 consecutive early stage OTSCC in-patients at a tertiary care oncology centre in Chennai between 1995 and 2008. Our study suggests that the earlier trends have clearly changed whereby nearly half of our patients are now never-tobacco users. The findings of the study indicate that a majority of the patients were never alcohol users (86.4%) and nearly half of them were never tobacco users (49.3%), and they had the best survival outcomes. This increasing trend of OTSCC among non-tobacco users is in contrast to our earlier experience of tongue cancer more than five decades ago.The median age of patients in our study was 53.3 years; the male to female ratio was approximately 2:1. The median follow up for the 458 patients was 53 months. Our study importantly as well as interestingly shows a conspicuous absence of association with the traditional risk factors, tobacco and alcohol.

Correlation between the retinal nerve fibre layer (RNFL) parameters measured using stratus optical coherence tomography and GDx VCC (Scanning laser polarimetry) in established glaucoma patients in south Indian population

Purpose: Optical Coherence Tomography and Scanning LASER polarimetry (GDx) are investigatory modalities used to evaluate the structural changes in the optic nerve and retina in glaucoma patients.This study aims to evaluate the correlation between the Retinal Nerve Fibre Layer (RNFL) parameters measured using Stratus-OCT (optical coherence tomography) and GDx VCC(scanning laser polarimetry) in established glaucoma patients in South Indian Population. Materials and methods: Prospectively planned cross sectional study of 67 eyes of 34 established glaucoma patients on medical management The mean age of patients was 46.911 years (SD+13.531). A complete ophthalmic examination, automated perimetry with octopus interzeag 1-2-3 perimeter, retinal nerve fiber analysis with GDx VCC and Stratus OCT was done. Correlation coefficients between the parameters of OCT and GDx VCC were calculated. Results: Statistically significant positive correlations were observed between GDx VCC and OCT parameters in the respective areas. Conclusion: The RNFL thicknesses measured by two different investigatory modalities OCT and GDx are well correlated despite the differences in values of RNFL thickness.

Relationship between the retinal nerve fibre layer (RNFL) parameters and visual field loss in established glaucoma patients in South Indian population

Purpose: Optical coherence tomography (OCT) and Scanning LASER polarimetry (GDX-VCC) are newer techniques to analyse retinal nerve fibre loss in glaucoma. This study aims to evaluate the relationship between the Retinal Nerve Fibre Layer(RNFL) parameters measured using Stratus-OCT and GDx-VCC and visual field loss by Octopus interzeag perimetry in established glaucoma patients in South Indian Population. Materials and methods: Prospectively planned cross sectional study of 67 eyes of 34 established glaucoma patients on medical management. The mean age of patients was 46.911 years (SD+13.531). A complete ophthalmic examination, automated perimetry with octopus interzeag 1-2-3 perimeter, retinal nerve fibre analysis with GDx VCC and Stratus OCT was done. The differences between the mean RNFL parameters in the presence or absence of field defects were evaluated. Results: The data analysed were mean deviation, loss variance, OCT total average nerve fibre thickness, GDX VCC- TSNIT average and Nerve fibre indicator (NFI).The data were split into two subgroups on the basis of presence or absence of visual field defect and analysed. The difference between the mean value of NFI between the subgroups was highly significant with a p value < 0.01.The OCT parameter Total average nerve fiber layer thickness differed significantly between the two subgroups (p value <0.05). The mean GDx TSNIT average did not differ significantly between the two subgroups. Conclusion: The total average nerve fibre thickness by OCT correlated better with visual field loss than the GDX TSNIT average .Among the GDx parameters, the NFI was found to be a better indicator of visual field damage than the average thickness.

Associations of Fuchs heterochromic iridocyclitis in a South Indian patient population

BackgroundThe purpose of this study is to look for any possible associations in 58 consecutive cases of Fuchs heterochromic iridocyclitis (FHI) in a South Indian patient population. Fifty-eight consecutive cases (59 eyes) of FHI underwent a detailed ocular and systemic evaluation. Routine laboratory investigations for uveitis including serum angiotensin-converting enzyme and enzyme-linked immunosorbent assay (ELISA) for toxoplasmosis (IgG and IgM) were done in all the cases. Syndrome Evaluation System comprising of multiplex nucleic acid amplification and signature specific hybridization on the aqueous fluid was done in all 59 eyes for herpes simplex virus (HSV), varicella zoster virus, cytomegalovirus (CMV), rubella virus, chikungunya virus, Toxoplasma, and Mycobacterium tuberculosis. The results were statistically assessed using the SPSS (version 15) package.ResultsThirty-three males and 25 females with FHI were included in the study. Systemic sarcoidosis was seen in two cases. Serological tests failed to confirm an association with toxoplasmosis in all the cases. Aqueous fluid analysis showed positivity only to HSV (one case), CMV (one case), and chikungunya virus (one case).ConclusionsWe do see associations of sarcoidosis, HSV, and CMV in FHI in our patient populations as well. The detection of chikungunya virus in a patient with FHI in our series adds to the list of associations with FHI.

Human Herpes Virus-8 Infections among Subjects with Human Immunodeficiency Virus Infection and Normal Healthy Individuals in India

Human herpes virus-8 (HHV-8) is etiologically associated with Kaposi's sarcoma. There is insufficient information on the epidemiology of HHV-8 infection from India. Blood samples from 87 human immunodeficiency virus (HIV)-infected individuals and 84 normal healthy blood donors were tested for the HHV-8 IgG antibodies. Further, a total of 309 whole blood samples from treatment-naïve HIV-1-infected individuals and from 70 normal healthy individuals were also collected and tested for HHV-8 DNA. The seroprevalence of HHV-8 was 4.7% in the South Indian population. There was no significant difference in the seroprevalence of HHV-8 in the HIV-infected and uninfected patients. None of the 379 samples tested were positive for HHV-8 DNA. Our study revealed a very low exposure of the South Indian patient population to HHV-8 and multicentric epidemiological studies are needed to understand the prevalence of HHV-8 in different regions of India and to confirm any gender-specific differences in seroprevalence.

PREDICTORS FOR TUBERCULAR UVEITIS

To look for clinical parameters that will assist in making a diagnosis of tubercular or sarcoid uveitis in a South Indian patient population Retrospective, nonrandomized, comparative study of 51 patients with a diagnosis of biopsy-proven tuberculosis and sarcoidosis. These patients had a minimum of 1-year follow-up after initiating treatment for either disease. Multivariate logistic regression analysis was used to determine clinical predictors of tubercular uveitis. The mean age group was 47.08 ± 11.19 years. There were 39 women and 12 men in the study. Multivariate logistic regression analysis shows likelihood of uveitis being tubercular in etiology using 3 variables: Schirmer test >10 mm, retinal vasculitis with areas of multiple, pigmented chorioretinal atrophy along blood vessels, and a positive Mantoux test 76.6%. A combination of Schirmer test >10 mm, retinal vasculitis with areas of multiple, pigmented chorioretinal atrophy along blood vessels, and positive Mantoux test may be used clinically to differentiate tubercular from sarcoid uveitis in our patient population.

Oral manifestations of HIV patients in South Indian population

Objectives:To study the prevalence of oral manifestations in HIV-infected patients and to correlate oral manifestations with age, gender, severity, and clinical staging.Materials and Methods:Fifty patients of either sex diagnosed as HIV positive were included in the study. The data obtained were analyzed statistically using Fisher's exact test and Chi-square test.Results:Among the 50 HIV-infected patients, oral manifestations were found in 40 (80.0%) patients. Thirty (60%) patients were seen in the age range between 31 and 65 years, and 29 (58%) patients were females. Majority of the patients [26 (52%)] were in the clinical staging C, of whom 23 (88.5%) were with manifestations with significant statistical value (P < 0.05). Patients with CD4 count less than 200 had manifestations in 22 (88%) patients. Correlation between reduction in CD4 count and presence of manifestations was significant (P < 0.05). Twenty-eight (80%) patients without antiretroviral therapy (ART) reported with manifestations. Correlation between ART and presence of manifestations was not significant (P = 1.00).Interpretation and Conclusion:Oral manifestations are the indicators for the disease progression. Clinical stage C and lower CD4 count may be useful predictors for HIV, with greater prevalence of oral manifestations.

Clinical Profile of Ocular Sarcoidosis in a South Indian Patient Population

Aim: To report the ocular and systemic features in patients with definite and presumed sarcoidosis presenting to a tertiary referral eye center in south India.Materials and Methods: Retrospective observational case series. Records of 51 patients with diagnosis of sarcoidosis were retrieved. A complete ophthalmic evaluation and systemic examination by a pulmonologist with appropriate laboratory investigations were done in all patients. Results were statistically analyzed using SPSS software.Results: The mean age group was 45.14 ± 10.91 years. Females were more common and 31 cases were biopsy proven. Panuveitis and thoracic involvement was the most common ophthalmic and systemic manifestations of sarcoid respectively. Posterior synechiae, granulomatous keratic precipitates, increased anterior chamber reaction, and cystoid macular edema were significantly more common in those presenting initially to an ophthalmologist.Conclusions: Sarcoidosis is increasingly recognized in south India as well. A complete review of systems with appropriate investigations is essential to prevent ocular or systemic morbidity.