European Journal of Molecular & Clinical Medicine

Acute disseminated encephalomyelitis (ADEM) is an acute inflammatory immune-mediated demyelinating disorder of the central nervous system usually occurring after a post infectious or post vaccineal event.⁽¹⁾ It is usually monophasic but can be polyphasic or be recurrent making the diagnosis difficult⁽²⁾. Commonly affects the children.  There is activation of t cell clones causing widespread demyelination involving the white matter of the brain and spinal cord. As it can affect any part of the neuraxis the clinical features are variable and polysymptomatic

Aim: The aim of the present study was to assess haematological and inflammatory parameters in sepsis patients.
Methods: The study was conducted at Medical intensive care unit at Dr. DY Patil medical college and hospital, DY Patil Vidyapeeth, Pimpri, Pune from October 2020 – September 2022 and 100 cases were included in the present study. Approval was taken from institutional ethics committee before commencing the study. Informed and written consent was taken from all the patients.
Results: Among the study population, 68.00% of them were male, 32.00% of them were female. On study population, 44.00% of them diagnosed with DIC. On study population, 61.00% of them were Survivors, 39.00% of them were non-survivors. The mean platelet on admission was 117624 ± 89241.13, it was 105860 ± 85661.89 at 24 hours, it was 98990 ± 83391.29 at 48 hours. The mean D Dimer at Admission was 4073.37 ± 4361.13, it was 3956.39 ± 2432.91 at 24 hours, it was 5284.33 ± 8445.54 at 48 hours. The mean Fibrinogen at Admission was 2.07 ± 0.85, it was 1.76 ± 0.86 at 24 hours, it was 1.47 ± 0.95 at 48 hours.  Among the study population, the mean ESR was 86.75 ± 97.97, the mean CRP was 73.7 ± 72.45, the mean Lactate was 28.95 ± 25.06, the mean Pro Calcitonin was 6.62 ± 3.4.
Conclusion: In uncontrolled cases of sepsis, acute organ dysfunction and shock may develop. Because of this rapid progression, it is of utmost importance that patients should be diagnosed and treated in a requisite time frame. The current literature and changing guidelines demonstrate that the bedside physical examination along with laboratory testing (haematologic and inflammatory biomarkers) are the most effective combination of parameters that clinicians can rely upon to accurately predict or diagnose sepsis in a critically ill patient.

The aim of this study is to compare of acute inflammatory response and ALVARADO scoring system for diagnosis of acute appendicitis: a prospective and observational study. All patient undergone routine laboratory and ultrasound investigation. No CT scan was done for any of the patient. Surgical residents calculated the results of the Alvarado & AIR scoring system, and data were entered in pre-prepared forms. The specialist surgeon on duty decided to operate on admitted patients. Histopathology samples were sent for confirmation of acute appendicitis, the results were correlated with preoperative scores.
Result: The present study included 100 patients with suspicion of appendicitis. There were 54% males and 46%) of females with male preponderance in the study. The mean age of the male was 34 years with a range of 7-84 years and female was 31 years with a range of 12-74 years. The most common age group in the study was 16-25 years (34%) followed by 26-35 years (28%). In the study, 38 cases of 100 (38%) were diagnosed pathologically as appendicitis
Conclusion: To conclude, AIR scoring performed well almost equally with Alvarado system with high specificity and high negative predictive value preventing unnecessary negative appendectomies. Follow up of these cases will help in deciding surgical intervention in unnecessary cases. It has high specificity when analyzing patients who fell under low-risk group (score < 8). The score has high negative predictive value there by reducing negative appendectomies. This scoring system also prevents unnecessary and costly radiological investigations thereby reducing the financial burden to the patients.

Role of diffusion weighted magnetic resonance imaging in evaluation and differentiation of inflammatory and neoplastic brain lesions.
Material and methods: This was a prospective study conducted in the Department of Radiodiagnosis, Index Medical College Hospital and Research Centre, Indore, Madhya Pradesh. 50 patients with acute focal neurological deficit and manifestations suggestive of brain lesions which could be neoplastic or inflammatory in nature were included in this study. Data was collected using pre-structured proforma which included details such as name, age, gender, presenting complaints and findings were noted for MRI and DWI imaging.
Results: In our study, sensitivity, specificity of DWI was found to be 47.6% and 50% respectively. The accuracy for DWI for correctly diagnosing benign or malignant lesions on the basis of cut-off value of ADC was found to be 40% with 95% confidence interval of 27.61% to 53.82%. However, diffusion weighted imaging (DWI) was not able to differentiate between inflammatory (benign) and malignant lesions conclusively.
Conclusion: It can be concluded from our study that diffusion weighted imaging (DWI) along with its apparent diffusion coefficient (ADC) values was not able to conclusively differentiate between benign (inflammatory) and malignant (neoplastic) lesions of the brain and further imaging studies such as MR spectroscopy, MR perfusion study etc. can be used to further evaluate lesions and differentiate between them.

Understanding the etiology and pathogenesis of periodontal diseases and their chronic, inflammatory and infectious nature necessitates recognizing the possibility that these infections may have effects somewhere in the body. The concept that oral diseases and systemic diseases influence each other goes back to the theory of “focal infection”. In 1891, Miller published his theory regarding focal infection in which he indicated that microorganisms and their products are able to access parts of the body that are adjacent to or distant from the mouth. The proponents of this concept assume that microorganisms present in dental plaque and their metabolic products may enter the bloodstream, thereby causing many systemic diseases and sometimes resulting in degenerative conditions. Associations have been reported between periodontal disease and cardiovascular disease (CVD), stroke, diabetes, preterm low birth-weight babies, respiratory infections and rheumatoid arthritis (RA).

Background:Oral lichen planus (OLP) is a chronic inflammatory disorder with a
relatively high prevalence varying from 0.9 % to 1.2%. It may be confined to oral
cavity or associated with the skin, nails and other mucosal sites. Oral lesions are
chronic, rarely undergo spontaneous remission and are often a source of morbidity.
OBJECTIVE - To investigate the epidemiological and clinical characteristics of oral
lichen planus (OLP) in a group of patients.
Materials and Methods: This is retrospective study done at Gandhi Hospital from 2017
to 2019. A total of 64 lichen planus patients with oral involvement were included. OLP
is diagnosed based on the morphology and associated lesions on the skin, nails or other
mucosa. A biopsy was done in doubtful cases.
Results: Out of 64 studied patients females(41) outnumbered males(23) .The common
age group was 30-60yrs. Isolated OLP was observed in 42%, with cutaneous LP 50%,
with nail involvement 3%, and with genital mucosa 4 %. Buccal mucosa is the
commonest site (84%) followed by tongue 28% and lip 20%. LP involving the lower lip
with actinic changes 5(39%) and pigmentation in 8(61%). The common patterns
observed were reticular 65.6%, erosive 11% and pigmented 11%. Other associations
were submucosal fibrosis in 6, diabetes 10, hypothyroidism 4, vitiligo 1, retro-positive 4,
HCV in 2.
Conclusion: In our study reticular pattern involving the buccal mucosa was the
commonest. Our study showed that LP involving the lower lip was mimicking actinic
cheilitis which may be differentiated. Association of LP with HCV was seen in only in
3.1 % of cases. Regular follow-up was needed for erosive or ulcerative and atrophic LP.