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Growth Hormone Deficiency (GHD) is one of the most important treatable endocrine causes of short stature. A problem anywhere in the Growth Hormone (GH) - Insulin-Like Growth Factor-1 (IGF-1) axis can lead to short stature. Childhood GH deficiency can be congenital, acquired, or idiopathic. Hereby, the authors present a case series consisting of five cases of short stature, aimed to provide an overview of the spectrum of GH-related disorders. All five patients presented to the Paediatric Endocrinology Outpatient Department of a tertiary care Institute with complaints of not gaining height. The patients in present case series had significant short stature (Z score for height <-3 SD (Standard Deviation) in each case). These patients were suspected of having GH deficiency based on clinical presentation and investigations. After a proper diagnostic work-up and GH stimulation tests, cases 1 to 4 were found to have GH deficiency. The 5th case was suspected of having Laron Syndrome based on high GH levels and low IGF-1. There were subtle differences in the spectrum of GH deficiency. The 1st case had Multiple Pituitary Hormone Deficiency (MPHD). Cases 2 to 4 had Isolated Growth Hormone Deficiency (IGHD). Case 2 had findings of pituitary stalk interruption on brain imaging. We found a genetic association in the 3rd case, while the 4th case had almost normal brain imaging. Cases 1 to 4 received GH therapy, and all showed appreciable height gain. These subtle differences can sometimes make the diagnosis difficult, and often a different approach to treatment is required. [ABSTRACT FROM AUTHOR]

Introduction: The presence of circulating maternal endotoxin can arise from pathogenic periodontal bacteria resulting in preterm labour and delivery of Low Birth Weight (LBW) infant. Aim: The aim of this study was to find if periodontitis induced maternal endotoxemia could be a risk factor for delivery of LBW infant. Materials and Methods: A total of 60 primiparous mothers between the age group of 18-35 years delivering LBW infants (weight ≤2500 gm) were selected for this case control study. Cases were 30 postpartum mothers with periodontitis whereas controls were 30 postpartum mothers without periodontitis. Periodontitis was defined according to WHO criteria, as pocket probing depth of ≥4 mm in atleast one site. Endotoxin level was assessed by a quantitative end point chromogenic limulus amebeocyte lysate (Lonza QCL 1000®). Odds Ratio (OR) was calculated to see if periodontitis was a risk factor. Results: Periodontitis increased the risk for occurrence of endotoxemia by more than three times among mothers delivering LBW infants with an OR of 3.21. Conclusion: Maternal endotoxemia due to periodontal infection can form a possible biological explanation for periodontitis as a risk factor for delivery of LBW babies. Future research is needed to study the effect of endotoxins in periodontal pathogenesis. [ABSTRACT FROM AUTHOR]

Introduction: Pomegranate (Punica granatum) fruit extract has anti-inflammatory, anti-bacterial, anti-oxidant and immunemodulatory features. Due to increased bacterial resistance to synthetic agents Pomegranate Extract Gel (PEG) could become a natural remedy for the treatment of periodontal disease. Aim: To compare topically applied PEG, chlorhexidine (CHX) gel, ornidazole-chlorhexidine (ORN-CHX) gel and Placebo Gel (PG) on clinical parameters and on gingival crevicular fluid (GCF) levels of interleukin-1β (IL-1β) and IL-8 and chemokine (C-C motif) ligand 28 (CCL28) levels in a two week human experimental gingivitis model. Materials and Methods: Eighty systemically healthy subjects were randomly assigned to one of the four groups; Group I: PEG, Group II: CHX gel, Group III: ORN-CHX gel, and Group IV: PG. On the selected quadrant the subjects refrained from routine hygiene procedure and solely used the topical gel. The primary outcome measured were IL-1β, IL-8 and CCL28 levels from GCF at baseline and 14 days. Gingival Index (GI), Plaque Index (PI), Bleeding On Probing (BOP) and Probing Depth (PD) were secondarily assessed at baseline, 14 and 60 days. Paired t-test and one-way ANOVA followed by post-hoc Tukey's test was used for intra and intergroup comparisons with p-value of 0.05 as significant. results: The PEG had an inhibitory effect on pro-inflammatory cytokines and chemokine. PEG showed significantly less increase in IL-1β, IL-8 (p=0.003, 0.002) while CCL28 levels showed no difference from baseline (p=0.15) when compared to other three groups (p<0.001). The BOP and GI among subjects using PEG showed less increase (p=0.01, 0.05) compared to other three gels (p<0.001) after 14 days. PEG and CHX-ORD gel were similar (p=0.96) in exhibiting lowered PI. conclusion: Pomegranate extract gel was effective in reducing the inflammatory markers and can be used as an adjunct to mechanical therapy for the treatment of gingivitis. [ABSTRACT FROM AUTHOR]