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A 32-year-old female patient presented with complaints of loss of appetite, weight loss (8-9 kg), and generalised weakness for three months. The patient also had a history of cough with expectoration for two months accompanied by abdominal pain, particularly on the left-side, and low-grade, intermittent fever for the last two weeks. The Erythrocyte Sedimentation Rate (ESR) was deranged, measuring 25 mm/hr. The Mantoux test was positive with an induration of 17 mm. The sputum study confirmed the diagnosis of tuberculosis by detecting acid-fast bacilli.

Since from long time the plant, Annona reticulata Linn. is known for its beneficial effects. Leaves of A. reticulata were screened for phytochemicals and in vitro antioxidant, antibacterial and antifungal activity. The shade dried leaves were extracted with methanol and aqueous methanolic extract was partitioned successively with n-butanol, chloroform and acetone solvents. Methanolic extract was subjected to antioxidant screening using DPPH free radical scavenging activity and H2O2 scavenging activity. Antibacterial and antifungal activity of extract and fractions were analyzed on eight different clinical bacterial and fungal strains using agar well diffusion method and broth dilution method (MIC and MMC determination). The antioxidant activity showed that the extracts exhibited scavenging effect in concentration-dependent manner. The extract showed potent inhibitory effect against Bacillus subtilis and Escherichia coli bacterial strains while in case of fungal strains the maximum effect was observed against Candida blanki. The maximum zone of inhibition of n-butanol, chloroform and acetone fractions was observed against B. subtilis, and E. coli respectively while all fractions exhibited potent inhibitory effect against C. blanki. MIC and MBC values were determined for active samples, methanol extract and chloroform fraction against Staphylococcus aureus, B. subtilis, E. coli and Pseudomonas aeruginosa which revealed lower MIC and MBC values. The fungal strains Candida albicans, Saccharomyces cerevisiae and C. blanki were used to calculate MIC and MFC values for methanol extract and acetone fraction which demonstrated lower MIC and MFC values. The results provided evidence that the plant is richly supplied with numerous phytoconstituents that might indeed be potential sources of natural antioxidant, antimicrobial agents and supplementary food.

Background and Objective: Nitric oxide (NO) is a widespread signaling molecule which is known to influence varied biological processes. However, an uncontrolled high level of NO accelerates tissue destruction. The pathogenesis of periodontal disease is also affected by smoking which alters the inflammatory response. The present study was thus performed to assess the effect of nonsurgical periodontal treatment on salivary and serum NO levels in smokers and nonsmokers with chronic periodontitis. Materials and Methods: Forty patients with chronic periodontitis, including 20 nonsmokers and equal number of smokers participated in the present study. Probing depth, clinical attachment level, plaque index, gingival index were assessed, serum and saliva samples were obtained from the patients at baseline and after Phase I therapy at 6 weeks to estimate NO by Griess colorimetric reaction. Results: Smokers showed higher serum and saliva NO levels 30.3 ± 3.28 and 50.4 ± 4.07 μM as compared to nonsmokers 20.05 ± 2.42 μM and 37.5 ± 2.95 μM, respectively, at baseline. After Phase I therapy, both the groups exhibited significant improvement in clinical parameters and reduction in serum and saliva NO levels; however, reduction was higher in nonsmokers. Conclusion: More destructive expression of periodontal disease in smokers causes an increase in the concentrations of NO and less reduction after Phase I therapy as compared to nonsmokers with chronic periodontitis. Hence, NO levels in saliva and serum could be used as indicators of periodontal inflammatory condition.

Background: Clinical attachment level is the most frequently used and acceptable parameter in monitoring periodontal status in diseased individual and denotes patterns of periodontal destruction. Awareness of root morphology and the condition of the periodontal tissues is essential for reliable periodontal pocket probing and for effective debridement of root surfaces. Clinically, it is challenging to observe exact nature of complex periodontal attachment loss. The aim of the present study was to evaluate patterns of periodontal destruction based on vertical and horizontal attachment loss. Materials and Methods: A total of 200 extracted teeth were obtained from chronic periodontitis patients. Prior to extraction, clinical measurements were recorded and after extraction, the teeth were stained with crystal violet. Root length, vertical and horizontal attachment loss were measured using digital caliper. Results: There was a significant difference between clinical attachment level and vertical attachment loss for both maxillary and mandibular teeth. Mean vertical attachment loss varied between 5.17 mm and 9.17 mm. Interproximal surfaces exhibited statistically significant vertical attachment loss in both maxillary and mandibular dentition. Results indicated that vertical attachment loss was more severe with teeth belonging to the anterior sextant whereas the horizontal attachment loss was more pronounced with posterior teeth. Conclusion: Both vertical and horizontal attachment loss were observed in all periodontally involved teeth. There was a difference in clinical measurements and actual periodontal status denoted by postextraction staining. These findings have an impact on determining the prognosis and appropriate treatment plan for patients.