23 December, 2014


The days of Face to Face expression are nearly gone....

Now it is the age of Facebook!!

Nearly everybody who knows to use internet has a Facebook account....!

Want to know something? Put a query on FB.... Loads of answers will pour in...

Want to wish your loved ones for their Birthday, anniversary?  FB is there...

The latest fad of the younger lot..... FB account!

The older generation is not far behind...

FB has literally revolutionized the way people use internet. The think-tank of FB is just awesome...

Think of the bigger picture, FB has made our world a “Global Village”. Anyone with an FB account can connect to people in the other end of the equator Just like that!

Social network’s potential is just waiting to be explored!

FB has revolutionized internet, FB has changed business models. Instead of spending money on creating websites, small scale businessmen have started developing and generating business via Facebook pages. FB has played a matchmaker, hell and havoc on interpersonal relationships as well...

Can FB revolutionize Healthcare also?

Yes !!

12 November, 2014


There has been a quantum leap in prevalence of diabetes in Chennai and Delhi, and if the figures apply for other parts of the country, India would be home to the largest diabetic population on earth.  The Centre for Cardiometabolic Risk Reduction in South Asia (CARRS) study conducted by the Madras Diabetic Research Foundation (MDRF) has shown that more than 24% of people in Chennai and Delhi, besides Karachi, are diabetics. This is a tenfold increase in their numbers since 1970, when the diabetic population stood at 2.3%. In Chennai, 38% of people above the age of 40 are diabetics. "Especially the Chennai numbers are startling," said Dr V Mohan of MDRF. "The study shows the prevalence of diabetes in people above 20 years of age has gone up from 18.6% six years ago to 24.7% now." In the past 40 years, diabetes has broken many barriers. While earlier it was believed to be the rich man's disease, today it is found in the poorest of people. Over time, diabetes has destroyed the urban-rural divide as well, as sedentary lifestyle and a high fat diet has become common among all Indians. "Everyone is at risk," said Dr Mohan. Adding to the trouble is Indian's genetic predisposition to diabetes. On the brighter side, detection at pre-diabetes stage and early intervention using a diet-exercise regime can prevent if not delay diabetes, experts have found. Diabetes has demolished another theory—that Indians living in the US are more prone to the disorder than those living in India. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study done by the Madras Diabetic Research Foundation (MDRF) compared the prevalence of diabetes among people in India and migrant Indians living in San Francisco. "While it was believed that NRIs were more prone to diabetes, the study showed that Indians living in India have surpassed that too. The prevalence of diabetes in Chennai was 38% in those above 40 years of age, compared to 24% among migrant Indians in San Francisco," said Dr V Mohan of MDRF. The MASALA study also showed that the prevalence of pre-diabetes was higher in San Francisco than in India. "This is simply because our folks are changing from the pre-diabetes phase into diabetes in a more rapid fashion than Indians living abroad," said Dr Mohan. While there has been a debate over whether genetic factors or environmental factors play a more important role in the high prevalence of diabetes in India, Dr Mohan pointed out that unchecked consumption of white rice was one of the major reasons for the alarming increase in diabetes cases in India, followed by physical inactivity and urbanization. "White rice intake and diabetes rates go hand in hand. Studies show that the risk of diabetes increases fourfold if the consumption of white rice increases from 200g to 400g for every individual," said the doctor. He said that consuming brown rice or rice rich in fibre would make a lot of difference in reducing the risk of diabetes and obesity. "It is high time we dropped the rice rich diet and included a lot of veggies in our meals.

Source - TOI

15 September, 2014


People with Diabetes can have sweets?

How to overcome craving?

What is the safest alternative to table sugar?

Well these are some interesting questions based on which countless amounts have been spent for research. The outcome – Many different types of alternatives were introduced. Some came with side effects and some came with a bitter after taste. As of now the most commonly used alternative is SUCRALOSE. Sucralose is 300 to 1000 times sweeter than our normal table sugar (sucrose). This sucralose was developed when scientists were actually trying to develop a sugar based insecticide. At that point the sweetness of sucralose was identified by chance. The scientist misheard the term “test” as “taste” and tasted it. He found the compound exceptionally sweet. Scientists Tate & Lyle patented it in 1976. Slowly the use of sucralose spread over countries and continents. Now sucralose is used in more than 80 countries all over the world. How our simple table sugar becomes sucralose? It goes through processing (Simple word to explain selective chlorination of sucrose, which substitutes three of the hydroxyl groups with chlorine. This chlorination is achieved by selective protection of the primary alcohol groups followed by acetylation and then deprotection of the primary alcohol groups.The partially acetylated sugar is then chlorinated with a chlorinating agent such as phosphorus oxychloride, followed by removal of the acetyl groups to give sucralose)

Sucralose safe?

Well.... anything in excess is definitely harmful. Even water in excess can kill you.
Sucralose is safe. Maximum dose is 9mg per Kg body weight per day.

Moral of the story –

You can have a sweet life with diabetes


Measure before you eat!

Sweet life!

01 September, 2014


Maggots! Maggots Maggots!!!  Ewww  ahhh ish.... 

But can you imagine that before advent of Life saving antibiotics these maggots had saved many lives and limbs!

Yes ! Exactly!

Maggots were used for treatment of sloughing wounds and deep seated infections.

Maggot therapy in olden days was a result of observation by army surgeons that the maggot infested wounds heal faster compared to non infested wounds.

William Baer was the first one to use Maggots in treatment of wounds and also showed that maggots can help the wound to heal faster.

This method became so popular that many hospitals developed their own insectaries to stock their own insect free maggots for treatment.

Many doctors were happy with this bio-debridement. 

The problems faced that time were Difficulty in getting insect free maggots, Cost & Difficulty in constructing a dressing to house these maggots around the wound.

Slowly maggots disappeared from the scene with advent of “Life- Saving Antibiotics”

Now Maggots are ready to make a comeback!


Because the Bacteria are becoming more and more resistant to antibiotics. Even before the drug reaches the stage of mass production resistant strains emerge. It is not uncommon for any Doctor to see reports carry these Dangerous terms – MRSA, ESBL, MBL, MDR strains, Pan – Drug Resistant Strains.

Literally we are running out of antibiotics. The small single celled invisible creatures are winning!

Maggot therapy is essentially a controlled therapeutic maggot infestation on a live host). It is controlled by selecting a safe strain and made germ free by using disinfectants. These maggots are introduced in special dressings that prevent them from leaving the wound.

Maggots are applied to the wound at a dose of 5–10 larvae per square centimetre of wound surface area and are left within their dressing for 48–72 h. The basic action comprises of Debridement, Disinfection, Stimulation of healing and Biofilm inhibition and eradication.
Medicinal maggots are like microsurgeons and are precise in their debridement. It is no wonder that they have found their way into the hearts and wounds of so many.
Despite our low cultural esteem for maggots, more and more clinicians and patients are turning to medicinal maggots for assistance with their wound healing. For most, the drawbacks of maggot therapy pale in comparison to the remarkable efficacy in treating even the most recalcitrant wounds.
Modern dressing materials have simplified the maggot therapy procedure and minimized the risk of escape. The establishment of laboratories throughout the world, along with access to overnight courier service in many regions, has made medicinal maggots readily available to millions of people.

20 August, 2014


Happy to announce the launch of our new website


This website has given me more flexibility to add pages on many more topics concerning community health.
This website has been designed to update general public about various health issues. 
The recent update was on the Ebola Outbreak, Inhaled Insulin ...
I cordially invite all my Friends, Wellwishers and everybody who is interested in health to visit this website..
As a Doctor i feel this website has given me an opportunity to talk on various health related topics and also to get feedback on a regular basis from you folks! 
I Hope that this website will slowly evolve into a very useful website to serve the common man.

Thanks to vistaprint for providing the website space and making my dream come true..

14 August, 2014


New member of the squad against Diabetes!


Canagliflozin is a newest member in treatment of Type 2 Diabetes. This drug can be used as adjuvant to Diet & Exercise.

Canagliflozin inhibits Sodium Glucose Transport protein Sub type 2. This protein is responsible for reabsoption of sugar in the kidneys.

By stopping the activity of Sodium Glucose Transport Protein -2 (SGLT-2) will result in loss of glucose in urine. Canagliflozin can help lose about 80-120mg/dl sugar. Additional benefits are better control of Hypertension due to osmotic diuresis and weight loss. 

Half life of Canagliflozin is upto 12hours, Hence a twice daily dosage is preferred.

Canagliflozin comes in  the strengths of 50mg and 150mg

A recent welcome addition is introduction of Invokamet (Canagliflozin + Metformin)

The available combinations are 

Canagliflozin 50 mg + Metformin 500mg
Canagliglozin 50mg + Metformin 1000mg
Canagliflozin 150 mg + Metformin 500mg
Canagliglozin 150mg + Metformin 1000mg

Since most of our patients require twice daily metformin this combination will help give better sugar control. 1 Tablet with advantage of two drugs. 
This drug may help patients attain a better control of blood sugars.
Chances of hypoglycemia are relatively less

This Drug cannot be used in patients with Renal failure, Hypotension and Type 1 Diabetes!

Some patients ( ~5%) may experience the side effects like Female genital mycotic infections, Urinary tract infections and increased urination.

My previous write up about Canagliflozin - CLICK HERE!

This drug being marketed by Johnson & Johnson is expected to come to India soon.

More in news from Johnson & Johnson - JNJ

Dr.Riyaz Sheriff
R.S. Clinic

02 August, 2014


 Tamarind Rice - July issue

Knowledge needs to be shared.

Here is one other way to do it.

My article published in Tamarind rice online magazine.

In this article STEP IN TIME i have given an introduction to exercise in Diabetes

You can read the article in July 2014 issue - CLICK HERE

Best part is............... Its FREE!!

Thank you Tamarind rice!

12 July, 2014



Everybody is talking about weight loss. Doctor’s advice weight loss to their patients whether it is Diabetes, Hypertension, Arthritis, Thyroid, Polycystic ovarian syndrome and the list is endless.....

Media on its part keeps playing ads for weight loss. Nowadays every third ad in TV is some or the other weight loss products. Some Say use XYZ equipment, some say wear ZYX to hide your tummy, some say Apply ABC oil and what not....

One group has started promoting food products as dietary supplements. If you read the food label it is mostly our everyday products with fibre put in an attractive packing with a hefty price tag along with a discount offer! (THIS OLD TRICK NEVER DIES)

The recent one to hit the market is something called GARCINIA CAMBOGIA.

Being a Diabetologist I started to develop some interest in this product to know what exactly it is.

So First We will start with the source and about the plant....

It grows in Southeast Asia, West and Central Africa.

In India it grows in Coastal Karnataka and Kerala. (Basically needs a moist climate)

It looks like a small pumpkin which can be Green,Yellow or reddish in colour.

These turn brown to black on drying.

It is also called Malabar Tamarind / Goraka/ Kattcha puli.

The other names for this GARCINIA CAMBOGIA are

Acid Hydroxycitrique,
Brindal Berry,
Brindle Berry,
Cambogia gummi-guta,
Garcinia Cambogi,
Garcinia cambogia,
Garcinia gummi-guta,
Garcinia quaesita,
Hydroxycitric Acid,
Mangostana cambogia,

Known uses of this product till 2012 are

Cooking – condiment

Ayurveda – Sour flavour is supposed to activate digestion

Found a beautiful description of processing of GARCINIA CAMBOGIA (KUDAMPULI) click here!


What happened in 2012?

United States television personality, Dr. Oz, promoted garcinia cambogia extract as "an exciting breakthrough in natural weight loss" Dr. Oz's previous endorsements have often led to a substantial increase in consumer interest in the promoted products.

There is a lack of scientific evidence and clinical trials do not support claims that Garcinia cambogia is an effective weight loss aid.  A meta-analysis of several clinical trials found no compelling evidence for short-term weight loss. Further, side- effects  namely hepatotoxicity (chemical-driven liver damage) — led to one preparation being withdrawn from the market.

A 1998 randomized controlled trial looked at the effects of hydroxycitric acid, the purported active component in Garcinia gummi-gutta, as a potential antiobesity agent in 135 people. The conclusion from this trial was that "Garcinia cambogia failed to produce significant weight loss and fat mass loss beyond that observed with placebo".

 Having read this i turned to see if any reliable sites had any literature on the subject. 

First and foremost was WebMD. This website just mentions possible for weight loss, side effects unknown, interactions unknown.

Next best option was to search for some scholarly articles on the subject. Many articles were discussing the subject based on experiments done in rats.

These two articles caught my eye.

High dose of Garcinia cambogia is effective in suppressing fat accumulation in developing male Zucker obese rats, but highly toxic to the testis

Lipid-lowering and antiobesity effect of (−)hydroxycitric acid

Albino rats of Wistar strain were fed lipogenic diet with and without the addition of (−)hydroxycitrate for a period of 15 days. It was observed that inclusion of (−)hydroxycitrate in the diet resulted in significant reduction in food intake, body weight, epididymal fat and serum triglyceride in the animals and also decrease in the feed efficiency ratio. The decrease in food intake, body weight gain and feed efficiency ratio brought about by (−)hydroxycitrate was dependent on the content of this compound in the diet.

The search for more human studies lead me to an article titled "  Garcinia cambogia (Hydroxycitric Acid) as a Potential Antiobesity Agent - ARandomized Controlled Trial"  published in the prestigious  JAMA

As per this article 135 overweight individuals were divided into two groups and one group was given GARCINIA CAMBOGIA and the other group was given placebo pills.

Both groups were on high fiber , low calorie diet

Final results Suggested that weight loss was better in the placebo group. 

There were some more studies showing no effect to minimal weight losing effects.


We will have to wait for more concrete large population studies. But for those who are interested YES you can go ahead because its a natural food. Has had a place in our kitchens as well as Ayurveda. So GARCINIA CAMBOGIA might not harm. Only thing I can tell you is to set a target for yourselves. The ideal weight loss target would be losing 5-10% of current body weight in first six months. Start exercising, Concentrate on potion sizes. Read food labels to find out the number of calories and fat content. 

Do not take it for granted that every product advertised on T.V is good!

Dr.Riyaz Sheriff.


07 July, 2014


I am extremely happy to share with you the opening of our clinic (R.S CLINIC) at Vettuvankeni, ECR, Chennai.

Me and my wife , Dr.Sheena M.B.B.S., M.D will be working together in this clinic.

Hopefully with God's grace our tiny effort succeeds.

Dr.Riyaz Sheriff M.B.B.S., M.D., PGDHS (Diabetes).,

General Physician & Diabetologist
Consulting hours – 7 P.M to 9 P.M

Dr.A.Sheena. M.B.B.S., M.D.

General Physician

Consulting hours – 9 A.M to 12 Noon

29 June, 2014


Hi folks,

Hope you all are doing well. After a break of 6 weeks from blogging I am back......!

So let’s start with good news!

There might be chance that out patients can use insulin without pricks!


FDA has approved Oral insulin for clinical use. It’s named AFREZZA (uh-FREZZ-uh)

AFREZZA is insulin that is breathed-in through your lungs (inhaled) and is used to control high blood sugar in adults with diabetes mellitus.

AFREZZA is not for use in place of long-acting insulin. AFREZZA must be used with long-acting insulin in people who have type 1 diabetes mellitus.

 AFREZZA is not for use to treat diabetic ketoacidosis.

It is not known if AFREZZA is safe and effective for use in people who smoke. AFREZZA is not for use in people who smoke or have recently stopped smoking(less than 6 months)

It is not known if AFREZZA is safe and effective in children under 18 years of age

This drug comes in a form of inhaler with cartridges of 4units and 8 units.

This is how it looks!
We hope this product will be in India soon.

One main side effect is that it can reduce lung function. Some of them also have mentioned about incidences of lung cancer but these side effect profile needs to be confirmed. This drug will be ideal if the side effects mentioned are not because of AFREZZA.

Will update as soon as I get more info on this product.

Dr.Riyaz Sheriff
R.S Clinic
165/3B Teacher's colony
Chennai 600115

12 May, 2014


Gestational diabetes is a condition where the blood sugars are elevated during pregnancy. This happens due to hormonal changes occurring during pregnancy. Hormones produced by the placenta help in providing more nutrients to the growing fetus. Some hormones act against insulin action and prevent the development of hypoglycaemia in the mother. To counteract this excess production of hormones against insulin the mother’s body produces more insulin. In most women these changes are not prominent enough to cause diabetes. Women are most vulnerable during the third trimester of pregnancy. In case the mother is not able to produce considerable amount of insulin to counteract the effect of these hormones they end up in what is called Gestational Diabetes.

So What? Why should we worry? Will it not go away after pregnancy?

Diabetes affects in various ways.....
It can result in
Birth defects affecting major organs like brain and heart
Large baby leading to difficult labor
May need caesarean section.
The baby, once delivered may end up in severe hypoglycaemia due to increased amounts of insulin in the system.

Who all can develop Gestational Diabetes ???

  • Overweight
  • High risk ethinicity
  • Patients in Prediabetes
  • Family history of diabetes
  • History of giving birth to large babies.
  • Previously giving birth to a stillborn baby
  • Having gestational diabetes with a previous pregnancy
  • History of polyhydramnios
  • Many women who develop gestational diabetes have no known risk factors.

How do we diagnose this condition??
High risk women should be screened for gestational diabetes as early as possible during their pregnancies.
All other women need to be screened between the 24th and 28th week of pregnancy.
The best test available is the oral glucose tolerance test. This test involves quickly drinking a sweetened liquid which contains calculated amount of sugar. Then blood samples are collected at an interval of one hour and 2 hours. 2 hour value more than 140mg/dl is considered indicative of gestational diabetes.

Let’s talk about the good news...
A simple solution to prevent  complications associated with gestational diabetes is by screening of pregnant women for gestational diabetes using Oral Glucose Tolerance Test and to keep the glucose level within prescribed  levels — fasting plasma glucose 90 mg/dl and two hours after meal — 120 mg/dl. The earlier ( 1999) WHO guidelines insisted a pregnant woman to come fasting for testing. The plasma glucose level was tested two hours after 75 mg of glucose was given to a woman. If the value was between 140 mg/dl and 199 mg/dl, the pregnant woman was diagnosed as having gestational diabetes. “The revised WHO guidelines retain the same value but the biggest difference is  that women need not come fasting for testing,” The rest of the procedure remains the same. The non-fasting plasma glucose level is tested two hours after 75 gm of glucose is given to the woman. “If the two-hour plasma glucose measurement is between 140 [mg/dl] and 199 [mg/dl], she is diagnosed as GDM
WHO’s non-fasting plasma glucose testing recommendation makes testing easy for pregnant women. The non-fasting test is patient-friendly and causes the least inconvenience to pregnant woman. The single-step procedure is easy to follow, economical, simple and evidence-based. This also reduces the incidence of nausea associated with intake of sweet liquids on empty stomach.
Screening for gestational diabetes should be done in the first trimester (at least by 12-16 weeks). Earlier, the screening was done at 24-28 weeks. The reason why WHO does not recommend the late screening (24-28 weeks) is because by the 12 week, the beta cells develop in the fetal pancreas. And these fetal cells respond to the elevated maternal glucose levels. As a result, when the fetus gets more than the required amount of nutrition (glucose), it gets converted into fetal fat; the fetus thereby gains weight and becomes big. So, the earlier the screening of pregnant women, the better the fetal outcome.

Dr.Riyaz Sheriff
Consultant Diabetologist

03 May, 2014


Saliva as a sample for diagnosis. Sounds excellent right? No more blood samples, no more pricks…. Well saliva is a clinically informative, biological fluid and can be useful prognosis, diagnosis and follow up of patients with various diseases.  The process of collection is simple, It is ideal for detection of disease as it contains specific soluble biomarkers. In future, salivary diagnosis can be simplified and become a more useful pain free diagnostic aid to human health. Salivary diagnostics is a dynamic and emerging field using nanotechnology and molecular diagnostics to help aid in the diagnosis. Diseases are diagnosed via

Patient reported symptoms
Examination and a medical history obtained by a Doctor
Analysis of blood , urine and other biological  samples.

The currently available biomarkers for infections include ions, antibodies, hormone levels, and a variety of disease-specific biomarkers. These assays are not available in all labs and are sent to distant places for analysis. The whole procedure is costly and time taking. Samples in form of swabs are currently collected only to diagnose Streptococcus pyogenes to diagnose “strep throat”, or a mucosal biopsy for suspected oral cancer. The concept of using saliva as a sample will be helpful in population studies and in children in whom taking proper samples is always troublesome.
Oral samples that are useful for diagnosis are Saliva, Gingival crevicular fluid, oral swabs, dental plaques and volatiles. Significant sample will be the one which collects DNA for the oral cavity. This principle has been used in forensic medicine. The other areas where saliva can be used as a sample are for hormonal assays ( Cortisol, Estriol, Estrogen and Testosterone).

Saliva in Cardiovascular disease –
C-reactive protein – This is an acute phase reactant and can be monitored using salivary samples. The problem is that CRP may be elevated in some periodontal diseases
Salivary immunoglobulins are elevated in coronary artery diseases. Salivary IgA can be used in conjunction with Electrocardiogram following myocardial infarction.
Elevated Lysozyme levels can be used as a marker for oral infection and hyperglycemia. There has been significant association between salivary Lysozyme with hypertension.

Saliva in Renal disease –
Generally some markers are associated with end stage renal disease. The list of markers included cortisol, nitrite, uric acid, sodium, chloride, pH, amylase and lactoferrin. Some scientists have used colormetric test strips were used to monitor salivary nitrate and uric acid before and after hemodialysis. They have concluded that saliva testing could be used in patients to decide when the patient needs dialysis.

Salivary phosphate has been successfully used as a clinical biomarker for hyperphosphatemia, which is an important contributor to cardiovascular calcification in
chronic renal failure (CRF). Evaluation of phosphate levels in saliva correlates positively with serum creatinine and the glomerular filtration rate. Thus, salivary phosphate may provide a better marker than serum phosphate for the initiation of treatment of hyperphosphatemia in CRF

Salivary biomarkers in psychological research

Stress and pain are often interrelated events. Investigators have attempted to distinguish them using a variety of model systems that induce either stress or pain, and subjects are monitored for changes in salivary biomarkers. Typical markers that have been identified include salivary amylase, cortisol, substance P, lysozyme and secretory IgA. Pain responses in dental pulp have been specifically associated with neuropeptides including calcitonin gene-related peptide (CGRP), substance P, neurokinin A and neurokinin P. Salivary testosterone levels have been associated with increased aggressive behavior and also with athletic activities. Several reports relate cognitive behavior to levels of tryptophan and serotonin, the latter being monitored in saliva. It should be pointed out that for studies in psychological and behavior fields. collection of saliva samples can be helpful , as a blood draw may induce both stress and pain in some individuals.

Saliva in detection of systemic malignancies –
Tumor marker C125 has been identified in saliva of subjects with malignant ovarian tumors. Many other tumor markers and tumor suppressors are under evaluation.

Diabetes biomarkers
As far as Diabetes is concerned an oral test to monitor blood glucose would be highly desirable. Unfortunately, while it is relatively easy to measure salivary glucose, due to the multiple sources of this material in the oral cavity, salivary glucose levels do not correlate with blood glucose levels. However, several other approaches are under investigation. One method recently described was to demonstrate a unique proteomic signature in saliva obtained from Type-2 diabetics as compared to control saliva, with 65 proteins showing greater than a 2-fold change. Many of these proteins were associated with metabolic and immune regulatory pathways. While further studies are clearly needed, these findings suggest that there may indeed be a unique salivary biomarker profile associated with diabetes. Another interesting approach to detect Type 1 diabetic hyperglycemia involves measuring exhaled methyl nitrate. One more method under study is by using gingival crevicular blood as a measure of blood glucose. In a study of fifty four subjects, blood obtained during a routine periodontal exam was collected and compared to blood obtained with a finger-stick; the study showed good correlation between samples collected from the two sites.

Salivary diagnostics for autoimmune diseases
Major rheumatoid factor diseases include Lupus Erythematosis, Scleroderma, and Sjogren's syndrome. These autoimmune diseases are characterized by the production of autoantibodies that attack normal tissue. Sjogren's syndrome is a disease characterized by dryness of the eyes and mouth and it may occur as a primary or a secondary disease. The clinical symptoms in the primary form are more restricted and are associated with lacrimal and salivary gland dryness. In secondary Sjogren's syndrome, patients undergo one of the autoimmune diseases mentioned above before Sjogren's symptoms develop. For decades, the sjogren syndrome  diagnosis has been based on oral examination, detection of blood biomarkers (autoantibodies to self-antigens (SS-A and SS-B), Rheumatoid factor and antinuclear antibodies, and by obtaining a confirmatory salivary gland biopsy. Studies are underway to using cutting-edge proteomics and genomics technologies. Saliva contained a series of biomarkers that could detect primary sjogren syndrome(pSS). In addition, the proteomic and genomic profile of these salivary markers reflected the damage to glandular cells, activated anti-viral immune response, or programmed cell death known to be involved in pSS pathogenesis. The value of these candidate salivary biomarkers for pSS diagnosis has been confirmed by quantitative realtime polymerase chain reaction (qRT-PCR) and immunoblotting techniques

Salivary biomarkers for infectious diseases
Many viral infections could be identified from salivary samples. These include a large range of Herpes viruses, Hepatitis viruses, HIV, Human Papillomavirus (HPV), Influenza virus, and Poliovirus. Fourteen bacterial pathogens were detected (by antibody, antigen or nucleic acid) including Escherichia coli, Mycobacterium tuberculosis, Helicobacter pylori, Treponema pallidum and a wide range of streptococcal species. Nonviral and non-bacterial infectious agents including Candida albicans, Toxoplama gondii, and Schistosoma mansoni were detectable, typically by antibodies to these infectious agents. These pathogens are responsible for both systemic and oral diseases.

Studies are currently underway to evaluate the efficacy of using Saliva as a clinical sample. Hopefully in future patients can keep aside their phobia for needles and concentrate more on their health. If this technology is successful it will aid in rapid and early diagnosis.

Adapted from  - Saliva as a Diagnostic Fluid, Dent Clin North Am. 2011 January ; 55(1): 159–178. doi:10.1016/j.cden.2010.08.004.