Intraoperative Performance and Early Postoperative Outcomes Following Phacoemulsification With Three Fluidic Systems: A Randomized Trial.

PURPOSE: To compare intraoperative performance and early postoperative outcomes following phacoemulsification with two systems using active fluidics and one using gravity-based fluidics. METHODS: In this prospective randomized trial, 200 eyes were randomized to the traditional and Active Sentry groups (n = 80 eyes each) where the Centurion Vision System was used with traditional or Active Sentry (Alcon Laboratories, Inc) hand-pieces, respectively, or the Infinit group (n = 40 eyes) where the Infiniti Vision System (Alcon Laboratories, Inc) was used. Within the traditional and Active Sentry groups, there were two subgroups with low (30 mm Hg) or high (55 mm Hg) intraocular pressure (IOP) used. Outcome measures compared were: cumulative dissipated energy (CDE), percentage change in central corneal thickness (CCT) at 1 day, 1 week, and 1 month, anterior chamber cells at 1 day and 1 week, rate of rise and fall of IOP following occlusion break, corneal endothelial cell density (ECD), and macular thickness 6 months postoperatively. RESULTS: CDE was significantly lower in group II compared to the traditional group (2.96 ± 1.4 vs 4.14 ± 2.2, P = .001). With 30 mm Hg IOP, the Active Sentry group had significantly less percentage change in CCT at 1 week postoperatively compared to the traditional handpiece group (0.01% vs 0.02%, P = .008). Incidence of anterior chamber cells less than grade 2 on day 1 was significantly higher in the Active Sentry group (82.9% vs 52%, P = .03). Percentage change in ECD was significantly lower in the Active Sentry group (-0.957 vs -0.98%, P = .005). Significantly faster rise of IOP to baseline following occlusion break was seen in the Active Sentry group. CONCLUSIONS: The use of Active Sentry handpiece was associated with lower CDE, less postoperative increase in CCT, fewer anterior chamber cells, and faster rise of IOP following occlusion break. [J Refract Surg. 2024;40(5):e304-e312.].

Knowledge of nutrition and physical activity in apparently healthy Indian adults.

OBJECTIVE: To assess knowledge of nutrition and physical activity; examine associations of knowledge with sociodemographic and anthropometric parameters; and evaluate the relationship between knowledge and practice in adults. DESIGN: In a cross-sectional design, 720 adults were selected using random sampling. Data on anthropometry, body fat, diet, physical activity, and nutrition and physical activity knowledge were collected using standardized questionnaires. Tertiles were used to categorize nutrition knowledge (NK) and physical activity knowledge (PK).SettingsSubjects selected through routine health checks from hospitals, housing societies and residential areas. SUBJECTS: A total of 720 adults (361 men) aged 35-50 years participated. RESULTS: Mean age was 42·7 (sd 9·4) years and mean BMI was 25·8 (sd 5·0) kg/m2. Mean energy intake was 64 %, protein was 68 % and fat was 144 % of the RDA. Mean NK and PK scores were 10·2 (sd 2·9) and 6·5 (sd 1·7), respectively, and were similar across genders (P>0·05). Individuals with higher education exhibited significantly higher NK and PK. Individuals with high fat had significantly higher NK and PK (P<0·05) than participants with normal fat percentage. Overweight and obese individuals had significantly higher PK (P<0·05). Multivariate regression modelling indicated that NK was positively associated with dietary intakes of leafy vegetables, salads and sprouts but negatively associated with fruit intake. BMI, television and reading time were positively associated with PK, even after adjusting for sociodemographic status. CONCLUSIONS: There is a need for increased efforts towards developing health education programmes focusing on transforming nutrition and physical activity knowledge into practice and adherence to guidelines.

Screening score for early detection of cardio-metabolic risk in Indian adults.

OBJECTIVES: To develop and to evaluate efficacy of screening score for early detection of cardio-metabolic risk (CMR) in adults. METHODS: Cross-sectional data on anthropometry, lipids, sugar levels, diet, and physical activity were collected on 720 adults (361 men, 35-50 year) using standardized techniques. Screening score was developed using regression analysis-cluster of risk conditions (blood pressure, lipids, and sugar levels) was dependent variable against age, sex, waist, diet, and physical activity as independent variables. Odd ratios were added to obtain final score and receiver-operating characteristic (ROC) curves were constructed to identify cut-off value of CMR score. RESULTS: Mean age and BMI were 42.7 ± 9.4 years and 25.7 ± 5.0 kg/m2. Analysis showed age, male sex, waist, lack of fruits, green leafy vegetables, and lack of physical activity were independent predictors for increased CMR (p < 0.05). Total score ranged from 0 to 20. Area under the curve for ROC was 0.728 [95% (CI) 0.67-0.78]. Criterion value >8 had sensitivity (76%) and specificity (56%) for screening cases with CMR. CONCLUSIONS: Screening score is a pragmatic way of identifying individuals with CMR without performing biochemical tests. Cost-effective community screening programs may be planned.

Bone Health Status in Indian Overweight/Obese Children.

This cross-sectional study, to assess bone health in Indian overweight, obese children in comparison with healthy controls was conducted in 245 (126 girls) children and adolescents aged 6-17 y in Pune, India. It was found that total body bone mineral content, bone area and bone mineral density adjusted for Tanner stage and weight were significantly lower in obese children as compared to overweight children, which in turn, was significantly lower than normal weight children (p < 0.05). Thus, overweight and obesity is negatively related to bone health in children and adolescents. Interventions need to be planned to increase peak bone mass accrual in overweight and obese children to reduce future risk of fracture and osteoporosis.

Influence of micronutrient status and socioeconomic gradient on growth indices of 2-18-year-old Indian girls.

Micronutrient deficiencies are common consequences of the plant-based diet in children from developing countries which may affect their linear and ponderal growth. The aim of the study was to investigate the association between micronutrient status and growth indices in Indian girls. In cross-sectional studies (2006-2010), data on weight, height and diet were collected on 1302 girls (2-18 years) from Pune city, India. Fasting hemoglobin was measured on 1118 girls and serum zinc was measured on 695 girls. Height-for-age Z-scores (HAZ) and body mass index for age Z-score (BMIZ) were computed using contemporary Indian references. HAZ >-1 was observed in 54% girls, and 18.1% were short (HAZ <-2). BMIZ was within the reference range (-2-1 than in short girls even after adjusting for socioeconomic status (SES). The mean serum zinc level of thin girls (BMIZ <-2) was significantly lower than those of both normal and overweight girls after adjusting for SES. Micronutrient sufficiency is of paramount importance for adequate growth in Indian girls.

Association of CYP1A1, GSTM1, and GSTT1 gene polymorphism with risk of oral submucous fibrosis in a section of North Indian population.

Genetic alterations in the genes expressing drug metabolizing enzymes can make an individual susceptible to various cancers. This study detects the polymorphisms at CYP1A1, GSTM1, and GSTT1 genes in a section of North Indian population and determines the susceptibility to oral submucous fibrosis (OSF). In this case-control study one hundred and two OSF patients were genotyped to detect the GSTM1, GSTT1, CYP1A1 polymorphism. Two hundred healthy controls were also included. Genotypes were determined using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) approach. The frequency of GSTM1 and GSTT1 genotype was higher in OSF patients, as compared to controls. A trend risk analysis showed 7.6 fold increase in risk, when both the genes were absent. The frequency of CYP1A1 (m1) and CYP1A1 (m2) genotypes was higher in controls. No polymorphic alleles were detected in the m4 site. CYP1A1 (m1) wild genotype in the absence of GSTM1 null genotype, falls under the highest risk group (OR 3.74). Our findings suggest that CYP1A1 (m1) genotype and (m2) genotype singly acts as a protective factor but in the absence of GSTM1 and/or GSTT1 gene significantly alters risk towards OSF.

Glutathione-S-transferase M1 and T1 genes and gastric cancer: a case control study in North Indian population.

BACKGROUND: Difference in the capacity of xenobiotic metabolising enzymes might be an important factor in genetic susceptibility to cancer. METHODS: A case control study involving forty one gastric cancer patients and one hundred and thirty controls was carried out to determine the frequency of GSTM1 and GSTT1 null genotypes. The frequency of GSTM1 and GSTT1 null genotype was observed by carrying out multiplex PCR. RESULTS: There was no difference in the frequencies of the GSTM1 and GSTT1 null and the combined GSTM1 and GSTT1 null genotype between patients and control. CONCLUSIONS: Our data suggest that GSTM1 and GSTT1 status may not influence the risk of developing gastric cancer.

An estimation and evaluation of total antioxidant capacity of saliva in children with severe early childhood caries.

BACKGROUND. The available evidence implicating the involvement of oxidative stress in the caries process suggests that local antioxidant status may be of importance in determining the susceptibility to the caries process. AIM. The aim of this study was to estimate the total antioxidant capacity (TAC) in unstimulated saliva of healthy children with and without severe early childhood caries (S-ECC) and to correlate the individual TAC level with dmft (d = decayed, m = missing, f = filled, t = teeth) score and age. MATERIAL AND METHODS. The TAC of saliva was investigated in 100 healthy children in the age range of 3-5 years divided in two groups, control and study group based on the absence or presence of caries, respectively. The antioxidant capacity of saliva was estimated by an adaptation of ABTS [2, 2'-Azino-di-(3-ethylbenzthiazoline sulphonate)] assay. RESULTS. The mean TAC level in the saliva of the children in study group was found to be significantly increased (P < 0.001), and a significantly linear regression was seen between the TAC and dmft score (P < 0.001) whereas it was insignificant between the TAC and age (P = 0.078). CONCLUSION. The results indicated that TAC of saliva increased significantly in children with S-ECC and increasing prevalence of dental caries predisposes to the increase in TAC of saliva.

Glutathione S-transferase M1 and T1 polymorphism and response to neoadjuvant chemotherapy (CAF) in breast cancer patients.

PURPOSE: Response to neoadjuvant chemotherapy (NACT) for breast cancer patients cannot be predicted; however, polymorphism of the glutathione S-transferase genes GSTM1 and GSTT1 can modify the response to chemotherapy. The aim of this study was to establish whether there is an association between the polymorphism of GSTM1 and GSTT1 and response to NACT. METHODS: The subjects of this study were 45 patients with locally advanced breast cancer (LABC), who received the cyclophosphamide, adriamycin, and 5-fluorouracil (CAF) regimen as NACT. We analyzed the relationship between the genotypes and responses to chemotherapy. RESULTS: The response rates to chemotherapy were better, although not significantly so, in patients with the GSTM1 and GSTT1 null genotypes (odds ratio [OR] 2.06 and 1.45). Similar findings were noted in patients with either or both of the null genotypes (OR 2.67 and 1.16). Among the responders, patients with the GSTM1 and GSTT1 null genotypes had higher rates of complete response following chemotherapy than those with one or more active allele (OR 1.8 and 1.3), although the difference was not significant. CONCLUSIONS: There was an association between the polymorphism of glutathione S-transferases and responses to chemotherapy, but the differences were not significant. However, larger studies are needed to investigate the role and efficiency of GST polymorphism in predicting response to chemotherapy.

Genetic polymorphism of CYP3A5 in Indian chronic myeloid leukemia patients.

CYP3A5 is an important genetic contributor to inter-individual differences in CYP3A-dependent clinically important drugs of metabolism and also of various endogenous compounds and environmental contaminants. The CYP3A5*3 allele results in a truncated protein with loss of CYP3A5 expression and CYP3A5*6 is associated with lower CYP3A5 catalytic activity. The polymorphism analysis was performed by PCR-RFLP and some representative cases by direct sequencing. Our case control study involved 183 consecutive North Indian CML patients in chronic phase of disease and 208 geographically and racially matched healthy controls. PCR-RFLP was carried out to determine the frequency of CYP3A5*3 and CYP3A5*6 genotypes. The relationship between these allelic variants and risk of CML was assessed by means of odds ratio (OR) with 95% confidence limits calculated by logistic regression. The frequencies of CYP3A5*1/*1, CYP3A5*1/*3, and CYP3A5*3/*3 genotypes in CML and controls were examined, and the quantitative comparison of the frequency distributions between CML versus control were performed, showing no significant differences among these comparison pairs (P = 0.88, 0.65, and 0.80, respectively). However, we did not find the CYP3A5*6 allele in any of the controls and leukemia patients. It is concluded that there is no association of this polymorphism with the risk of chronic myeloid leukemia.

Role of GSTM1 and GSTT1 polymorphism: susceptibility to oral submucous fibrosis in the North Indian population.

Molecular epidemiological studies have provided evidence that individual susceptibility to cancer is mediated by both genetic and environmental factors. Several allelic variants of polymorphic glutathione s-transferases (GSTs) show impaired enzyme activity and are suspected to increase the host's susceptibility to various cancers. To determine the association of GST variants with the risk of oral submucous fibrosis (OSF), the distribution of polymorphisms in GSTM1 and GSTT1 was studied in 90 OSF patients and 130 healthy controls. Genotypic analysis was performed by multiplex PCR. The relationship between the null genotypes and the risk of OSF was assessed by means of odds ratios (OR) with 95% confidence intervals (CI) calculated by logistic regression. The frequency of both the GSTM1 and GSTT1 null genotypes was higher in the OSF cases than in the controls. The prevalence of the GSTM1 null genotype in the OSF cases was 46.6% as compared to 29.2% in the controls (OR 2.12, 95% CI 1.2-3.9) and GSTT1 null was 24.4% in the OSF cases versus 10.7% in the controls (OR 2.68, 95% CI 1.22-5.96). There was evidence of an increased risk with the absence of both genotypes (7.5-fold; OR 7.5, 95% CI 2.3-24). Our findings suggest that the GSTM1 and GSTT1 null genotypes, separately or in combination, increase the risk of developing OSF in the North Indian population.

Increased frequencies of glutathione-S-transferase (GSTM1 and GSTT1) null genotypes in Indian patients with chronic myeloid leukemia.

Inherited differences in the capacity of xenobiotic metabolizing enzymes might be an important factor in genetic susceptibility to cancer. Null genotypes of glutathione-S-transferases (GSTs) exhibit absence of enzymatic activity and are hypothesized to be at increased risk of developing cancers. The aim of the study was to examine whether null genotypes of GSTM1 and GSTT1 confer susceptibility to chronic myeloid leukemia (CML). We carried a case control study involving 80 consecutive North Indian CML patients (58 males, 22 females; age (mean+/-S.D.) 36.2+/-10.9 years) and 105 healthy individuals (59 males, 46 females; age (mean+/-S.D.) 36.8+/-11.3 years). Multiplex PCR was carried out to determine the frequency of GSTM1 and GSTT1 null genotypes. The relationship between GSTM1, GSTT1 genotypes and risk of CML was assessed by means of odds ratio (OR) with 95% confidence limits calculated by logistic regression. A test for trend (P(trend)) in increasing the risk of CML having more than one putative high-risk allele or genotype was evaluated by means of the chi-square test. There was no difference in the frequencies of the GSTM1 null genotype and the combined GSTM1 and GSTT1 null genotypes between patients and controls in the study. However, statistical significance was found with GSTT1 null genotype frequency in CML patients as compared to controls (16/80 (20%) versus 9/105 (8.5%); OR=2.67, 95% CI: 1.03-7.01). It projects a 2.67-fold increased risk for CML in individuals with GSTT1 null genotype as compared to those possessing both alleles of the gene. Our findings suggest that heritable GST status may influence the risk of developing CML.