Mean rate of progression of visual fields in patients with primary open-angle glaucoma and ocular hypertension attending a tertiary care center in South India - A prospective cohort study using FORUM® Glaucoma Workplace software

Purpose

To find out the mean rate of progression (MROP) of visual fields (VF) in patients with primary open-angle glaucoma (POAG) and ocular hypertension (OHT) using FORUM® Glaucoma Workplace.

Methods

Two hundred and one eyes of 105 patients were included in this prospective cohort study. Patients with POAG and OHT were recruited, and VF analysis with 24-2 and or 10-2 was done using SITA standard strategy in Zeiss Humphrey Visual Field Analyzer (HFA). All the previous VFs were identified from FORUM software, and the baseline indices were recorded from the first reliable VF analysis. The present VF analysis was compared to the previous one using FORUM software, and the rate of progression (ROP) in VF was obtained by Guided Progression Analysis.

Results

MROP of VF in the POAG group was - 0.085 dB/year, ranging from -2.8 to 2.8 dB/year with a standard deviation (SD) of 0.69. In the OHT group, the MROP of VF was -0.003 dB/year, ranging from - 0.8 to 0.5 dB/year with an SD of 0.27. The MROP of VF in medically treated eyes with POAG was -0.14 dB/year with an SD of 0.61 and in surgically treated eyes was -0.02 dB/year with an SD of 0.78. The overall baseline mean VF index (VFI) was 83.19% and the final mean VFI was 79.80%. There was a statistically significant decrease in the mean VFI value from baseline to the final visit (P-value 0.0005).

Conclusion

The mean ROP of VF in the POAG group was -0.085 dB/year and in the OHT group was - 0.003 dB/year.

Outcomes of bleb needling in primary glaucoma: A prospective interventional study in a South Indian population

Purpose

This study was conducted to assess the outcomes of bleb needling for the treatment of failure of filtration surgeries in primary glaucoma with a follow-up of six months.

Methods

This prospective interventional study included patients with primary glaucoma who underwent trabeculectomy or combined glaucoma and cataract surgery with failed or failing bleb after six weeks of surgery and less than two years. A comprehensive examination including best-corrected visual acuity (BCVA), intraocular pressure (IOP) measurement, gonioscopy, slit-lamp examination, and bleb morphology grading was done. Selected patients underwent a subconjunctival bleb needling with mitomycin C (MMC) (dose 0.2 mg/ml). Postoperatively, patients were followed up on the first, third, and sixth months and were assessed with respect to IOP, need for antiglaucoma medication (AGM), and complications.

Results

Sixty eyes of 59 patients were included. Preoperatively, 33.3% of patients were on one AGM, whereas postoperatively at the third month 51.7% and at the sixth month 50% of patients were on no AGM. There was a statistically significant decrease in IOP (P < 0.001) from preoperative (mean: 23.8 ± 7.86 mmHg) to postoperative first month (mean: 19.8 ± 9.08 mmHg), third month (mean: 17.4 ± 5.4 mmHg) and sixth month (mean 16.6 ± 4.39). According to the defined criteria in the current study, we achieved 22 (37.9%) successes, 31 qualified successes (53.4%), and 5 (8.6%) failures. Univariate regression analysis showed a higher failure rate among younger age groups. Gender, laterality, and intraoperative complications were not significant statistically.

Conclusion

Bleb needling is a safe and effective procedure for the treatment of failed filtration surgeries.

Ethnic Association of Cusp of Carabelli Trait and Shoveling Trait in an Indian Population

INTRODUCTION

Variations in the structure of teeth have always been of great interest to the dentist from the scientific as well as practical point of view. Additionally, ever since decades inter trait relationships have been a useful means to categorize populations to which an individual belongs.

AIM

To determine the association between Cusp of Carabelli and Shoveling Trait in a selected Indian population native of Bangalore city, Karnataka, India.

MATERIALS AND METHODS

A cross-sectional study was carried out in 1885 children aged between 7-10 years. Casts of the study subjects were made to study the presence of Cusp of Carabelli of right maxillary permanent molar and shoveling trait of right maxillary permanent central incisor using the Dahlberg's classification and Hrdliucka's classification respectively. Linear regression was used to assess the association of cusp of carabelli trait with the tooth dimensions and logistic regression was used to evaluate the association of the carabelli trait with gender and presence/absence of shoveling.

RESULTS

A 40.5% of subjects had Cusp of Carabelli on first molar and 68.2% had shoveling on upper central incisor. The study revealed positive association between the two traits studied in the population. A significant difference was also found with presence of Cusp of Carabelli and the buccolingual tooth dimension of the maxillary molar (p<0.05).

CONCLUSION

There is an association between the Cusp of Carabelli and the shoveling trait in the present study population, and this will be valuable in the determination of ethnic origin of an individual.

Evaluation of the effect of three supplementary oral hygiene measures on salivary mutans streptococci levels in children: A randomized comparative clinical trial

OBJECTIVE

The aim of this study was to evaluate and compare the effect of tongue scraping, tongue brushing, and saturated saline on salivary MS levels.

MATERIALS AND METHODS

A single-blinded, randomized, parallel group clinical trial was conducted in children aged 9-12 years. Total sample of 45 subjects were randomly assigned to three groups, that is, Group A, Group B, and Group C comprised of 15 each. Group A, Group B, and Group C were asked to do tongue scraping, tongue brushing and saturated saline rinsing twice daily, respectively for 21 days. Saliva samples, collected from the subjects on the baseline, 7(th) day and 21(st) day, were inoculated on mitis salivarius bacitracin agar and incubated at 37°C for 48 h. The mean streptococcal colony forming counts were enumerated. The data were subjected to statistical analysis using Wilcoxon signed rank sum test for intragroup comparisons and Mann-Whitney U-test for intergroup comparisons.

RESULTS

Intragroup comparisons showed statistically significant reduction in MS levels (P < 0.01). However, the intergroup comparisons showed no statistically significant difference (P > 0.05).

CONCLUSION

The oral hygiene measures evaluated proved equal efficacy in reducing the colony counts. Hence, there is a need to emphasize the importance of incorporating supplementary oral hygiene measures in daily oral care.

Prevalence of aberrant dental morphological details in 6-10 year old school children in an Indian population

Background:

Variations in the structure of teeth have always been a great curiosity to the dentist from the scientific and practical point of view.

Aim:

To evaluate the prevalence of a few aberrant morphological features namely, cusp of Carabelli in primary maxillary second molar and in permanent first molar, five cusp in primary maxillary second molar and permanent first molar, shoveling and double shoveling with respect to permanent maxillary central incisors, four cusped primary mandibular second molar and permanent first molar, six cusped primary mandibular second molar and permanent first molar and seven cusped primary mandibular second molar and permanent first molar in 6–10 year old children belonging to the East Bengaluru, a City in India.

Design:

A cross-sectional survey was conducted among 2111 children by two stage sampling method. Type III examination was performed. The findings were subjected to Chi-square test.

Results:

83.8% of the studied population had one or more of the variations checked for, as mentioned above. The variation most commonly seen was double shoveling (66.6%) followed by shoveling (65.7%). No significant results were observed in any trait with respect to gender.

Conclusion:

This study is the first of its kind, providing a baseline data of the prevalence of morphological details in the pediatric Indian population.

Esthetic and biologic mode of reattaching incisor fracture fragment utilizing glass fiber post

Trauma to the anterior teeth affects the esthetic and psychological well-being of the patient. Advancement in the adhesive dentistry has facilitated the restoration of the coronal tooth fractures by minimally invasive procedures when the original tooth fragment is available. Reattachment of fractured fragment offers immediate treatment with improved preponderant aesthetics and restoration of function. Here, we describe a case of complicated fracture of the maxillary left immature permanent central incisor, which was treated endodontically followed by esthetic reattachment of the fractured fragment using the glass fiber post. Functional demands and esthetic considerations of the patient were fully met with this biologic mode of fragment reattachment.

Prevalence and severity of molar incisor hypomineralization in children aged 11-16 years of a city in Karnataka, Davangere

INTRODUCTION

Molar incisor hypomineralization (MIH) describes the clinical picture of hypomineralization of systemic origin affecting one or more first permanent molar. There is a rarity of prevalence studies in Indian population.

OBJECTIVES

The main aim of this study was to investigate the prevalence of MIH in a population of South Indian children.

SETTINGS AND DESIGN

A cross-sectional epidemiological survey, included 2000 children aged 11-16 years chosen by stratified random sampling from government and private schools of Davangere, a city in South India.

MATERIALS AND METHODS

Evaluation of MIH and decayed, missing and filled teeth was carried out in these children by a calibrated examiner. The severity of hypomineralization was recorded according to the Wetzel and Reckel scale.

STATISTICAL ANALYSIS

Chi-square test was used to analyze the categorical data. P ≤ 0.05 was considered for statistical significance.

RESULTS

About 8.9% of all examined children showed at least one ill-structured first permanent molar in terms of MIH. The male and female ratio was found to be 1:1.1. The decreasing order of occurrence of MIH affected teeth were permanent maxillary molars, maxillaryincisors, mandibular molars and the mandibular incisors.

CONCLUSION

The prevalence of MIH in the permanent dentition of south Indian children was 8.9%. There is a need for a proper planned preventive and restorative program with regard to the increasing prevalence of MIH.

Relationship between Glycosylated Hemoglobin, Serum Nitric Oxide and Mean Arterial Blood Pressure

BACKGROUND

Hypertension is about twice as frequent in individuals with diabetes as in those without diabetes. Formation of glycosylated conjugates like HbA1c is implicated to have many effects on the vascular endothelium which leads to the development of hypertension in diabetes. Nitric oxide (NO)-dependent vasodilatation has been shown to be an important factor in the maintenance and regulation of peripheral vascular tone. Studies correlating these parameters give conflicting results. Hence the present study was designed to correlate HbA1c, Serum NO & mean arterial blood pressure.

AIMS

To study the relationship between glycosylated hemoglobin, serum nitric oxide & mean arterial blood pressure.

SETTINGS AND DESIGN

It is a case control study with 28 type 2 diabetic hypertensives, 32 type 2 diabetic normotensives and 51 controls (non diabetic normotensives).

MATERIALS & METHODS

The study subjects included 28 type 2 diabetic hypertensives, 32 type 2 diabetic normotensives and 51 controls (non diabetic normotensives) [ADA 2010 and JNC7]. FBS, PPBS, PCV, Hb, HbA1c & serum NO estimation and BP recording was done in all the study subjects. Normalised mean arterial blood pressure (MAPn) and calculated glycosylated hemoglobin (cHbA1c) were calculated from mean arterial BP (MAP) and HbA1c respectively.

STATISTICAL ANALYSIS

was done using R commander software. The difference in the distribution of cHbA1c, MAPn & NO levels between all 3 groups was measured using ANOVA and Kruskal-Wallis test. Correlation between the parameters was measured by Correlation coefficient and logistic regression (Spearman linear regression) analysis (univariate and multivariate).

RESULTS

There was a significant difference in the distribution of cHbA1c, MAPn & NO levels (p<0.001) between all 3 groups, whether measured by ANOVA or Kruskal-Wallis test. On univariate analysis, there was a positive correlation between cHbA1c & MAPn (ρ= +0.26), a negative correlation between NO & MAPn (ρ = -0.54) and cHbA1c & NO (ρ= -0.66) .On multivariate analysis, not only NO, but contrary to univariate analysis, cHbA1c also showed a negative association with MAPn.

CONCLUSION

As the severity of diabetes increases, there is increase in BP, which is mainly due to the marked decrease in NO level which masks the negative correlation between HbA1c on MAPn.

A morphological study of variations in the branching pattern and termination of the radial artery

INTRODUCTION

Coronary artery bypass grafting is an established means of treating advanced coronary artery disease. In recent years, there has been an increased interest in the radial artery as an entry route during coronary angiography. Accurate knowledge of the branching pattern of this artery and its relation to surrounding structures is of great importance in the care of surgical patients.

METHODS

This study was conducted on 75 formalin-fixed upper limbs in order to note the variations in the branching pattern and termination of the radial artery.

RESULTS

The radial artery divided into three branches in 2.7% of cases and into two branches in 52.0% of cases. The radial recurrent artery originated from the brachial artery instead of the radial artery in 12.0% of cases. The radial recurrent artery, palmar carpal artery, first dorsal metacarpal artery and superficial palmar artery were absent in 1.3%, 26.7%, 9.3% and 5.3% of cases, respectively. 6.7% of cases had a high origin of the superficial palmar artery.

CONCLUSION

The rich photographic documentation of the variation of branching pattern and termination of radial artery is not only of academic interest but also useful to surgeons and radiologists working in the same area.

Triiodothyronine and melatonin influence antioxidant defense mechanism in a teleost Anabas testudineus (Bloch): in vitro study

The effect of the hormones triiodothyronine (T3) and melatonin on antioxidant defense system was studied in 6-propyl thiouracil (6-PTU)-treated or photoperiod-exposed teleost Anabas testudineus. 6-PTU (2 microg/g) treatment or photoperiod exposure (24 h) increased malondialdehyde (MDA) and conjugated dienes (CD) concentrations, indicating increased lipid peroxidation (LPO) in the experimental conditions. T3 or melatonin (10(-6) M) treatment for 15 min in vitro in PTU-treated fish reversed the activity of superoxide dismutase (SOD), catalase and glutathione content. T3-treated group showed no change in glutathione peroxidase (GPx) activity, whereas melatonin treatment decreased its activity. T3 inhibited glutathione reductase (GR) activity. Photoperiod exposure (physiological pinealotomy) induced a stressful situation in this teleost, as evidenced by LPO products and antioxidant enzyme activities. Melatonin and T3 treatment for 15 min in vitro also reversed the effect of photoperiod on peroxidation products and the SOD and catalase activities. GR activity decreased in photoperiod-exposed group and melatonin and T3 treatment reversed the activities. The antioxidant enzymes responded to the stress situation after 6-PTU treatment and photoperiod exposure by altering their activities. The study suggested an independent effect of T3 and melatonin on antioxidant defence mechanism in different physiological situations in fish.

Tri-iodo thyronine regulates antioxidant enzyme activities in different cell fractions through a mechanism sensitive to actinomycin D in a teleost, Anabas testudineus (Bloch)

The present study evaluated the effects of hyperthyroid state on lipid peroxidation and antioxidant enzymes in the crude (CF), post nuclear (PNF) and mitochondrial fractions (MF) of the fish liver. The in vivo injection of T3 (200ng) did not change the lipid peroxidation products, malondialdehyde (MDA) and conjugated dienes (CD), while actinomycin D (10microg), a potent mRNA inhibitor when administered with T3 increased them. The antioxidant enzymes like superoxide dismutase (SOD) and catalase (CAT), glutathione peroxidase (GPx) and glutathione reductase (GR) had an increased activity in CF and MF of hyperthyroid group to compete the increased oxidative stress, but actinomycin D partially inhibited the T3-induced activity. SOD and CAT activities in PNF of hyperthyroid group had no change, the glutathione concentration varied depending on the GPx and GR activity. Hyperthyroidism decreased the protein content, while simultaneous administration of actinomycin D inhibited the T3 action of elevating the protein content. The results suggest that the antioxidant defense status in A. testudineus is modulated by thyroid hormone, through an action sensitive to actinomycin D.