Genetic Architecture of Circulating Very-Long-Chain (C24:0 and C22:0) Ceramide Concentrations

OBJECTIVE: Total ceramide concentrations are linked with increased insulin resistance and cardiac dysfunction. However, recent studies have demonstrated that plasma concentrations of specific very-long-chain fatty ceramides (C24:0 and C22:0) are associated with a reduced incidence of coronary heart disease and all-cause mortality. We hypothesized that specific genetic loci are associated with plasma C22:0 and C24:0 concentrations.METHODS: Heritability and genome-wide association studies of plasma C24:0 and C22:0 ceramide concentrations were performed among 2,217 participants in the Framingham Heart Study Offspring Cohort, adjusting for cardiovascular risk factor covariates and cardiovascular drug treatment.RESULTS: The multivariable-adjusted heritability for C22:0 and C24:0 ceramides was 0.42 (standard error [SE], 0.07; p=1.8E-9) and 0.25 (SE, 0.08; p=0.00025), respectively. Nineteen single nucleotide polymorphisms (SNPs), all on chromosome 20, significantly associated with C22:0 concentrations; the closest gene to these variants was SPTLC3. The lead SNP (rs4814175) significantly associated with 3% lower plasma C22:0 concentrations (p=2.83E-11). Nine SNPs, all on chromosome 20 and close to SPTLC3, were significantly associated with C24:0 ceramide concentrations. All 9 were also significantly related to plasma C22:0 levels. The lead SNP (rs168622) was significantly associated with 10% lower plasma C24:0 ceramide concentrations (p=9.94E-09).CONCLUSION: SNPs near the SPTLC3 gene, which encodes serine palmitoyltransferase long chain base subunit 3 (SPTLC3; part of the enzyme that catalyzes the rate-limiting step of de novo sphingolipid synthesis) were associated with plasma C22:0 and C24:0 ceramide concentrations. These results are biologically plausible and suggest that SPTLC3 may be a potential therapeutic target for C24:0 and C22:0 ceramide modulation.

Evaluation of the antibacterial and physical properties of glass ionomer cements containing chlorhexidine and cetrimide: An in-vitro study.

Background: Incorporation of antibacterial agents frequently results in changes in the physical properties of restorative materials. Materials and Methods: This in-vitro study investigated the antibacterial and physical properties of Glass ionomer cement (GIC) with chlorhexidine and cetrimide, to determine the optimal concentration, for incorporation of these agents to obtain antibacterial GICs for use with the Atraumatic restorative treatment approach. This was assessed using the agar diffusion test. Chlorhexidine diacetate and cetrimide were added to Glass ionomer cement type-IX (GIC-FUJI IX) at 1 and 2% W/W ratio. The experimental GIC specimens were placed on agar plates inoculated with Lactobacillus casei, and the area of inhibition was calculated after 48 hours. Results: All the experimental GICs exhibited inhibition of bacteria, but the sizes were dependent on the concentration of the antibacterial agent. Incorporation of chlorhexidine diacetate and cetrimide, at 2%, significantly decreased the compressive strength, and the setting time was extended a little by the addition of any concentration of chlorhexidine and cetrimide. Conclusions: The present study demonstrated that experimental GICs containing chlorhexidine diacetate and cetrimide were effective in inhibiting bacteria associated with caries, and incorporation of 1% cetrimide was optimal to give the appropriate antibacterial and physical properties.

Spiral CT diagnosis and endodontic management of an anatomically variant palatal root with two canals in a maxillary first molar.

This case report presents the endodontic management of an anatomically variant palatal root with 2 canals (Vertucci type II) in a maxillary first molar, which was confirmed with the help of spiral computed tomography (SCT). This serves to remind clinicians that such anatomic variations should be taken into account during the endodontic treatment of maxillary molars and highlights the invaluable aid of the SCT in accurate diagnosis and in negotiating the complex morphologic variations in root canals, thus enabling successful endodontic management.

Risk factor profile for chronic non-communicable diseases: Results of a community-based study in Kerala, India.

Background & objectives: Kerala State is a harbinger of what will happen in future to the rest of India in chronic non-communicable diseases (NCD). We assessed: (i) the burden of NCD risk factors; (ii) estimated the relations of behavioural risk factors to socio-demographic correlates, anthropometric risk factors with behavioural risk factors; (iii) evaluated if socio-demographic, behavioural and anthropometric risk factors predicted biochemical risk factors; and (iv) estimated awareness, treatment and adequacy of control of hypertension and diabetes, in Kerala state. Methods: A total of 7449 individuals (51% women) stratified by age group, sex and place of residence were selected and information on behavioural risk factors; tobacco use, diet, physical activity, alcohol use, measured anthropometry, blood pressure was collected. Fasting blood samples were analysed for blood glucose, total cholesterol, high density lipoprotein cholesterol and triglycerides in a sample subset. Using multiple logistic regression models the associations between socio-demographic and anthropometric variables with biochemical risk factors were estimated. Results: The burden of NCD risk factors was high in our sample. Prevalence of behavioural and each of the biochemical risk factors increased with age, adjusting for other factors including sex and the place of residence. The odds ratios relating anthropometric variables to biochemical variables were modest, suggesting that anthropometric variables may not be useful surrogates for biochemical risk factors for population screening purposes. Interpretation & conclusions: In this large study of community-based sample in Kerala, high burden of NCD risk factors was observed, comparable to that in the United States. These data may serve to propel multisectoral efforts to lower the community burden of NCD risk factors in India in general, and in Kerala, in particular.

Knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city.

OBJECTIVES: This study was done to find out the knowledge and attitudes of pharmacists regarding oral health care and oral hygiene products in Chennai city. MATERIALS AND METHODS: A cross-sectional survey among a sample of the pharmacists in Chennai city was done and data regarding their knowledge and attitudes towards oral health care and oral hygiene products were obtained using a closed-ended questionnaire. RESULTS: Among the 60 pharmacies approached, 50 pharmacists participated in the study and completed the questionnaire. Though 48% of the participants gave a positive answer when asked whether they had met the dentist practicing close to their pharmacies, the frequency with which they met the dentist ranged from once a week (24%) to once a month (28%). Most of the pharmacists stocked oral health-related products, which comprised 15-25% of their total stock. Of these products toothpaste was the most common (62%), followed by mouth rinses (12%). Toothache or painful teeth was the most common dental problem (78%) for which patients approached the pharmacists for advice. With regard to the advice given, 38.5% of the pharmacists asked the patient to consult a nearby dentist after dispensing medications, while 22.4% of the pharmacists dispensed antibiotics and painkillers without any referral. Seventy percent of the pharmacists expressed interest in giving oral health care advice to patients. However, many of them (38%) felt that lack of proper knowledge is a barrier to providing oral health care advice. CONCLUSION: It is clear from the present study that pharmacists are presently an underutilized resource, and there is a definitive need to improve their training and access to information on available dental services.

Tobacco use among school children in Chennai city, India.

AIMS: The present study was done to build a database on prevalence of tobacco use among students of grade 8 to 10 in Chennai city, for the purpose of advocacy of tobacco control and planning tobacco control interventions and evaluation. MATERIALS AND METHODS: A two-stage stratified probability sample of students in grades 8-10 corresponding to 13 to 15 years of age were selected from private/government aided private schools and purely government aided corporation schools. Data was collected by a pretested, closed-ended self-administered questionnaire. RESULTS: A total of 1255 students participated in this survey. Among them 64.4 boys and 35.6% were girls. Ever tobacco use was reported by 37.6% of the students (41.6 males and 30.2% females). Current users of tobacco (any products) were reported by 41.1% of the students. Prevalence was more among boy students (46.3%) when compared to that of girl students (31.6%). There existed no significant difference between current users of tobacco based on the zones of the school. Tobacco users prevalence was found more in corporation schools when compared to that of private schools. Parental and friends tobacco use was reported more often by tobacco users compared to never users. Purchasing tobacco products in a store was reported by 82.5% and almost no one was refused because of age. Almost everyone reported watching a lot of cigarette advertisements on TV, whereas about half reported watching advertisements on other medias like outdoor hoardings (45.7%), newspapers (65.3%) and social events (67.4%). CONCLUSION: This study demonstrates that among the 13 to 15-year old school going children (corresponding to grades 8 to 10) in Chennai city, the current tobacco use is high.

Anatomical variations of mandibular premolars in Chennai population.

AIM: To analyse the prevalence of anatomical variations of mandibular premolars in Chennai population. METHODOLOGY: It was observed, during the routine treatment of mandibular premolars that aberrations were becoming common. This necessitated an encompassing study on 500 patients, evaluating the occurrence of these aberrations. The parameters of this study included sex predilection, unilateral/ bilateral occurrences, and comparison of the incidence of anatomical variations in mandibular first and second premolar canal configuration. The study pattern was designed to observe these premolars using Radiovisiography (RVG) in different angulations to highlight the anatomical aberrations. The results were subjected to statistical analysis, which were performed using SPSS (Statistical Package for Social Science) statistical program version 10.0.5. Descriptive statistics were computed for all the variables. RESULT: The present study revealed high incidence of anatomical aberrations in mandibular premolars among Chennai population. Out of the 500 patients studied, 123 patients [24.6%] showed anatomical variance in the canal configuration. There was high incidence of Vertucci's Type IV canal configuration as compared to Type V, Type II and Type VIII in the descending order of occurrence. CONCLUSION: Within the limitations of this in-vivo study, it was inferred that the incidence of aberrations in the canal configuration of mandibular premolars is common and due considerations are to be given during endodontic intervention.

Assessment of status of salt iodization in Delhi.

The National Capital Territory (NCT) of Delhi was identified as an iodine deficiency endemic area in 1980. The government of NCT of Delhi banned the sale of non-iodised salt since 1989. The present study was aimed to estimate the iodine content of salt consumed in the households of the state. Thirty clusters were selected using population proportionate to size cluster sampling procedure. In each identified cluster one primary school was randomly selected. In each school, 60 salt samples were collected from an equal number of school children. The iodine content of a total of 1854 salt samples collected was analyzed using the standard iodometric titration method. Forty one per cent of families consumed salt with an iodine content of less than 15 ppm. Salt with nil iodine content was consumed only by 1.4% of the beneficiaries which indicated successful implementation of universal salt iodization programme in the state.

Iodine deficiency in district Kinnaur, Himachal Pradesh.

The state of Himachal Pradesh is a known iodine deficiency endemic region since the last 40 years. The state government is supplying iodised salt to the district since 1970. No recent survey has been conducted on the prevalence of iodine deficiency from the district Kinnaur which is located at an average altitude of 10,000 feet above sea level. A total of 1094 children in the age group of 6-10 years were included in the study and clinically examined. The total goitre prevalence of 6.1% was found in the subjects studied. Urine samples were collected from 226 children and were analysed using standard laboratory procedures. It was found that the percentage of children with < 2 mcg/dl, 2-4.9 mcg/dl, 5-9.9 mcg/dl and 10 and above mcg/dl of urinary iodine excretion (UIE) level was 1.3, 5.8, 10.6 and 82.3 respectively. A total of 242 salt samples were collected and analysed using the standard iodometric titration method. Results showed that almost 90% of the families were consuming salt with an iodine content of 15 ppm and more which is the stipulated level of iodisation of salt. The findings of the study indicate that iodine nutrition is in the transition phase from iodine deficient to iodine sufficient. Findings revealed a need for further strengthening the monitoring of the quality of salt being distributed in Kinnaur to achieve elimination of iodine deficiency.

Treatment of threshold retinopathy of prematurity.

This report deals with our experience in the management of threshold retinopathy of prematurity (ROP). A total of 45 eyes of 23 infants were subjected to treatment of threshold ROP. 26.1% of these infants had a birth weight of > 1,500 gm. The preferred modality of treatment was laser indirect photocoagulation, which was facilitated by scleral depression. Cryopexy was done in cases with nondilating pupils or medial haze and was always under general anaesthesia. Retreatment with either modality was needed in 42.2% eyes; in this the skip areas were covered. Total regression of diseases was achieved in 91.1% eyes with no sequelae. All the 4 eyes that progressed to stage 5 despite treatment had zone 1 disease. Major treatment-induced complications did not occur in this series. This study underscores the importance of routine screening of infants upto 2,000 gm birth weight for ROP and the excellent response that is achieved with laser photocoagulation in inducing regression of threshold ROP. Laser is the preferred method of treatment in view of the absence of treatment-related morbidity to the premature infants.

Assessment of iodine deficiency in selected blocks of east and west Champaran districts of Bihar.

OBJECTIVE: A survey conducted in 1964 reported a goitre prevalence of 40.3% in East and West Champaran districts of Bihar. No recent survey has been documented on the prevalence of iodine deficiency in these districts. The present study was therefore undertaken (i) to assess the prevalence of IDD in these districts, and (ii) to estimate the iodine content of salt consumed by population. METHODOLOGY: In each district, one block was selected. In each block more than 630 children in the age group of 6-12 years were included in the study and were clinically examined. Urine samples were collected from 261 children and were analyzed using standard laboratory procedures. A total of 456 salt samples were collected from children and 35 from traders from the two districts and analyzed using the standard iodometric titration method. RESULTS: The total goiter prevalence was 11.6%. The percentage of children with < 2, 2.0-4.9, 5.0-9.9 and > or = 10 mcg/dl of urinary iodine excretion level were 12.3, 13.4, 23.4 and 51.0, respectively. The median urinary iodine excretion of the children was 10.0 mcg/dl. None of the families were consuming salt with a nil iodine content and about 29.3%, were consuming salt with less than 15 ppm of iodine. Of the 35 salt samples collected from traders, all had iodine and about 17% had less than 15 ppm of iodine. CONCLUSION: The study stresses the need for strengthening the existing system of monitoring of quality of salt being provided in the East and West Champaran districts by Government of Bihar.

Assessment of iodine deficiency disorders using the 30 cluster approach in the National Capital Territory of Delhi.

OBJECTIVE: Iodine Deficiency Disorders (IDD) are a major public health problem in India. The National Capital Territory (NCT) of Delhi is a known iodine deficiency endemic area. The Delhi Government banned the sale of non-iodised salt since 1989. The present study was conducted to assess the status of IDD after 7 years of salt iodisation programme in the state. DESIGN: Cross sectional. METHODOLOGY: The recent indicators recommended by the World Health Organization-United Nations Childrens Fund-International Council for the Control of Iodine Deficiency Disorders (WHO-UNICEF-ICCIDD) were utilized for the assessment of IDD. A total of 30 clusters were selected using population proportionate to size cluster sampling procedure. In each identified cluster, one primary school was selected using random sampling. A total of 6911 school children in the age group of 8-10 years were included for the study. RESULTS: The total goiter prevalence rate was 8.6% while 2.1, 8.4, 17.6 and 71.9% of the children had urinary iodine excretion levels of < 2, 2-4.9, 5-9.9 and 10 and above mcg/dl, respectively. The median urinary iodine excretion was 17 mcg/dl. Of the 1854 salt samples analyzed, salt with a nil iodine content was consumed only by 1.4% of the beneficiaries. Forty one per cent of families consumed salt with an iodine content of less than 15 ppm. CONCLUSION: IDD continues to be a public-health problem in the NCT of Delhi. There is a need of strengthening the existing monitoring system for the quality of iodised salt.