Correlation of clinical profiles with obstructive sleep apnea and metabolic syndrome.

BACKGROUND: Obstructive sleep apnea (OSA) is a common condition being increasingly recognized and is associated with many diseases. Few data are available for Indian patients and public health hazard of the condition continues to be seriously underestimated in this country. The objective of this study was to evaluate the prevalence of obesity, hypertension, diabetes mellitus, and hyperlipidemia (HLP) in a South Indian population with proven OSA. METHODS: A retrospective analysis of data accrued in patients undergoing polysomnography (PSG) was undertaken. Two hundred thirty-four patients of either sex in the age of 54 ± 11 years who tested positive for OSA were compared with control group. An apnea-hypopnea index (AHI) of >5 in the presence of snoring and daytime somnolence was taken to define sleep apnea. RESULTS: The mean AHI among the study group with OSA was 31.3 ± 18.6 as compared with 1.2 ± 0.5 in the control group. The BMI among patients with OSA was 36 ± 6 as compared with 29 ± 4 in comparison group (p < 0.001). Among the patients with OSA, 31% were having HLP, 59% were diabetics, and 86% were hypertensive. Subjects with PSG-proven OSA had significant levels of day time sleepiness, lack of concentration, changes in mood, morning headache, and dry mouth. Nonrestorative sleep, awakening with choking, nocturnal dyspnea, insomnia with frequent awakenings, nocturia, and diaphoresis were observed in (>80%) patients. A significant difference in the sleep efficiency (16%), sleep onset (14%), and mean saturation (9%) was observed in the study group as compared to the control group. CONCLUSIONS: The risk of obesity, hypertension, diabetes mellitus, and HLP in OSA syndrome patients was almost three times more than that of the comparing group.

Exposure to benzene induces oxidative stress, alters the immune response and expression of p53 in gasoline filling workers.

BACKGROUND: Chronic exposure to benzene can lead to deleterious effects on many biological systems including blood and blood-forming organs. We investigated the adverse effects of benzene among workers occupationally exposed to benzene in India. METHODS: Four hundred twenty-eight gasoline filling workers occupationally exposed to benzene and 78 unexposed individuals were recruited for this study. Benzene concentration was determined by gas chromatography, reactive oxygen species (ROS) by dichlorofluorescin diacetate (DCFH-DA) method, malondialdehyde (MDA) by thiobarbituric acid reactive substances assay (TBARS), total superoxide dismutase (T-SOD) by RANSOD kit and glutathione (GSH) by 5,5'-dithiobis-(2-nitrobenzoic acid) (DTNB) reaction, respectively. CD4, CD8, IgG were carried out by using fluorescence activated cell sorter (FACS Calibur) and mRNA expression of p53 by reverse transcriptase PCR (RT-PCR). RESULTS: A significant increase in the concentration of benzene and its byproducts in both blood and urine were found in the workers compared with the controls. The levels of ROS and MDA were significantly elevated, and GSH and total T-SOD were decreased in the workers compared with the controls. A statistically significant decrease in the immunoglobulin levels, CD4T cells, CD4/CD8 ratio was observed in workers (vs. controls), whereas no significant difference was observed in CD8T cells. p53 gene expression was markedly higher in workers than in controls. CONCLUSION: Occupational exposure to benzene causes oxidative stress, immune suppression and increases the expression of tumor-suppressing gene p53 in gasoline filling workers. These bio-functional markers might be useful in screening and surveillance for occupational hazard.

Hepatoprotective, immunomodulatory, and anti-inflammatory activities of selenocystine in experimental liver injury of rats.

The study was evaluated to investigate the efficacy of selenocystine (CysSeSeCys), a well-known organoselenium compound, on the prevention of carbon tetrachloride (CCl(4))-induced acute hepatic injury in Wistar rats. Forty healthy male Wistar rats were utilized in this study. Acute hepatotoxicity was induced by CCl(4) intoxication in rats. Serum biological analysis, oxidative stress, immune parameters, and gene expression of COX-2 and CYP2E1 were carried out. Pretreatment of CysSeSeCys prior to CCl(4) administration significantly prevented an increase in serum hepatic enzymatic activities. In addition, pretreatment of CysSeSeCys significantly prevented the formation of ROS, MDA, depletion of glutathione, and alteration of antioxidant enzyme activities in the liver of CCl(4)-intoxicated rats. This study also revealed that pretreatment with CysSeSeCys normalized the levels of interleukin 6 and10, IgG, and CD4 cell count. Pretreatment of CysSeSeCys significantly reversed COX-2 inflammatory response and the upregulation of CYP2E1 expression as well. Histopathological changes induced by CCl(4) were also significantly attenuated by CysSeSeCys pretreatment. CysSeSeCys has a potent hepatoprotective effect on CCl(4)-induced liver injury in rats through its antioxidative, immunomodulatory and anti-inflammatory activity.

A comparative clinical survey of the prevalence of refractive errors and eye diseases in urban and rural school children.

OBJECTIVE: To assess the prevalence of refractive error and common ocular diseases in school-aged children in urban and rural populations in and around Hyderabad, India. DESIGN: Population-based, cross-sectional study. PARTICIPANTS: A total of 3314 school children, 1789 from urban areas and 1525 from rural areas. METHODS: The examination included visual acuity measurements, retinoscopy and autorefraction under cycloplegia, examination of the anterior segment and external eye, and ocular motility evaluation. RESULTS: In the urban group the prevalence of uncorrected presenting and best-corrected visual impairment (< or = 20/40 in the better eye) was 9.8%, which dropped to 7.1% with presenting vision and was further reduced to 1.1% with best-corrected visual acuity. Uncorrected visual acuity in the rural group was 6.6%, which dropped to 3.3% with presenting vision and was further reduced to 2.5% with best-corrected visual acuity. The prevalence of refractive error was greater (25.2%) in the urban than the rural group (8%). Myopia measured with autorefraction was observed in 51.4% of urban children and 16.7% in rural children. Increased literacy rate, duration of study hours, and older age of the child were found to have contributed more to the prevalence of myopia in the urban group. Hyperopia with autorefraction was found to be 3.3% in the urban and 3.1% in the rural group. Hyperopia was associated with younger age in the study group. Trachoma was the leading cause of ocular morbidity in the rural group (3.5%) compared with the urban group (0.16%). Night blindness was reported in 3.2% of children in the rural group and 0.33% in the urban group. Vitamin A deficiency, low socio-economic status, and poor personal and environmental hygienic practice were found to have a positive correlation with ocular morbidity among rural group children. CONCLUSIONS: Provision of health education, periodic visual screening programs, and primary eye care by trained health care personnel in the elementary schools will prevent the prevalence of refractive errors and common ocular diseases in school children.

Impact of organic solvents and environmental pollutants on the physiological function in petrol filling workers.

Long term exposure to solvents and air pollutants can lead to deleterious effects on respiratory, haematological and thyroid functioning. The aim of this study was to investigate whether chronic exposure to solvents like benzene and pollutants like carbon monoxide in petrol filling workers had adverse effect on blood parameters, thyroid and respiratory functions. The study group consisted of 42 healthy, non-smoker petrol filling workers, aged 20-50 years with work (exposure) duration from 2-15 years while 36 healthy subjects of the same age group served as controls. Physical examination and measurement of pulmonary functions by portable electronic spirometer were performed. Complete blood pictures (CBP) were determined by normal haematology lab procedure and hormones by Chemiluminescence immunoassay (CLIA) light absorption techniques. There was a significant decrease in the lung volumes and capacities; the restrictive pattern was more prevalent in the workers when compared with the control groups. But in the workers exposed for long period (more than 10 years) the restrictive pattern was changed to mixed pattern. A significant increase in haemoglobin (Hb) (>16 mg %) and red blood cells (RBC) (5.4 million cells/mm3) were observed in workers with longer period of exposure when compared with the control subjects (14.483 mg% and 4.83 million cells/mm3 for Hb and RBC respectively). White blood cell count except eosinophils and platelets were significantly lower in workers compared to controls. Marked increase in the tetra iodothyroinine (T4), free thyroxine (T4F) level and significant decrease in thyroid stimulating hormones (TSH), and tri-iodothyronine (T3) were observed between long term exposed and non-exposed groups. Till now researchers focused only on the effect of solvents in workers professionally exposed to solvents without considering the effect of concomittant air pollution. The result obtained from present study indicates that there is a significant toxic effect of solvents and air pollutants on workers exposed for longer duration. Improved detection and prevention technologies are needed to answer environmentally related health questions for petrol filling workers.