Can acid produced from probiotic bacteria alter the surface roughness, microhardness, and elemental composition of enamel? An in vitro study.

Probiotics are live microorganisms that upon administration in adequate amounts provide various health benefits to the host. Probiotics are "lactic acid-producing bacteria" as they release large amounts of organic acids, particularly lactic acids, in their surrounding environment. Although the acids produced by probiotics are beneficial for gastrointestinal and vaginal health, the acidogenic nature of probiotics has raised concerns among dental professionals, especially concerning their effect on the enamel and dentin. Previous studies have found that probiotics can lower the pH of the saliva and cause essential elements like Calcium and Phosphorus to leach from the enamel. This can alter the surface topography of enamel and increase the risk of enamel defects. Studies have also noted that probiotic bacteria can replace cariogenic bacteria and lower the risk of tooth decay. However, the effect of acid produced by probiotics on the enamel surface remains unclear. Hence, the present study aims to evaluate the effect of probiotics on the surface roughness, microhardness, and elemental composition of enamel compared to 0.1 M Lactic acid (demineralizing agent). Twenty enamel sections were randomly divided into groups and subjected to a pH cycling model using a probiotic suspension and 0.1 M lactic acid. The changes in the surface roughness, microhardness, surface morphology, and elemental composition of the enamel with regard to Carbon, Oxygen, Sodium, Hydrogen, Magnesium, Phosphorus, Fluoride, Chlorine, and Calcium of the enamel were evaluated before and after the emersion in both the groups. The results showed a significant increase in the mean surface roughness in the probiotic group before and after the exposure. The microhardness of the enamel decreased along with altered arrangement of the enamel prisms, increased striations, scratch marks, and pitting after exposure to the probiotic group. A decrease in the atomic/weight% for Calcium, Phosphorous, Fluoride, Aluminium, and Oxygen and an increase in the weight/atomic% for Carbon, Nitrogen, and Sodium were noted compared to the baseline in the probiotic solution. The results in the probiotic group were comparable to the 0.1 M lactic acids. The pH changed from 5.78 to 3.06 at the end of 24 h in the probiotic group. Based on these findings, we conclude that exposure to probiotics can affect microhardness and surface roughness and cause leaching of essential elements like Calcium and Phosphorous from the enamel.

Correlational analysis between salivary and blood glucose levels in individuals with and without diabetes mellitus: a cross-sectional study.

OBJECTIVE: To estimate the association of patient-related demographic, socioeconomic status, physical activity, stress, and dietary factors influencing the relationship between salivary and blood glucose levels in individuals with and without diabetes mellitus (DM). METHOD: This cross-sectional study was conducted on 166 participants with and without DM. Saliva and blood were collected to estimate the glucose levels. Age, gender, occupation, socioeconomic and education level, BMI, hip to waist circumference, stress, dietary pattern, lifestyle, physical activity, family history of diabetes, and type of diabetes were recorded. The association of saliva to predict blood glucose levels was analysed using Spearman Rank Correlation and how these patient-related factors influence the correlation was estimated for future machine learning models. The difference in medians for various groups was calculated using the Mann-Whitney U Test or Kruskal Wallis Test. RESULTS: Blood glucose level is not significantly correlated to salivary glucose level. However, a statistically significant difference in the median blood glucose levels for diabetic participants (median = 137) compared to healthy controls (p-value < .05) was noted. The correlation between blood and salivary glucose was more positive for higher levels of glucose (Spearman 0.4). Age, alcohol consumption, monthly wages, intake of vegetables, and socioeconomic status affect blood glucose levels. CONCLUSION: A correlation between saliva and blood glucose levels in healthy individuals was weak. Saliva should only be used as a monitoring tool rather than a diagnostic tool and is more reliable for patients with poorly controlled diabetes mellitus.

Influence of polycystic ovary syndrome on the periodontal health of Indian women visiting a secondary health care centre.

OBJECTIVES: Periodontal disease and polycystic ovary syndrome (PCOS) share risk factors like obesity, insulin resistance, and dyslipidemia, along with evidence of chronic inflammation in the two conditions. Evaluating the influence of PCOS on periodontal health would, therefore, identify a possible association. MATERIALS AND METHODS: Sixty women, divided into equal groups of PCOS and healthy patients, were clinically examined for periodontal parameters like probing depth (PD), plaque index (PI), modified gingival index (mGI), and bleeding on probing (BOP). Fasting blood sugar (FBS), insulin (FI), triglycerides (TG), and free testosterone along with serum and gingival crevicular fluid (GCF) levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were the biochemical parameters evaluated. RESULTS: Women with PCOS had statistically significant differences in mGI, PI, testosterone, FBS, and TG when compared with healthy women (p < 0.05). MDA levels in serum and GCF between women with PCOS and controls were also significantly different. BOP and mGI showed a moderate positive correlation (r = 0.45 and 0.44) with serum levels of MDA. Relatively greater gingival inflammation was observed in patients with PCOS compared to healthy controls, independent of the risk factors present. CONCLUSION: PCOS seemed to have an impact on gingival inflammation, in addition to the effect of dental plaque and other local factors in the oral cavity, in PCOS patients when compared with healthy individuals. CLINICAL RELEVANCE: Women diagnosed with PCOS may have probabaility of co-existing gingival inflammation. Therefore, emphasis on medical treatment for PCOS and periodic screening for periodontal disease may be warranted.

Association between Lipoprotein(a) concentration and adverse cardiac events in patients with coronary artery disease: An observational cohort study.

This prospective study investigated the association between lipoprotein (a) [Lp(a)] levels and adverse cardiac events in patients undergoing percutaneous coronary intervention (PCI) for coronary artery disease. Among 600 patients, 79.16 % were male. Kaplan Meier analysis revealed significantly higher incidence rates of cardiac death, major adverse cardiac events, myocardial infarction, revascularization and stroke in patients with elevated Lp(a) (≥30 mg/dL). The Cox Regression model identified Lp(a) ≥30 mg/dL as a significant risk factor for adverse events (HR: 4.2920; 95%CI: 2.58-7.120; p < 0.05). Elevated Lp(a) levels were associated with an increased risk of adverse cardiac events in coronary artery disease patients undergoing PCI.

Confounding Factors Responsible for Elevated Lp(a) Levels in Patients with Coronary Artery Disease.

BACKGROUND: Cardiovascular diseases (CVDs) are a leading cause of global mortality, motivating research into novel approaches for their management. Lipoprotein(a) (Lp(a)), a unique lipoprotein particle, has been implicated in atherosclerosis and thrombosis, suggesting its potential as a therapeutic target for CVDs. AIM: This study aimed to investigate the association of Lp(a) levels with various cardiovascular parameters and events among patients with confirmed cardiovascular disease. METHODOLOGY: A prospective study was conducted, enrolling 600 participants, predominantly comprising males (79%), with a mean age of 52.78 ± 0.412 years diagnosed with cardiovascular disease. The follow-up was done for 18 months. Patient demographics, blood investigations, and occurrence of major adverse cardiac events (MACE) were collected. SPSS version 21 was used to statistically analyze the relationships between elevated Lp(a) levels and factors such as age, glycated hemoglobin, mortality, MACE, cardiac death, target vessel revascularization, and stroke. RESULTS: The study revealed significant (P < 0.05) associations between elevated Lp(a) levels and advanced age, increased glycated hemoglobin levels, as well as occurrences of all-cause mortality, MACE, cardiac death, target vessel revascularization, and stroke. Notably, a significant (P < 0.05), association between high Lp(a) levels and acute coronary syndrome (ACS) emerged, suggesting Lp(a)'s role in advanced cardiac events. CONCLUSION: The findings highlight the potential significance of Lp(a) as a notable risk factor in cardiovascular health. The observed associations between elevated Lp(a) and adverse cardiovascular events, including ACS, underscore its pathogenic role. Consequently, this study supports the rationale for further research into Lp(a)-specific therapeutic interventions, offering substantial promise in refining the management strategies for cardiovascular diseases.

Dose-Response Relationship of Photobiomodulation Therapy on Matrix Metalloproteinase in Healing Dynamics of Diabetic Neuropathic Ulcers-An in vivo Study.

Individuals with diabetic foot ulcers have overlapped the inflammatory, proliferative and remodeling phase, making the tissue vulnerable to delayed healing responses. We aimed to establish the dose-response relationship of photobiomodulation therapy of different doses and matrix metalloproteinases in the healing dynamics of diabetic neuropathic ulcers. Diabetes was induced in 126 Albino Wistar rats, and neuropathy was induced to the hind paw by a sciatic nerve injury method. An excisional wound was created on the neuropathy-induced leg. Photobiomodulation therapy of dosages 4, 6, 8, 10, 12 and 15 J cm-2 and wavelength 655 nm and 808 nm was irradiated. Photobiomodulation therapy of dosages 4, 6 and 8 J cm-2 showed better wound healing properties with optimized levels of matrix metalloproteinases-1 and 8. We observed a strong dose response in the experimental group treated with 6 and 8 J cm-2 . The findings from the present study conclude that photobiomodulation therapy of dosages 4, 6 and 8 J cm-2 is suggestive of usefulness in diabetic neuropathic ulcer healing. Markers like matrix metalloproteinases may give a clear direction on response to the therapy. Based on the findings from the present study, we recommend to validate the findings for safety and efficacy in future through human prospective randomized controlled clinical trials.

Dose-response relationship of photobiomodulation therapy and oxidative stress markers in healing dynamics of diabetic neuropathic ulcers in Wistar rats.

Purpose: Diabetic foot ulcers are reported to be the most expensive complications of diabetes, with high morbidity and mortality rates. If the necessary care is not provided for the wound to heal, the individual may end up amputating the affected feet. Photobiomodulation therapy is a promising non-pharmacological treatment option for wound healing. The objective of the present study is to establish a dose-response relationship between photobiomodulation therapy and oxidative stress markers in the healing dynamics of diabetic neuropathic ulcers in Wistar rats. Methodology: Diabetic neuropathy was induced in 126 Albino Wistar rats. An excisional wound of an area of 2cm2 was made on the neuropathy-induced leg. Photobiomodulation therapy of dosages 4, 6, 8, 10, 12, and 15 J/cm2 of wavelengths 655 and 808 nm was irradiated. The control group animals were kept un-irradiated. The outcome measures were assessed during wound healing's inflammatory, proliferative and remodelling phases. Results: In the experimental group, animals treated with photobiomodulation therapy at doses of 4, 6, and 8 J/cm2 showed better wound healing dynamics. Photobiomodulation therapy modulated the reactive oxygen species and antioxidant levels, thereby improving the oxidative status of the wound. Conclusion: Photobiomodulation therapy of dosages 4, 6, and 8 J/cm2 is effective and is a promising adjuvant modality in treating diabetic neuropathic ulcers. There was a strong dose-response relationship in the experimental groups treated with 4, 6 and 8 J/ cm2. Supplementary Information: The online version contains supplementary material available at 10.1007/s40200-022-01157-2.

Effect of photobiomodulation therapy on inflammatory cytokines in healing dynamics of diabetic wounds: a systematic review of preclinical studies.

CONTEXT: Delayed wound healing in diabetes mellitus (DM) is due to the overlapping phases of the healing process. The prolonged inflammation and altered levels of inflammatory cytokines lead to deformed cell proliferation. Photobiomodulation alleviates the expression of inflammatory cytokines and promotes tissue repair, thereby restoring the wound healing process. OBJECTIVE: To find out the effect of photobiomodulation therapy (PBMT) in the healing dynamics of diabetic wounds with particular emphasis on interleukin-6, interleukin-1ß, and tumour necrosis factor-α. METHODS: Scientific databases searched using keywords of the population: DM, intervention: PBMT, and outcomes: inflammatory cytokines. RESULTS: We have included five preclinical studies in the present systematic review for qualitative analysis. These studies evaluated the effect of PBMT at different wavelengths, dosage, and time on wound healing in DM. CONCLUSIONS: The systematic review concludes that PBMT regulates inflammatory cytokines levels, enhances cell proliferation, and migration, thereby improving the wound healing properties.

Effect of Photobiomodulation Therapy on Oxidative Stress Markers in Healing Dynamics of Diabetic Neuropathic Wounds in Wistar Rats.

BACKGROUND: Prolonged and overlapping phases of wound healing in diabetes are mainly due to the redox imbalance resulting in the chronicity of the wound. Photobiomodulation therapy works on the principle of absorption of photon energy and its transduction into a biological response in the living tissue. It alleviates the cellular responses, thereby improving the mechanism of wound healing in diabetes. OBJECTIVE: To find out the effect of photobiomodulation therapy of dosage 4 J/cm2 in the healing dynamics of diabetic neuropathic wounds in Wistar rats and its relation with oxidative stress markers. METHODOLOGY: Diabetes was induced using Streptozotocin of 60 mg/kg of body weight to eighteen female Wistar rats. Neuropathy was induced by the sciatic nerve crush injury followed by an excisional wound of 2 cm2 on the back of the animal. Experimental group animals were treated with dosage 4 J/cm2 of wavelength 655 and 808 nm, and control group animals were kept unirradiated. The biomechanical, histopathological, and biochemical changes were analysed in both groups. RESULTS: There was a reduction in mean wound healing time and an increased rate of wound contraction in the experimental group animals compared to its control group. The experimental group showed improved redox status, and histopathological findings revealed better proliferative cells, keratinisation, and epithelialization than un-irradiated controls. CONCLUSIONS: Photobiomodulation therapy of dosage 4 J/cm2 enhanced the overall wound healing dynamics of the diabetes-induced neuropathic wound and optimised the oxidative status of the wound, thereby facilitating a faster healing process.

Effect of Duration of Mobile Phone Use on the Salivary Flow and Total Antioxidant Capacity of Saliva and Salivary Immunoglobulin A Level: A Cross-sectional Study.

Introduction: The objective of this study was to observe the effects of the duration of handheld mobile phone usage on the salivary flow, salivary immunoglobulin A (IgA) level, and salivary markers for oxidative stress. Materials and Methods: Eighty-one students were categorized into three groups based on their duration of mobile phone usage after age- and gender-matching. Students were grouped as: mobile phone usage <20 min/day (Group A), mobile phone usage 20-60 min/day (Group B), and mobile phone usage >60 min/day (Group C). Saliva was collected to evaluate salivary flow rate, salivary IgA level, and salivary markers for oxidative stress. Results: The salivary flow rate showed no statistically significant difference between the three groups (P = 0.180). There was no statistically significant difference in the salivary IgA between the three groups (P = 0.237). There was a statistically significant difference in the malondialdehyde (MDA) level between the three groups (P = 0.042). On pair comparison between the groups, group B and group C had a statistically significant difference (P = 0.019) in the MDA level. There was no statistically significant difference in the salivary thiol level between the three groups (P = 0.237). Conclusion: The duration of handheld mobile phone usage did not show any significant effects on the salivary flow rate, salivary IgA, and thiol levels. There was an increase in the salivary MDA concentration in subjects using handheld mobile phones for a longer duration, indicating higher oxidative stress in salivary glands exposed to mobile phone radiofrequency electromagnetic waves for a longer duration.

Lifestyle Modification with Physical Activity Promotion on Leptin Resistance and Quality of Life in Metabolic Syndrome - A Systematic Review with Meta-Analysis.

OBJECTIVE: This study focused to systematically extract, summarize and analyse the data on the effect of lifestyle modification on leptin resistance and quality of life in metabolic syndrome. METHODS: The systematic search was done using PubMed, Cochrane Database, EMBASE, Science Direct, CINAHL, Springer link, Web of Science from 2000-2018. English language articles and quantitative studies focusing on leptin resistance and quality of life were included. Random effect analysis was adopted to pool data and estimate 95% CI. The meta-analysis was done separately for leptin resistance and quality of life which included a total of 9 studies on both RCTs and Non-RCTs. RESULTS: The meta-analysis of RCTs reported insignificant effect of lifestyle modification on leptin resistance in metabolic syndrome when compared to comparison group (-5.94(-14.28, 2.41). Two clinical trials showed a significant effect with pooled data (5.52(2.14, 8.91). Meta-analysis of RCTs focusing on quality of life showed significant effect on mental component (4.89 (0.16, 9.62) of quality of life (2.36 (-3.67, 8.39) when compared to comparison group. CONCLUSION: This meta-analysis suggested that lifestyle modification has a potential to improve leptin resistance and mental component of quality of life in metabolic syndrome. However, more clearly defined studies are required to come to a stronger conclusion.

Indicators of oxidative stress in thyroid cancer.

Ferric reducing antioxidant power (FRAP), myeloperoxidase (MPO) activity and the levels of protein thiols and carbonyls were estimated in the blood samples of thyroid cancer patients (n = 20) before and after thyroidectomy, as well as in healthy controls (n = 10) to study the extent of damage caused by tumor tissue proliferation-induced oxidative stress and to ascertain that oxidative stress levels drop, when there was no proliferation. A significant decrease (p<0.001) in the levels of serum protein thiols and FRAP as well as a significant increase (p<0.001) in the levels of protein carbonyls and MPO activity in the blood of thyroid cancer patients before surgery was observed as compared to healthy controls. All the parameters studied also showed a significant difference (p<0.001) in their respective levels in thyroid cancer patients, pre- and post-thyroidectomy. These findings present the role of oxidative stress as a pathological implication of thyroid cancer.

Effect of Green, Tulsi, and Areca Teas on the Color Stability of Two Composite Resin Materials - an in vitro Spectrophotometric Analysis.

OBJECTIVE: To compare the effect of Green, Tulsi, and Areca teas on the color stability of two composite materials on the 30th and 60th days. MATERIALS AND METHODS: Two light cure composite restorative materials, Brilliant EverGlow (Group 1) and Brilliant NG, (Group 2) with different resin and filler characteristics were selected. The test solutions selected were Green tea, Tulsi tea, Areca tea, and artificial saliva (control group). In total, 104-disc shaped specimens were fabricated using a custom made brass mold as per the manufacturer instructions. All specimens were put in storage for rehydration and complete polymerization at 37°C in distilled water for 24 hours. Specimens of each composite material were randomly divided into four subgroups of 13 samples. Tea solutions were freshly prepared, and specimens were immersed in the respective solutions every day for 15 minutes for 60 days. Specimens were stored in artificial saliva after the immersion regimen. The color evaluation was done before immersion, on the 30th and 60th day, using a digital reflectance spectrophotometer. RESULTS: At 30 days, Group 1 specimens immersed in Areca and Green teas showed significantly higher mean values than those in control and Tulsi tea. At 60 days in Group 1, specimens in Areca tea showed significantly higher mean value, followed by Green tea, Tulsi tea, and control. At 30 and 60 days in group 2, specimens in control had significantly lower mean values than other tea preparations. Group 1 showed a higher mean difference in ΔE than Group 2 specimens immersed in Green and Areca teas at 30 days (P=0.001 and 0.001) and 60 days (P=0.001 and <0.001), respectively. CONCLUSION: All herbal tea preparations exhibited staining potential, which increased over time, and Areca tea showed the highest staining potential. Understanding the staining potential of newer tea preparations on recent composite materials helps the clinician to choose the right restorative materials.

Association of cigarette smoking with superoxide dismutase enzyme levels in subjects with chronic periodontitis.

BACKGROUND: Smoking, which is an important risk factor for periodontitis, induces oxidative stress in the body and causes an imbalance between reactive oxygen species (ROS) and antioxidants, such as superoxide dismutase (SOD). In the present study, the influence of smoking on the periodontium was determined by estimating the levels of SOD in light and heavy smokers with periodontitis. METHODS: Seventy subjects in the age range of 20 to 55 years, including 60 smokers and 10 non-smokers (controls), were selected. Clinical parameters recorded were plaque index (PI), probing depth (PD), and attachment loss (AL). Smokers were divided into light smokers (<10 cigarettes/day) and heavy smokers (> or = 10 cigarettes/day) and into three subgroups: healthy, mild periodontitis, and moderate periodontitis. Gingival crevicular fluid (GCF) and saliva samples were collected. SOD levels were analyzed using spectrophotometric assay. RESULTS: The mean levels of SOD in the GCF and saliva of smokers were decreased compared to controls. Intra- and intergroup analyses showed a significant reduction in the levels of SOD in the GCF and saliva of heavy smokers compared to light smokers and the control group. CONCLUSIONS: There was a progressive reduction in SOD levels from healthy non-smokers to light smokers to heavy smokers. These findings highlight the need to augment the efforts of smoking-cessation programs. The benefits of reduced smoking and improved antioxidant levels may motivate smoking cessation.

Increased Levels of Acetylcholinesterase, Paraoxonase 1, and Copper in Patients with Moderate Depression- a Preliminary Study.

BACKGROUND: Depression is a common and widespread mood disorder, which affects an emotional level that varies widely in its intensity. Biochemical parameter alterations have been observed in different depression types. In the present study, we examined acetylcholinesterase (AChE), paraoxonase 1 (PON1), and copper levels in moderately-depressed patients and healthy controls to ascertain whether the measurement of red blood cell (RBC) AChE, and plasma PON1 and copper could be used to evaluate moderate depression. METHODS: This case control study was performed in the Department of Biochemistry, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India. Patients who met ICD 10 diagnostic criteria were considered as cases. Goldberg's General Health Questionnaire 28 (GHQ-28) was used to select controls. Four ml of blood was collected from 24 cases and 20 controls aged 35-70 years and used to determine RBC AChE, and plasma PON1 and copper levels. RESULTS: Red blood cell AChE, and plasma PON1 and copper levels were significantly greater in patients with moderate depression than in controls. Further, a receiver operating characteristic curve for validity of the biochemical parameters in plasma from patients with moderate depression indicated sensitivity and specificity above 85% for copper and PON1. CONCLUSION: Red blood cell AChE, plasma PON1, and copper levels may have roles in the pathogenesis of depressive disorders.

Ischemia-Modified Albumin, Creatinine, And Paraoxonase-1 Levels in Serum of Patients Undergoing Intravenous Contrast-Enhanced Computed Tomography and Its Association with Contrast-Induced Nephropathy.

BACKGROUND: Following contrast-enhanced computed tomography (CECT) contrast-induced nephropathy (CIN) may occur in patients with renal insufficiency or diabetes. Creatinine, the most common marker of CIN, may not be an accurate measure of damage and is affected by many non-renal factors. Our aim was to evaluate ischemia-modified albumin (IMA) as an early CIN marker and correlate it with paraoxonase-1 (PON-1) and creatinine before and after CECT. METHODS: Forty-eight adult patients scheduled for intravenous CECT, regardless of indication or body region for CECT, were included in this prospective study. Venous blood samples were obtained 12-24 hours before and after contrast media (CM) administration. Ischemia-modified albumin and PON-1 were estimated using methods described by Bar-Or et al. and Dantoine et.al., respectively. Creatinine was estimated on an automated analyzer. RESULTS: Significant differences in IMA (P < 0.001) and PON-1 (P < 0.001) levels were found between pre- and post-CECT samples, while the difference for creatinine was not significant (p = 0.073). No correlation was found between IMA and PON-1 or IMA and creatinine in either the pre- or post-CECT samples. CONCLUSION: After CM administration patients are subjected to oxidative stress and/or ischemia, as revealed by elevated IMA and decreased PON-1 levels; however, creatinine levels, most commonly estimated to assess reduced renal function, did not reflect the condition accurately. IMA may be a sensitive marker for CIN but further studies are required to confirm its usefulness.

Dose-dependent effects of fenugreek seed extract on the biochemical and haematological parameters in high-fat diet-fed rats.

OBJECTIVE: The present study was carried out to assess the effects of fenugreek seed extract on various biochemical and haematological parameters in high-fat diet (HFD)-fed rats. METHODS: Female Wistar rats were allocated into five groups (n = 6): 1) control rats, 2) HFD-fed control rats 3) rats fed with HFD and fenugreek (FG) seed extract at doses of 200 mg/kg/day, 300 mg/kg/day, and 400 mg/kg/day for 12 weeks. Blood was collected to examine the biochemical and haematological parameters using a veterinary blood cell counter; blood indices such as MCV, MCH, MCHC, red blood cell distribution width, haemoglobin (Hb) levels, haematocrit, and platelet counts were measured. Blood samples were centrifuged at 3000 rpm for 10 min at room temperature to obtain serum for the estimation of lipid profiles, and aspartate transaminase and alanine transaminase levels. RESULTS: Rats fed with FG at a dose of 400 mg/kg/day showed a significant increase in the red blood cell count, Hb levels, haematocrit, and MCV, and a significant decrease in the lymphocyte count. The total cholesterol, triglyceride, and low-density lipoprotein levels increased significantly (p < 0.05) in rats from the HFD control group, compared to those in the normal control group, but decreased significantly in rats fed with 400 mg/kg/day of FG. CONCLUSION: The results of the current study suggest that FG seed extract exhibits hypolipidaemic activity and significantly improves the activity of hepatic enzymes, and the blood counts and indices in rats with HFD-induced obesity.

Goal-Directed vs Traditional Approach to Intraoperative Fluid Therapy during Open Major Bowel Surgery: Is There a Difference?

INTRODUCTION: Optimum perioperative fluid therapy is important to improve the outcome of the surgical patient. This study prospectively compared goal-directed intraoperative fluid therapy with traditional fluid therapy in general surgical patients undergoing open major bowel surgery. METHODOLOGY: Patients between 20 and 70 years of age, either gender, ASA I and II, and scheduled for elective open major bowel surgery were included in the study. Patients who underwent laparoscopic and other surgeries were excluded. After routine induction of general anaesthesia, the patients were randomised to either the control group (traditional fluid therapy), the FloTrac group (based on stroke volume variation), or the PVI group (based on pleth variability index). Fluid input and output, recovery characteristics, and complications were noted. RESULTS: 306 patients, with 102 in each group, were enrolled. Five patients (control (1), FloTrac (2), and PVI (2)) were inoperable and were excluded. Demographic data, ASA PS, anaesthetic technique, duration of surgery, and surgical procedures were comparable. The control group received significantly more crystalloids (3200 ml) than the FloTrac (2000 ml) and PVI groups (1875 ml), whereas infusion of colloids was higher in the FloTrac (400-700 ml) and PVI (200-500 ml) groups than in the control group (0-500 ml). The control group had significantly positive net fluid balance intraoperatively (2500 ml, 9 ml/kg/h) compared to the FloTrac (1515 ml, 5.4 ml/kg/h) and PVI (1420 ml, 6 ml/kg/h) groups. Days to ICU stay, HDU stay, return of bowel movement, oral intake, morbidity, duration of hospital stay, and survival rate were comparable. The total number of complications was not different between the three groups. Anastomotic leaks occurred more often in the Control group than in the others, but the numbers were small. CONCLUSIONS: Use of goal-directed fluid management, either with FloTrac or pleth variability index results in a lower volume infusion and lower net fluid balance. However, the complication rate is similar to that of traditional fluid therapy. This trial is registered with CTRI/2018/04/013016.

Serum Bile Acids in Patients With Primary Open-angle Glaucoma.

PURPOSE: To measure the serum bile acids (SBA) in patients with primary open-angle glaucoma (POAG) and to compare with nonglaucomatous controls. PATIENTS AND METHODS: A hospital-based case control study of 90 patients above the age of 40 years was conducted. Patients with POAG formed the study group and individuals without glaucoma in the same age group formed the control group. SBA estimation was done using ELISA kit enzymatic assay technique and the median value was compared between the 2 groups. RESULTS: The median of SBA level was found to be more in POAG patients when compared with the control group. The difference was statistically significant (P<0.001). Median SBA level was not affected by the age or sex of the participants in the study. CONCLUSIONS: "Bile acids" may have a role in the oxidative stress and apoptosis involved in the pathophysiology of POAG.

Amelioration of arsenic-induced oxidative stress in CHO cells by Ixora coccinea flower extract.

Chronic exposure to inorganic arsenic creates various health problems. Ixora coccinea flower extract was investigated for its ability to protect against arsenic-induced cytotoxicity and genotoxicity in CHO cell line. MTT assay confirmed the efficacy of the extract in ameliorating arsenic-induced cytotoxicity. The value (48 mM) of 24 h inhibitory concentration (IC50) of sodium arsenate for CHO cells was obtained by MTT assay. Various free radical scavenging assays like DPPH, ABTS and nitric oxide scavenging assay confirmed antioxidant activity of the Ixora coccinea flower extract. Pretreatment of the extract significantly inhibited the arsenic-induced DNA damage (p < 0.01) in CHO cells. The extract administration significantly (p < 0.01) inhibited the intracellular ROS and depolarization of mitochondrial membrane induced by sodium arsenate. Ixora coccinea flower extract reduced oxidative stress in cells. Antioxidant enzymes like catalase and SOD activity was restored significantly (p < 0.01) in pretreated CHO cells. Ixora coccinea flower extract also exhibited the anti-apoptotic potential by decreasing the percentage apoptotic index (p < 0.01). These results may expand the applications of Ixora coccinea flowers as an alternative food with antioxidant properties and protective functions against arsenic (iAs) induced toxicological effects.