Development of a Transparent Transgenic Zebrafish Cellular Phenotype Tg(6xNF-kB:EGFP); Casper(roy-/-, nacre-/-) to Study NF-kB Activity.

NF-κB signaling has broad effects on cell survival, tissue growth, and proliferation activities. It controls many genes that are involved in inflammation and thus is a key player in many inflammatory diseases. The elevation of NF-κB activators is associated with elevated mortality, especially in cancer and cardiovascular diseases. The zebrafish has emerged as an important model for whole-organism in vivo modeling in translational research. In vertebrates, in-vivo spatial resolution is limited due to normal opacification of skin and subdermal structure. For in vivo imaging, skin transparency by blocking the pigmentation via chemical inhibition is required and the maintenance of this transparency is vital. The Casper(roy-/-, nacre-/-) mutant of zebrafish maintains this transparency throughout its life and serves as an ideal combination of sensitivity and resolution for in vivo stem cell analyses and imaging. We developed an NF-kB:GFP/Casper transparent transgenic zebrafish cellular phenotype to study inflammatory processes in vivo. We outline the experimental setup to generate a transparent transgenic NF-kB/Casper strain of zebrafish through the cross-breeding of Casper and NF-kB transgenic adult fish and have generated F01 in the form of heterozygous progeny. The transgenic F01 progeny was further inbred to generate heterozygous progenies from F1 to F4 generations. Furthermore, it continued to successfully develop the homozygous strain Tg(6xNF-kB:EGFP); Casper(roy-/-, nacre-/-) in the F05 generation. This novel strain of F05 generation showed 100% homozygosity in the transgenic transparent progeny of Tg(6xNF-kB:EGFP); Casper(roy-/-, nacre-/-). The strain has been confirmed by generating the F06 generation of homozygous progeny and again verified and validated for its homogeneity in the F07 generation. The newly developed novel transparent transgenic strain of the NF-kB reporter line has been coined as "Tg(6xNF-kB:EGFP); Casper(roy-/-, nacre-/-)gmc1". We have established a newly generated phenotype of transparent transgenic zebrafish for time-lapse in vivo confocal microscopy to study the cellular phenotype and pathologies at the cellular level over time. This will allow for quantifying the changes in the NF-kB functional activities over time and allow the comparison of control and cardiac-oncology experimental therapeutics. We validated the newly developed Tg(6xNF-kB:EGFP); Casper(roy-/-, nacre-/-)gmc1 homozygous strain of zebrafish by studying the inflammatory response to bacterial lipopolysaccharide (LPS) exposure, tolerance, and the inhibitory role of a potential novel drug candidate against LPS-induced inflammation. The results establish the unique application of newly developed strains by identifying hit and lead drug candidates for experimental therapeutics.

ACGME Interventional Cardiology Milestones 2.0-an overview: Endorsed by the Accreditation Council for Graduate Medical Education.

This document provides an overview of the rationale, development, interpretation, and practical suggestions for implementation of the new Accreditation Council for Graduate Medical Education (ACGME) Interventional Cardiology (IC) Milestones 2.0. Previously, IC programs used the general ACGME Milestones for internal medicine. The IC Milestones version 2.0 updates the ACGME competencies to be specific to training in IC. In 2019 an ACGME working group consisting of IC program directors, a lay representative, and representatives from the American Board of Internal Medicine met to develop the IC Milestones version 2.0. The ACGME IC Milestones 2.0 establishes a framework for formative feedback for trainees within domains of patient care, medical knowledge, systems-based practice, practice-based learning and improvement, professionalism, and interpersonal and communication skills. The 2021 IC Milestones 2.0 provides a framework for IC mentors and trainees to identify areas for improvement or commendation help stimulate meaningful educational discussions, and provide the basis for self-reflection and self-improvement.

Coronary Microvascular Dysfunction and Heart Failure with Preserved Ejection Fraction - implications for Chronic Inflammatory Mechanisms.

Coronary Microvascular Dysfunction (CMD) is now considered one of the key underlying pathologies responsible for the development of both acute and chronic cardiac complications. It has been long recognized that CMD contributes to coronary no-reflow, which occurs as an acute complication during percutaneous coronary interventions. More recently, CMD was proposed to play a mechanistic role in the development of left ventricle diastolic dysfunction in heart failure with preserved ejection fraction (HFpEF). Emerging evidence indicates that a chronic low-grade pro-inflammatory activation predisposes patients to both acute and chronic cardiovascular complications raising the possibility that pro-inflammatory mediators serve as a mechanistic link in HFpEF. Few recent studies have evaluated the role of the hyaluronan-CD44 axis in inflammation-related cardiovascular pathologies, thus warranting further investigations. This review article summarizes current evidence for the role of CMD in the development of HFpEF, focusing on molecular mediators of chronic proinflammatory as well as oxidative stress mechanisms and possible therapeutic approaches to consider for treatment and prevention.

Three Technologies That Will Guide Revascularization of Chronic Coronary Syndrome Patients into the 21st Century: A Review.

Although medical therapy is the preferred first-line treatment for patients with chronic coronary syndrome (CCS), revascularization remains an important consideration. We present a review that identifies the three diagnostic technologies most important to guiding the decision to revascularize patients with CCS: (1) cardiac computed tomography, (2) intracoronary imaging, and (3) lesion-specific physiological guidance.

Assessment of Effect of Fixed Orthodontic Treatment on Gingival Health: An Observational Study.

BACKGROUND: Prime components of fixed orthodontic treatments decrease the self-cleansing ability of the tongue and the cheeks leading to an increase in production of bacterial plaque. Hence, the present study was undertaken for assessing the effect of fixed orthodontic treatment on gingival health. MATERIALS AND METHODS: A total of 120 patients who were scheduled orthodontic treatment were enrolled. Complete data records of all the patients were recorded. Intra- and extraoral radiographs were obtained and photographic records were noted in separate pro forma. Complete intraoral examination of all the patients was carried out for recording visible plaque, any inflammation (visible clinically), and gingival recession. Based on the assessment of gingival texture and capillary transparency, analysis of gingival biotype was done. Follow-up records were assessed. RESULTS: The mean visible plaque value before treatment and after treatment was found to be 3.11 and 5.81, respectively. The mean visible inflammation value before treatment and after treatment was found to be 2.89 and 15.43, respectively. The mean gingival recession score value before treatment and after treatment was found to be 0.19 and 0.383, respectively. A significant increase in the visible plaque value, visible inflammation value, and gingival recession score was observed posttreatment. While comparing the gingival biotype, it was seen that in both the maxillary and mandibular arches, there was an increase in the thick gingival biotype while there was a decrease in thin maxillary biotype. CONCLUSION: There is a significant increase in plaque accumulation, inflammation, and gingival recession following fixed orthodontic treatment. Hence, during the course of orthodontic treatment, regular oral prophylaxis should be done.

Development of Tg(UAS:SEC-Hsa.ANXA5-YFP,myl7:RFP); Casper(roy-/-,nacre-/-) Transparent Transgenic In Vivo Zebrafish Model to Study the Cardiomyocyte Function.

The zebrafish provided an excellent platform to study the genetic and molecular approach of cellular phenotype-based cardiac research. We designed a novel protocol to develop the transparent transgenic zebrafish model to study annexin-5 activity in the cardiovascular function by generating homozygous transparent skin Casper(roy-/-,nacre-/-); myl7:RFP; annexin-5:YFP transgenic zebrafish. The skin pigmentation background of any vertebrate model organism is a major obstruction for in vivo confocal imaging to study the transgenic cellular phenotype-based study. By developing Casper(roy-/-,nacre-/-); myl7; annexin-5 transparent transgenic zebrafish strain, we established time-lapse in vivo confocal microscopy to study cellular phenotype/pathologies of cardiomyocytes over time to quantify changes in cardiomyocyte morphology and function over time, comparing control and cardiac injury and cardio-oncology. Casper contributes to the study by integrating a transparent characteristic in adult zebrafish that allows for simpler transparent visualization and observation. The Casper(roy-/-,nacre-/-) transgenic progenies developed through cross-breeding with the transgenic strain of Tg(UAS:SEC-Hsa.ANXA5-YFP,myl7:RFP). Confocal and fluorescent microscopy were being used to obtain accurate, precise imaging and to determine fluorescent protein being activated. This study protocol was conducted under two sections; 1.1: Generation of homozygous Tg(UAS:SEC-Hsa.ANXA5-YFP,myl7:RFP); Casper(roy-/-,nacre-/-) zebrafish (generation F01-F06) and 1.2: Screening and sorting the transparent transgenic progeny and in vivo imaging to validate cardiac morphology through in vivo confocal imaging. We coined the newly developed strain as Tg(UAS:SEC-Hsa.ANXA5-YFP,myl7:RFP); Casper(roy-/-,nacre-/-)gmc1. Thus, the newly developed strain maintains transparency of the skin throughout the entire life of zebrafish and is capable of application of a non-invasive in vivo imaging process. These novel results provide an in vivo whole organism-based platform to design high-throughput screening and establish a new horizon for drug discovery in cardiac cell death and cardio-oncology therapeutics and treatment.

Management of Acute Pulmonary Embolism With a Pulmonary Embolism Response Team.

Despite recent advances in the assessment, risk stratification, and treatment of acute pulmonary embolism (PE), it remains a leading cause of cardiovascular morbidity and mortality in the United States each year. Patient presentation and prognosis are heterogeneous, and a variety of diagnostic and therapeutic instruments have arisen to assist in providing patients with the appropriate level of care and aggressiveness of approach. Fortunately, a growing number of institutions now have pulmonary embolism response teams (PERT) that urgently assist with risk assessment and management of patients with massive and sub-massive PE. In service of providers at the point of contact with acute PE, this review aims to summarize the data pertinent to rapid risk assessment and the interpretation of diagnostics used to that end. The role of PERT and the indications for systemic fibrinolysis and invasive therapies are also discussed.

Don't Ignore That Chest Pain: Positionally Dependent Coronary Subclavian Steal Syndrome.

Coronary subclavian steal syndrome (CSSS) is a complication incurred after coronary artery bypass grafting (CABG), characterized by retrograde blood flow through the left internal mammary artery (LIMA) graft to the left subclavian artery (SCA) distal to a SCA stenosis, thereby compromising myocardial perfusion from the LIMA despite its patency. We present a 40-year-old female with a history of triple-vessel CABG who presented with crescendo angina, notably when elevating her arms above her head. Atypical angina related to arm activity following successful LIMA bypass should prompt angiography directed to the left SCA, as well as to the LIMA graft. Typically, cases of CSSS are claudication dependent and not positionally related. This suggests a two-pronged pathophysiological mechanism of both demand ischemia and mechanical obstruction, which is not well described in previous literature.

Single-Laboratory Validation to Extend the Scope of AOAC Official MethodSM 2015.06 to Indian Infant, Child, and Adult Nutritional Matrixes.

BACKGROUND: AOAC Method 2015.06 is a Final Action Official MethodSM for the determination of 12 elements (Na, Mg, P, K, Ca, Cr, Mn, Fe, Cu, Zn, Se, and Mo) in infant formula and adult nutritional products, based on inductively coupled plasma (ICP)-MS. Currently, its scope does not include certain kinds of formulations used in India. The method would likely be used more in Indian laboratories if its performance were characterized on Indian matrixes. OBJECTIVE: In this study we describe a typical single-laboratory validation (SLV) exercise designed to characterize the precision and accuracy of AOAC Method 2015.06 for common Indian nutritional matrixes so that the scope of the method can be extended to include them. METHOD: Six matrixes specific to the Indian market were carried through an SLV and the Standard Method Performance Requirements (SMPRs®) previously published for this method were used to evaluate the results. RESULTS: The method demonstrated typical repeatability (<5% RSD), and intermediate precision (5-8% RSD) on the Indian matrixes, with very few exceptions. Accuracy was demonstrated by overspike recoveries in the range of 90-110% over 3 days for the Indian matrixes, as well as excellent agreement with previously published results for three additional matrixes tested. Some of the new Indian matrixes required alternate sample preparation procedures versus the usual reconstitution prescribed by the SMPRs. CONCLUSIONS: The SLV results showed that AOAC Method 2015.06 can be extended to include these Indian matrices. HIGHLIGHTS: The two special sample preparation procedures can now be considered validated.

Repeatability of Orbscan III for anterior segment parameters in normal eyes.

PURPOSE: Assessment of repeatability of Orbscan III in measuring steep keratometry (sKm), flat keratometry (fKm), thinnest corneal thickness (TCT), anterior chamber depth (ACD), white-to-white diameter (WTW) and 3 mm and 5 mm zonal irregularity in healthy eyes. METHODS: In this prospective observatioanl study 100 eyes of 50 participants underwent three consecutive scans on Orbscan III by a single examiner with a gap of 5 minutes between scans. Statistical analysis was performed to assess the repeatability of sKm, fKm, TCT, WTW, ACD and parameters of 3- and 5 mm irregularity. Within subject standard deviation (Sw), coefficient of variation (CoV) and test retest variability (TRT) was calculated for the commonly used parameters. WERE THE MAIN OUTCOME MEASURES.: The repeatability of sKm, fKm, TCT, WTW, ACD, 3 mm and 5 mm zonal irregularity on Orbscan III. RESULTS: Total of 50 patients (25 male and 25 female) who fulfilled inclusion and exclusion criteria were assessed. sKm, fKm, TCT and WTW were found to have a TRT of 0.31, 0.29. 21.5 and 0.27, respectively, and the ICC values were found to be over 0.9, denoting high repeatability. Repeat measurements of parameters of irregularity and ACD were found to be statistically similar, again denoting similarity between repeat measurements. CONCLUSION: Orbscan III provides repeatable measurements of Sim-k, anterior chamber depth, thinnest corneal thickness, 3 mm and 5 mm zonal irregularity and white-to-white diameter in healthy eyes.

Photorefractive keratectomy (PRK) Prediction, Examination, tReatment, Follow-up, Evaluation, Chronic Treatment (PERFECT) protocol - A new algorithmic approach for managing post PRK haze.

PURPOSE: The aim of this study was to discuss the possible risk factors predisposing to post photorefractive keratectomy (PRK) haze formation and develop and validate a risk scoring system, so that this could be applied to our clinical practice as an algorithmic approach. METHODS: Study was divided into 2 arms, in the retrospective arm we looked at 238 eyes of patients undergoing PRK where certain presumed risk factors from literature and clinical experience were identified and statistical significance of association was studied in the development of corneal haze. The risk scoring system was applied to the 450 eyes in the prospective arm for validation. This was then used to formulate an algorithmic approach to manage post-PRK haze. RESULTS: 22 out of 238 eyes in the retrospective arm developed haze where risk factors such as contact lens intolerance, altered tear film break up time, meibomian gland drop out and vitamin d levels were significantly associated with post-PRK haze (p < 0.05) and these factors were identified in the prospective arm. Treatment of these modifiable factors led to a significant reduction in post-PRK haze. CONCLUSION: Thus identifying and treating risk factors of haze in patients undergoing PRK could improve surgical outcomes and patient satisfaction.

Epithelial remodelling masquerading as keratoconus progression: An interesting case report.

A 25-year-old male patient presented with chief complaints of itching in both eyes (OU) for the past one month. Detailed ophthalmic examination showed best-corrected visual acuity of 6/6 OU. On slit-lamp examination of the left eye, Vogt's striae were documented and rest of the anterior segment was normal OU. Pentacam-HR and ASOCT confirmed the diagnosis of keratoconus. The patient was started on Trehalose containing preparation for both eyes. On follow-up visit at 8 months, progression was documented on Pentacam-HR. MS-39 showed epithelial remodeling, but no stromal or posterior elevation, indicative of a pseudo-progression. Corneal epithelial remodeling post topical trehalose containing eye drops application has been very sparsely reported in literature. It is an important differential to consider when faced with a situation of a likely progression of keratoconus, especially to differentiate true from pseudo-progression.

Study of Attenuation of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation using Intra-oral Ivabradine.

CONTEXT: Endotracheal intubation is one of the most commonly performed procedures, where rapid and dramatic hemodynamic changes which adversely affect the patient may occur during the perioperative period. Various strategies have been applied to attenuate these responses in high-risk individuals. Ivabradine is a very unique cardiotonic drug in the medical literature which reduces the heart rate without jeopardizing hemodynamics in unhealthy, compromised patients. AIMS AND OBJECTIVE: The aim of this study is to evaluate the effect of oral ivabradine on the hemodynamics during laryngoscopy and endotracheal intubation in patients undergoing surgical procedure under general anesthesia and to note the side effects and complications. SETTINGS AND DESIGN: This was a prospective, randomized, and double-blind controlled study. SUBJECTS AND METHODS: A total of 50 American Society of Anesthesiologists physical status I patients between 20 and 50 years age comparable in demographic variables of either sex, undergoing surgery under general anesthesia were randomized into two groups, namely, Group T and Group C of 25 each. Group T (test group) received tablet ivabradine 5 mg 1 h before intubation. Group C (control group) received placebo 1 h before intubation. The pulse rate, systolic and diastolic blood pressures, and mean arterial pressure were recorded for around 10 min and surgery was not allowed to commence. These hemodynamic variables were measured preoperatively, at intubation, after 1 min, 5 min, 8 min and 10 min postintubation. STATISTICAL ANALYSIS USED: The Chi-square test and ANOVA test using INDOSTAT software for hemodynamics were used in this study. RESULTS: There was an increase in all parameters in the control group during and postintubation and was undisturbed in the test group as compared to base line. The increase was constant up to 3 min and got settled within 5 min in the control group. CONCLUSION: Ivabradine had better patient compliance in terms of blunting laryngoscopic pressor.

Google Trends: Opportunities and limitations in health and health policy research.

Web search engines have become pervasive in recent years, obtaining information easily on a variety of topics, from customer services and goods to practical information. Beyond these search interests, however, there is growing interest in obtaining health advice or information online. As a result, health and health policy researchers are starting to take note of potential data sources for surveillance and research, such as Google Trends™, a publicly available repository of information on real-time user search patterns. While research using Google Trends™ is growing, use of the dataset still remains limited. This paper offers an overview of the use of such data in a variety of contexts, while providing information on its strengths, limitations, and recommendations for further improvement.

Comparison of Epidural Bupivacaine and Dexmedetomidine with Bupivacaine and Fentanyl for Postoperative Pain Relief in Lower Limb Orthopedic Surgery.

CONTEXT: Different trials have shown that multimodal analgesia through different techniques is associated with superior pain relief. Opioids as epidural adjunct to local anesthetics have been in use for long and α2 agonists are being increasingly used for same. The present study aims at comparing the hemodynamic, sedative, and analgesic effects of epidurally administered fentanyl and dexmedetomidine when combined with bupivacaine. AIMS: The aim of this study was to compare the efficacy of epidural dexmedetomidine with bupivacaine versus epidural fentanyl with bupivacaine for postoperative pain relief. SUBJECTS AND METHODS: In this ongoing randomized double-blind study, 70 patients with ASA physical status classes I and II of either sex between 20 and 60 years scheduled for lower limb orthopedic surgeries under epidural block were randomly divided into two Groups (n = 35). After epidural block with 15 ml of 0.5% bupivacaine, Group I received 1 µg/kg of fentanyl and Group II received 1 µg/kg of dexmedetomidine. Onset and duration of sensory block, motor block, and time to request for the first postoperative analgesia were recorded. STATISTICAL ANALYSIS USED: The statistical analysis was performed using SPSS (Statistical Package for the Social Sciences) Version 15.0 Statistical Analysis Software, Mann-Whitney U-test and Chi-square test. RESULTS: The time to achieve T10 sensory block was early in Group I (dexmedetomidine) (8.10 + 1.03 min) as compared to Group II (15.03 + 1.67 min). Onset of motor was earlier in Group I (15.10 + 1.49 min) as compared to Group II (22.77 + 1.41 min). In Group I (dexmedetomidine), the majority of patients required 2-3 rescue doses, while in Group II (fentanyl), the majority of patients required 3-4 rescue doses. CONCLUSIONS: Dexmedetomidine seems to be a better alternative to fentanyl as an epidural adjuvant due to early onset of sensory anesthesia, prolonged postoperative analgesia, and lower consumption of rescue analgesia.

Utility of the HAS-BLED Score in Risk Stratifying Patients on Dual Antiplatelet Therapy Post 12 Months After Drug-Eluting Stent Placement.

INTRODUCTION: Current guidelines recommend continuation of dual anti-platelet therapy (DAPT) for 12 months after percutaneous coronary intervention (PCI). Recent studies have shown benefit in continuing DAPT beyond 12 months but at the risk of increase bleeding. To date, there has been little data on risk stratifying patients to determine who can continue DAPT beyond 12 months at minimal bleeding risk. METHODS: All patients who underwent drug-eluting stent (DES) placement from January 1, 2013 to September 30, 2014 were reviewed. Patients who had follow-up for at least 12 months, placement of 2nd generation everolimus-coated DES, and were on DAPT for at least 12 months were included. Patients with a history of atrial fibrillation, follow-up time less than 12 months, or were on concurrent oral anticoagulation therapy were excluded. RESULTS: Five hundred thirty-one patients were analyzed as described above. Two hundred two patients included in our study with 7 patients in the bleeding cohort and 195 patients in no-bleed cohort. The HAS-BLED score in patients who had a bleeding episode vs. those who did not was 3.29 vs. 2.24 (P value of 0.0009). Although not statistically significant, patients who had a bleeding episode were more likely to have renal dysfunction, alcohol use, be on prasugrel, and be on 325mg of aspirin. CONCLUSION: The study shows that the HAS-BLED score can be of utility in risk stratifying patients in determining who can continue DAPT beyond 12 months. Furthermore, a HAS-BLED score of less than 2 may help guide extended DAPT beyond 12 months at minimal bleeding risk. © 2016 Wiley Periodicals, Inc.

SOIL 222Rn CONCENTRATION, CO2 AND CH4 FLUX MEASUREMENTS AROUND THE JWALAMUKHI AREA OF NORTH-WEST HIMALAYAS, INDIA.

Soil 222Rn concentration, CO2 and CH4 flux measurements were conducted around the Jwalamukhi area of North-West Himalayas, India. During this study, around 37 soil gas points and flux measurements were taken with the aim to assure the suitability of this method in the study of fault zones. For this purpose, RAD 7 (Durridge, USA) was used to monitor radon concentrations, whereas portable diffuse flux meter (West Systems, Italy) was used for the CO2 and CH4 flux measurements. The recorded radon concentration varies from 6.1 to 34.5 kBq m-3 with an average value of 16.5 kBq m-3 The anomalous value of radon concentrations was recorded between Jwalamukhi thrust and Barsar thrust. The recorded average of CO2 and CH4 flux were 11.8 and 2.7 g m-2 day-1, respectively. The good correlation between anomalous CO2 flux and radon concentrations has been observed along the fault zone in the study area, suggesting that radon migration is dependent on CO2.

An examination of unmet health needs as perceived by Roma in Central and Eastern Europe.

BACKGROUND: Roma comprise the largest ethnic minority in Europe, with an estimated population of 10-12 million. Roughly 50-60% of European Roma live in the countries of Central and Eastern Europe. In this study, we set out to quantify and explain disparities in unmet health needs for Roma populations relative to non-Roma populations, using self-reported access to health care. METHODS: The United Nations Development Programme/World Bank/European Commission 2011 regional Roma survey was used for this study (12 countries, 8735 Roma and 4572 non-Roma living in same communities), with self-reported unmet health need (did not consult a doctor or health professional when they felt it was necessary in past year) as the primary outcome. Multivariable logistic regressions were performed to study the determinants of unmet health need for Roma populations relative to non-Roma populations. Covariates controlled for included sociodemographic characteristics, economic ability, health status and healthcare access. RESULTS: We found in unadjusted models that Roma throughout Central and Eastern Europe, with the exception of Montenegro, are two to three times more likely to report having an unmet health need in the past 12 months than non-Roma living nearby. These disparities largely remain significant, even after adjusting for gender, age, marital status, employment status, education, number of chronic conditions, health insurance status and geographical proximity to medical providers. CONCLUSIONS: Controlling for conventional measures of access to medical care (i.e. geographic access to providers and health insurance) does not eliminate observed disparities in unmet need. Although improving funding and routine access to healthcare services for Roma is important in its own right as a means of increasing inclusion, there is a need for detailed assessments of the barriers that exist in each country, within and outside the health system, coupled with measures to implement existing commitments on Roma rights.

Microscope Integrated Intraoperative Spectral Domain Optical Coherence Tomography for Cataract Surgery: Uses and Applications.

AIM: To demonstrate the uses and applications of a microscope integrated intraoperative Optical Coherence Tomography in Micro Incision Cataract Surgery (MICS) and Femtosecond Laser Assisted Cataract Surgery (FLACS). METHODS: Intraoperative real time imaging using the RESCAN™ 700 (Carl Zeiss Meditec, Oberkochen, Germany) was done for patients undergoing MICS as well as FLACS. The OCT videos were reviewed at each step of the procedure and the findings were noted and analyzed. RESULTS: Microscope Integrated Intraoperative Optical Coherence Tomography was found to be beneficial during all the critical steps of cataract surgery. We were able to qualitatively assess wound morphology in clear corneal incisions, in terms of subclinical Descemet's detachments, tears in the inner or outer wound lips, wound gaping at the end of surgery and in identifying the adequacy of stromal hydration, for both FLACS as well as MICS. It also enabled us to segregate true posterior polar cataracts from suspected cases intraoperatively. Deciding the adequate depth of trenching was made simpler with direct visualization. The final position of the intraocular lens in the capsular bag and the lack of bioadhesivity of hydrophobic acrylic lenses were also observed. CONCLUSIONS: Even though Microscope Integrated Intraoperative Optical Coherence Tomography is in its early stages for its application in cataract surgery, this initial assessment does show a very promising role for this technology in the future for cataract surgery both in intraoperative decision making as well as for training purposes.