Sir Hurkisondas Nurrotumdas Medical Research Society

Purpose: To compare the efficacy and safety of Opposite Clear Corneal Incision to reduce pre-existing astigmatism after phacoemulsification in tertiary Eye Care centre of India.In this prospective, comparative study 160 patients planned for phacoemulsification were divided into 2 groups.Group A received a foldable IOL through 3.2 mm clear corneal incision made on the steeper meridian along with a 3.2 mm opposite clear corneal incision in an attempt to reduce pre-existing astigmatism.Group B received a foldable IOL through a single clear corneal incision made on the steeper meridian.The preoperative and postoperative data at day 7, 1 month, 3 months and 6 months, on UCVA, BCVA, astigmatism was compared between the groups.Results: A total of 160 patients were enrolled in the study.These patients were divided into 2 groups with 80 patients in each group.The mean preoperative astigmatism was 1.40 +/-0.31 in group A which reduced to 0.61 +/-0.14D after 6 months.The mean preoperative astigmatism was 1.34 +/-0.26D in group B, which reduced to 0.98 +/-0.18D after 6 months of follow up.The average mean astigmatic reduction in group A and B was 0.79 D and 0.30 D respectively.There was a significant difference in mean astigmatism between both the groups after 6 months of follow up (p Value < 0.05).95% of patients had uncorrected visual acuity between 6/6 -6/9 in group A whereas 55% patients had UCVA between 6/6 -6/9 after 6 months (p Value < 0.05).None of the patients had UCVA less than 6/18 in both groups.The BCVA was between 6/6 -6/9 in 97.5% and 95% of patients in group A and group B respectively, which showed no significant difference in terms of BCVA. Conclusion:Being an advancement in refractive lenticular surgery, Opposite Clear Corneal Incision is a safe and cost effective procedure in reducing mild to moderate preexisting corneal astigmatism if reliable preoperative corneal topography readings using pentacam are available.They may be employed during phacoemulsification surgery to further enhance visual outcomes and patient satisfaction.

Background & objectives:Oxidative stress is known to have a causal role in hypertension. Klotho has emerged as a novel anti-aging molecule to inhibit oxidative stress at cellular level. This study aimed at evaluating the gene expression of klotho and antioxidative enzymes, manganese superoxide dismutase (Mn-SOD) and catalase, in peripheral blood mononuclear cells of essential hypertensive patients as compared to normotensive healthy controls.Methods:Ninety-nine newly diagnosed hypertensives and 103 age- and BMI-matched controls were recruited. The participants were non-diabetic and not on any medication. Soluble α-klotho levels were detected using enzyme-linked immunosorbent assay. Gene expression was evaluated by quantitative real-time polymerase chain reaction.Results:Soluble α-klotho levels were significantly lower (27%, P=0.001) in patients as compared to controls. The trend remained same when compared against 44 out of 103 controls considered for gene expression analysis. Relative gene expression of klotho and catalase were 3-fold and 1.25-fold lower in patients as compared to controls, respectively. ΔCt value-based gene expression were also significantly lower for both genes (P=0.001). A decreasing but non-significant trend was observed for Mn-SOD gene expression. ΔCt value-based gene expression of catalase positively correlated with that of Mn-SOD in patient (rs=0.448) and control (rs=0.547) groups (P<0.001). In patients, the gene expression of Klotho positively correlated with that of catalase (rs=0.498, P=0.001), but not Mn-SOD (rs=0.155, P=0.126).Interpretation & conclusions:In the present study on newly diagnosed hypertensives, klotho and catalase gene expression were found to be significantly lower as compared to controls, indicating the role of oxidative stress in this patient group. In addition, a significant correlation between Klotho and catalase gene expression suggests a role for klotho in essential hypertension with respect to antioxidant defence.

Soluble Klotho protein is present in blood, urine, and cerebrospinal fluid and works as a humoral factor exerting different biological effects. Several animal studies have demonstrated the association of age-related neurodegeneration with Klotho deficiency. Lower Klotho levels have been reported in patients suffering from cognitive impairment, dementia, Alzheimer's disease, Parkinson's disease, multiple sclerosis, and other neurodegenerative diseases. Due to its antiaging properties, Klotho is the obvious choice to be studied as a protective/therapeutic agent in neurobiology. In this review, we have attempted to shed light on the different neurodegenerative diseases affected by deficiency of Klotho and its neuroprotective role against pathogenicity of the disease.

Mycobacterium chelonae is a rapidly growing mycobacteria, causes cutaneous, soft tissue, and rarely lung infections. Here we present a rare case of extensive infection of face at multiple sites by Mycobacterium chelonae, with an unusual presentation, diagnosed by using conventional methods.

Objective: UCP2 is a mitochondrial membrane transporter expressed in white adipose tissue and involved in regulation of energy balance. In this present study, we examined the depot specific comparison of UCP2 gene expression in different metabolic states, in order to explore the potential role of UCP2 in human obesity and diabetes. We also determined UCP2’s association with adiponectin and insulin resistance with different parameters of the metabolic syndrome.Methods: Subcutaneous adipose tissue (SAT) and omental adipose tissues (OAT) were obtained from 69 subjects, including 23 non-obese controls, 26 obese and 20 obese T2DM patients. Metabolic syndrome and other clinical features were studied. Adiponectin and UCP2 gene expression was quantitated by Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR).Results: UCP2 gene expression was significantly reduced in obese and diabetic patients compared with controls. Interestingly, we found that UCP2 gene expression was reduced more in omental fat compared with subcutaneous fat and this effect was observed only in males but not in females. Partial correlation analysis showed significant association with the obesity parameters waist circumference, insulin and HOMA-IR, the lipid parameter triglyceride and the adipokine adiponectin.Conclusion: Reduced UCP2 gene expression in obese and diabetic patients and its association with obesity parameters and HOMA-IR confirms its role as a candidate gene in the study of obesity and diabetes in our population. Also, its association with triglycerides implicates its role in lipid metabolism. An association between adiponectin and UCP2 gene expression may provide us with an innovative therapeutic strategy to prevent obesity related diseases, like diabetes and CVD.

Allograft rejection continues to be a major problem and is the leading cause of graft loss in renal transplant recipients. Histocompatibility testing plays an important role in selection of donors for transplantation. A correct assignment of HLA antigens is considered important given that inadequate HLA matching of patient-donor pairs is associated with rejection in kidney transplantation. The present study was to assess a long and successful graft survival in end stage renal failure patients. 50 live related renal transplant patient-donor pairs were selected at random (n=100). Serological HLA A, B and DR typing results were compared to typing results obtained using sequence-specific primers in the polymerase chain reaction. In spite of using a very large panel of antisera in the serological method, there were 6 blank or undefined antigens (2 in the A locus, 1 in the B locus and 3 in the DR locus). The PCR-SSP low resolution method allowed identification of these blanks. Results reveal that screening test should be carried by serology . Ambiguous or blank antigens by serology should be confirmed by DNA typing. The best graft survival was obtained in patients transplanted with kidneys from HLA identical siblings, while kidneys from haplo-identical donors gave lower graft survival. The HLA matching was apparent in both, 3 months graft survival as well as in long-term, which is >1 year in this study . There was no difference in graft survival when various family members are used as donors like father, mother and sibling. There was no upper recipient age limit for transplantation, although older recipients fared better than younger recipients.

Primary tumors of the omentum are uncommon, and leiomyomas arising in the omentum are exceedingly rare. We report on a patient who presented with a large abdominal cyst presumed to be an omental cyst. At laparoscopy, after aspiration, the cyst was found to be attached to a solid mass arising from the greater omentum. The entire tumor was successfully excised laparoscopically. Histopathology and immunohistochemistry revealed it to be an omental leiomyoma with a large degenerative cystic component. Treatment by a minimal access approach allowed the patient to recover rapidly with a short convalescence. Our case confirms the feasibility and safety of a minimal access surgical approach to a rare pathological entity.

The outcome of renal transplantation is improved by cyclosporine and tacrolimus. However, its success is limited by drug-induced nephrotoxicity. Therefore, monitoring their levels is important. These levels are influenced mainly by CYP3A4, CYP3A5 and MDR- 1 genes. These levels also affect target molecules of CNIs, mainly IL-2. Inter-individual differences in these levels have been attributed to SNPs in these genes and hence study of these SNPs assumes significance. So far no study has been carried out on Indian renal transplant recipients covering the SNPs of the genes involved in metabolism, efflux and drug target of CNIs, hence the data is lacking for Indian population. The aim is to study A-392G SNP of CYP3A4, A6986G SNP of CYP3A5, C3435T SNP of MDR-1 and T-330G SNP of IL-2 genes and correlate with CNI blood levels. Hundred healthy subjects and 100 consecutive renal transplant recipients; 56 on CsA and 44 on tacrolimus were genotyped by PCR followed by restriction enzyme assay for mentioned SNPs. No significant difference was observed between level/dose (L/D) ratio of CNIs and CYP3A4 and IL-2 SNPs. However, median L/D ratio for tacrolimus was significantly higher in subjects with CYP3A5*3/*3 (n = 24) (P = 0.011) and MDR- 1 3435TT (n = 18) (P = 0.0122). The findings from this study show that homozygous mutant patients for CYP3A5 and MDR-1 gene SNPs could be managed with lower tacrolimus dose to avoid nephrotoxicity.