Efficacy of low-vision devices in elderly population with age-related macular degeneration

Purpose: Age?related macular degeneration (AMD) is a common cause of blindness, residual damage to macular area in spite of treatment necessitates visual rehabilitation by means of low?vision aids (LVAs). Methods: Thirty patients suffering from different stages of AMD requiring LVAs were included in this prospective study. Patients with nonprogressive, adequately treated AMD were enrolled over a 12?month period, prescribed requisite LVAs and followed?up for a minimum 1?month period. Before and after provision of LVAs, near work efficiencies were evaluated by calculating reading speed as words per minute (wpm) under both photopic and mesopic light conditions, and impact of poor vision on activities of daily living (ADL) was quantified by modified standard questionnaire based on Nhung X et al. questionnaire. Results: Of the 30 patients mean studied with mean age of 68 ± 10 years, 20 patients (66.7%) had dry AMD in better eye and 10 (33.3%) had wet AMD. Post?LVA, near visual acuity improved significantly and all cases were able to read some letters on near vision chart with an average improvement of 2.4 ± 0.96 lines. The different LVAs prescribed were high plus reading spectacles (up to 10 D) in 23.3%, hand?held magnifiers in 53.3%, base in prisms in 10%, stand held magnifiers in 6.7%, and bar and dome magnifiers in 3.3%. Conclusion: LVAs are effective in visual rehabilitation in patients with AMD. Self?reported reduction in visual dependency and improvement in vision?related quality of life post use of aids corroborated perceived benefit.

Bibliometric analysis of pediatric glaucoma

Purpose: This study aimed to describe visual outcomes in cases of pediatric uveitis in an Indian population and to analyze various factors affecting these outcomes. Methods: Single?center, retrospective chart review of 277 cases of uveitis in patients under the age of 18 years. Variables assessed included age and sex distribution, anatomical location of uveitis, systemic associations, complications, and various treatment strategies used, including long?term immunomodulation and surgical management of complications if required. The main outcome was the final visual acuity. Results: At the final visit, 51.5% of the eyes showed improvement in the final visual acuity, while vision remained stable in 28.7% and 19.7% of the eyes showed worsening of vision at the final follow?up. A total of 19.4% of patients were blind in at least one eye at the final visit, and 16 patients (5.77%) remained bilaterally blind at the final follow?up. The presence of cataract (p = 0), posterior uveitis (p = 0.005), and retinal detachment (p = 0.014) were the most significant risk factors for predicting worse visual outcomes. More than half (65.7%) of patients reported a complication at some point in their follow?up, and the most common complication was cataract. In total, 50.9% of patients required long?term immunomodulatory therapy. Conclusion: Pediatric uveitis remains a challenging condition to treat and follow?up, and the visual outcome remains guarded for most patients. in infectious cataracts, particularly in CMV infections, compared to other cataract subtypes. Tgf? showed significantly low expression in various cataract subtypes, whereas vimentin had elevated gene expression in infectious and prenatal cataracts. Conclusion: A significant association between lens gene expression patterns in phenotypically and etiologically distinct subtypes of pediatric cataracts suggests regulatory mechanisms in cataractogenesis. The data reveal that cataract formation and presentation is a consequence of altered expression of a complex network of genes.

Comparison of the conventional CMAC and the D-blade CMAC with the direct laryngoscopes in simulated cervical spine injury-a manikin study / Comparação do C-MAC convencional e C-MAC D-blade com laringoscópios diretos em simulação de lesão da coluna cervical-estudo em modelo / Comparação do C-MAC convencional e C-MAC D-blade com laringoscópios diretos em simulação de lesão da coluna cervical-estudo em modelo / Comparación del C-MAC convencional y C-MAC D-blade con laringoscopios directos en simulación de lesión de la columna cervical (estudio en modelo)

BACKGROUND: CMAC videolaryngoscope has recently been introduced for videoscope guided intubation. The aim of our study was to compare and evaluate the efficacy of the conventional blade and the angulated D blade of the CMAC videolaryngoscope with the direct laryngoscopes in simulated cervical spine injury patients on the airway manikin. MATERIALS AND METHODS: Following power analysis, 33 resident doctors were enrolled to perform endotracheal intubation using all the 4 different laryngoscopes namely the Macintosh laryngoscope, McCoy laryngoscope, conventional CMAC videolaryngoscope and the D blade of the CMAC videolaryngoscopes on the airway manikin in simulated cervical spine injury. The demographic variables of the resident doctors were recorded. The outcomes measured included vocal cord visualization (Cormack-Lehane grading), time taken to intubate, number of attempts for successful intubation and optimizing maneuvers required. RESULTS: The use of indirect videolaryngoscopes resulted in better glottic visualization in comparison to the direct laryngoscopes (CL-I) in 20/33 (60.6%) in the Macintosh group, 24/33 (72.7%) in McCoy group, 30/33 in (90.9%) in Vlc group and 32/33 (96.9%) in Vld group. The time taken to intubate averaged to 15.54 ± 2.6 in Macintosh group, 18.90 ± 4.47 in McCoy group, 20.21 ± 7.9 in Vlc group and 27.42 ± 9.09 in Vld group. The 1st attempt intubation success rate was 84.8% (Macintosh), 72.7% (McCoy), 90.9% (Vlc) and, 78.7% (Vld). CONCLUSIONS: The overall performance of the conventional CMAC blade proved to be the best when compared with the D-blade CMAC, Macintosh blade and the McCoy blade for intubation in simulated cervical spine patients by anesthesia residents. .

JUSTIFICATIVA E OBJETIVO: o videolaringoscópio C-MAC foi recentemente introduzido para orientar a intubação. O objetivo deste estudo foi comparar e avaliar a eficácia do laringoscópio C-MAC de lâmina convencional e C-MAC de lâmina angulada (D-blade) com laringoscópios diretos em simulação de pacientes com lesão de coluna cervical usando modelo de vias aéreas. MATERIAIS E MÉTODOS: após a análise do poder do estudo, 33 médicos residentes foram inscritos para realizar intubações endotraqueais, usando todos os quatro laringoscópios diferentes: laringoscópio Macintosh, laringoscópio McCoy, videolaringoscópios C-MAC convencional e C-MAC D-blade em modelos de vias aéreas com simulação de lesão da coluna cervical. As variáveis demográficas dos médicos residentes foram registradas. Os resultados avaliados incluíram visualização das pregas vocais (classificação de Cormack-Lehane), tempo necessário para intubar, número de tentativas para intubação bem-sucedida e manobras de otimização necessárias. RESULTADOS: o uso de laringoscópios indiretos resultou em melhor visualização da glote em comparação com os laringoscópios diretos (CL-I) em 20/33 (60,6%) no grupo Macintosh, 24/33 (72,7%) no grupo McCoy, 30/33 (90,9%) no grupo Vlc e 32/33 (96,9%) no grupo Vld. A média do tempo necessário para entubar foi de 15,54 ± 2,6 no grupo Macintosh, 18,90 ± 4,47 no grupo McCoy, 20.21 ± 7,9 no grupo Vlc e 27,42 ± 9,09 no grupo Vld. A taxa para a primeira tentativa de intubação bem-sucedida foi de 84,8% (Macintosh), 72,7% (McCoy), 90,9% (Vlc) e 78,7% (Vld). CONCLUSÃO: o desempenho geral da lâmina do C-MAC convencional mostrou ser melhor quando comparado com o das lâminas ...

JUSTIFICACIÓN Y OBJETIVO: el videolaringoscopio C-MAC fue recientemente introducido para orientar la intubación. El objetivo de este estudio fue comparar y evaluar la eficacia del laringoscopio C-MAC de lámina convencional y C-MAC de lámina angulada (D-blade) con laringoscopios directos en una simulación de pacientes con lesión de la columna cervical usando modelo de vías aéreas. MATERIALES Y MÉTODOS: después del análisis del poder del estudio, 33 médicos residentes fueron inscritos para realizar intubaciones endotraqueales, usando 4 laringoscopios diferentes: laringoscopio Macintosh, laringoscopio McCoy, videolaringoscopios C-MAC convencional (Vlc) y C-MAC D-blade (Vld) en modelos de vías aéreas con simulación de lesión de la columna cervical. Las variables demográficas de los médicos residentes fueron registradas. Los resultados evaluados incluyeron la visualización de las cuerdas vocales (clasificación de Cormack-Lehane), tiempo necesario para intubar, número de intentos para intubación exitosa y maniobras de optimización necesarias. RESULTADOS: el uso de laringoscopios indirectos trajo como resultado una mejor visualización de la glotis en comparación con los laringoscopios directos (CL-I) en 20/33 (60,6%) en el grupo Macintosh, 24/33 (72,7%) en el grupo McCoy, 30/33 (90,9%) en el grupo Vlc y 32/33 (96,9%) en el grupo Vld. El tiempo medio necesario para intubar fue de 15,54 ± 2,6 en el grupo Macintosh; 18,90 ± 4,47 en el grupo McCoy; 20,21 ± 7,9 en el grupo Vlc; y 27,42 ± 9,09 en el grupo Vld. La tasa para el primer intento de intubación exitoso fue de un 84,8% (Macintosh), un 72,7% (McCoy), un 90,9% (Vlc) y un 78,7% (Vld). CONCLUSIÓN: el rendimiento global de la lámina del C-MAC convencional mostró ser mejor cuando se le comparó con el de las láminas ...

Antioxidant and Antibacterial Potential of Different Fractions from Roots of Eriosema chinense Vogel.

Aim: The roots of the plant Eriosema chinense Vogel (Leguminosae-Papilionoideae) is taken in the form of vegetable and is traditionally used for the treatment of diarrhoea by the tribal people of Meghalaya, India. Therefore, the present study is an attempt to assess the antioxidant and antibacterial potential of different fractions from roots of Eriosema chinense along with quantitative estimations of phytoconstituents. Study Design: Extraction, fractionation, analysis and antibacterial evaluation. Place and Duration of Study: Department of Pharmaceutics, Indian Institute of Technology, Banaras Hindu University, India between April 2012 to October 2012. Methods: Different fractions i.e. aqueous, ethyl acetate, chloroform and hexane fractions were obtained from ethanol extract of roots of Eriosema chinense and were subjected to preliminary phytochemical screening and quantification of total phenols, tannins, flavonoid and flavonol. All the fractions were then evaluated for in-vitro antioxidant activity by using different models, which includes total antioxidant capacity, assay of reducing power, free radical scavenging activity, nitric oxide scavenging assay, H2O2 scavenging activity and scavenging of hydroxyl radical. The study also included assessment of antibacterial activity of all fractions against bacterial strains including those implicated in diarrhoea. Results: The chloroform fraction was found to be highly rich in flavonoids and phenols, which was followed by ethyl acetate fraction. In all the tested antioxidant models, chloroform and ethyl acetate fraction demonstrated the highest antioxidant potential as indicative through their IC50 values. All the fractions except aqueous fraction depicted a potent antibacterial activity at their respective higher concentration. Conclusion: The antioxidant and antibacterial potential of Eriosema chinense may be attributed to the presence of phenols and flavonoids which plays a significant role in treatment of oxidative stress, cardiovascular arrests, inflammation, cancer and diarrhea.

Formulation and evaluation of colon targeted drug delivery system of levetiracetam using pectin as polymeric carrier.

The aim of the present work was to develop and evaluate colon specific sustained release tablet using levetiracetam (LEV), microbially degradable polymeric carrier (pectin), coating material and matrix forming polymers. The colon targeted tablet was prepared by wet granulation technique using different percentage of pectin as matrix carrier, starch mucilage as a binding agent, HPMC K-100 as swellable polymer and coated with Eudragit polymers. Pectin, drug and physical mixture were evaluated for incompatibility study by Fourier transform infrared spectroscopy (FTIR) and differential scanning calorimetry (DSC). All the batches of matrix tablet (F1-F4) were subjected for in-vitro dissolution in various simulated gastric fluids for suitability for colon specific drug delivery system. Tablets were evaluated for micromeritic properties of granules, physical properties, drug content, water uptake and erosion characteristics. F2 was optimized and subjected to coating based on evaluation results. The dissolution study of F2 revealed, in simulated intestinal fluid (SIF) release was 40.48% at the end of 6h and in simulated colonic fluids (rat caecal content) was 102.88% after degradation at the end of 8h. The colon targeted matrix tablet of LEV showed no change either in physical appearance, drug content or dissolution pattern after performing stability study for 3 months. The studies confirmed that, the designed formulation could be used potentially for colon delivery by controlling drug release in stomach and the small intestine.