Evaluation of the agreement and reliability of Transpalpebral Tonometers compared with Goldmann Applanation Tonometer – A systematic Review and Meta-Analysis Protocol

In 2020, the global prevalence of glaucoma was estimated to be 76 million and it was projected to increase to 111.8 million by 2040. Accurate intraocular pressure (IOP) measurement is imperative in glaucoma management since it is the only modifiable risk factor. Numerous studies have compared the reliability of IOP measured using transpalpebral tonometers and Goldmann applanation tonometry (GAT). This systematic review and meta-analysis aims to update the existing literature with a reliability and agreement comparison of transpalpebral tonometers against the gold standard GAT for IOP measurement among individuals presenting for ophthalmic examinations. The data collection will be performed using a predefined search strategy through electronic databases. Prospective methods-comparison studies published between January 2000 and September 2022 will be included. Studies will be deemed eligible if they report empirical findings on the agreement between transpalpebral tonometry and Goldmann applanation tonometry. The standard deviation and limits of agreement between each study and their pooled estimate along with weights and percentage of error will be reported using a forest plot. Cochrane’s Q test and the I2 statistic will be used to assess heterogeneity, and the publication bias will be investigated using a funnel plot, Begg’s and Egger’s tests. The review results will provide additional evidence on the reliability of transpalpebral tonometers that, in turn, could possibly assist practitioners to make informed decision about using it as a screening or diagnostic device for clinical practice, outreach camps, or home-based screening. Institutional Ethics Committee registration number: RET202200390. PROSPERO Registration Number: CRD42022321693.

Presence and development of strabismus in children with telecanthus, epicanthus and hypertelorism

Purpose: To study the presence and development of strabismus in children with telecanthus, epicanthus, and hypertelorism. Methods: This is a prospective, longitudinal, and observational study. Sixty children aged between 6 months and 18 years with telecanthus, epicanthus, and hypertelorism in isolation or in combination were recruited. A detailed analysis of the history, determination of best corrected visual acuity, complete evaluation of strabismus, and ocular examination were carried out. The presence of telecanthus, epicanthus, and hypertelorism and associated strabismus, if any, was noted. All children were followed up for a minimum and maximum period of 12 and 18 months, respectively, to analyze the strabismus (previously present) and for detection of strabismus in those who did not have. The data were analyzed descriptively with mean and standard deviation. Chi square test and Fishers exact test were used to analyze the data between the groups. A P value less than 0.05 was considered to be statistically significant. Results: Telecanthus was the most common lid feature (55%). At baseline, ten (16.66%) children had strabismus (six: esotropia; four: exotropia). Two (3.33%) children underwent surgery. One child developed exotropia at the third follow?up (18 months). At the end of the study, 11 (18.33%) children had strabismus. No significant association was seen between lid characteristics and the type of strabismus. Conclusion: Children with telecanthus, epicanthus, and hypertelorism in isolation or in combination may or may not have associated strabismus. These features can pose difficulty in strabismus diagnosis, which mandates a careful examination, especially in younger age groups and small?angle strabismus. On the other hand, children without strabismus need longer follow?up to detect the development of strabismus and to initiate further management at the earliest.

Chemo-biological evaluation of antidiabetic activity of Mentha arvensis L. and its role in inhibition of advanced glycation end products

Background: There has been enormous curiosity in the development of alternative plant based medicinesto control diabetes, oxidative stress and related disorders. One of the therapeutic approaches is to reducepostprandial release of glucose in the blood. Two key enzymes that are involved in reducing postprandialglucose are a-amylase and a-glucosidase. Mentha arvensis L. has been traditionally used by several tribesas a medicinal plant to treat various disorders.Objective: The present study was undertaken to test M. arvenisis L. for inhibition of postprandialhyperglycemia.Material and method: We performed various in vitro and in vivo tests to evaluate efficacy of M. arvenisis L.for antidiabetic activity (postprandial hyperglycemia).Results: Methanolic extract of M. arvensis L. leaves showed DPPH free radical scavenging activity (morethan 78% mg/ml) and high antiglycation potential (more than 90% inhibition of AGE formation). Methanolic extract also showed remarkable inhibitory effects on a-amylase (more than 50% mg/ml) and aglucosidase (68% mg/ml) and significant inhibition of postprandial hyperglycemia in starch induced diabetic Wistar rats.Conclusion: The non-insulin dependent antidiabetic or inhibition of postprandial hyperglycemic activityof methanolic extract of M. arvensis L. leaves was shown by using in vitro and in vivo approaches in thepresent study.© 2018 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

The comparison of apache II and apache IV score to predict mortality in intensive care unit in a tertiary care hospital

Background: The prognostication of critically ill patients, in a systematic way, based on definite objective data is an integral part of the quality of care in Intensive Care Unit (ICU). Acute physiology and chronic health evaluation (APACHE) scoring systems provide an objective means of mortality prediction in Intensive Care Unit (ICU). The aims of this study were to compare the performance of APACHE II and APACHE IV in predicting mortality in our intensive care unit (ICU).Methods: A prospective observational study was conducted in a 13 bedded intensive care unit (ICU) of a tertiary level teaching hospital. All the patients above the age of 12 years, irrespective of diagnosis managed in ICU for >24hours were enrolled. APACHE II and APACHE IV scores were calculated based on the worst values in the first 24hours of admission. All enrolled patients were followed up, and outcome was recorded as survivors or non survivors. Observed mortality rates were compared with predicted mortality rates for both the APACHE II and APACHE IV. Receiver operator characteristic curves (ROC) were used to compare accuracy of the two scores.Results: APACHE II score of the patients ranged from 1 to 32 and APACHE IV score of the patients ranged from 25 to 142. There was good correlation between APACHE II and APACHE IV scores with the spearman’s rho value of 0.776 (P<0.01). Discrimination for APACHE II and APACHE IV models were good with area under ROC curve of 0.805 and 0.832 respectively. APACHE IV was more accurate than APACHE II in this regard. The cut-off point with best Youden index for APACHE II was 17 and for APACHE IV were 72 respectively for predicting mortality.Conclusions: Discrimination was better for APACHE IV than APACHE II model however Calibration was better for APACHE II than APACHE IV model in present study. There was good correlation between the two models observed in present study.

Patho-physiological evaluation of Duranta erecta for the treatment of urolithiasis

Background: Urolithiasis is the third common disorder of the urinary system affecting 10e15% of thegeneral population. In recent years, search for new antilithiatic drugs from natural sources has assumedgreater importance.Objectives: This study was performed to investigate the anti-urolithiatic activity of methanolic extract ofDuranta erecta leaves by in vitro and in vivo analysis.Materials and methods: The study was designed to determine presence of phytochemicals in D. erecta, itsyield in percentage, antioxidant activity against 2, 2-diphenyl-1-picrylhydrazyl (DPPH) and anti-microbial property against few bacteria. In vitro analysis was carried out study anti-urolithiatic property ofD. erecta by nucleation assay and synthetic urine assay for inhibition of calcium oxalate and calciumoxalate monohydrate crystals formation. An in vivo experiment was performed on Wistar rats forconfirmation of anti-urolithiatic property of D. erecta in animal model.Results: D. erecta has the presence of primary and secondary metabolites like glycoside, saponins, sterols,flavonoids, phenols, tannins, alkaloids, carbohydrates and proteins. Methanolic extract of D. erecta gave avery good yield (60%). D. erecta proved its antioxidant potential by 93.51% inhibition of DPPH radical at aconcentration of 1000 mg/mL where ascorbic showed 94.71% of DPPH radical at the same concentration.In vitro tests like nucleation assay and synthetic urine assay showed that D. erecta inhibits formation ofcalcium oxalate and calcium oxalate monohydrate crystals. It also showed the anti-microbial property byformation of zone of inhibition against few bacteria. An in vivo experiment on Wistar rat animal modelconfirmed the anti-urolithiatic property of D. erecta L. leaves extract.Conclusions: Based on the results, we reported that D. erecta may treat calcium oxalate crystal depositionin the kidney by preventing hyperoxaluria-induced peroxidative damage to the renal tubular membranesurface (lipid peroxidation). It has anti-microbial potential so it may also inhibit the secondary bacterialinfection in kidney. Based on the data, it can be concluded that this herb can be used as a potential antiurolithiasis agent for kidney stone removal.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

P.vivax infection in a known case of sickle cell anaemia (SCA) – changing trends.

We report a case of P.vivax infection in a case of sickle cell anaemia. The patient was a known case of sickle cell anaemia and was admitted with chief complaints of Fever with chills and rigors since 4 to 5 days and investigations were sent in microbiology laboratory for detection of malarial antigen and he was found to be positive for P.vivax by both rapid test and Giemsa staining. It is thought that malaria is rare in patients of sickle cell anaemia as infected RBCs sickle and malarial parasites cannot survive in those RBCs.

Effect of yogic exercises on symptoms of musculoskeletal disorders of upper limbs among computer users: A randomised controlled trial.

Background and Objectives:Upper extremity musculoskeletal disorders (MSD) are very common in regular computer users and leading cause of work related illness. The objective of the present study is to evaluate effectiveness of yogic exercises in the improvement of symptoms of MSDs of upper limbs. Materials and Methods: 60 study participants were randomly divided into two groups that is yoga with counselling and only counselling group for 12 weeks. Symptom severity and functional status were assessed using the self administered Boston Carpal Tunnel Questionnaire and predesigned symptom questionnaire before and after intervention. Results: There was significant reduction in symptom severity score (P = 0.002) and improvement in functional status score in yoga with counselling group when compared to only counselling group. There is also a significant decrease in self reported symptoms like CT myalgia symptom (P = 0.019) and improvement in weakness. Conclusion: The present study showed a yoga based regimen is more effective than counselling alone in relieving symptoms of computer related musculoskeletal disorders.

Morpho-anatomy of Solanum pseudocapsicum

Morpho-anatomical features in leaves, stems and unripe fruits of Solanum pseudocapsicum L., Solanaceae, were investigated by histological methods. Anatomically the plant may be characterised by the presence of uniseriate trichomes, anomocytic stomata, calcium oxalate needles in leaves while presence of oval to circular compound starch grains, angular vessels, vertically upright, uni-biseriate rays and intraxylary phloem with differentiation of internal cambium abutting marginal pith cells and protoxylem in transverse view. Development of distinct internal cambium may be considered as a characteristic feature for S. pseudocapsicum. Intraxylary secondary phloem was composed of sieve tube elements, companion cells and axial parenchyma cells.

Dental caries vaccine.

Dental caries is one of the most common diseases in humans. In modern times, it has reached epidemic proportions. Dental caries is an infectious microbiologic disease of the teeth that results in localized dissolution and destruction of the calcified tissue. Dental caries is a mulitifactorial disease, which is caused by host, agent, and environmental factors. The time factor is important for the development and progression of dental caries. A wide group of microorganisms are identified from carious lesions of which S. mutans , Lactobacillus acidophilus , and Actinomyces viscosus are the main pathogenic species involved in the initiation and development of dental caries. In India, surveys done on school children showed caries prevalence of approximately 58%. Surveys among the U.S. population showed an incidence of 45.3% in children and 93.8% in adults with either past or present coronal caries. Huge amounts of money and time are spent in treating dental caries. Hence, the prevention and control of dental caries is the main aim of public health, eventually the ultimate objective of public health is the elimination of the disease itself. Recently, dental caries vaccines have been developed for the prevention of dental caries. These dental caries vaccines are still in the early stages.

Fatal cellulitis caused by Apophysomyces elegans.

A case of cellulitis of the left lateral side of the face caused by the zygomycete Apophysomyces elegans in a healthy male following a road traffic accident is reported. The contaminated soil was the source of fungus. Broad aseptate fungal hyphae were seen in the necrosed tissues. Extensive tissue debridement and treatment with amphotericin B were not successful in controlling the rapid invasion of the tissues by the fungus. Patient developed angioinvasion, severe cellulitis and finally succumbed to the infection three weeks after admission.

Evaluation of hepatoprotective activity of Clerodendrum serratum L.

The ethanol extract of C. serratum roots and ursolic acid isolated from it were evaluated for hepatoprotective activity against carbon tetrachloride induced toxicity in male Wistar strain rats. The parameters studied were estimation of liver function serum markers such as serum total bilirubin, total protein, alanine transaminase, aspartate transaminase and alkaline phosphatase activities. The ursolic acid showed more significant hepatoprotective activity than crude extract. The histological profile of the liver tissue of the root extract and ursolic acid treated animal showed the presence of normal hepatic cords, absence of necrosis and fatty infiltration as similar to the controls. The results when compared with the standard drug silymarin, revealed that the hepatoprotective activity of the constituent ursolic acid is significant as similar to the standard drug.

Allele-specific suppression of the temperature sensitivity of fitA/fitB mutants of Escherichia coli by a new mutation (fitC4): isolation, characterization and its implications in transcription control.

The temperature sensitive transcription defective mutant of Escherichia coli originally called fitA76 has been shown to harbour two missense mutations namely pheS5 and fit95. In order to obtain a suppressor of fitA76, possibly mapping in rpoD locus, a Ts+ derivative (JV4) was isolated from a fitA76 mutant. It was found that JV4 neither harbours the lesions present in the original fitA76 nor a suppressor that maps in or near rpoD. We show that JV4 harbours a modified form of fitA76 (designated fitA76*) together with its suppressor. The results presented here indicate that the fit95 lesion is intact in the fitA76* mutant and the modification should be at the position of pheS5. Based on the cotransduction of the suppressor mutation and/or its wild type allele with pps, aroD and zdj-3124::Tn10 kan we have mapped its location to 39.01 min on the E. coli chromosome. We tentatively designate the locus defined by this new extragenic suppressor as fitC and the suppressor allele as fitC4. While fitC4 could suppress the Ts phenotype of fitA76* present in JV4, it fails to suppress the Ts phenotype of the original fitA76 mutant (harbouring pheS5 and fit95). Also fitC4 could suppress the Ts phenotype of a strain harbouring only pheS5. Interestingly, the fitC4 Ts phenotype could also be suppressed by fit95. The pattern of decay of pulse labelled RNA in the strains harbouring fitC4 and the fitA76* resembles that of the original fitA76 mutant implying a transcription defect similar to that of fitA76 in both these mutants. The implications of these findings with special reference to transcription control by Fit factors in vivo are discussed.

HIV-1 western blot assay: What determines an indeterminate status?

BACKGROUND: The Western blot assay is the gold standard for the detection of antibodies to human immunodeficiency virus type 1 (HIV-1). However, indeterminate Western blot reactivity to HIV-1 proteins may occur in individuals, who may not be infected with HIV. AIM: This retrospective study was aimed to determine the diagnostic value of the interpretation criteria in relation to commercial kits for HIV-1 diagnosis. METHODS AND MATERIALS: A total of 556 serum/plasma specimens collected from high-risk population attending our HIV clinic from 2000-2004 were tested by three different western blot kits: NEW LAV BLOT I (n=244), HIV BLOT 2.2; (n=112), Genetic Systems HIV-1 (n=237). And the results of western blot strips were analyzed using the various interpretation criteria: WHO/NACO, CDC/ ASTPHLD, ARC, FDA, CRSS and JHU. Some specimens were run on more than one kit. RT-PCR assay was performed on 5 specimens, which were indeterminate with LAV BLOT I. RESULTS: The discrepancy in LAV BLOT I positive results were between 157(64)-176(72), and indeterminate results were between 44(18) to 63(25). No such variations were observed in genetic systems. There are some HIV negative (by PCR) specimens were indeterminate in LAV BLOT I revealing the kit more sensitive and less effective for diagnostic purpose. CONCLUSION: The genetic systems kit is superior to other kits we analyzed and its results are concordant with HIV-1 PCR results. To report, the choice of western blot commercial kit is paramount important than the use of particular interpretation criteria for the diagnosis of HIV-1.

Hepatoprotective activity of Leucas hirta against CCl4 induced hepatic damage in rats.

Methanol and aqueous leaf extracts of L. hirta demonstrated hepatoprotective activity against carbon tetrachloride induced liver damage in rats. The parameters studied were serum total bilirubin, total protein, alanine transaminase, aspartate transaminase and alkaline phosphatase activities. The hepatoprotective activity was also supported by histopathological studies of liver tissue. Results of the biochemical studies of blood samples of CCl4 treated animals showed significant increase in the levels of serum markers and decrease in total protein level reflecting the liver injury caused by CCl4. Whereas blood samples from the animals treated with methanol and aqueous leaf extracts showed significant decrease in the levels of serum markers and increase in total protein indicating the protection of hepatic cells. The results revealed that methanol leaf extract followed by aqueous extract of L. hirta could afford significant protection against CCl4 induced hepatocellular injury.

Towards understanding lamin gene regulation.

The lamins are components of the nuclear lamina, which forms a fibrous meshwork lining the inner nuclear membrane. Lamina-membrane interactions play a crucial role during nuclear disassembly and reassembly at mitosis, whereas lamina-chromatin association has been proposed to be essential for chromatin organization. The composition of the lamina changes considerably during embryonic development and cell differentiation. Recent studies have provided insights into the regulation of the lamin genes.

Reversal of benzodiazepine sedation with flumazenil in a patient with tetanus

A 54-year-old female patient admitted with a diagnosis of tetanus had her sedation reversed with an infusion of flumazenil. Flumazenil appears to be of use in reversal of sedation in patients with accumulation of benzodiazepine after prolonged administration.

Molecular organization of great millet (Sorghum vulgare) DNA.

Approximately 52% of the nuclear genome of great millet (Sorghum vulgare) consists of repetitive DNA which can be grouped into very fast, fast and slow components. The reiteration frequencies of the fast and slow reassociating components are 7000 and 92 respectively. Approximately 90% of the genome consists of repeated sequences interspersed amongst themselves and with single copy sequences. The interspersed repeat sequences are of three sizes viz. > 1·5 kilobase pairs, 0·5–1·0 kilobase pairs and 0·15–0·30 kilobase pairs while the size of the single copy sequences is 3·0 kilobase pairs. Hence the genome organization of great millet is essentially of a mixed type.

DNA Sequence organization In finger millet (Eleusine coracana).

Approximately 39 to 49% of the genome of finger millet consists of repetitive DNA sequences which intersperse with 18% of single copy DNA sequences of 1900 nucleotide pairs. Agarose gel filtration and electrophoresis experiments have yielded the sizes of interspersed repeated sequences as 4000-4200 nucleotide pairs and 150-200 nucleotide pairs. Approximately 20% of the repeated DNA sequences (4000-4200 nucleotide pairs) are involved in long range interspersion pattern, while 60% of the repeated DNA sequences (150-200 nucleotide pairs) are involved in short period interspersion pattern. Based on the data available in literature and the results described here on DNA sequence organization in plants, it is proposed that plants with haploid DNA content of more than 2.5 pg exhibit mostly the short period interspersion pattern, while those with haploid DNA content of less than 2.5 pg show diverse patterns of genome organization.