Tea tree oil, a vibrant source of neuroprotection via neuroinflammation inhibition: a critical insight into repurposing Melaleuca alternifolia by unfolding its characteristics / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Over the past few decades, complementary and alternative treatments have become increasingly popular worldwide. The purported therapeutic characteristics of natural products have come under increased scrutiny both in vitro and in vivo as part of efforts to legitimize their usage. One such product is tea tree oil (TTO), a volatile essential oil primarily obtained from the native Australian plant, Melaleuca alternifolia, which has diverse traditional and industrial applications such as topical preparations for the treatment of skin infections. Its anti-inflammatory-linked immunomodulatory actions have also been reported. This systematic review focuses on the anti-inflammatory effects of TTO and its main components that have shown strong immunomodulatory potential. An extensive literature search was performed electronically for data curation on worldwide accepted scientific databases, such as Web of Science, Google Scholar, PubMed, ScienceDirect, Scopus, and esteemed publishers such as Elsevier, Springer, Frontiers, and Taylor & Francis. Considering that the majority of pharmacological studies were conducted on crude oils only, the extracted data were critically analyzed to gain further insight into the prospects of TTO being used as a neuroprotective agent by drug formulation or dietary supplement. In addition, the active constituents contributing to the activity of TTO have not been well justified, and the core mechanisms need to be unveiled especially for anti-inflammatory and immunomodulatory effects leading to neuroprotection. Therefore, this review attempts to correlate the anti-inflammatory and immunomodulatory activity of TTO with its neuroprotective mechanisms.

Dietary nutritional status of AIDS orphans / 中国学校卫生

Objective@#To understand the dietary nutritional status of AIDS orphans aged 7-12 in Urumqi, and to provide a scientific basis for promoting growth, development and health.@*Methods@#Using a random sampling method, a total of 309 children aged 7-12, from Urumqi were selected. The sample included 98 orphans with AIDS, 66 orphaned children not affected by AIDS, and 145 cases of non orphaned children. A 24 hour diet review method was used to record the diet of all three groups of children who received three meals per day, energy levels and the nutrient intake of AIDS orphans and their attainment were analyzed according to the daily recommended nutrient intake (RNI) of Chinese residents.@*Results@#The detection rate of wasting in the AIDS orphans group was 44.9%, which was higher than that in the orphans without AIDS group (40.9%) and the non orphaned group ( 28.2 %); the overweight rates of AIDS orphans and orphans without AIDS were 3.1% and 3.0%, respectively, which were both lower than those of non orphaned children (8.3%); the average daily intake of energy and dietary nutrients in the AIDS orphans group was lower than that in the other two groups, and the intake of vitamin A, vitamin B 2, vitamin B 6, vitamin C,vitamin D, folic acid, calcium, zinc, and iron was seriously insufficient, the intake of food grains, vegetables, fruit, eggs, milk and dairy products, and the average daily intake of oil was lower among AIDS orphans than orphans without AIDS and non orphaned children, additionally,except for food grains,eggs, there were significant differences between the three groups ( F =3.02，5.23，27.86，16.59， P <0.05), and the daily intake of vegetables, aquatic products, eggs and milk in AIDS orphans and orphans was lower than the recommeded intake.@*Conclusion@#A higher rate of wasting, unbalanced nutrient intake, and poor nutritional status was found among AIDS orphans aged 7-12 in Urumqi. Therefore, there is a need to improve the dietary structure of AIDS orphans with the aim of promoting healthy development.

Determination of Bergenin in Different Parts of Bergenia ciliata using a Validated RP-HPLC Method

Bergenia ciliata (Family: Saxifragaceae) is a folklore remedy for the treatment of various ailments in Asian countries. Bergenin (1) has been isolated as an active constituent in many studies, however, the amount of bergenin has not been determined in all parts of the plant. A simple RP-HPLC method was developed to determine the amount of bergenin in methanol extracts of leaves, rhizomes and roots of the plant. Separation was achieved on an Agilent Eclipse XDB-C18 column maintained at 25 o C using isocratic solvent system (water: methanol: acetic acid; 62.5:37:0.5 v/v/v) adjusted at pH 2 0 at a flow rate of 1.0 mL/min. and detected at 275 nm. Correlation coefficient (0.9952) showed linearity of concentration (5-200 μg/mL) and response. The values of LOD (0.00947 μg/mL) and LOQ (0.02869 μg/mL) indicated that method was sensitive. The recovery of bergenin was 99.99-100% indicating accuracy of method. The methanol extract of rhizomes contained higher amount of bergenin (19.4%) than roots (9.2%) and leaves (6.9%). It is concluded that methanol extract of rhizomes is a better source of bergenin than other parts of the plant. The findings are useful for standardization of bergenin containing extracts and herbal preparations.

Determination of Bergenin in Different Parts of Bergenia ciliata using a Validated RP-HPLC Method

Bergenia ciliata (Family: Saxifragaceae) is a folklore remedy for the treatment of various ailments in Asian countries. Bergenin (1) has been isolated as an active constituent in many studies, however, the amount of bergenin has not been determined in all parts of the plant. A simple RP-HPLC method was developed to determine the amount of bergenin in methanol extracts of leaves, rhizomes and roots of the plant. Separation was achieved on an Agilent Eclipse XDB-C18 column maintained at 25 o C using isocratic solvent system (water: methanol: acetic acid; 62.5:37:0.5 v/v/v) adjusted at pH 2 0 at a flow rate of 1.0 mL/min. and detected at 275 nm. Correlation coefficient (0.9952) showed linearity of concentration (5-200 μg/mL) and response. The values of LOD (0.00947 μg/mL) and LOQ (0.02869 μg/mL) indicated that method was sensitive. The recovery of bergenin was 99.99-100% indicating accuracy of method. The methanol extract of rhizomes contained higher amount of bergenin (19.4%) than roots (9.2%) and leaves (6.9%). It is concluded that methanol extract of rhizomes is a better source of bergenin than other parts of the plant. The findings are useful for standardization of bergenin containing extracts and herbal preparations.

Empathy In Caribbean Medical Students Assessed Using The Toronto Empathy Questionnaire

Introduction: Empathy is the emotional process to understand a patient’s state of being and current emotion.Empathy, through humanization of medical students, plays an important role while learning and practicing theart of medicine. Our study aims to quantify empathy as an indicator of humanization, in medical studentsthroughout their education.Subjects and Methods: A cross-sectional questionnaire survey was performed on basic medical and clinicalscience students at Avalon University School of Medicine, Curacao. Standard Toronto Empathy Questionnaire[TEQ] was utilized to quantify the empathy.Results: Average TEQ scores of the basic students in MD1 - MD4 were 51.55 ± 4.16, 49.42±3.58, 46.72±4.60,48.86±6.17 respectively. Overall TEQ scores were slightly higher in basic science students in comparison to theclinical students (48.82 ± 5.12 vs 48.74 ± 4.01, P=0.46).Conclusions: Empathy scores were higher in basic science medical students in comparison to the clinicalstudents. Lack of progression of empathy amongst medical students needs to be addressed. We recommendmedical schools to adapt and instill the virtue of empathy in the course curriculum

Globalising artificial intelligence for improved clinical practice

Artificial intelligence (AI) technologies are facilitating the work of modern healthcare organisations to leverage the power of big data in clinical practice. In most cases, AI-based systems improve clinical decision-making using multiple layers of information and pre-specified algorithms. In addition, recent AI technologies like machine learning can learn from existing data and perform predictive operations resulting in a robust performance in clinical settings (1, 2). Such innovations are likely to serve the healthcare industry by minimising human error, savings costs, and maximising informed decision-making. However, critical challenges may affect the applications of AI in clinical settings, which include the effects on patient-provider communication, safety and efficacy of health services, and humane aspects of caregiving.

Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence / 한국역학회지

Objectives@#Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent coronavirus disease 2019 (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases. @*Methods@#We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population. @*Results@#Among 1,364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes. @*Conclusions@#This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.

Mental health outcomes of quarantine and isolation for infection prevention: a systematic umbrella review of the global evidence / 한국역학회지

Objectives@#Transmission of infectious diseases is often prevented by quarantine and isolation of the populations at risk. These approaches restrict the mobility, social interactions, and daily activities of the affected individuals. In recent coronavirus disease 2019 (COVID-19) pandemic, quarantine and isolation are being adopted in many contexts, which necessitates an evaluation of global evidence on how such measures impact the mental health outcomes among populations. This umbrella review aimed to synthesize the available evidence on mental health outcomes of quarantine and isolation for preventing infectious diseases. @*Methods@#We searched nine major databases and additional sources and included articles if they were systematically conducted reviews, published as peer-reviewed journal articles, and reported mental health outcomes of quarantine or isolation in any population. @*Results@#Among 1,364 citations, only eight reviews met our criteria. Most of the primary studies in those reviews were conducted in high-income nations and in hospital settings. These articles reported a high burden of mental health problems among patients, informal caregivers, and healthcare providers who experienced quarantine or isolation. Prevalent mental health problems among the affected individuals include depression, anxiety, mood disorders, psychological distress, posttraumatic stress disorder, insomnia, fear, stigmatization, low self-esteem, lack of self-control, and other adverse mental health outcomes. @*Conclusions@#This umbrella review found severe mental health problems among individuals and populations who have undergone quarantine and isolation in different contexts. This evidence necessitates multipronged interventions including policy measures for strengthening mental health services globally and promoting psychosocial wellbeing among high-risk populations.

Knowledge regarding diarrhoea prevention and its management and its determinants among mothers of under 5 age children in urban area of Sangareddy, Telangana

Background: Diarrhoea is the second leading cause of death in children under five years of age, and is responsible for killing around 5,25,000 children every year. A major determinant of child health is the health and knowledge of the mother. So the knowledge, attitude and health practices of the mothers directly reflect on the health and vitality of the child.Methods: A community based cross sectional type of study was conducted among mothers who had children of 0-5 years of age using pre designed, pretested structured questionnaire. Study area was 5 urban slum pockets in Tertiary care hospital of Sangareddy, Telangana. 255 mothers were selected for the study using random sampling technique.Results: Out of the total 255 study populations most of the mothers were literate, living in nuclear families belonging to Hindu religion. About half of the mothers had knowledge regarding diarrhoea and 71.4% of the mothers have given hospital treatment for it. When asked about 78.4% of mothers told that they follow preventive health practices. Majority of mothers had a good knowledge regarding steps to be taken by health care facility during diarrheal attack.Conclusions: On the basis of the present study, there was a significant association of knowledge regarding diarrhoea with maternal literacy and socio economic status. This study brought out the health seeking behaviour of mothers of under five children.

Evaluation of efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar spine surgery in prone position: a prospective randomized double blind placebo controlled study

Background: Endotracheal intubation is associated with postoperative sore throat. The aim was to evaluate the efficacy of intravenous magnesium sulphate versus dexamethasone for prevention of postoperative sore throat in patients undergoing lumbar surgery in prone position.Methods: 150 patients of ASA physical status I and II in the age group of 18 to 70 years were divided into three groups of 50 each. group I (magnesium sulphate) received intravenous magnesium sulphate 30 mg. kg-1 in a total of 50 ml of normal saline for 10 minutes after intubation, group II (dexamethasone group) received intravenous dexamethasone 8 mg in 50 mL normal saline for 10 minutes after intubation and group III (placebo group) received 50 ml of normal saline for 10 minutes after intubation. The incidence and severity of postoperative sore throat and hoarseness was assessed by an anesthesiologist unaware of the group allocation, on arrival in the post anesthesia care unit at 0 h, and at 1 h, 6 h, 12 h, and 24 h thereafter.Results: Both incidence and severity of sore throat and incidence of hoarseness was more in placebo group than magnesium sulphate group and dexamethasone group and was statistically significant (p<0.05) and was comparable between magnesium sulphate and dexamethasone groups.Conclusions: Endotracheal intubation is associated with sore throat and hoarseness of voice. Magnesium sulphate and dexamethasone given intravenously reduce the incidence and severity of sore throat and hoarseness associated with endotracheal intubation.

Prevalence of overweight and obesity among women of >20 years

Background: Obesity is a newly emerging, global pandemic problem involving developed as well as developing countries. Even in countries like India, which are typically known for high prevalence of under nutrition, significant proportions of overweight and obese now coexist with the undernourished. Overweight and Obesity are the 5th leading risk of global deaths. Rapidly changing diets and lifestyles are increasing the global obesity epidemic. According to recent estimates, there are more than one billion overweight people worldwide, and some 300 million of these are estimated to be obese. Obesity is one of the important risk factors for non communicable disease like CAD, stroke, cancer, depression etc, going to increase burden of non communicable diseases in terms of morbidity and mortality. Aims and objectives were to determine the prevalence of overweight and obesity among women of >20 years and to identify various factors associated with overweight and obesity. Methods: A community based cross sectional study was conducted and 446 women of 20-60 years age were included in the study. A Predesigned questionnaire was used for the study. Anthropometric measurements such as weight, height, waist circumference were measured using standard techniques. Results: In the present study, prevalence of overweight in the study population was 28.2% and obesity 13.6%. Overweight & Obesity were significantly associated with family history, comorbid conditions etc. Conclusions: Prevalence of overweight & obesity is increasing in developing countries like India due to changing life styles, diet patterns and sedentary life style. This observation emphasizes large scale awareness campaign about overweight and obesity

Influence of salinity stress on the uptake of magnesium, phosphorus, and yield of salt susceptible and tolerant sorghum cultivars (Sorghum bicolor L.)

Sorghum is cultivated all over the world to satisfy the needs of food, feed, fiber, and industrial raw material. Itis moderately tolerant to salinity and drought stress. The use of salt-tolerant varieties is one best way to increaseplant productivity in saline soils. Present research work was planned to determine the effect of NaCl on foursorghum genotyes (two salt tolerant, i.e., Sandalbar and JS-2002; two salt sensitive, i.e., Noor and FJ-115). Dataindicated that salt stress adversely affected the magnesium and phophorus contents in shoots and roots of allthe four genotypes. Maximum magnesium and phosphorus accumulation were recorded in Sandalbar genotype,followed by Noor and the minimum occurred in the JS-2002 and FJ-115 sorghum genotypes in the case ofshoots. The number of panicles/plant, grain weight/panicle, 1,000-grain weight, and grain yield/plant was alsoreduced by the NaCl stress. The maximum number of panicles and grain weight per panicle was obtained inSandalbar (2.13), followed by JS-2002 (2.0) and the minimum number of panicles was present in FJ-115 (1.96)under saline stress. The maximum 1,000-grain weight decline was calculated in FJ-115 (69.3%), followed byNoor (46%) and the least decrease was noted in Sandalbar (15.2%), followed by JS-2002 (19.4%) in sorghumgenotypes. However, the effect of salt stress was less prominent on salt tolerant genotypes as compared to saltsensitive ones in all these yield components. It was concluded that Sandalbar sorghum genotype has a potentialto be developed for seed and for biomass production at salinity stressed areas.

Gender-based violence among Rohingya refugees in Bangladesh: a public health challenge

On August 25, 2017, the military and paramilitary forces of Myanmar launched “clearance operations” against the Rohingya population in Rakhine state of Myanmar. In the resulting humanitarian crisis, a Médecins Sans Frontières (MSF) report estimated that the number of deaths crossed 9000 within the first 31 days of these “operations”. In addition to mass murder, other atrocities including burning down of residences, torture, rape, kidnapping continued to be practised on the Rohingya living in Myanmar. Those who could escape, braved great risks to cross the border between Bangladesh and Myanmar to seek refuge in Cox’s Bazaar district of Bangladesh. Currently, the number of refugees living in temporary camps has crossed one million, and local and international agencies are attempting to support them with basic living amenities and medical care. Their physical and mental health status is a global concern calling for immediate action. The magnitude of violence has been much higher among the adolescent girls and women of reproductive age.

Development and validation of a stability-indicating RP-HPLC-FLD method for determination of 5-[[4-chlorophenoxy] methyl]-1, 3, 4- oxadiazole-2-thiol; A novel drug candidate

The present study describes the development and validation of a simple high performance liquid chromatographic method for the determination of a novel drug candidate, 5-[[4-chlorophenoxy] methyl]-1, 3, 4- oxadiazole-2-thiol. The stability-indicating capacity of the method was evaluated by subjecting the compound's solution to hydrolytic, oxidative, photolytic, transition metal- and thermal- stress. The chromatographic separation was achieved over a C18 column [Promosil, 5 microm, 4.60 × 250 mm], maintained at 25°C, using an isocratic mobile phase comprising a mixture of acetonitrile and acidified water of pH 2.67 [1:1, v/v], at a flow rate of 1.00 mL/min and detection using a fluorescent light detector [excitation at 250 nm and emission at 410 nm]. The Beer's law was followed over the concentration range 2.50-50.00 microg/mL. The recovery [98.56-100.19%, SD <5%], intraday accuracy and precision [97.31-100.81%, RSD<5%] and intermediate accuracy and precision [98.10-99.91%, RSD<5%] indicated that the method was reliable, repeatable, reproducible and rugged. The resolution and selectivity factors of the compound's peak from the nearest resolving peak, particularly in case of dry heat and copper metal stress, were found to be greater than 2 and 1, respectively, which indicated specificity and selectivity. The compound was extensively decomposed in alkaline-hydrolytic, oxidative, metal- and dry heat- stress. However, the compound in acidic and neutral conditions was resistant to photolysis. The results of the present study indicate that the developed method is specific, selective, sensitive and suitable, hence, may be used for quality control, stability testing and preformulation studies

Prunus domestica alters functions of frog's heart

Prunes could exert cardiovascular protective effects. Trials have demonstrated antihypertensive effects of Prunus domestica. The aim of this study was to find out if prunes could alter cardiac functions that may help understanding the mode of control of hypertension. Changes in rate and contractile force of frogs' heart were recorded using Power Lab. Effects of prunes' extracts: aqueous [10, 20, 40%]; methanolic, acetonic, ethanolic and chloformic [10%]; were evaluated and compared with other drugs. We tested effects of acetylcholine and atropine [10-5], adrenaline, propranolol, verapamil and diltiazem [10[-3]]; NaC1, KCl, CaC1[2], MgC1[2] [10% w/v] on frog's heart alone and with prunes/drugs. All extracts of prunes significantly reduced HR and contractile force. Prunes combined with acetylcholine, propranolol or verapamil significantly enhanced bradycardia; whereas it blocked tachycardia produced by epinephrine, atropine or calcium; moreover prunes blocked the significant increase in HR and cardiac contractility produced by CaCl[2]; and reduced HR along with MgC1[2]. NaCl and KCl alone or with prunes had non-significant effects on frog's heart. In conclusion, Prunus domestica plays a key role in modification of intracellular Ca+2 concentration resulting in negative ionotropic and chronotropic effects [similar to cholinergic stimulation and adrenergic or calcium channel blockade] that could lead to hypotensive effects

Effects of methanolic and aqueous extracts of Ipomoea batatas L on mineral contents level [calcium and magnesium] in alloxan-induced diabetic rats

In diabetic patients, electrolyte disorders frequently occur with the characteristic changes in minerals like calcium and magnesium etc. Several medicines are used to manage diabetes mellitus but they exert adverse effects. Plants are a valuable alternative to synthetic medicines because they are easily available, economical and have fewer side effects. Ipomoea batatas L is a well-known antidiabetic plant [sweet potato] but its effects on calcium and magnesium concentration have not studied. The prime focus of this study is to estimate the potential of Ipomoea batatas L peel-off on magnesium and calcium level in Alloxan-induced diabetic rats. Alloxan monohydrate was mixed in 0.9% NaCl solution and administrated [150 mg/kg [S/C]] to male Wistar rats to induce diabetes. After three days blood samples were collected and blood glucose level was recorded. Wistar rats having a blood glucose level of 200 mg/dl and above were selected for the study. Methanol and water extract of Ipomoea batatas L peel–off was given orally with a dose rate of 4g/day. Calcium and magnesium estimation was done using an atomic absorption spectrophotometer. Our results revealed an increase in both the calcium and magnesium level in heart, brain, liver, hind limb, and forelimb after Ipomoea batatas extract treatment. In kidneys decreased calcium level was noted as they excrete calcium. Mineral [Calcium, magnesium] level was increased in all organs except kidney after both extracts treatment. Ipomoea batatas being anti-diabetic in nature also maintain the homeostasis of calcium and magnesium in diabetes. Therefore, we propose the long-term use of such agents might help in the prevention of diabetes-associated complications. However, the validation of these results to human population needs further extensive study

Study on tooth morphological variations among various ethnic groups of Pakistan

The aim of the study was to elucidate the prevalence of some accessory dental morphological traits variations in permanent teeth of population belonging to Swati, Gujar and Jadoon ethnic groups. The study sample was 300 subjects [100 of each group] volunteer students both male and females aged 12-21 taken in different schools of targeted areas having specifically Swati, Gujar and Jadoon residents. The study period was from July-January 2010. The prepared dental plaster casts were examined for morphological variations such as shoveling, bushman canine, distal accessory ridge and cusp of Carabelli. These traits were analyzed through Arizona state university tooth morphology system. The occurrence rate of each morphological trait was calculated as percentage of total sample size. In results the cusp of Carabelli exhibited maximum expression in Swati group while in Swati and Gujars more shoveling was observed as compared to Jadoons however the Bushmen canine was totally absent in these groups. The dentist should be aware of these dental morphological variations because in actual life the teeth morphology expresses more variations than in textbooks

Effects of exercises on pregnancy related low back pain: a quasi experimental study

Objective: To evaluate the effect of therapeutic exercises on pregnancy related low back pain in a tertiary care hospital of Karachi

Material and Methods: This was a quasi-experimental study with non-probability convenience sampling technique. Study was carried out at Liaquat National Hospital Karachi. Patients were divided into two groups [Experimental and Control]. Inclusion criteria were age <30 years, 2nd and 3rd trimester, stable medical status and those who gave the informed consent. Exclusion were pregnancy induced hypertension [>140/90mmHg], Cardiac disease, diabetes mellitus, persistent vaginal bleeding, history of miscarriages, decreased foetal movement. Data was collected through assessment Modified Oswestry Low back pain disability questionnaire. SPSS version 23.0 was used to analyze the data

Results: A total of 30 samples were selected for the study. There were 15 respondents in experimental while 15 in control group. Disability levels were found to be significantly decreased after post treatment in experimental group with P-value= 0.002. It was seen that number of patients was increased from 1[6.7%] to 6[40%] in minimal disability group whereas crippled back pain group in pre-treatment group was totally shifted towards minimal or moderate pain 3[20.0%] and no case was seen in post-treatment

Conclusion: Low back pain in pregnancy can disturb daily life routine but exercise therapy and proper counselling will lead stress free life to female in gestation. After post treatment in experimental group showed decrease in pain as compare to control group who were not provided any exercise therapy. Working women in experimental group also showed decrease by crippled back pain to moderate pain after exercise. So in the end researcher suggest that physiotherapy exercises play a vital role in reducing Low Back Pelvic Pain [LBPP] during pregnancy

Effect on Corneal Dioptric power in patients undergoing 23G Suture less plana vitrectomy

Objective: To determine the effect of 23-gauge pars plana vitrectomy on corneal dioptric power through a comparison of difference in pre- and post- surgery keratometry

Study Design: Prospective non-comparative interventional type

Place and Duration of Study: The study was conducted at the Armed Forces Institute of Ophthalmology [AFIO] Rawalpindi from Dec 2016 to Jul 2017

Material and Methods: We studied 33 patients [33 eyes] who underwent 23-gauge vitrectomy with mean age of 46.4 +/- 12.8 years. Among them 13 were females and 20 were males. These patients were divided in four groups on the basis of pre-surgical diagnosis. 18 [55%] patients had rhegmatogenous retinal detachment, 9 [27%] had macular holes 3 [9%] with Vitreous hemorrhage and last 3 [9%] had dislocation of intraocular lens. Total vitrectomy was performed in all patients by standard 23G pars plana vitrectomy [PPV] procedure as used with three scleratomies and tunnel shaped incision. Keratometry readings before the surgery and at the end of 1st, 6th and 12th post procedural weeks were recorded in horizontal [K1] and vertical meridian [K2] by utilizing topcon auto kerato-refractometer

Results: The pre-operative dioptric power of cornea in horizontal and vertical meridian [K1 and K2 respectively] was statistically compared with post- operative dioptric power of cornea at the end of 1st, 6th and 12th postoperative weeks. At the end of first post- operative week there was significant difference between pre and post-operative corneal dioptric power with horizontal p-value<0.05 and vertical <0.04; leading to astigmatism. However, at the end of 6th and 12th post procedural weeks there was no significant difference between pre and post-operative corneal dioptric power which is evident with insignificant p-values. The p-value at the end of 6[th] post-operative week was 0.521 and 0.57 for K1 and K2 respectively. At the end of 12th post-procedural week these values are 0.854 and 0.941 for K1 and K2 respectively. Clinically these patients did not have any sign or symptoms of astigmatism

Conclusion: 23G was found safe procedure in vitreoretinal surgery with no insignificant change in corneal dioptric power except in cases in which silicone oil was used. However, due to small study group and short follow up further studies with longer follow-ups are required to establish the long-term changes in corneal dioptric power after 23G suture less vitrectomy

Medication errors and strategies for their prevention

Medication errors occur every day causing injury to the patients and even deaths. The health care professionals are not fully aware of the damages done by medication errors in terms of patients' discomfort and economic burden. There is a need to provide information about medication errors to health care providers. This article reviews research done on the various aspects of medication errors. The research work done on prescribing errors, transcribing errors, dispensing errors, administration errors and discharged summaries errors have been examined. Eight strategies to reduce the occurrence of medication errors have been reviewed: [1] Electronic prescribing and computerized physician order entry [CPOE] with clinical decision support systems [CDSSs], [2] Bar Code, [3] Interventions to reduce medication errors, [4] Medication Error Reporting Systems [MERSs], [5] Alerts about medication errors, [6] Prevention of harm from high-alert drugs, [7] Smart Infusion Pumps and [8] Telemedicine or Telehealth or Telepharmacy. Statistical tests used in medication error studies have also been stated