Patient stratification using point of care biomarkers in dry eye disease

With changes in lifestyle, such as the increasing use of digital screens and rising demand for refractive surgery, dry eye disease has become increasingly prevalent in recent times. While we are equipped with a number of diagnostic modalities and a myriad of treatment forms, ranging from topical medication to procedural therapies, the condition remains an enigma in terms of varied patient satisfaction. An understanding of the molecular basis of a disease may open up new avenues in the customization of its treatment. We attempt to simplify this in the form of a stepwise protocol to incorporate biomarker assays in dry eye management.

Effect of Puta on in vitro anticancer activity of Shataputi AbhrakBhasma on lung, leukemia and prostate cancer cell lines

Background: Rasashastra needs to be upgraded using the technological advances, with regards to drugprocessing, development and therapeutics. The potential of Rasaaushadhis need to be explored by subjecting them against newer life threatening diseases like cancer where contemporary medicine haslimitations. Abhrak Bhasma, one of the drugs of Rasashastra, has some peculiar attributes. According toclassical Rasashastra texts, Shataputi Abhrak Bhasma is regarded as a Rasayan, whose efficacy is in directproportion to the number of Putas. Thus increasing number of Putas not only has a significant effect onthe physical, analytical aspects but also the therapeutic effect of the Abhrak Bhasma.Objectives: To screen in vitro anticancer activity of Abhrak Bhasma at various stages of Putas (20, 50, 100).To evaluate and thus validate the principle from classical Rasashastra texts, which explains direct relationof number of Putas with therapeutic efficacy.Materials and methods: Shataputi Abhrak Bhasma, at various stages of its preparation was subjected toin vitro anticancer activity on three different cancer cell lines (LungHOP62, LeukemiaU937, ProstateDU145) at Tata Memorial Centre- Advanced Centre for Treatment, Research Education in Cancer, NaviMumbai. SRB assay was followed to evaluate the anti-proliferative activity.Results: It was found that Abhrak Bhasma shows concentration dependent positive in vitro anticanceractivity on all three cell lines with highly significant activity on prostate cancer cell lines. Anticanceractivity of Abhrak Bhasma is in the order 100 Puti > 50 Puti > 20 Puti. Shataputi Abhrak Bhasma hadmaximum activity on prostate cancer cell lines almost equivalent to positive control drug adriamycin.Conclusion: The in vitro anticancer activity of Shataputi Abhrak Bhasma increases with increasing numberof Putas, thus revalidating the direct relation between number of Putas and efficacy of the drug.© 2017 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Publishing Services byElsevier B.V

Validation of PC 1000 Hz Reaction Timer with Biopac® MP 36 for Recording Simple Reaction Time

Background: In neuropsychological assessment, the time taken by a subject or patient to respond tostimulus provides valuable information about processing in central and peripheral nervous system. Reactiontime is a simple and inexpensive method commonly used in cognitive and sport physiology to assess thesensory-motor performance of an individual.Objective: To compare and validate the baseline values of simple reaction time obtained using the PC 1000Hz reaction timer with Biopac® MP 36.Materials and Methods: 50 healthy subjects (32 males and 18 females) with age of 22.78±3.90 yrs andBMI of 24.820±3.59 kg/m2 participated. Visual (VRT) and auditory (ART) reaction time were estimated usingPC 1000 Hz reaction timer and Biopac® MP 36 separately for minimum of three trials each.Results: There was no significant difference found in ART and VRT values of the subjects estimated by PC1000 Hz and Biopac® MP 36. A strong significant (P<0.01) correlation was found in ART (r=0.92) and VRT(r=0.94) in between the devices. Bland Altman plot also showed that variations for VRT and ART were withinthe acceptable range.Conclusion: The present validation study recommend that the assessment of simple reaction time forauditory and visual stimulus by PC 1000 Hz reaction timer is reliable one and compared with other techniquesit has more advantages such as portable in nature and simplicity to use either in laboratory or in fieldoriented study for the evaluation of psychomotor and cognitive function.

Perceptions of first year dental students on case based learning in Physiology

Background: Application of basic science knowledge to clinical practice is the aim of first year undergraduate dental curriculum. To bring in application of basic science theory to the clinical dental application, a case based learning (CBL) approach has been tried among first year dental students. Materials and methods: Randomized control trial was conducted by grouping first year undergraduate dental students (N= 73) into traditional group (N=35) and CBL group (N=38). Conventional lecture was given to traditional group and case based lecture and small group discussion for CBL group facilitated by faculty. Pre and post tests were administered for both the groups. Perceptions on CBL approach were collected using a questionnaire. Results were analyzed using paired and unpaired ‘t’ test. Results: Test scores were expressed in mean ± SD. deviation. Post-tests scores of traditional - (7.5 ±1.6) and CBL (7.7±1.9) groups were significantly higher than pretest scores of traditional - (5.7 ± 1.4) and CBL (4.9 ± 1.7) groups. Attitude score showed positive perceptions for most of the parameters. Conclusion: The first time CBL approach for Physiology concept provoked interest among dental students. Participants felt the method involved them in active learning and they recommended this approach to other sessions as well. Recall of factual knowledge did not improve significantly over traditional method, but was equally effective.

Screening for Glucokinase (GCK) Gene Mutation in Gestational Diabetes Women in Western Region of Saudi Arabia.

Aim: The study involved screening of three exons of glucokinase gene (7, 8 and 9) to detect mutations at posi­tions 682A>G, p.T228A, 895G>C, p.G299R and 1148C>A, p.S383X, respectively in Saudi pregnant women with or without gestational diabetes. Study Design: Retrospective study. Place and Duration of Study: The Obstetrics and Gynecology clinic of King Abdul-Aziz Hospital in South Jeddah between May and October 2013. Methodology: A sample of 100 Saudi pregnant women classified as healthy (control, N = 50 (pregnant women without diabetes)) or with gestational diabetes (N = 50) was analyzed for mutations in the GCK gene. Blood samples were taken and DNA was extracted from whole blood. The target part of GCK gene was amplified by the polymerase chain reaction (PCR). The specific amplified regions were digested by restriction enzymes: BstUI for exon 7, HhaI for exon 8 and BfaI for exon 9, and electrophoresed on agarose gel. Mutations were screened by restriction fragment length polymorphism. Results: Fasting glucose levels were statistically higher in gestational diabetes women than controls (P-value = 0.00). The difference in Glucose Challenge Test (GCT) values between two groups shows significante p-value = 0.00. However, We observed that there was no significant correlation between any of the GCK mutations and gestational diabetes in Saudi population. Conclusion: The glucokinase gene mutations do not affect glucose metabolism in pregnant Saudi women.

Oral Bio Dissolving Films in Dentistry: A New Perspective in Treatment Modality.

The environment of oral cavity provides a large surface area for the delivery of drugs bypassing the first pass metabolism in the liver. Hence, the oral cavity is being targeted for providing quicker delivery of drugs for immediate action. However, oral delivery system in the form of tablets/ capsules needs modifications in elderly, children, and unconscious patients because of the fear of choking and aspiration. To overcome these problems much research is being undertaken to develop oral bio dissolving films as an alternative to tablets. The objective of the article was to provide an overview of the composition, advantages and disadvantages, and uses of bio dissolving films in the field of medicine and dentistry.

Postnatal development of testis in gaddi goat (capra hircus) / Desarrollo postnatal del testículo en la cabra gaddi (capra hircus)

A study was conducted on the testicles of 30 male Gaddi goats, divided into 3 groups viz; prepubertal (0 day to 18 months), pubertal (<18 months to >5 yrs) and post- pubertal (>5 yrs) ages. The study revealed that the testis was covered by fibroserous tunica albuginia having outer fibrous layer and inner vascular layer with smooth muscle fibers at birth. The tunica albuginia continuously grew in thickness from prepubertal to postpubertal animals. The septula testis arising from the tunica albuginia, divided the parenchyma in lobules and converged at mediastinum testis. Few differentiated and undifferentiated Leydig cells were present in the intertubular spaces of neonates, which enormously increased in pubertal animals and replaced by fibroblasts in the postpubertal animals. The parenchyma comprised of solid sex cords in new born kids. These were converted into luminated tubules after 6 months of age and had clear cut tubuli contorti and tubuli recti leading to the mediastinum testis. In "0" day old kids, sex cords were filled with undifferentiated small cells located peripherally along the basement membrane and large primordial germ cells located centrally. By six months of age, latter started showing sign of degeneration and thus luminization of tubules started. Spermatogenesis startedin the seminiferous tubules of 12-18 months goat. In pubertal animals all the stages of spermatogenic cells and Sertoli cells were identified in the seminiferous tubules. The population of gonia cells and primary + secondary spermatocytes were 35% and 30% respectively. In postpubertal animals gonia cells were reduced to <30% and Primary + secondary spermatocytes were <20%. Many degenerating seminiferous tubules showed hyalinization, fibrosis and giant cells. The stroma and parenchyma ratio which was 35:65 at birth became 30:60 at 6 months, 25:75 at 12 months and 15:85 in pubertal and 20:80 in postpubertal animals. Increased stroma in last phase was associated with replacement of seminiuferous tubules by fibrous elements.

Se realizó un estudio en 30 testículos de cabras Gaddi machos divididos en 3 grupos: prepúberes (0 días a 18 meses), púberes (<18 meses y >5 años) y post-púberes (>5 años). El estudio reveló que los testículos al nacimiento estaban cubiertos por una túnica albugínea fibroserosa con una capa fibrosa externa y otra capa vascular interna con fibras musculares lisas. En los animales prepúberes hasta los pospúberes, la túnica albugínea mostró un crecimiento continuo de espesor. El septo testicular derivado de la túnica albugínea, divide el parénquima en lóbulos convergentes en el mediastino testicular. En los espacios intertubulares de los testículos de los recién nacidos, se observaron escasas células interticiales diferenciadas e indiferenciadas, sin embargo, se registró un aumento importante en los animales púberes las cuales fueron reemplazadas por fibroblastos después de la pubertad. El parénquima en los testículos de los animales recién nacidos estaba compuesto por cordones sexuales continuos. Estos se convierten en túbulos luminados después de los 6 meses de edad, evidenciando túbulos contorneados y rectos que conducen al mediastino testicular. En animales de 0 días de edad, los cordones sexuales presentaban pequeñas células no diferenciadas y situadas periféricamente a lo largo de la membrana basal y grandes células germinales primordiales céntricas. A los seis meses de edad, este último comenzó a mostrar signos de degeneración. La espermatogénesis se inició en los túbulos seminíferos desde los 12 a 18 meses de edad. En los animales púberes se identificaron en los túbulos seminíferos todas las etapas de las células de espermatogénesis y células sustentaculares. La población de células gonia fue del 35% y de espermatocitos primarios más secundarios 30%. En los animales pospúberes las células gonia se redujeron a <30% y espermatocitos primarios más secundarios a < 20%. Muchos túbulos seminíferos presentaron degeneración. La relación parénquima/estroma fue 35:65 al nacer, luego de 30:60 a los 6 meses, de 25:75 a los 12 meses, de 15:85 en animales prepúberes y 20:80 en la pubertad. El aumento del estroma en la última fase fue asociado con el reemplazo de los túbulos seminíferos por elementos fibrosos.

Prenatal development of pelvic urethra in goat (Capra hircus) / Desarrollo prenatal de la uretra pélvica en cabras (Capra hircus)

The study was conducted on the embryo/foeti of goat from 0-150 days of gestation, divided into group I (0-30 days), group II (31-60 days), group III (61-90 days), group IV (91-120 days) and group V (121-150 days of gestation). In group I whole embryo was processed and serial sections were cut whereas, in rest of the groups, pelvic urethra was dissected out and the tissues from the representative areas were used for the study. Grossly, on 49.33 days of gestation the pelvic urethra was present in the form of smooth cylindrical tube, approximately 4mm in length. The primordial of vesicular gland and bulbourethral gland appeared on 52 days of gestation at the junction of neck of urinary bladder with pelvic urethra and at the junction of pelvic and penile urethra respectively. The length, width, height and circumference of pelvic urethra increased with increased in gestation period, however the length (7 times) and circumference (9 times) increased maximum from group II to group V. The morphometrical parameters (length, width, height and circumference) of pelvic urethra were significantly correlated with the age and weight of foetus throughout gestation period. The colliculus seminalis, which was present in the form of ridge on 72 days of gestation, became distinct on 75 days of gestation. Histologically, on 28 days of gestation, the urogenital sinus was present as a cleft with in the cluster of cells. On 55 days of gestation, the process of luminization started with in the wall of pelvic urethra, which started first in its caudal part and proceeded cranially. All the four layers (Tunica mucosa, submucosa, muscularis and adventitia) were distinct. The lumen was lined with 3-4 layers of stratified epitheliumin group II but in group III on 70 days of gestation and beyond this distinct transitional epithelium was present. The formation of cavernous spaces started at 59 days of gestation...

El estudio se realizó sobre embriones/fetos de cabras de 0 a 150 días de gestación, divididos en grupo I (0-30 días), grupo II (31-60 días), el grupo III (61-90 días), grupo IV (91 a 120 días) y grupo V (121-150 días de gestación). En el grupo I embriones enteros fueron procesados mediante cortes seriados, en el resto de los grupos, la uretra pélvica fue disecada y los tejidos de las áreas representativas se utilizaron para su estudio. Macroscópicamente, a los 49,33 días de gestación de la uretra pélvica estaba presente en forma de tubo cilíndrico liso, aproximadamente 4 mm de longitud. El primordio de la glándula vesicular y la glándula bulbouretral apareció a los 52 días de gestación en el cruce de cuello de la vejiga urinaria con la uretra pélvica y el cruce de la uretra pélvica y pene respectivamente. La longitud, ancho, alto y circunferencia de la uretra pélvica aumentó con el avance del período de gestación, sin embargo, la longitud (7 veces) y el perímetro (9 veces) aumentó en el grupo II y V. Los parámetros morfométricos (longitud, ancho, alto y circunferencia) de la uretra pélvica se correlacionaron significativamente con la edad y el peso del feto durante toda la gestación. El colículo seminal, que estaba presente en la forma de cresta a los 72 días de gestación, se mostró distinta a los 75 días de gestación. Histológicamente, en 28 días de gestación, el seno urogenital estaba presente como una hendidura con un grupo de células. En 55 días de gestación, el proceso de luminización comenzó en la pared de la uretra pélvica, que comenzó en su primera parte caudal y procedió cranealmente. Las cuatro capas (túnica mucosa, submucosa, muscular y adventicia) eran distintas. La luz estaba cubierta con 3-4 capas de epitelio estratificado en el grupo II, pero en el grupo III a los 70 días de gestación y más, un epitelio de transición distinto estuvo presente. La formación de espacios cavernosos comenzó a los 59 días de gestación...

Correlation between difficulty & discrimination indices of MCQs in formative exam in Physiology.

Introduction: Difficulty index (P) and discrimination index (D) are the parameters used to evaluate the standard of multiple choice questions (MCQs) in examination. Accordingly the standard of MCQs can be interpreted as excellent, acceptable or poor. This study was intended to find out the standard of MCQs in formative examination in Physiology. The study also intended to find out correlation between P and D. Materials and Methods: There were 240 MCQ items, taken from the past 4 year batches of 100 students and were analyzed for level of difficulty and discrimination index. The relationship between them for each test item was determined by Pearson correlation analysis using SPSS 11.5. Results: There was a wide distribution of item difficulty indices (8.57 to 95.71) and discrimination indices (-0.54 to 0.8).The mean difficulty index (P) was 52.53 + 20.59 and mean discrimination index was 0.30+ 0.18. On average, about 23% of the MCQ items were easy (P >70%), while about 15% were difficult (P <30%). The remaining 62% items were within acceptable range (30 to 70%). In all 4% of the items showed negative discrimination and 21% of the items exhibited poor discrimination. The remaining 75% of the items were in the range of acceptable to excellent discrimination. The discrimination index exhibited slight positive correlation with difficulty index (r = 0.191, P=0.003<0.01). The maximal discrimination (D=0.6-0.8) was observed with moderately easy/difficult items (P = 40% - 60%). Conclusion: The majority (75%) of the items was acceptable as far as difficulty and discriminative indices were concerned. Moderately easy/difficult items had maximal discriminative ability. Too easy and too difficult items gave poor discrimination index. Negative discrimination was observed in only 4% of the items indicating faulty items or incorrect keys.

Age Related Structural Changes in the Bulbourethral Gland of Gaddi Goat (Capra hircus) / Cambios Estructurales Relacionados con la Edad en la Glándula Bulbouretral de la Cabra Gaddi (Capra hircus)

A study was conducted on the bulbourethral glands of 30 Gaddi goats, divided into three groups of 10 animals in each viz; Prepubertal (1 day old to < 18 months of age), Pubertal (18 months to < 5yrs of age) and Postpubertal (>5yrs of age). The study revealed that the glands grew at a faster speed up-to 6 months of postnatal life after which the pace slowed down considerably. Almost 10 times increase in weight and more than three times increase in all the linear mensurations were observed in prepubertal group from the time of birth. The stroma vs parenchyma ratio which was 80:20 in one-day-old kids showed three times increase in parenchyma in prepubertal animals, and the ratio became 43:57. In one day old kids luminated and non-luminated secretory end pieces were arranged in small groups around widely luminated duct; the forerunner of the central cistern. Initially the gland contained serous as well mucous end pieces; the latter being more preponderant. But in pubertal animals it became a mucous type gland, with only a little numbers of serous end pieces. Histochemically, the glandular acini were reactive to PAS and Alcian blue indicated the presence of glycol-muco-complex in the secretory components of gland.

Se realizó un estudio sobre las glándulas bulbouretrales de 30 cabras Gaddi, divididas en tres grupos de 10 animales cada uno; prepúberes (desde 1 día de edad hasta <18 meses), púberes (desde 18 meses hasta <5 años de edad) y postpuberales (>5 años de edad). El estudio reveló que las glándulas crecen a una mayor velocidad hasta los 6 meses de vida postnatal, después de lo cual el ritmo baja considerablemente. En el grupo prepuberal se observó un aumento casi 10 veces en peso y más de tres veces en todas las mediciones lineales. La relación estroma v/s parénquima fue de 80:20 el primer día postnacimiento, mostrando un aumento de tres veces en el parénquima en los animales prepúberes, llegando a una proporción 43:57. En una de las cabras de un día de edad las piezas terminales secretoras luminal y no-luminal se organizaron en pequeños grupos alrededor del conducto luminal; el precursor de la cisterna central. Inicialmente la glándula contenía piezas terminales serosas y mucosas. Esta última tenía una mayor preponderancia. Sin embargo, en animales puberales se convirtió en una glándula de tipo mucosa, con sólo un pequeño número de piezas terminales serosas. Histoquímicamente, los acinos glandulares reactivos al PAS y azul Alcian indicaron la presencia de glicol-muco-complejos en los componentes de secreción de la glándula.

Gerentological studies on the gross and histomorphology of the vesicular gland of gaddi goat (Copra hircus) / Estudios gerontológicos en anatomía e histomorfología de la glándula vesicular de cabra gaddi (Cabra hircus)

The study was conducted on the vesicular glands of 30 entire pure male Gaddi goats from birth to 5yrs and 6 months of age, divided into three equal size groups of 10 animals in each viz; Pre-pubertal (lday old to <18 months of age), Pubertal (18 months to < 5years of age) and Post-pubertal (>5 years) age groups. In new born kid the glands were small, white cord like. It became "?" shaped at 6 months and "S" shaped at 12 months of age. A significant growth in size and weight of gland occurred at 6 month, then up to 12 month and beyond it grew slowly. The secretory acini of the lobules were lined by pseudostratified ciliated columnar epithelium which contained A-tall columnar, B-basal and C-narrow columnar type of cells. The number per unit area and size of the gland increased with age significantly from birth in the prepubertal animals and up to puberty. In post-pubertal animals it did not grow significantly, rather the connective tissue elements were increased in the capsule (adventitia). The intralobular connective tissue however, decreased at the expense of growth of acini at all ages.

Se realizó un estudio de las glándulas vesiculares de 30 cabras Gaddi, macho, totalmente puras desde el nacimiento hasta los 5 años y 6 meses de edad, divididas en tres grupos de 10 animales cada uno, pre-puberal (día 1 de edad a <18 meses de edad), pubertad (18 meses a <5 años de edad) y post-puberal (> 5 años). En el recién nacido las glándulas eran pequeñas, como un cordón blanco. Se presentó en forma de "?" a los 6 meses y de "S" a los 12 meses de edad. Un importante crecimiento en tamaño y peso de la glándula se produjo a los 6 meses, luego de 12 meses y más, creció lentamente. Los acinos secretores de los lóbulos se alinearon como epitelio columnar ciliado pseudoestratificado, los cuales contienen células de tipo A-columnar alto, B-basal y C-columnar estrecho. El número por unidad de área y el tamaño de la glándula aumentó significativamente con la edad desde su nacimiento en los animales prepuberes y hasta la pubertad. En animales post-puberales no creció significativamente, y los elementos del tejido conectivo se incrementaron en la cápsula (adventicia). Sin embargo, el tejido conectivo intralobular, disminuyó a expensas del crecimiento de los acinos, en todas las edades.