Bilateral Nevus of Ota with Phakomatosis pigmentovascularis treated with 1064 nm picosecond laser: A Case Report

Nevus of Ota is an uncommon dermal melanosis in the Indian subcontinent and is rarely associated with capillary malformations, classified as type II phakomatosis pigmentovascularis (PPV). It usually presents unilaterally as mottled, slate blue, or dark bro wn macules; bilateral presentation is only seen in a few cases. A 20 - year female presented to Dermatology OPD of a tertiary hospital with bilateral nevus of Ota involving the cheeks, temples, nose, forehead, and sclera of the eyes for one year. She also ha d a port wine stain on the right arm, forearm, back, bittock, and thigh since birth without any other systemic involvement. We treated nevus of Ota with six sessions of 1064 nm picosecond laser every month at 0.8 J/cm 2 with significant improvement in the appearance of the lesions and no adverse effects. This case highlights the importance of thoroughly examining pigmented lesions for additional cutaneous findings and the potential use of a 1064 nm picosecond laser to tr eat such lesions.

Case Study of Ayurvedic Management of Spastic Cerebral Palsy

Cerebral palsy is a group of permanent, non-progressive motor impairment syndromes secondary to lesions or anomalies of the brain arising in the early stages of its development. It has a high prevalence rate of 2- 3 per 1000 children. Among the various types, spastic cerebral palsy remains the most common, affecting about 61% of all people with cerebral palsy. In Ayurveda, this could be taken as a Vata predominant condition and included as Sarvangavata. Vatavyadhi treatment like Snehana, Swedana, Shodana and Brimhana, along with supportive therapies could give wonderful results. An 8 ½-year-old boy, a known case of post meningeal hydrocephalus with spastic cerebral palsy was treated in the In-Patient Department of Government Ayurveda College, Thiruvananthapuram. He was treated based on the principle of Vatavyadhi chikitsa with various Ayurvedic medicines internally and appropriate Panchakarma procedures, along with physiotherapy and speech therapy. He has been assessed before and after the treatment using the Modified Ashworth Scale and Barthel Index, and noticeable improvement has been got. Here spastic cerebral palsy was managed solely using Ayurveda medicines, the apt Panchakarma procedures and supportive therapies. Significant improvements in the quality of life of the child was seen. Ayurveda treatments along with supportive therapies are highly effective in managing spastic cerebral palsy, thereby imparting a better standard of living.

Cataract surgery outcomes in pediatric patients with systemic comorbidities

Purpose: The aim of the study was to evaluate the outcomes of cataract surgery in patients of the pediatric age group with systemic comorbidities. Methods: Medical records of 54 eyes (30 patients) of the pediatric age group with systemic comorbidities who had undergone cataract surgery in a tertiary?care center were reviewed. The following parameters were recorded: systemic comorbidity; toxoplasmosis, rubella, cytomegalovirus, herpes simplex, HIV (TORCH) profile, best spectacle?corrected visual acuity (BSCVA), strabismus, nystagmus, and cataract morphology. Results: Thirty patients with a mean age of 55 months (9 months–14 years) were included. On average, every child was seen by three physicians, and the mean duration between the first visit to a physician and presentation to our center was 2.23 ± 0.67 years. The various causes for delay in referral include multiple referrals due to a lack of general anesthesia services in 78% of cases, a long waiting list at the referral hospital in 35% of cases, and a lack of awareness at the primary?care physician level in 50% of cases. The mean BSCVA at presentation was 1.4 logMAR (0.3 to 3 logMAR). The most common cataract morphology was that of zonular cataract (31.48%; 17/54). Strabismus and abnormal eye movements were observed in 27.7% (15/54) and 33.3% (18/54) of eyes, respectively. Various systemic associations were periventricular leukomalacia (12/30), Down’s syndrome (6/30), seizure disorder (6/30), cardiac valvular anomalies (6/30), Marfan’s syndrome (4/30), hypothyroidism (4/30), rubella (3/20), cytomegalovirus (3/20), cerebral palsy (2/30), nephrotic syndrome (2/30), Type 1 diabetes mellitus (1/30), microcephaly (1/30), cryptogenic West syndrome (1/30), congenital rubella syndrome (1/30), and Tourette syndrome (1/30). The mean postoperative corrected distance visual acuity (CDVA) at 2?year follow?up improved to 1.0 logMAR (0 to 3 logMAR). No postoperative complications were reported at the final follow?up. Around 70% of the parents reported improvement in their child’s psychomotor skills. Conclusion: Intellectually impaired pediatric patients with cataract should be operated upon whenever there is a presence of infrastructure, and unnecessary delay in surgery should be avoided by referring the patient to higher centers. Even though objective improvement in visual acuity was suboptimal, there was definitely an improvement in the psychomotor skills of the patients.

Outcomes of surgical intervention in cases of ectopia lentis

Purpose: To evaluate the outcomes of surgical intervention in cases of ectopia lentis. Methods: This retrospective study included all cases of ectopia lentis that presented between June 2015 and March 2019 in a tertiary care center. They were reviewed retrospectively. The corrected distance visual acuity (CDVA), severity of lens subluxation, type of surgery, intra?operative and post?operative complication, and specular count were recorded. Results: Seventy?eight eyes of 57 cases with a mean age at surgery of 14.73 years were analyzed. Intra?lenticular lens aspiration was the most common (n?62/78; 79.5%) surgical procedure followed by lens aspiration, intra?capsular cataract extraction, phaco?aspiration, and pars?plana lensectomy. Simultaneous intra?ocular lens (IOL) implantation was performed in 46.2% (n?32/78) of the eyes. The mean CDVA improved from 0.85 ± 0.55 logMAR to 0.44 ± 0.29 logMAR at 6 weeks follow?up. The post?operative CDVA was significantly better in the pseudo?phakic group compared to the aphakic group (p?0.02). The patient’s age at the time of surgery and the degree of subluxation did not impact the final visual outcome. Intra?operative complication included vitreous hemorrhage (n?1) and lens matter drop (n?1). Post?operative complications were noted in 26.9% of the eyes (n?21/78) with a higher complication rate in the pseudo?phakic group (p?0.00). A second intervention was required in 7.7% of the eyes (n?6/78). Conclusion: Age and degree of subluxation at the time of surgery do not influence the final visual outcome in cases of ectopia lentis undergoing lens extraction surgery. IOL implantation results in better visual outcomes but is associated with a high complication rate.

Ocular manifestations in Kindler syndrome

We aimed describe the chronic ocular sequelae of Kindler syndrome. All cases of Kindler syndrome with ocular involvement that presented to a tertiary eye care center were included. Three cases of Kindler syndrome with ocular changes were reviewed. Case 1 (10 years, female) had recurrent epithelial breakdown with severe dry eye and corneal opacity secondary to keratitis. Case 2 (28 years, male) had symblepharon , ocular surface keratinization , and severe dry eye. Case 3 (16 years , female ) had partial limbal stem cell deficiency with dry eye. All cases were treated with topical lubricants, short course of low?potency steroids and immuno?modulators. Attention must be paid to the eye in addition to the oro?an?genital mucosa to avoid longterm ocular sequelae

Ginseng used for bone tissue scaffold

The scaffold based tissue engineering materialized for bone tissue therapy. Gelatin-glutaraldehyde cross linked scaffold was prepared by solvent casting -porogen leaching method. It was characterized by FTIR and SEM microphotograph analysis. Absence of peak at waves no. 1625 cm?1 in ATR-FTIR indicated formation of cross-linking. FE-SEM micrograph showed honeycomb pad like structure with high porosity. Methanolic extract of Withania somnifera (Ashwagandha) root extract induced MC3T3 E1 osteoblast cell adhesion and proliferation on porous gelatin scaffold. GC-MS analysis pointed out presence of 4-amino- 2-ethyl-3-methylquinoline, an active phyto-chemicals having tissue regeneration potential. High anti-oxidant capacity down regulates cell death mechanism by scavenging free radical. The biocompatible gelatin scaffold has RGD moiety that attune the MC3T3 E1 osteoblast cell adhesion. Withania somnifera root extract may boost up cell proliferation on scaffold. Therefore treatment with Withania somnifera root extract may be the new approaches for designing bone tissue scaffold for bone tissue therapy.

Mutations in SARS-CoV-2 viral RNA identified in Eastern India: Possible implications for the ongoing outbreak in India and impact on viral structure and host susceptibility

Direct massively parallel sequencing of SARS-CoV-2 genome was undertaken from nasopharyngeal andoropharyngeal swab samples of infected individuals in Eastern India. Seven of the isolates belonged to the A2aclade, while one belonged to the B4 clade. Specific mutations, characteristic of the A2a clade, were alsodetected, which included the P323L in RNA-dependent RNA polymerase and D614G in the Spike glycoprotein. Further, our data revealed emergence of novel subclones harbouring nonsynonymous mutations, viz.G1124V in Spike (S) protein, R203K, and G204R in the nucleocapsid (N) protein. The N protein mutationsreside in the SR-rich region involved in viral capsid formation and the S protein mutation is in the S2 domain,which is involved in triggering viral fusion with the host cell membrane. Interesting correlation was observedbetween these mutations and travel or contact history of COVID-19 positive cases. Consequent alterations ofmiRNA binding and structure were also predicted for these mutations. More importantly, the possibleimplications of mutation D614G (in SD domain) and G1124V (in S2 subunit) on the structural stability of Sprotein have also been discussed. Results report for the first time a bird’s eye view on the accumulation ofmutations in SARS-CoV-2 genome in Eastern India.

A Comparative Study Regarding Knowledge of Hand Hygiene amongst Medical and Nursing Students in a Tertiary Care Hospital of West Bengal.

Unfortunately, infections acquired during receiving health care contribute significantly in morbidity and mortality worldwide and hands are the principal mode of germ transmission in all health care facilities. Therefore, hand hygiene is the most useful intervention to curb the spread of harmful germs and avert health care-associated infections (HCAIs). But, health care providers very poorly comply with standard practices of hand hygiene. There is a paucity of studies which looks at the knowledge of standard hand hygiene precautions among medical and nursing students in eastern India. This study was conducted to assess and compare level of knowledge amongst medical and nursing students and to identify gaps in their knowledge.METHODSThis cross sectional study was performed by selecting 95 Second Professional MBBS students and 31 first year B.Sc. Nursing students with verbal consent and their level of knowledge was assessed with WHO hand hygiene questionnaire and analysed using percentages.RESULTSOut of total 27 questions asked, only 13 questions were answered correctly by more than 50% students of both groups but only 7 and 5 questions were correctly responded by more than 75% nursing and medical students respectively. Nursing students were significantly more aware in response to 5 questions whereas medical students outperformed their counterpart in only 3 questions. This study revealed that definitely there was a gap in the knowledge regarding hand hygiene amongst medical and nursing students but still comparatively nursing students were more knowledgeable in this field.CONCLUSIONSRepeated hand hygiene training sessions with monitoring and immediate performance feedback to generate awareness amongst students and to provide the current knowledge regarding prevention of HCAIs are the need of the hour.

Comparative Study of in vivo Gastrointestinal Absorption of Mustard Oil Emulsions Prepared with Different Types of Medium Chain Fatty Acids

Absorption of dietary fats is generally in the form of emulsions. The present study assessed the preparation and gastrointestinal absorption efficiency of three emulsions of mustard oil containing three types of medium chain fatty acids (MCFAs) in a rat model. Methods: Caprylic acid (C8:0), capric acid (C10:0) and lauric acid (C12:0) were chosen as the MCFAs. Mustard oil emulsions were formulated using each of the MCFAs and lecithin as an emulsifier. The characteristics of the formulations including optical microscopy, particle size, zeta potential analysis and viscosity studies were assessed. Thereafter the intestinal digestion patterns of the three MCFA rich mustard oil emulsions were compared using a single pass perfusion test. Results: The particle size of the emulsions varied between 212.70 nm and 312.70 nm. Physical characterisation such as a zeta potential study confirmed that all emulsions were thermodynamically stable. The absorption study was monitored at 30 min intervals of up to 2 h The absorption of C8:0 emulsion was found to be maximum (27.78%) followed by C10:0 emulsion (24.81%) and C12:0 emulsion (22.50%). The differences in absorption efficiency of the emulsions could be attributed to the smaller chain length of C8:0 which was more rapidly absorbed by the intestine. Conclusion: In vivo gastrointestinal absorption of MCFA rich mustard oil emulsions was compared; caprylic acid-rich mustard oil showed the highest absorption rate in comparison to the other two emulsions. Further in vivo studies are required to establish the mechanism of absorption of structured lipids containing MCFAs.

Value addition of corn husks through enzymatic production of xylooligosaccharides

ABSTRACT Corn husks are the major wastes of corn industries with meagre economic significance. The present study was planned for value addition of corn husk through extraction of xylan, followed by its enzymatic hydrolysis into xylooligosaccharides, a pentose based prebiotic. Compositional analysis of corn husks revealed neutral detergent fibre 68.87%, acid detergent fibre 31.48%, hemicelluloses 37.39%, cellulose 29.07% and crude protein 2.68%. Irrespective of the extraction conditions, sodium hydroxide was found to be more effective in maximizing the yield of xylan from corn husks than potassium hydroxide (84% vs. 66%). Application of xylanase over the xylan of corn husks resulted into production of xylooligosaccharides with different degree of polymerization namely, xylobiose and xylotriose in addition to xylose monomer. On the basis of response surface model analysis, the maximum yield of xylobiose (1.9 mg/ml) was achieved with the enzymatic hydrolysis conditions of pH 5.8, temperature 44°C, enzyme dose 5.7U/ml and hydrolysis time of 17.5h. Therefore, the corn husks could be used as raw material for xylan extraction vis a vis its translation into prebiotic xylooligosaccharides.

rare case of sudden-onset respiratory distress in an infant

Chylothorax is an unusual cause of pleural effusion after the neonatal period in children without a previous history of cardiothoracic surgery. Determination of the causes of this condition can be often challenging. Herein, we present a case of a 6-month-old male infant, presenting with sudden severe breathlessness, which was later diagnosed as spontaneous left-sided chylothorax

Under-nutrition among adolescents: A survey in five secondary schools in rural Goa.

Background. This study was done in 2008–09 to assess the nutritional status among adolescents (10–19 years of age, Classes V–XII) in 5 schools in rural Goa to inform the content of a health promotion intervention in these schools. Methods. Three methods were used. First, nutritional status was measured by assessing body mass index among 1015 students during a health camp in each school. Second, a diet analysis was done to measure energy and protein intake of 76 randomly selected underweight students. Third, a selfreport questionnaire survey measured the prevalence of hunger among 684 students. Results. One-third of students (338; 37.8% boys and 27.5% girls) who attended the health camps were underweight and 59.2% of the 684 students who completed the survey reported experiencing hunger due to inadequate food consumption. More boys were underweight than girls (p<0.001) and under-nutrition was uniform across all the years of schooling. Energy intake of underweight students was significantly lower than the recommended daily allowance. The results were shared with the School Health Promotion Advisory Boards to generate information on the stakeholders’ perception about the issue and ways to address it. Conclusion. There is an immediate need to address the high burden of hunger and under-nutrition in adolescents of both sexes in schools by instituting routine annual monitoring of nutritional status, extending the mid-day meal programme to all school-going adolescents, providing nutritional counselling for underweight adolescents and expanding research on the causes and impact of under-nutrition and evaluation of the impact of the enhanced mid-day meal programme.

Reported willingness and associated factors related to utilization of voluntary counseling and testing services by female sex workers in Shandong Province, China / 生物医学与环境科学（英文）

<p><b>OBJECTIVE</b>To explore reported willingness and factors associated with utilization of voluntary counseling and testing services by female sex workers (FSWs) in China and to offer recommendations to optimize use of such services.</p><p><b>METHODS</b>A questionnaire to explore willingness to use VCT was designed based on social ecological theory and formative qualitative research. A cross-sectional survey was conducted among FSWs from entertainment venues. Single and multiple logistic regression analyses were employed to examine factors associated with reported willingness to utilize VCT.</p><p><b>RESULTS</b>A total of 970 FSWs provided valid questionnaires, with 69% (669) expressing willingness to utilize VCT. Factors at the interpersonal level associated with reported willingness included knowledge about VCT, desire to get help if diagnosed as HIV positive, ability to imagine life after an HIV positive diagnosis, and perceived support for VCT from peers, managers, and family members. Availability of free antiretroviral (ARV) treatment represented a factor at policy level. Other factors included intention to leave sex work in the near future, having had a previous HIV test, and lack of a suspected STD history.</p><p><b>CONCLUSIONS</b>The rate of reported willingness to use VCT among FSWs was substantially higher than that of actual VCT utilization (11%). The next step is to explore the connection between reported willingness and actual use. Based on these findings, peer education, VCT knowledge dissemination, and free ARV treatment should be emphasized to increase FSWs' willingness to use VCT.</p>

Diagnosis of leptospirosis by recombinant antigen based single serum dilution ELISA.

BACKGROUND & OBJECTIVES: Leptospirosis, a zoonosis with a worldwide distribution is an acute febrile illness caused by spirochaetes of the pathogenic Leptospira interrogans. Microscopic agglutination test (MAT), the reference method for diagnosis was successively done to evaluate the modified ELISA which was developed with the recombinant LipL32 antigen for the detection of anti-leptospiral antibodies in human serum samples. METHODS: The recombinant LipL32 antigen was developed from the serovar Pomona strain Pomona of the pathogenic L. interrogans species. The predicted titre at a single working dilution was plotted against the observed antiserum titre. Subsequently, predicted antibody activity titres were determined directly from the standard curve by solving the regression line equation. The relative sensitivity, specificity and accuracy of the single dilution ELISA for the detection of anti-leptospiral antibodies were determined in comparison to the MAT. RESULTS: A linear relationship was found between the predicted antibody titres at a single working dilution of 1:250 and the corresponding observed serum titres by the standard serial-dilution method. Regression analysis was used to determine a standard curve from which an equation was derived that allowed demonstration of the mentioned correlation. The equation was then used to convert the corrected absorbance readings of the single working dilution directly into the predicted ELISA antibody titres. A high level of sensitivity of 96 per cent and specificity of 91 per cent between ELISA and MAT titres was found. The kappa value was almost 1.0 indicating perfect agreement. INTERPRETATION & CONCLUSIONS: The r LipL32 ELISA was proved to be sensitive, specific and accurate as compared to the standard MAT and the test could be efficiently utilized as a screening test for a large number of human serum samples for the detection of leptospiral antibodies.

Protective effect of ascorbic acid against oxidative stress induced by inorganic arsenic in liver and kidney of rat.

Ascorbic acid treatment in arsenic trioxide treated rats increased arsenic excretion, inhibited lipid peroxidation, improved GSH status, regulated GSSG turnover and also restored glutathione-S-transferases activity in liver and kidney. Suitable mechanisms leading to ascorbic acid protection have been discussed. Upregulation of GSH dependent enzymes was found to be necessary for a protective effect. Protection is finally attributed to higher GSH levels observed in the liver and kidney of ascorbic acid and inorganic arsenic treated rats. It is also concluded that ascorbic acid protection is influenced by gender dependent factors. Arsenic poisoning is a global problem now. Gender differences need to be considered while applying therapeutic measures.

Amelioration of arsenic toxicity by L-Ascorbic acid in laboratory rat.

A study so as to confirm the protective effects of L-ascorbic acid against inorganic arsenic (As23) toxicity was made in male Wistar rats. Multiphase observations made on iAs concentration in target organs viz. liver and kidney, liver function, histopathological changes, ultrastructural alterations, lipid peroxidation, oxidative stress and iAs-DNA interaction strongly favoured its ameliorative effects. These effects could mainly be attributed to its antioxidative property. It offers help in regeneration of GSH and alpha-tocopherol. The chelaticn of iAs by ascorbic acid has also been hypothesized. Inhibition of DNA damage by ascorbic acid in liver and kidney appears to be the most significant part of this study On the basis of these results, we conclude that administration of L-ascorbic acid to arsenic affected population may prevent the occurrence of fatal human diseases.