Exploring various novel diagnostic and therapeutic approaches in treating diabetic retinopathy.

Diabetic retinopathy is regarded as a common manifestation of diabetes mellitus, being a prominent cause of visual impairment and blindness. This microvascular complication is marked by the appearance of microaneurysms, elevated vascular permeability, capillary blockage, and proliferation of neovasculature. The etiology behind retinopathy is ambiguous and the efficacy of current treatment strategies is minimal. Early diagnosis of this complication using a biomarker with high sensitivity and specificity is very essential for providing better therapeutic strategies. The current available therapeutic options are limited with various adverse effects. Laser treatment is not beneficial in all the situations, economic constraints being the major challenge. Surgical interventions are employed when pharmacotherapy and laser treatment fail. New pharmacological treatments are becoming a necessity for treating the condition. This review highlights the use of various diagnostic tools, emerging biomarkers for early detection of diabetic retinopathy, pathological mechanisms associated with the disease, current therapeutic approaches used and future strategies for more enhanced treatment options and more potent pharmacological actions.

Microneedling in Combination With 15% Trichloroacetic Acid Peel Versus 25% Pyruvic Acid Peel in the Treatment of Acne Scars.

BACKGROUND: Acne scars are a permanent disfiguring sequel of acne. OBJECTIVE: To compare the efficacy of microneedling with 15% trichloroacetic acid (TCA) peel versus microneedling with 25% pyruvic acid peel in the management of postacne scars. MATERIAL AND METHODS: Thirty patients with atrophic acne scars were randomized into 2 groups receiving microneedling on both sides of the face at 0,6, and 12 weeks and 15% TCA on one side and 25% pyruvic acid on other side at 3,9, and 15 weeks. Acne scar scoring performed using the Echelle D'Evaluation Clinique des Cicatrices D'Acne (ECCA) and visual analogue scales by patient and physician were used to grade improvement at all visits and at 21 weeks. RESULTS: The mean ECCA score on the TCA side declined from 151.17 ± 26.90 to 138.83 ± 30.56 and on the pyruvic side declined from 151.83 ± 27.53 to 141.33 ± 28.92 after 21 weeks (statistically significant: p-value <.05). Comparing the ECCA on the TCA and pyruvic sides at 21 weeks was not significant. VAS showed moderate-to-marked improvement after 3 months in both groups. CONCLUSION: In our study, the combination modality showed early reduction in rolling and boxcar compared with icepick scars. These peels led to improvement in overall texture of the skin, hence more patient satisfaction. On comparing ECCA, a significant difference was not observed.

A comparative interventional study of narrowband ultraviolet B alone and narrowband ultraviolet B in combination with microneedling in patients with stable vitiligo.

BACKGROUND: Vitiligo is a cosmetically concerning common disorder of depigmentation. Narrowband Ultraviolet B (NB-UVB) phototherapy is a well-established mode of treatment for vitiligo. Microneedling is a simple method that has been used for vitiligo treatment in adjunct with NB-UVB and has been shown to induce repigmentation in a few studies; however, there is limited study in the literature. AIMS: To compare the efficacy of NB-UVB alone versus NB-UVB in conjunction with microneedling in patients of stable vitiligo. METHODS: Thirty patients of non-segmental vitiligo with patches tending toward symmetry, stable for at least 6 months were included. Patches on right side of body (side A) were subjected to both microneedling every 2 weeks and NB-UVB three times a week, while patches on left side of body (side B) were subjected to NB-UVB alone thrice weekly for 4 months or till complete resolution of lesions whichever was earlier. Patients were followed up for another 2 months. Response was assessed by photographic record and Vitiligo Area Severity Index (VASI score) calculated at baseline and every month for 6 months. RESULTS: The mean VASI score improvement in both the groups as compared to baseline was statistically significant (p-value < .01). However, the difference in mean VASI scores between the two groups was not statistically significant (p-value = .17). CONCLUSION: NB-UVB is an effective modality for treatment of vitiligo, but there is no additional benefit of combining microneedling with it.

GIS-based evaluation of groundwater geochemistry and statistical determination of the fate of contaminants in shallow aquifers from different functional areas of Agra city, India: levels and spatial distributions.

The quality of groundwater is very important in Agra because groundwater is the main source of water for drinking, domestic, agricultural and industrial uses. A groundwater geochemistry study was conducted in Agra where 28 samples were collected from shallow aquifers in May 2016 from different sites. The aim of this research was to assess the quality of groundwater for drinking purposes in the study area. Arc-GIS has been used to prepare geographic information system-based spatial distribution maps of different major elements. The groundwater quality was analyzed for various physico-chemical parameters, major cations and anions and some trace metals. The observed values were compared with BIS and WHO standards. Statistical parameters such as the mean, median, standard deviation, skewness and kurtosis were used to analyze the hydrogeochemical characteristics of the groundwater. Correlation coefficient analysis and principal component analysis (PCA) were performed to identify the sources of the water constituents. Our results showed that most of the samples exceeded the acceptable limit for drinking water standards. The sequence of abundance of the main cations was generally Na+ > Ca2+ > Mg2+ > K+, while the anions in order of abundance were HCO3 - > Cl- > SO4 2- and NO3 - > F-. All of the trace metals were within the permissible limit except for iron and manganese. The hazard index value of 5.7 × 10-2 indicated that there was no potential health risk in the study area. Ca2+, Mg2+, Cl- and SO4 2- were the dominant hydrogeochemical facies in the majority of the groundwater samples. Most of the parameters such as TDS, Cl-, HCO3 -, SO4 2-, NO3 -, Ca2+, Mg2+, Na+, K+ and TH showed strong correlations with each other, which were due to natural processes such as weathering, exchangeable ions and reduction/oxidation, as well as anthropogenic activity around the study area. The water quality index indicated that the water quality was poor at 46.43% of the sampling sites, very poor at 28.57% of the sites and unsuitable for drinking purposes at 25% of the sampling sites. Gibbs diagrams suggested rock weathering as a major driving force for controlling the groundwater chemistry in the study area, along with evaporation as a minor influence.

A biodegradable adamantane polymer with ketal linkages in its backbone for gene therapy.

In this report we present a polyketal, termed pADK, which has adamantane groups embedded in its backbone, and degrades into neutral excretable compounds. pADK was synthesized via click chemistry and had a MW of 49 472 and a PDI of 1.74. We demonstrate here that pADK can increase the transfection efficiency of CD1800 (PEI of 1800 modified ß-cyclodextrin) 60 fold, yet cause no increase in toxicity.