Primary eyecare in paediatrics population (PREPP) - II study: Study of satisfaction of services and barrier for not reporting to the base hospital on referral among pediatric patients treated in six major vision centers of a tertiary eye care facility in Southern India.

PURPOSE: This study was conducted in continuation of Primary Eyecare in Paediatrics Population (PREPP-I) and was aimed to assess parents' satisfaction with pediatric-eye-care services across six vision centers (VCs) of a tertiary eye hospital in Southern India. The barriers among the parents for not attending the base hospital (BH) when referred from these VCs were also evaluated. METHODS: A standard-validated-satisfaction questionnaire (VSQ) was used to assess patient satisfaction. Responses were assessed on a 5-point Likert scale: 0 (very dissatisfied) to 4 (very satisfied) against each response. Responses were expressed as percentages with 0 (very dissatisfied) and 100% (very satisfied). Patients were referred with a form mentioning reasons for referral (urgent/non-urgent). All referrals were evaluated by the principal investigator. In case of failure to report, parents were enquired about the barrier based on the validated barrier questionnaire (VBQ) over a telephonic conversation. RESULTS: All 250 patients of the PREPP-1 study were included in the satisfaction study. Different domains were evaluated using VSQ (accessibility of VC, waiting hours, financial aspects, spectacle dispensing service, and teleophthalmology). The overall satisfaction was 75%. The most common reason for dissatisfaction was the lack of meeting the ophthalmologist in person, followed by waiting time. 58 patients wanted to visit BH to consult a pediatric ophthalmologist in person (23%). For the barrier study, 14 out of 47 referrals did not report and were evaluated using VBQ (knowledge, physical, time, and financial barriers). The majority had a financial barrier (43%), followed by knowledge (28.6%) and time barrier (14%). CONCLUSION: PREPP-II demonstrated that 3/4 th of pediatric patients are happy to be treated at VC with teleophthalmology services. However, a significant percentage want to consult a specialist at BH. One-fourth of total referrals did not report to BH due to financial constraints and a lack of awareness of the child's condition.

No significant difference in thick versus thin osteochondral flap trochleoplasty in the treatment of trochlear dysplasia: A systematic review.

PURPOSE: Trochleoplasty has become increasingly utilised to address patellar instability in the setting of severe trochlear dysplasia. There remains a paucity of literature on the outcomes of 'thick'- versus 'thin'-osteochondral flap trochleoplasty. The purpose of this study is to compare clinical and radiographic outcomes between patients with patellar instability with symptomatic trochlear dysplasia treated using a 'thick' versus 'thin' osteochondral flap trochleoplasty. METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines using a PRISMA checklist. Quality assessment of final articles was conducted by two blinded reviewers. Articles were separated based on the use of a 'thick' versus 'thin' flap trochleoplasty. Data collection consisted of recording the following variables: patient demographics, indications for trochleoplasty, mean follow-up time, additional procedures performed during trochleoplasty, patient-reported outcome measures (PROMs), radiographic outcomes (tibial tubercle-trochlear groove [TT-TG] distance, Caton-Deschamps Index [CDI] and sulcus angle [SA]) and the incidence of any postoperative complications and patellar redislocation rates. RESULTS: A total of 24 studies, consisting of 927 patients, were identified as meeting inclusion criteria. A total of five papers described a 'thick' flap technique, while 19 papers described the use of a 'thin' flap technique. No significant difference in the mean improvement of Kujala scores was appreciated when comparing 'thick' versus 'thin' techniques (p > 0.05). Improvements in mean radiographic outcomes based on TT-TG, CDI and SA were observed in both 'thick' and 'thin' flap trochleoplasty groups. The overall redislocation rate was 0.35%. CONCLUSION: No significant difference in Kujala scores was observed in patients undergoing trochleoplasty utilising 'thick' versus 'thin' technique, while improvements in mean TT-TG, CDI and SA were noted in both technique groups, with an overall redislocation rate of 0.35%. LEVEL OF EVIDENCE: Level IV.

Genetic variations in tumor-suppressor miRNA-encoding genes and their target genes: focus on breast cancer development and possible therapeutic strategies

MicroRNAs (miRNAs) negatively affect gene expression by binding to their specific mRNAs resulting in either mRNA destruction or translational repression. The aberrant expression of various miRNAs has been associated with a number of human cancer. Oncogenic or tumor-suppressor miRNAs regulate a variety of pathways involved in the development of breast cancer (BC), including cell proliferation, apoptosis, metastasis, cancer recurrence, and chemoresistance. Variations in miRNA-encoding genes and their target genes lead to dysregulated gene expression resulting in the development and progression of BC. The various therapeutic approaches to treat the disease include chemotherapy, radiation therapy, surgical removal, hormone therapy, chemotherapy, and targeted biological therapy. The purpose of the current review is to explore the genetic variations in tumor-suppressor miRNA-encoding genes and their target genes in association with the disease development and prognosis. The therapeutic interventions targeting the variants for better disease outcomes have also been discussed (AU)

Genetic variations in tumor-suppressor miRNA-encoding genes and their target genes: focus on breast cancer development and possible therapeutic strategies.

MicroRNAs (miRNAs) negatively affect gene expression by binding to their specific mRNAs resulting in either mRNA destruction or translational repression. The aberrant expression of various miRNAs has been associated with a number of human cancer. Oncogenic or tumor-suppressor miRNAs regulate a variety of pathways involved in the development of breast cancer (BC), including cell proliferation, apoptosis, metastasis, cancer recurrence, and chemoresistance. Variations in miRNA-encoding genes and their target genes lead to dysregulated gene expression resulting in the development and progression of BC. The various therapeutic approaches to treat the disease include chemotherapy, radiation therapy, surgical removal, hormone therapy, chemotherapy, and targeted biological therapy. The purpose of the current review is to explore the genetic variations in tumor-suppressor miRNA-encoding genes and their target genes in association with the disease development and prognosis. The therapeutic interventions targeting the variants for better disease outcomes have also been discussed.

Deciphering the role of KRAS gene in oncogenesis: Focus on signaling pathways, genetic alterations in 3'UTR, KRAS specific miRNAs and therapeutic interventions.

Cancer is a significant cause of death after cardiovascular disease. The genomic, epigenetic and environmental factors have been found to be the risk factor for the disease. The most important genes that develop cancer are oncogenes and tumor suppressor genes. Among oncogenes, KRAS has emerged as a significant player in the development of many cancers. Dysregulation of the RAS signaling pathway either on account of mutation in significant genes involved in the pathway or aberrant expression of different miRNAs targeting these genes including KRAS. The focus is also on the alterations in 3'UTR of the KRAS gene sequence as well as the changes in the miRNA encoding genes especially the one targeting the KRAS gene. Efforts are also being put in to target the dysregulated KRAS gene as a therapeutic approach to treat different cancers. However, there are some challenges like resistance to KRAS inhibitors that need to be addressed.

Traumatic posterior sternoclavicular joint dislocation - Current aspects of management.

The posterior sternoclavicular joint dislocation is a rare and potentially life-threatening injury, as massive haemorrhage can occur at the time of trauma, during reduction manoeuvres and drilling. These injuries are rare and a collective experience of managing them is of paramount importance. We present our multidisciplinary experience of managing several of these injuries in our centre, with learning points we have identified. Assessment should include Computerised Tomography Angiography (CTA) to assess the anatomy of the joint including the proximity to the underlying innominate vein and to identify any bleeding. Both closed reduction and open reconstruction have the potential for massive haemorrhage which can be controlled successfully with direct access to the underlying vessel. We recommend that all reductions should be performed in the presence of a cardiothoracic surgeon who can gain vascular control in the head, neck, and thorax. In specific high-risk cases, pre-emptive venous catheterisation can also be considered. We recommend that a discussion and rehearsal for intra-operative bleeding should be undertaken with the whole theatre team, with roles assigned pre-emptively and to allow identification of any deficiencies in staff expertise or equipment. Of the five recent cases managed in our centre one patient had a closed reduction and four had open reductions. Success of closed reductions within 48 h is high and these can be attempted up to 10 days after injury. Our patient undergoing closed reduction had a favourable outcome and returned to professional rugby at five months. Open reduction was performed in a physeal fracture as there was a delay to surgery and callus had begun to form and had the potential to adhere to the underlying vessel. In this case we performed open reduction and stabilised with tunnelled suture fixation. Our preferred method of reconstruction uses a palmaris graft with internal figure of eight bracing. One patient had a subsequent fracture of the medial clavicle around the drill holes that healed without further intervention. Despite good reduction and stability achieved following palmaris reconstructions, two patients are experiencing ongoing symptoms of globus and one with voice change without any objective underlying cause.

Projected climate extremes over agro-climatic zones of Ganga River Basin under 1.5, 2, and 3° global warming levels.

Recurring floods, droughts, heatwaves, and other hydro-meteorological extreme events are likely to be increased under the climate change scenarios. The increased risk of these extreme events might have more exposure to the population; thus, it is important to discuss such extreme events and their projected behavior under a changing climate scenario. In the present study, we have computed the extreme precipitation and temperature indices over the 10 agro-climatic zones falling under the Ganga River Basin (GRB)utilizing a high-resolution daily gridded temperature and precipitation multi-model ensembled CMIP6 dataset (0.25° × 0.25°) under global warming levels of 1.5 °C, 2 °C, and 3 °C. We found that the annual daily minimum temperature (TNN) showed a higher rise of about 67% than the maximum temperature (TXX) of 48% in GRB. The basin also experiences a greater increase in the frequency of warm nights (TN90P) of about 67.71% compared to warm days (TX90P) of 29.1% for the 3 °C global warming level. Along with extreme indices, the population exposed due to the impact of the extreme maximum temperature has also been analyzed for progressive warming levels. Population exposure to extreme temperature event (TXX) has been analyzed with 20-year return period using GEV distribution method. The study concludes that the exposed population to extreme temperature event experienced an increase from 46.99 to 52.16% for the whole Ganga Basin. Consecutive dry days (CDD) and consecutive wet days (CWD) both show a significant increasing trend, but CWD has a significant increase in the majority of the zones, while CDD shows a significant decreasing trend for some of the zones for three warming levels periods. Extreme climate indices help to understand the frequency and intensity of extreme weather events such as heavy rainfall, droughts, and heatwaves to develop early warning systems and adaptation strategies to mitigate such events.

Zinc-solubilizing Bacillus spp. in conjunction with chemical fertilizers enhance growth, yield, nutrient content, and zinc biofortification in wheat crop.

Micronutrient deficiency is a serious health issue in resource-poor human populations worldwide, which is responsible for the death of millions of women and underage children in most developing countries. Zinc (Zn) malnutrition in middle- and lower-class families is rampant when daily calorie intake of staple cereals contains extremely low concentrations of micronutrients, especially Zn and Fe. Looking at the importance of the problem, the present investigation aimed to enhance the growth, yield, nutrient status, and biofortification of wheat crop by inoculation of native zinc-solubilizing Bacillus spp. in conjunction with soil-applied fertilizers (NPK) and zinc phosphate in saline soil. In this study, 175 bacterial isolates were recovered from the rhizosphere of wheat grown in the eastern parts of the Indo-Gangetic Plain of India. These isolates were further screened for Zn solubilization potential using sparingly insoluble zinc carbonate (ZnCO3), zinc oxide (ZnO), and zinc phosphate {Zn3(PO4)2} as a source of Zn under in vitro conditions. Of 175 bacterial isolates, 42 were found to solubilize either one or two or all the three insoluble Zn compounds, and subsequently, these isolates were identified based on 16S rRNA gene sequences. Based on zone halo diameter, solubilization efficiency, and amount of solubilized zinc, six potential bacterial strains, i.e., Bacillus altitudinis AJW-3, B. subtilis ABW-30, B. megaterium CHW-22, B. licheniformis MJW-38, Brevibacillus borstelensis CHW-2, and B. xiamenensis BLW-7, were further shortlisted for pot- and field-level evaluation in wheat crop. The results of the present investigation clearly indicated that these inoculants not only increase plant growth but also enhance the yield and yield attributes. Furthermore, bacterial inoculation also enhanced available nutrients and microbial activity in the wheat rhizosphere under pot experiments. It was observed that the application of B. megaterium CHW-22 significantly increased the Zn content in wheat straw and grains along with other nutrients (N, P, K, Fe, Cu, and Mn) followed by B. licheniformis MJW-38 as compared to other inoculants. By and large, similar observations were recorded under field conditions. Interestingly, when comparing the nutrient use efficiency (NUE) of wheat, bacterial inoculants showed their potential in enhancing the NUE in a greater way, which was further confirmed by correlation and principal component analyses. This study apparently provides evidence of Zn biofortification in wheat upon bacterial inoculation in conjunction with chemical fertilizers and zinc phosphate in degraded soil under both nethouse and field conditions.

Comprehensive analysis of culture conditions governing differentiation of MSCs into articular chondrocytes.

Treatment of osteoarthritic patients requires the development of morphologically and mechanically complex hyaline cartilage at the injury site. A tissue engineering approach toward differentiating mesenchymal stem cells into articular chondrocytes has been developed to overcome the drawbacks of conventional therapeutic and surgical procedures. To imitate the native micro and macro environment of articular chondrocytes, cell culture parameters such as oxygen concentration, mechanical stress, scaffold design, and growth factor signalling cascade regulation must be addressed. This review aims to illuminate the path toward developing tissue engineering approaches, accommodating these various parameters and the role these parameters play in regulating chondrogenesis for better articular cartilage development to treat osteoarthritis effectively.

Osteoarthritis is a common problem where the protective layer of cartilage on the joints wears away. It's difficult to treat with current methods. However, stem cell therapy is a promising alternative that has been researched a lot recently. Stem cells are special cells that can change into different types of tissue, including cartilage. Scientists are trying to figure out how to get these stem cells to grow into cartilage effectively. They are also trying to understand how stem cells find the right place in the body to go and do their job. By modifying the genes of stem cells and using special materials and growth factors, scientists hope to improve the effectiveness of stem cell therapy for osteoarthritis.

Acute abducens nerve palsy with acute disseminated encephalomyelitis-like presentation following COVID-19 vaccination.

We report two adult cases of abducens nerve palsy presenting immediately (within weeks) after they received the first dose of Covishield vaccination. Magnetic resonance imaging (MRI) of the brain obtained after the onset of diplopia demonstrated demyelinating changes. The patients had associated systemic symptoms. Post-vaccination demyelination typically known as acute disseminated encephalomyelitis (ADEM) associated with several vaccines is more common in children. Although the mechanism of the nerve palsy remains unclear, it is suspected to be related to the post-vaccine neuroinflammatory syndrome. Cranial nerve palsies and ADEM-like presentations may represent part of the neurologic spectrum following COVID-vaccination in adults, and ophthalmologists should be aware of these sequelae. Although cases of sixth nerve palsy following COVID vaccination are already reported, associated MRI changes have not been reported from India.

Oncogenic metabolic reprogramming in breast cancer: focus on signaling pathways and mitochondrial genes.

Oncogenic metabolic reprogramming impacts the abundance of key metabolites that regulate signaling and epigenetics. Metabolic vulnerability in the cancer cell is evident from the Warburg effect. The research on metabolism in the progression and survival of breast cancer (BC) is under focus. Oncogenic signal activation and loss of tumor suppressor are important regulators of tumor cell metabolism. Several intrinsic and extrinsic factors contribute to metabolic reprogramming. The molecular mechanisms underpinning metabolic reprogramming in BC are extensive and only partially defined. Various signaling pathways involved in the metabolism play a significant role in the modulation of BC. Notably, PI3K/AKT/mTOR pathway, lactate-ERK/STAT3 signaling, loss of the tumor suppressor Ras, Myc, oxidative stress, activation of the cellular hypoxic response and acidosis contribute to different metabolic reprogramming phenotypes linked to enhanced glycolysis. The alterations in mitochondrial genes have also been elaborated upon along with their functional implications. The outcome of these active research areas might contribute to the development of novel therapeutic interventions and the remodeling of known drugs.

Bacterial ACC deaminase: Insights into enzymology, biochemistry, genetics, and potential role in amelioration of environmental stress in crop plants.

Growth and productivity of crop plants worldwide are often adversely affected by anthropogenic and natural stresses. Both biotic and abiotic stresses may impact future food security and sustainability; global climate change will only exacerbate the threat. Nearly all stresses induce ethylene production in plants, which is detrimental to their growth and survival when present at higher concentrations. Consequently, management of ethylene production in plants is becoming an attractive option for countering the stress hormone and its effect on crop yield and productivity. In plants, ACC (1-aminocyclopropane-1-carboxylate) serves as a precursor for ethylene production. Soil microorganisms and root-associated plant growth promoting rhizobacteria (PGPR) that possess ACC deaminase activity regulate growth and development of plants under harsh environmental conditions by limiting ethylene levels in plants; this enzyme is, therefore, often designated as a "stress modulator." TheACC deaminase enzyme, encoded by the AcdS gene, is tightly controlled and regulated depending upon environmental conditions. Gene regulatory components of AcdS are made up of the LRP protein-coding regulatory gene and other regulatory components that are activated via distinct mechanisms under aerobic and anaerobic conditions. ACC deaminase-positive PGPR strains can intensively promote growth and development of crops being cultivated under abiotic stresses including salt stress, water deficit, waterlogging, temperature extremes, and presence of heavy metals, pesticides and other organic contaminants. Strategies for combating environmental stresses in plants, and improving growth by introducing the acdS gene into crop plants via bacteria, have been investigated. In the recent past, some rapid methods and cutting-edge technologies based on molecular biotechnology and omics approaches involving proteomics, transcriptomics, metagenomics, and next generation sequencing (NGS) have been proposed to reveal the variety and potential of ACC deaminase-producing PGPR that thrive under external stresses. Multiple stress-tolerant ACC deaminase-producing PGPR strains have demonstrated great promise in providing plant resistance/tolerance to various stressors and, therefore, it could be advantageous over other soil/plant microbiome that can flourish under stressed environments.

Arbuscular mycorrhizal fungi-mediated activation of plant defense responses in direct seeded rice (Oryza sativa L.) against root-knot nematode Meloidogyne graminicola.

Rhizosphere is the battlefield of beneficial and harmful (so called phytopathogens) microorganisms. Moreover, these microbial communities are struggling for their existence in the soil and playing key roles in plant growth, mineralization, nutrient cycling and ecosystem functioning. In the last few decades, some consistent pattern have been detected so far that link soil community composition and functions with plant growth and development; however, it has not been studied in detail. AM fungi are model organisms, besides potential role in nutrient cycling; they modulate biochemical pathways directly or indirectly which lead to better plant growth under biotic and abiotic stress conditions. In the present investigations, we have elucidated the AM fungi-mediated activation of plant defense responses against Meloidogyne graminicola causing root-knot disease in direct seeded rice (Oryza sativa L.). The study describes the multifarious effects of Funneliformis mosseae, Rhizophagus fasciculatus, and Rhizophagus intraradices inoculated individually or in combination under glasshouse conditions in rice plants. It was found that F. mosseae, R. fasciculatus and R. intraradices when applied individually or in combination modulated the biochemical and molecular mechanisms in the susceptible and resistant inbred lines of rice. AM inoculation significantly increased various plant growth attributes in plants with simultaneous decrease in the root-knot intensity. Among these, the combined application of F. mosseae, R. fasciculatus, and R. intraradices was found to enhance the accumulation and activities of biomolecules and enzymes related to defense priming as well as antioxidation in the susceptible and resistant inbred lines of rice pre-challenged with M. graminicola. The application of F. mosseae, R. fasciculatus and R. intraradices, induced the key genes involved in plant defense and signaling and it has been demonstrated for the first time. Results of the present investigation advocated that the application of F. mosseae, R. fasciculatus and R. intraradices, particularly a combination of all three, not only helped in the control of root-knot nematodes but also increased plant growth as well as enhances the gene expression in rice. Thus, it proved to be an excellent biocontrol as well as plant growth-promoting agent in rice even when the crop is under biotic stress of the root-knot nematode, M. graminicola.

Determining the Time Required to Achieve Clinically Significant Outcomes on the PROMIS Upper Extremity Questionnaire After Arthroscopic Rotator Cuff Repair.

Background: Clinically significant outcome (CSO) thresholds for the Patient-Reported Outcome Measurement Information System-Upper Extremity (PROMIS-UE) score have been previously defined after arthroscopic rotator cuff repair (RCR). However, the time required to achieve CSOs for the PROMIS-UE score is unknown. Purpose: To (1) determine the time required to achieve the minimal clinically important difference (MCID), substantial clinical benefit (SCB), and Patient Acceptable Symptom State (PASS) score thresholds after RCR for the PROMIS-UE questionnaire and (2) identify patient factors associated with earlier or delayed achievement of these clinical benchmarks. Study Design: Case-control study; Level of evidence, 3. Methods: A prospectively maintained institutional database was retrospectively reviewed for consecutive patients who underwent RCR between January 2018 and January 2019. Patients were included if they completed the PROMIS-UE questionnaire both preoperatively and at standardized postoperative time intervals: 5 to 7 months (6-month time point), 11 to 13 months (1-year time point), and ≥23 months (2-year time point). Kaplan-Meier survival curves with interval censoring were used to define the cumulative percentage of patients who achieved the MCID, SCB, and PASS. Patient variables associated with earlier or delayed achievement of the MCID, SCB, and PASS were determined using Weibull parametric survival regression analysis. Results: Included were 105 patients undergoing RCR (age, 57.3 ± 10.3 years; body mass index, 31.5 ± 6.1 kg/m2). By 2-year follow-up, the cumulative percentage of patients achieving the MCID, SCB, and PASS was 86.7%, 76.2%, and 74.3%, respectively. The mean time required to reach the MCID, SCB, and PASS score thresholds was 9.5 ± 3.8, 10.3 ± 4.4, and 9.8 ± 4.6 months, respectively. Factors associated with delayed achievement of CSOs included greater baseline PROMIS-UE score (MCID and SCB) and workers' compensation insurance (PASS). Greater baseline PROMIS-UE scores were associated with earlier achievement of the PASS. Conclusion: Most patients achieved CSOs for the PROMIS-UE within 12 months of RCR. Patient-specific factors found to be associated with earlier or delayed achievement of CSOs can be used to inform patient discussions on the expected timeline for recovery after RCR.

Self-isolated MIMO antenna using mixed coupling by close coupling technique.

A self-isolated multiple-input-multiple-output (MIMO) antenna in a compact shared ground structure is proposed for 5G systems. The proposed MIMO antenna consists of customized M-pattern, closely coupled members. It benefits to attain good isolation of the targeted bandwidth transversely without additional de-coupling structures. It is discovered that the arm of M-pattern antenna members can cancel out the coupling on the system and achieve sound isolation among antenna members. A relevant matching circuit model is discussed to show how the suggested theory works in principle. The mixed couplings among antenna members neutralize by modifying the antenna shape with the help of electric and magnetic coupling and surface currents. The proposed self-isolated 2-member MIMO antenna demonstrates sound isolation superior to 15 dB transversely in the frequency bands dedicated to 5G NR: n48/n78 and long-term evolution (LTE) band 42/43/48/52 (3.2-3.98 GHz). Moreover, the proposed 2-member design structure has a scalability advantage. It is extended into an 8-members structure, where a pair of antennas located at each side of the frame offers orthogonality. The proposed 8-members M-pattern MIMO is validated using fabricated and simulated measurements. The investigational results show that the 8-members MIMO (M-shaped) system is effective in higher order MIMO antenna design and offers more than 20 dB isolation transversely in the frequency band 5G NR n48 and LTE band 42/43/52(3.29-3.66 GHz).

Primary eye care in pediatric population-I study (PREPP-I study): Demographic and clinical profile of pediatric patients treated in six major vision centers of a tertiary eye care facility in South India.

Purpose: The study intends to evaluate the demographic and clinical profile of pediatric patients (0-18 years) attending six vision centers (VCs) of a tertiary eye care facility in south India. Methods: This is a cross-sectional observation study conducted at six major peripheral VCs of a tertiary eye care facility in South India from June 20 to Dec 20. All children presenting at the VCs under a base hospital (BH) in Pondicherry, whose parents gave consent were included. Data were entered by the ophthalmic assistants in the VC and cross checked by the principal investigator at the BH. Results: A total of 250 pediatric patients were brought to the VCs during the study period, predominantly males (60.8%), with a mean age of 8.2 ± 4.5 years (0-18 years). Half of them were staying within 5 km from the VCs. Most children were escorted by their parents (88%), and the expenditure of travel to the VC was affordable for most of the parents (75%). Also, 53.6% of patients were in their primary school, while schooling had not started for 28% of children. Visual acuity (VA) could be assessed only for school-going children and older children due to lack of age-matched VA assessment tools. Most children (91.3%) had uncorrected VA better than or equal to 6/18 in the better eye, and approximately 3% had VA worse than 6/60. All patients had best corrected VA of 6/6-6/18 after cycloplegic refraction. Most children reported to the VC for allergic conjunctivitis (25%), followed by refractive error (13%) and squint (10.4%). Urgent referral to the BH was made for 47 children. Conclusion: Primary eye care in pediatric population-I (PREPP-I) showed that most children can be treated at the VCs and only one-fifth of the children require active intervention at higher referral centers. Further study on satisfaction of services provided for pediatric patients in these VCs and barriers of not reporting to the BH when referred are considered for the PREPP-II study.

Evaluation of Osmotolerant Potential of Halomonas sulfidaeris MV-19 Isolated from a Mud Volcano.

Salinity is one of the major challenges for cultivation of crops in a sustainable way because it severely affects plant growth and yield. Keeping this challenge in view, in the current study, a salt-tolerant Halomonas MV-19 was isolated from an extreme niche of mud volcano of Andaman Nicobar Island, India and identified on the basis of standard morphological, biochemical, and physiological tests and identified as Halomonas sulfidaeris strain MV-19 by 16S rRNA gene sequencing. The bacterium can grow on nutrient agar and nutrient broth supplemented with 3.5 M (≥ 20%) sodium chloride (NaCl). Sugar utilization assay revealed that H. sulfidaeris MV-19 utilizes only three sugars (dextrose, fructose, and mannose) from among twenty four tested sugars. The best growth of H. sulfidaeris MV-19 was observed in nutrient broth supplemented with 8% NaCl. When the broth was supplemented with dextrose, fructose, and mannose, the H. sulfidaeris MV-19 grew maximally in nutrient broth supplemented with 8% NaCl and 5% fructose. This strain produced exopolysaccharides (EPS) in nutrient broth supplemented with 8% NaCl and sugars (dextrose, fructose, and mannose). The EPS production was increased by 350% (three and half time) after addition of 5% fructose in nutrient broth compare with the EPS production in nutrient broth without supplemented with sugars. H. sulfidaeris MV-19 strain can produce EPS, which can help aggregate soil particle and reduced osmotic potential in soil, thus, be useful in alleviation of salinity stress in different crops cultivated in saline soils. The findings of the current investigation are expected to contribute towards effective abiotic stress management.

Ethnobotany, botany, phytochemistry and ethnopharmacology of the genus Thalictrum L. (Ranunculaceae): A review.

ETHNOPHARMACOLOGICAL RELEVANCE: Thalictrum (Ranunculaceae) is known for its important alkaloids which have been reported to exhibit various pharmacological activities, viz. antitumor, antimicrobial, antitussive, antiamebic, hypotensive effects, HIV antiviral, etc. Throughout the world, the plant has been used as a tonic, purgative, stimulant, aperient and is utilized in various systems of medicine in the treatment of various ailments like snake bite, jaundice, rheumatism, stomachache, wounds, swellings, uterine tumors, paralysis, joints pain, nervous disorders, toothache, diarrhea, piles, fever, peptic ulcer, ophthalmic, headache, diuretic, dyspepsia, convalescence, etc. AIMS OF THIS REVIEW: To bring together all the information regarding the botany, phytochemistry, ethnobotany and ethnopharmacology of Thalictrum and identify the gaps in the existing studies so that full medicinal potential of the genus can be realized. METHODS: Available literature on botany, geography, traditional uses, phytochemicals, and pharmacology was gathered by referring to library and electronic searches in PubMed, Science Direct, Google Scholar, relevant journals and books. RESULTS: A variety of phytochemicals like alkaloids, essential oils, glycosides, phenols and terpenoids have been reported from Thalictrum species. Alkaloids are the most dominant diverse group with 178 different types. The crude extracts and isolates exhibit a gamut of pharmacological activities, namely anticancer, antimalarial, antioxidant, antipyretic, anti-tumor, ant-influenza virus, contraceptive and immunosuppressive. Northalrugosidine, an alkaloid from T. alpinum shows in vivo antileishmanial activity. So far, cytotoxic effects of only three Thalictrum species, viz. T. dasycarpum, T. foliolosum and T. simplex have been reported. Thl isolated from T. simplex is found to be 50% toxic (CC50%) at the concentration ranging from 53 to 95 µM. CONCLUSIONS: Thalictrum has tremendous medicinal values used in many traditional systems of medicine. It has multiple chemical components and still there is scope to explore more. Multiple chemical constituents and its utilization signify its high demand in the drug markets or pharmaceutical companies. In depth phytochemical studies along with in vitro studies with respect to their active principles can help in tapping the full medicinal potential of the genus.

Obstetric and Maternal Outcomes After B-Lynch Compression Sutures: A Meta-Analysis.

This review article aimed to determine the obstetric and maternal outcomes after B-Lynch compression sutures to control atonic postpartum hemorrhage (PPH). This meta-analysis was performed after registering the protocol in the PROSPERO database with the registration number CRD42022355358. Two independent reviewers systematically searched electronic databases and search engines (PubMed, Cochrane Library, and Google Scholar) to retrieve published articles from inception to July 2022. The obstetric and maternal outcomes after the B-Lynch compression suture were computed using the random-effects model in pooled proportion with a 95% confidence interval (CI). Meta-regression analysis and subgroup analysis were performed to explain any source of possible heterogeneity. Quality assessment of the included studies was done using Joanna Briggs Institute (JBI) tools which are critical appraisal tools for systematic reviews and meta-analyses. This meta-analysis included a total of 30 studies involving 1,270 subjects. The pooled proportion of B-Lynch suture alone was 91% (95% CI = 82-97%). The combined proportion of B-Lynch suture plus another compression suture was 1% (95% CI = 0-3%), and the pooled proportion of B-Lynch suture plus vessel ligation was 3% (95% CI = 1-6%). The pooled proportions of PPH controlled and hysterectomies were 94% (95% CI = 91-97%, I2 = 65.3%) and 7% (95% CI = 4-10%, I2 = 72.13%), respectively. Therefore, B-Lynch suture (either alone or in combination with other techniques) is a simple and effective measure to control atonic PPH.