Casearia tomentosa fruit extracts exposed larvicidal activity and morphological alterations in Culex quinquefasciatus and Aedes albopictus under in vitro and semi field conditions.

Mosquitoes are notorious insects that transmit a wide range of infectious diseases, including zika, malaria, chikungunya, filariasis, and dengue. The overuse and incorrect application of synthetic pesticides to control mosquitoes has resulted in resistance development and environmental contamination, both of which have had a negative impact on human health. To address this issue, the larvicidal and pupicidal potential of acetone extract from Casearia tomentosa fruits was investigated. The extract was evaluated in a lab setting against all larval instars and pupa of Culex quinquefasciatus and Aedes albopictus, as well as against third instar larvae in a semi-field condition. Purified compounds through TLC were also tested against 3rd instar larvae of both mosquito and non-target organisms. The FT-IR and GC-MS analyses were used to characterise the extract. Morphological aberration caused by the acetone extract was observed using FESEM. The anal gills and respiratory siphon of both mosquitoes showed significant deformation from their normal state. 100 ppm was found to cause 100% larval mortality at 24 h of exposure in case of Cx. quinquefasciatus and at 72 h of exposure in Ae. albopictus larvae. After 72 h of exposure under in vitro conditions, the extract demonstrated considerable larvicidal activity with LC50 values of 38.33 and 47.56 against 3rd instar larvae of Culex quinquefasciatus and Aedes albopictus, respectively. The acetone extract can be considered as a highly effective mosquito larvicidal agent that is safe for the environment.

Developing ophthalmology in Cambodia.

Over 180,000 Cambodian people are blind and a further 10,000 suffer avoidable blindness each year. Ninety percent of this blindness is avoidable, 79% is curable and 11% is preventable. Three-quarters of this blindness is due to cataracts and the remainder is due to uncorrected vision, glaucoma, corneal scarring and pterygium. The Khmer Sight Foundation (KSF) is a charity reincarnated by Professor Sunil Shah and Sean Ngu. Its mission is to deliver a sustainable eye care model for the country. KSF takes a three pronged approach to this. It is working to develop sustainable eye-care within the country through building physical infrastructure. The second approach is to impact the current cataract backlog of over 300,000 patients with the aid of international support. Thirdly, KSF is paving the way for the next generation through the development of an optometry education programme and training of Cambodian ophthalmologists. Here we present the workings of KSF, clinical cases we have encountered and elaborate upon the future goals of this charity.

Do topical ocular antihypertensives affect Dacryocystorhinostomy outcomes: The Coventry experience.

BACKGROUND: It has been suggested that ocular antihypertensives are associated with an increased risk of nasolacrimal duct obstruction. This study aims to assess the effect of topical antihypertensive treatment on surgical outcomes for patients undergoing Dacryocystorhinostomy (DCR) with intubation. METHODS: Single centre, retrospective analysis of 170 operations carried out on 144 patients between January 2014 and January 2019. Statistical analysis of DCR failure rates comparing patients on topical ocular antihypertensive treatment and those not on any topical ocular antihypertensive treatment was carried out following medical case record analysis. RESULTS: 6.9% of patients undergoing DCR surgery were on topical antihypertensive treatment. The overall failure rate for all DCR operations during this time period was 11.2%. There was a statistically significant higher rate of primary DCR failure in patients on antihypertensive treatment (p = 0.02), with the endonasal DCRs worse affected (p = 0.01). The most commonly used topical treatments were carbonic anhydrase inhibitors (CAI, 81.8%), followed by beta-blockers (72.7%). All patients who had failure of primary DCR were using topical beta-blockers and CAI at the time of surgery and post-operatively. There was no statistically significant association between failure rates and the use of preserved or unpreserved drops (p = 1.0) CONCLUSIONS: Topical ocular antihypertensive treatment may lead to a higher failure rate for DCR surgery due to the provocation of an inflammatory cicatricial response. Beta-blockers and CAIs appear to have the strongest association. Considering a primary external approach in this group as well as switching the class of topical antihypertensive treatment pre-operatively could perhaps improve DCR outcomes.

The use of periocular fillers in aesthetic medicine.

The periocular area is the first to display signs of ageing. Dermal fillers are an increasingly popular, minimally invasive method for facial rejuvenation. The eye is anatomically delicate and complex. Therefore, special consideration must be taken if dermal fillers are employed. This article examines the literature to assess the efficacy and safety of dermal fillers around the eye as well as the management of complications secondary to dermal filler use, such as oedema, granuloma formation, filler migration, xanthelasma, skin necrosis and visual loss. Hyaluronic acid (HA) is the most popular and commonly employed dermal filler for periocular use. It is effective, with good observer improvement and patient satisfaction (p<0.0001). Ninety percent of adverse events are mild in nature and self-resolve within 1 month. Malar oedema is a delayed complication unique to the periocular area, occurring in 11% of patients. This can be managed with use of hyaluronidase if a HA filler has been employed. Other complications, such as granuloma formation, filler migration and xanthelasma, have also been reported with variable management outcomes. Vascular adverse events include skin necrosis and visual loss. No Level 1 evidence exists for the management of visual loss. Two cases of visual restoration have been identified in the literature; however, this is rare.

Restructuring emergency eye services during COVID-19 in a tertiary referral centre.

BACKGROUND/AIMS: Maintaining emergency eye services is crucial during the COVID-19 pandemic. This article describes the introduction of a new restructured referral pathway to reduce the burden on healthcare providers and create a safe environment. METHODS: During January and February 2020 (group 1), all appointments were face-to-face with a walk-in eye casualty. The first audit cycle comprised all patients in group 1. The primary audit criteria were discharge rates, referral to subspeciality and reattendance. In April 2020, a remodelled system was implemented in which walk-in attendance ceased and was replaced with telephone triage coupled with digital imaging via NHS email for remote clinical review. Patients requiring further assessment following this triage were invited in for face-to-face appointments. A reaudit was conducted during April-July 2020 (group 2) following implementation of these COVID-19 protocol changes. RESULTS: In group 1, 2868 appointments (100.0%) were face-to-face and in group 2 4870 (100.0%) appointments were telephone consults that resulted in 2639 (54.2%) face-to-face appointments. The rate of discharge in the first cycle and second cycle were 55.3% and 76.9% respectively (P<0.0001). Furthermore 2298 (47.2%) patients were able to be discharged following telephone consultation in group 2. CONCLUSIONS: Using this telephone and digital imaging review triage system, the authors have demonstrated a significant reduction in the need for face-to-face reviews. The reduction in avoidable patient face-to-face reviews allows the system to move from saturated to sustainable while increasing accessibility to services for patients who may not be able to present for face-to-face review. This complete audit cycle successfully charts interventions that maximise accessibility, reduce unnecessary hospital visits and deliver safe and prompt management during the pandemic.

Leachable lead and cadmium in microwave-heated ceramic cups: possible health hazard to human.

In this study, we assessed the leachability as well as health risk associated with the consumption from glazed, colourful, ceramic cups, containing lead and cadmium. Both metals leached into the 2.5-min microwave-heated (convection mode, at 140 °C) double-distilled water in concentrations above 0.5 mg/L, the permissible limits of leachable Pb and Cd in ceramic mugs set by United States Food and Drug Administration (US FDA). On an average, significantly higher Pb leached in new cups, 7.69 ± 0.56 mg/L, compared to that in old cups, 3.15 ± 0.15 mg/L. Cd leached similarly in both old (1.97 ± 0.14 mg/L) and new cups (1.57 ± 0.005 mg/L). The chronic daily intake of Pb by children and adults, respectively, consuming from new cups were 1.3-5× and 1.28-6× more than that from old cups. In both the cases, intake values far exceeded WHO reference dose of 0.0006 mg Pb/kg bw/day in children (< 11 years) and 0.0013 mg Pb/kg bw/day in adults. Such levels of Pb consumption in children might be predicted to be associated with decrement in IQ by at least 1 point and adverse effects in adults, especially, women of childbearing age. The daily intake of Cd from these cups ranged from 0.002-0.049 mg/kg bw/day, which was also above permissible limit. Consequently, high hazard quotient and hazard index (both more than 1) were observed for these metals, which might impart individual as well as cumulative effects on the health. Thus, apart from other dietary as well as inhalation sources of contaminants (which were not studied here), regular consumption of beverages alone in glazed, ceramic cups increased chances of Pb- and Cd-related health risks to humans.

Predictive Walking-Age Health Analyzer.

A simple, low-power and wearable health analyzer for early identification and management of some diseases is presented. To achieve this goal, we propose a walking pattern analysis system that uses features, such as speed, energy, turn ratio, and bipedal behavior to characterize and classify individuals in distinct walking-ages. A database is constructed from 74 healthy young adults in the age range from 18 to 60 years using the combination of inertial signals from an accelerometer and a gyroscope on a level path including turns. An efficient advanced signal decomposition method called improved complete ensemble empirical mode decomposition with adaptive noise (improved CEEMDAN) was used for feature extraction. Analyzes show that the gait of healthy able-bodied individuals exhibits a natural bipedal asymmetry to a certain level depending on the activity-type and age, which relate to individual's functional attributes rather than pathological gait. The analysis of turn ratio, a measure of activity-transition energy change and stability, indicated turning to be less locally stable than straight-line walking making it a more reliable measure for determining falls and other health issues. Extracted features were used to analyze two distinct walking-age groups of the healthy young adults based on their walking pattern, classifying 18-45 years old individuals in one group and 46-60 years old in the other group. Our proposed simple, inexpensive walking analyzer system can be easily used as an ambulatory screening tool by clinicians to identify at risk population at the early onset of some diseases.

Drugs - Do we need them? Applications of non-pharmaceutical therapy in anterior eye disease: A review.

Natural products have been in use long before the introduction of modern drug therapies and are still used in various communities worldwide for the treatment of anterior eye disease. The aim of this review is to look at the current non-pharmaceutical modalities that have been tried and assess the body of existing evidence behind them. This includes alternative medicine, existing non-pharmaceutical therapy and more recent low and high tech solutions. A detailed search of all available databases including MEDLINE, Pubmed and Google was made to look for English-language studies for complementary and alternative treatment modalities (CAM), natural therapies and new modalities for anterior eye disease such as blepharitis, dry eye and microbial keratitis. We have included a broad discussion ranging from traditional treatments like honey and aloe vera which have been used for centuries, to the more recent technological advances like Intense Pulsed Light (IPL), LipiFlow and photoactivated chromophore for corneal cross linking in infectious keratitis (PACK-CXL). Alternative management strategies may have a role in anterior eye diseases and have a potential in changing the way we currently approach them. Some of the available CAM could play a role if incorporated in to current management practices of not only chronic diseases like blepharitis and dry eye, but also acute conditions with significant morbidity like microbial keratitis. Further large-scale randomized control trials stratified by disease severity are required to improve our understanding and to evaluate the use of non-pharmaceutical therapy against current practice.

Nutrient profile of porridge made from Eleusine coracana (L.) grains: effect of germination and fermentation.

Porridge (koozh) is one of the traditional foods made from Eleusine coracana L. grains (Finger millet). It is a soft food prepared from processed (germinated & fermented) finger millet flour (FMF). However, in the modern world of fast food, koozh is usually prepared from non-processed (non-germinated & non-fermented) FMF. Hence, present study was undertaken to evaluate the macro and micro nutrient contents in koozh prepared from germinated (fermented & non-fermented) and non-germinated (fermented & non-fermented) FMF. Highest protein, carbohydrate and glycoprotein contents were found in koozh prepared from germinated & non-fermented FMF. The free amino acid contents are higher in germinated & fermented condition when compare to other preparations. No significant change was observed in the calorific value of all preparations. There is no statistical difference in macro-nutrients & micro-nutrients minerals such as calcium, iron, magnesium, manganese, phosphorous and zinc among all the preparations. However, copper content is higher in non-germinated condition, whereas selenium, silicon and sulphur are higher in germinated FMF when compared to others. Significant level of total phenol, total flavonoid and free radical scavenging activity was observed in all preparations, which increased further during fermentation. The present observations, lead us to conclude that koozh prepared from germinated & non-fermented FMF contains higher level of carbohydrate, protein and glycoprotein, however germinated & fermented koozh has increased aminoacids, phytochemicals and free radical scavenging activity. Hence it is suggested that the consumption of koozh made from germinated & fermented FMF may provide easily digestible and energetic nutrients for healthier life.

Validity and repeatability of the Aladdin ocular biometer.

AIM: To assess the accuracy and reproducibility of biometry undertaken with the Aladdin (Topcon, Tokyo, Japan) in comparison with the current gold standard device, the IOLMaster 500 (Zeiss, Jena, Germany). SETTING: University Eye Clinic, Birmingham, UK and Refractive Surgery Centre, Kiel, Germany. METHODS: The right eye of 75 patients with cataracts and 22 healthy participants were assessed using the two devices. Measurements of axial length (AL), anterior chamber depth (ACD) and keratometry (K) were undertaken with the Aladdin and IOLMaster 500 in random order by an experienced practitioner. A second practitioner then obtained measurements for each participant using the Aladdin biometer in order to assess interobserver variability. RESULTS: No statistically significant differences (p>0.05) between the two biometers were found for average difference (AL)±95% CI=0.01±0.06 mm), ACD (0.00±0.11 mm) or mean K values (0.08±0.51 D). Furthermore, interobserver variability was very good for each parameter (weighted κ≥0.85). One patient's IOL powers could not be calculated with either biometer measurements, whereas a further three could not be analysed by the IOLMaster 500. The IOL power calculated from the valid measurements was not statistically significantly different between the biometers (p=0.842), with 91% of predictions within±0.25 D. CONCLUSIONS: The Aladdin is a quick, easy-to-use biometer that produces valid and reproducible results that are comparable with those obtained with the IOLMaster 500.