Prevalence of Ocular Hypertension in Patients Above 40 Years of Age.

INTRODUCTION: Ocular hypertension is a condition with elevated intraocular pressure that needs to be monitored closely to prevent glaucoma and other complications. The study aims to find out the prevalence of ocular hypertension in patients aged more than 40 years. MATERIALS AND METHODS: This is a hospital based cross-sectional study conducted in a community based tertiary hospital of Nepal. RESULTS: Mean age of the patients was 47.53years. 62% of the patients were males and 38% were females. Mean intraocular pressure in the right eye was 15.8 mmHg and mean intraocular pressure in left eye was 16.2 mm Hg. Prevalence of ocular hypertension was 6%. CONCLUSION: All patients more than 40 years of age should undergo detailed ocular examination for early detection and treatment of ocular hypertension.

Rhegmatogenous Retinal Detachment with Spontaneous Dialysis of the Ora Serrata in Neurofibromatosis Type 1: A Case Report.

Neurofibromatosis type 1 is a genetic disorder that follows an autosomal dominant pattern of inheritance. Ocular involvement is not uncommon, but spontaneous dialysis of the retina in the absence of a history of trauma is a rare clinical entity. Rare cases of retinal involvement such as retinal detachment or dialysis of ora serrata could be linked with the abnormal cell-matrix formation in neurofibromatosis type 1. Here, we present a case of a 36-year-old man having Neurofibromatosis Type 1 with spontaneous dialysis of ora serrata without prior history of ocular trauma. A routine fundoscopic examination should be done in addition to the examination of the anterior chamber in patients with neurofibromatosis type 1 despite the absence of ocular complaints. Keywords: case reports; neurfibromatosis type 1; ora serrata; retinal; retinal detachment.

Blindness among Patients with Type II Diabetes Mellitus Presenting to the Outpatient Department of Ophthalmology of a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Diabetic retinopathy is a major microvascular complication of diabetes, and may progress to sight-threatening stages causing blindness with a consequent decrease in their quality of life. This study aimed to find out the prevalence of blindness among patients with type II diabetes mellitus attending the Outpatient Department of Ophthalmology of a tertiary care hospital. Methods: A descriptive cross-sectional study was conducted among patients with type II diabetes mellitus presenting to the Outpatient Department of Ophthalmology of a tertiary care centre from 2 August 2021 to 30 June 2022 after receiving ethical approval from the Institutional Review Committee (Reference number: 74/2021). Diabetic patients underwent detailed eye examination including vision, slit lamp biomicroscopy examination, and fundus evaluation with full pupil dilation. Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Results: Among 449 type II diabetic patients, blindness was seen in 17 (3.79%) (2.02-5.56, 95% Confidence Interval) patients. Among them, 1 (5.88%) had severe non-proliferative diabetic retinopathy, 3 (17.65%) had proliferative diabetic retinopathy and 8 (47.06%) had severe diabetic macular oedema. Conclusions:  The prevalence of blindness among patients with type II diabetes mellitus was less than in other studies conducted in similar settings. Screening and timely management of diabetic retinopathy could reduce the prevalence of blindness due to diabetic retinopathy. Keywords: blindness; diabetic retinopathy; prevalence.

Non-strabismic Binocular Vision Dysfunction among the Medical Students of a Teaching Hospital: A Descriptive Cross-sectional Study.

Introduction: Non-strabismic binocular vision dysfunctions are visual disorders that affect the person's binocular vision and visual outcome while performing near tasks and are very common among medical students. This study aimed to find out the prevalence of non-strabismic binocular vision dysfunction among the medical students of a teaching hospital. Methods: A descriptive cross-sectional study was conducted among medical students of a teaching hospital from 25 April 2022 to 25 May 2022. Ethical approval was obtained from the Institutional Review Committee of the same institute (Reference number: 139/17). A detailed ocular evaluation including history, visual acuity, refraction, and detailed orthoptic evaluation was done. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Out of 284 students, 79 (27.81%) (22.60-33.02, 95% Confidence Interval) had non-strabismic binocular vision dysfunctions. Convergence insufficiency was the commonest one seen in 38 (48.10%), followed by divergence excess seen in 8 (10.12%) and convergence excess seen in 8 (10.12%) students. Conclusions: The prevalence of non-strabismic binocular vision dysfunction among medical students was lower than in other studies conducted in similar settings. Keywords: binocular vision; convergence excess; convergence insufficiency; prevalence.

Comparison of Intraocular Pressure among Individuals with Systemic Hypertension and those with Normal Blood Pressure.

INTRODUCTION: Systemic blood pressure, by far, is one of the most important factors that can have an effect on intraocular pressure. We have compared the intraocular pressure (IOP) among patients with systemic hypertension and those with normal blood pressure. MATERIALS AND METHODS: A hospital based case control study was conducted from March 2017 to March 2018 in the Ophthalmology outpatient department at Dhulikhel Hospital. A total of 100 patients with hypertension were included in the case group (hypertensive group) and 100 cases with no systemic or ocular disease were included in the control group (normotensive group). Mean intraocular pressures were calculated and compared between the two groups. RESULTS: Mean age of patients was 49.03 years in hypertensive group and 47.53 years in normotensive group. Mean IOP of the right eye in those with hypertension was 16.10 mmHg and in the left eye was 15.8 mmHg. Similarly mean IOP of the right eye in the normotensive group was 15.8 mmHg and the left eye was 16.2 mmHg. The difference between mean IOP of hypertensive and normotensive individuals was not statistically significant (p > 0.05). The prevalence of ocular hypertension was found to be 7.5%. CONCLUSION: There was no statistically significant difference in IOP between hypertensive and normotensive individuals. However, a statistically significant difference in IOP was noted between 'hypertensive with controlled blood pressure' and 'hypertensive with uncontrolled BP' indicating that high blood pressure may be associated with high IOP.

A Review of Biopolymers' Utility as Emulsion Stabilizers.

Polysaccharides, polynucleotides, and polypeptides are basic natural polymers. They have various applications based on their properties. This review mostly discusses the application of natural polymers as emulsion stabilizers. Natural emulsion stabilizers are polymers of amino acid, nucleic acid, carbohydrate, etc., which are derived from microorganisms, bacteria, and other organic materials. Plant and animal proteins are basic sources of natural emulsion stabilizers. Pea protein-maltodextrin and lentil protein feature entrapment capacity up to 88%, (1-10% concentrated), zein proteins feature 74-89% entrapment efficiency, soy proteins in various concentrations increase dissolution, retention, and stability to the emulsion and whey proteins, egg proteins, and proteins from all other animals are applicable in membrane formation and encapsulation to stabilize emulsion/nanoemulsion. In pharmaceutical industries, phospholipids, phosphatidyl choline (PC), phosphatidyl ethanol-amine (PE), and phosphatidyl glycerol (PG)-based stabilizers are very effective as emulsion stabilizers. Lecithin (a combination of phospholipids) is used in the cosmetics and food industries. Various factors such as temperature, pH, droplets size, etc. destabilize the emulsion. Therefore, the emulsion stabilizers are used to stabilize, preserve and safely deliver the formulated drugs, also as a preservative in food and stabilizer in cosmetic products. Natural emulsion stabilizers offer great advantages because they are naturally degradable, ecologically effective, non-toxic, easily available in nature, non-carcinogenic, and not harmful to health.

Cerebral Artery Aneurysm Masquerading as Ptosis in a Child.

An 8-year-old female presented to Eye OPD of Dhulikhel Hospital, Kathmandu University Hospital, with drooping of the right upper lid and inability to move right eye ball since 3 days. She had no history of trauma or fall injury. On ocular examination, visual acuity was 6/6 on both eyes and there was severe ptosis on the right eye in which eyeball remained abducted with restriction of ocular motility on all gazes. The pupil was dilated and 6mm on the right eye in room light. Posterior segment examination was normal. MRI angiography was done which revealed a right Posterior cerebral artery aneurysm.

Discerning the catalytic mechanism of Staphylococcus aureus sortase A with QM/MM free energy calculations.

Sortases are key virulence factors in Gram-positive bacteria. These enzymes embed surface proteins in the cell wall through a transpeptidation reaction that involves recognizing a penta-peptide "sorting signal" in a target protein, cleaving it, and covalently attaching it to a second substrate that is later inserted into the cell wall. Although well studied, several aspects of the mechanism by which sortases perform these functions remains unclear. In particular, experiments have revealed two potential sorting signal binding motifs: a "Threonine-Out" (Thr-Out) structure in which the catalytically critical threonine residues protrudes into solution, and a "Threonine-In" (Thr-In) configuration in which this residue inserts into the binding site. To determine which of these is the biologically relevant state, we have performed a series of conventional and hybrid quantum mechanics/molecular mechanics (QM/MM) molecular dynamics simulations of the Staphylococcus aureus sortase A (SrtA) enzyme bound to a sorting signal substrate. Through the use of multi-dimensional metadynamics, our simulations were able to both map the acylation mechanism of SrtA in the Thr-In and Thr-Out states, as well as determine the free energy minima and barriers along these reactions. Results indicate that in both states the catalytic mechanisms are similar, however the free energy barriers are lower in the Thr-In configuration, suggesting that Thr-In is the catalytically relevant state. This has important implications for advancing our understanding of the mechanisms of sortase enzymes, as well we for future structure based drug design efforts aimed at inhibiting sortase function in vivo.

Weak intra-ring allosteric communications of the archaeal chaperonin thermosome revealed by normal mode analysis.

Chaperonins are molecular machines that use ATP-driven cycles to assist misfolded substrate proteins to reach the native state. During the functional cycle, these machines adopt distinct nucleotide-dependent conformational states, which reflect large-scale allosteric changes in individual subunits. Distinct allosteric kinetics has been described for the two chaperonin classes. Bacterial (group I) chaperonins, such as GroEL, undergo concerted subunit motions within each ring, whereas archaeal and eukaryotic chaperonins (group II) undergo sequential subunit motions. We study these distinct mechanisms through a comparative normal mode analysis of monomer and double-ring structures of the archaeal chaperonin thermosome and GroEL. We find that thermosome monomers of each type exhibit common low-frequency behavior of normal modes. The observed distinct higher-frequency modes are attributed to functional specialization of these subunit types. The thermosome double-ring structure has larger contribution from higher-frequency modes, as it is found in the GroEL case. We find that long-range intersubunit correlation of amino-acid pairs is weaker in the thermosome ring than in GroEL. Overall, our results indicate that distinct allosteric behavior of the two chaperonin classes originates from different wiring of individual subunits as well as of the intersubunit communications.