Lévy Flight Model of Gaze Trajectories to Assist in ADHD Diagnoses.

The precise mathematical description of gaze patterns remains a topic of ongoing debate, impacting the practical analysis of eye-tracking data. In this context, we present evidence supporting the appropriateness of a Lévy flight description for eye-gaze trajectories, emphasizing its beneficial scale-invariant properties. Our study focuses on utilizing these properties to aid in diagnosing Attention-Deficit and Hyperactivity Disorder (ADHD) in children, in conjunction with standard cognitive tests. Using this method, we found that the distribution of the characteristic exponent of Lévy flights statistically is different in children with ADHD. Furthermore, we observed that these children deviate from a strategy that is considered optimal for searching processes, in contrast to non-ADHD children. We focused on the case where both eye-tracking data and data from a cognitive test are present and show that the study of gaze patterns in children with ADHD can help in identifying this condition. Since eye-tracking data can be gathered during cognitive tests without needing extra time-consuming specific tasks, we argue that it is in a prime position to provide assistance in the arduous task of diagnosing ADHD.

Angiokeratoma of tongue in the pediatric age group: a rare presentation.

BACKGROUND: Angiokeratoma is a rare cutaneous presentation with unknown etiology. CASE PRESENTATION: A case of a 10-year male, who was presented to the ENT OPD with a swelling over the posterior aspect of the tongue. The chief complaints included growth on the right side of the posterior third of the tongue which was extending up to the base of the tongue on the same side. CONCLUSION: Excisional biopsy was taken and sent for histopathology which was suggestive of inflamed angiokeratoma. Post-excision there is no recurrence till date.

Vascular reconstruction of the decellularized biomatrix for whole-organ engineering-a critical perspective and future strategies.

Whole-organ re-engineering is the most challenging goal yet to be achieved in tissue engineering and regenerative medicine. One essential factor in any transplantable and functional tissue engineering is fabricating a perfusable vascular network with macro- and micro-sized blood vessels. Whole-organ development has become more practical with the use of the decellularized organ biomatrix (DOB) as it provides a native biochemical and structural framework for a particular organ. However, reconstructing vasculature and re-endothelialization in the DOB is a highly challenging task and has not been achieved for constructing a clinically transplantable vascularized organ with an efficient perfusable capability. Here, we critically and articulately emphasized factors that have been studied for the vascular reconstruction in the DOB. Furthermore, we highlighted the factors used for vasculature development studies in general and their application in whole-organ vascular reconstruction. We also analyzed in detail the strategies explored so far for vascular reconstruction and angiogenesis in the DOB for functional and perfusable vasculature development. Finally, we discussed some of the crucial factors that have been largely ignored in the vascular reconstruction of the DOB and the future directions that should be addressed systematically.

Assessment of Visual Evoked Potential to Detect Visual Pathway Dysfunction in Gestational Diabetes Mellitus: A Longitudinal Case-Control Study With Postpartum Follow-up.

BACKGROUND: The increasing prevalence of gestational diabetes mellitus (GDM) during pregnancy has opened the opportunity to study its short- and long-term effects on maternal ophthalmic health. Visual evoked potential (VEP) is a non-invasive electrophysiological test that detects functional disturbances along the visual pathway before the physical signs of diabetic retinopathy (DR) can set in. This longitudinal study is aimed at the assessment of changes in VEP in GDM during different stages of pregnancy and 6-12 weeks after parturition by comparing it with normoglycemic controls. DESIGN AND METHOD: Diagnosed cases of GDM were recruited along with normoglycemic controls at 24-28 weeks of gestation. Each participant was required to attend two follow-up appointments at 32-38 weeks of gestation and 6-12 weeks after parturition. A blood sample was taken in a fasting state to record biochemical parameters. VEP was recorded using Neuropack S1 MEB-9400 electrodiagnostic equipment (Nihon Kohden, Tokyo, Japan) in a dark room by providing pattern reversal stimuli to each eye. RESULTS: A total of 29 participants (15 in the control group and 14 in the GDM group) completed the entire study procedure. The observed mean P100 latency of both eyes in the GDM group was recorded longer as compared to that in the control group at baseline and during late pregnancy. Although the mean P100 latency saw a significant decline in postpartum visits as compared to that in late pregnancy, the values were higher than in the control group. P100 latency at baseline correlated significantly to serum advanced glycated end products' (AGE'S) levels in the GDM group. CONCLUSION: Our study findings reflect that the diagnosis of GDM is associated with significant changes in VEP during and after pregnancy as compared to that of healthy pregnant women.

Trans-septal Suturing Versus Merocel Nasal Packing: A Post Septoplasty Comparison.

It has been observed that nasal packing following septoplasty contributes to co-morbidities like post-operative pain, bleeding and increased duration of hospital stay. Trans-septal suturing has been suggested as a safe and effective alternative with a view to obviate the need for nasal packing and the hence avoid the discomfort associated with it. To compare the outcome of trans-septal suturing technique with merocel nasal packing after septoplasty. This was a prospective comparative study done on 60 patients who underwent septoplasty. The patients were divided randomly into 2 groups, while Group A comprised of patients undergoing Post-operative nasal packing with poly vinyl alcohol sponge (also commercially called Merocel), Group B included patients who underwent nasal septal suturing after surgery. The postoperative pain, hemorrhage and duration of hospital stay were the main parameters that were assessed and a comparison was drawn between the post-operative outcome of two techniques. Post-operative global pain score was 62.18 ± 4.75 in the group A (patients with nasal packing) and 24.73 ± 4.29 (patients with trans-septal suturing) in group B ('p'value was < 0.0001). Post-operative bleeding was noticed in 19 patients (out of 30) in group A, and in 2 patients of group B ('p'value was < 0.0001). 27 out of 30 patients of Group A were discharged on day 2 whereas 24 out of 30 patients of Group B required only 1 day of hospital stay after the surgery ('p' value was < 0.0001). Trans-septal suturing technique reduces the duration of hospital stay, causes lesser post-operative bleeding and pain and is a relatively less painful technique than merocel nasal packing.

Host nuclear repositioning and actin polarization towards the site of penetration precedes fungal ingress during compatible pea-powdery mildew interactions.

MAIN CONCLUSION: Actin polarization and actin-driven host nuclear movement towards the fungal penetration site facilitates successful host colonization during compatible pea-Erysiphe pisi interactions. Proper nuclear positioning in plant cells is crucial for developmental processes and response to (a)biotic stimuli. During plant-fungal interactions, the host nucleus moves toward the infection site, a process regulated by the plant cytoskeleton. Notably, rearrangement of the plant cytoskeleton is one of the earliest cellular responses to pathogen invasion and is known to impact penetration efficiency. Yet, the connection between host nuclear movement and fungal ingress is still elusive, particularly in legumes. Here, we investigated the host nuclear dynamics during compatible interactions between Pisum sativum (pea) and the adapted powdery mildew (PM) fungus Erysiphe pisi to gain insights into the functional relevance of PM-induced nuclear movement in legumes. We show that the host nucleus moves towards the fungal appressorium before penetration and becomes associated with the primary haustorium. However, the nucleus migrates away from the primary infection site as the infection progresses toward colony expansion and sporulation. Treatment of pea leaves with the actin-polymerization inhibitor, cytochalasin D, abolished host nuclear movement towards the fungal penetration site and restricted PM growth. In contrast, treatment with oryzalin, a microtubule-polymerization inhibitor, had no effect. In addition to nuclear movement, strong polarization of host actin filaments towards the site of appressorial contact was evident at early infection stages. Our results suggest that actin focusing mediates host nuclear movement to the fungal penetration site and facilitates successful colonization during compatible pea-PM interactions.

Modified graphene oxide nanoplates reinforced 3D printed multifunctional scaffold for bone tissue engineering.

Successful regeneration of load-bearing bone defects remains a major challenge in clinical orthopaedics. Designing biologically active 3-dimensional scaffolds possessing physiological responsiveness can potentially overcome current limitations. Here, we have described a novel approach to fabricate scaffolds with modified nanosheets reinforced on mechanically customized thermoplastic polymer-based 3D printed constructs. In this article, we have developed polydopamine-reduced graphene oxide (PD-RGO) reinforced 3D printed PLA scaffold for bone tissue construction. RGO was synthesized by reduction of GO under alkaline conditions using dopamine. 3D printed polylactic acid (PLA) scaffold with defined porosity was doped with PD-RGO. The designed scaffold was studied for its physiochemical properties and human umbilical cord-derived mesenchymal stem cell (hMSC) behaviour within the scaffold. In vitro hMSC studies revealed the influence of fibre direction and nanocoating on directional cell growth and proliferation. The fabricated scaffold showed antioxidant property along with pro-angiogenic and osteoinductive potential. The designed scaffold also successfully prevented the formation of biofilm. In vivo heterotopic implantation of the differentiated hMSC loaded scaffold confirmed the biocompatibility and bio functionality of the scaffold. In summary, the designed nanoplates doped 3D printed scaffold displays stem cell responsive, integrative and pro-regenerative multi functionalities, thereby, exhibiting potential application as bone tissue regeneration treatment alternative.

How have smallholder farmers used digital extension tools? Developer and user voices from Sub-Saharan Africa, South Asia and Southeast Asia.

Digital extension tools (DETs) include phone calls, WhatsApp groups and specialised smartphone applications used for agricultural knowledge brokering. We researched processes through which DETs have (and have not) been used by farmers and other extension actors in low- and middle-income countries. We interviewed 40 DET developers across 21 countries and 101 DET users in Bihar, India. We found DET use is commonly constrained by fifteen pitfalls (unawareness of DET, inaccessible device, inaccessible electricity, inaccessible mobile network, insensitive to digital illiteracy, insensitive to illiteracy, unfamiliar language, slow to access, hard to interpret, unengaging, insensitive to user's knowledge, insensitive to priorities, insensitive to socio-economic constraints, irrelevant to farm, distrust). These pitfalls partially explain why women, less educated and less wealthy farmers often use DETs less, as well as why user-driven DETs (e.g. phone calls and chat apps) are often used more than externally-driven DETs (e.g. specialised smartphone apps). Our second key finding was that users often made - not just found - DETs useful for themselves and others. This suggests the word 'appropriation' conceptualises DET use more accurately and helpfully than the word 'adoption'. Our final key finding was that developers and users advocated almost ubiquitously for involving desired users in DET provision. We synthesise these findings in a one-page framework to help funders and developers facilitate more useable, useful and positively impactful DETs. Overall, we conclude developers increase DET use by recognizing users as fellow developers - either through collaborative design or by designing adaptable DETs that create room for user innovation.

Emerging Trends in Mesenchymal Stem Cells Applications for Cardiac Regenerative Therapy: Current Status and Advances.

Irreversible myocardium infarction is one of the leading causes of cardiovascular disease (CVD) related death and its quantum is expected to grow in coming years. Pharmacological intervention has been at the forefront to ameliorate injury-related morbidity and mortality. However, its outcomes are highly skewed. As an alternative, stem cell-based tissue engineering/regenerative medicine has been explored quite extensively to regenerate the damaged myocardium. The therapeutic modality that has been most widely studied both preclinically and clinically is based on adult multipotent mesenchymal stem cells (MSC) delivered to the injured heart. However, there is debate over the mechanistic therapeutic role of MSC in generating functional beating cardiomyocytes. This review intends to emphasize the role and use of MSC in cardiac regenerative therapy (CRT). We have elucidated in detail, the various aspects related to the history and progress of MSC use in cardiac tissue engineering and its multiple strategies to drive cardiomyogenesis. We have further discussed with a focus on the various therapeutic mechanism uncovered in recent times that has a significant role in ameliorating heart-related problems. We reviewed recent and advanced technologies using MSC to develop/create tissue construct for use in cardiac regenerative therapy. Finally, we have provided the latest update on the usage of MSC in clinical trials and discussed the outcome of such studies in realizing the full potential of MSC use in clinical management of cardiac injury as a cellular therapy module.

Generation and transplantation of hepatocytes-like cells using human origin hepatogenic serum for acute liver injury treatment.

Liver failure is a critical disease for which regenerative therapies are still being explored. The major limitation in the use of a clinical grade, viable cell-based therapy approach is the scarce availability of sufficient number of in-vitro differentiated hepatocyte-like cells (HLC) that can induce regeneration and ameliorate liver injury. Here, we report for the first time an approach to engineer HLCs using sera of hyperbilirubin patients that act as a reservoir of differentiation factor. Utilizing our humanized approach, mesenchymal stem cells (hMSC) derived from umbilical cord tissue were transdifferentiated into HLC using patient-derived serum along with dimethyl sulfoxide (DMSO). We studied the effects of serum on the proliferation, cell cycle analysis, and apoptosis of hMSC by various differentiation combinations. We optimized the hepatic transdifferentiation ability of hMSC with hyperbilirubin serum treatment for a period of 7 days. Assessment of HLC functionalities was shown by quantifying the HLC spent medium for albumin and urea secretions. Transplantation of HLC in an acute liver injury (ALI) rat model showed an effective improvement in the liver function and histological changes in the liver. The results of this study suggest that hMSC-derived HLC using humanized hepatogenic serum holds a promising potential for cell transplantation, as an efficient therapy modality for liver failure in humans.

Relationship between advanced glycated end products and maternal cognition in gestational diabetes: a case control study.

OBJECTIVE: Gestational diabetes (GDM) is a form of glucose intolerance which manifests during pregnancy. There is lack of literature regarding the study of cognitive functions in GDM. Recent evidences suggests an increase in accumulation of serum Advanced glycated end products (AGE'S) during GDM. Accumulation of AGE's in brain can induce changes in permeability of blood brain barrier and creates oxidative stress and inflammation that can alter cognitive functions. In this study we hypothesize that diagnosis of GDM in pregnancy is related to lower cognitive scores which is correlated to increased serum AGE's level. METHOD: This was a cross sectional case control study which recruited 60 participants in total consisting of two groups with 30 participants in each - diagnosed cases of GDM and healthy pregnant controls. Subjects were recruited from OPD of Obstetrics & Gynecology department in a tertiary care hospital in South India at gestational age of 32-36 weeks. On the first appointment, biochemical parameters of Fasting plasma glucose (FPG) & HbA1C was measured in both groups. Serum was obtained for testing levels of N Carboxy methyl lysine (N-CML) (a form of AGE). On second appointment, pen and paper neurocognitive tests including Montreal cognitive tests (MOCA) and Trail making test (TMT A & B) was presented. Event related potentials (ERP's) are time locked EEG wave signals produced in response to a sensory, motor or cognitive event. P300 is an "endogenous" ERP produced by cognitive processing in response to a stimuli presented to subject. P300 wave Latency and amplitude was recorded in both the groups as an objective marker of cognitive processing. Above mentioned biochemical and neurocognitive parameters were compared between both the groups and correlation analysis between serum AGE levels and neurocognitive parameters was performed using SPSS software. RESULTS: Biochemical parameters of HbAIC & N-CML(A form of AGE) levels were increased in GDM group (HbA1C 6.01±0.30 and N CML 236.25 ± 68.9) vs Control group (HbA1C 4.11 ± 0.68 and NCML 198.42 ± 44.2). Scores in MOCA were significantly lower in GDM (28 (27-29)) group as compared to controls (24 (23-25)). GDM subjects took significantly greater time to perform TMT A (24.59 ± 2.60 s) test than controls (29.7 ± 1.72 s). Significant changes were not found in P300 Latency & amplitude in GDM group. Decreased MOCA scores and increased duration of TMT A attempt were correlated with increased serum AGE concentration in GDM group. CONCLUSIONS: Our study indicates the vulnerability of women suffering from GDM to cognitive impairment during pregnancy. Lower scores in cognitive tests were correlated to AGE accumulation in GDM women.

Rhino-Orbito-Cerebral Mucormycosis During the Second Wave of Covid-19: The Indian Scenario.

Mucormycosis is a life threatening, opportunistic infection often seen in individuals with a weak immune system. With an upsurge of cases of Covid-19, a drastic increase in cases of Rhino-Orbito-Cerebral Mucormycosis is being witnessed at present. This article has been written with the purpose of understanding the factors responsible for it and the challenges it brings along for the Indian health-care system at present. Possible solutions for dealing with these problems have also been included in the manuscript. Google, PubMed and ENT Cochrane databases were searched without a time limit using key words like "Mucormycosis", "Rhino-cerebral-mucormycosis" in conjunction with "COVID-19" and "SARS CoV-2". We found 34 articles to be relevant and hence included them to write this review. Rhino-Orbito-Cerebral Mucormycosis is being seen due to coming together of the three entities-the agent, host and environment that constitute the epidemiological triad for this disease in India. Responsible factors are uncontrolled diabetes mellitus, overzealous use of steroids and antibiotics and other environment related issues. The solutions for these problems lie in spreading awareness about prevention of these practices along with early diagnosis and treatment of mucormycosis. To deal effectively with this situation, particularly when there is an existing overload on otolaryngologists and the rest of the health-care system, a multipronged and multilevel collaborative approach is the need of the hour. With effective Standard Operating Procedures and guidelines promoting a multidisciplinary approach for early diagnosis and treatment, we can surely overcome this situation.

Maternal Chromium Levels in Gestational Diabetes: Systematic Review and Meta-Analysis.

The topic of maternal Chromium (Cr) levels in Gestational Diabetes Mellitus (GDM) has remained controversial; some studies have found lower levels of Cr in GDM population, whereas others found no significant changes in Cr status in GDM. Therefore, this systematic review and meta-analysis was aimed at qualitatively and quantitatively synthesizing past studies to find the relationship of maternal Cr levels with GDM. The study protocol was registered at International prospective register for systematic reviews (PROSPERO) (ID CRD42021272979). Strict adherence to the Preferred Reporting Items for Systematic review and Meta-analysis checklist, 2009 was followed during the entire study. Random-effect model for calculation of distribution of true effect sizes was used for the meta-analysis with a confidence interval (CI) of 95%. The pooled Standard Mean Difference of control and GDM groups were compared using Z statistics with a P value of <.05 as significant. Six studies were included for the systematic review and four studies entered meta-analysis. The test of overall effect revealed that the pooled Cr values did not differ significantly between controls and GDM group (Z = 1.52, P =0.13). Heterogeneity between the studies was high (I2 = 97%). A subgroup analysis revealed that results varied as per place of study, trimester of pregnancy, and Cr estimation technique. Results from meta regression analysis revealed that sample size of individual studies (Q = 0.003, P =0.67) and year of publication of studies (Q = 0.22, P =.48) had no significant effect on the overall Standard Mean Difference. Factors such as ethnicity, lack of history of infection, and diet history can influence the results of this study.

Mesenchymal Stem Cells for Cardiac Regeneration: from Differentiation to Cell Delivery.

Mesenchymal stem cells (MSCs) are so far the most widely researched stem cells in clinics and used as an experimental cellular therapy module, particularly in cardiac regeneration and repair. Ever since the discovery of cardiomyogenesis induction in MSCs, a wide variety of differentiation protocols have been extensively used in preclinical models. However, pre differentiated MSC-derived cardiomyocytes have not been used in clinical trials; highlighting discrepancies and limitations in its use as a source of derived cardiomyocytes for transplantation to improve the damaged heart function. Therefore, this review article focuses on the strategies used to derive cardiomyocytes-like cells from MSCs isolated from three widely used tissue sources and their differentiation efficiencies. We have further discussed the role of MSCs in inducing angiogenesis as a cellular precursor to endothelial cells and its secretory aspects including exosomes. We have then discussed the strategies used for delivering cells in the damaged heart and how its retention plays a critical role in the overall outcome of the therapy. We have also conversed about the scope of the local and systemic modes of delivery of MSCs and the application of biomaterials to improve the overall delivery efficacy and function. We have finally discussed the advantages and limitations of cell delivery to the heart and the future scope of MSCs in cardiac regenerative therapy.

Covid-19 and Ear Surgery: Treatment Strategies and Triage during the Post-lockdown Period.

The accumulated disease burden during lockdown period, due to postponement of regular surgeries, is expected to put additional pressure on surgeons during the post-lockdown period. Due to the contagious nature of SARS-CoV-2 and its suspected presence in middle ear mucosa and mastoid, Ear surgeons are bound to face a challenging situation in present times as well as in times to come. Through this article we aim to streamline fresh management strategies particularly for the post-lockdown period keeping in mind that immunity after vaccination may take a few months to develop due to various factors discussed in the article. The ENT Cochrane, Pubmed and Web of Science databases were searched extensively using the terms 'Covid-19 and SARS-CoV-2 in conjunction with Ear surgery and Otology. Data collected from these, put together with our experience helped us in putting forward fresh management strategies to deal with the current situation being experienced worldwide. To reduce the risk of infection to the healthcare staff, we have suggested a new triage strategy for ear surgeries to reduce the accumulated disease burden in the post-lockdown period until immunity by vaccination develops amongst a good number of Ear surgeons. Also we have put forward certain operating guidelines that might prove helpful for the Ear surgeon during these times. Fresh Triage guidelines mentioned in this article are particularly meant to help ear surgeons reduce the accumulated disease burden in the post lockdown-period with ease and efficacy. Since ear surgery poses a risk of infection to the healthcare workers, specific guidelines pertaining to ear surgery during the pandemic are mentioned in detail which in our opinion can be of immense help to all the healthcare professionals involved in ear procedures till the time the vaccine is administered on a large scale.

Robotic Surgery in Otolaryngology During the Covid-19 Pandemic: A Safer Approach?

The COVID-19 outbreak was announced a pandemic by the World Health Organization in March 2020. The contagious nature of this virus to spread through droplets, puts the ENT surgeon at an added risk of exposure and infection, particularly while performing various aerosol generating procedures of the oral cavity and upper airway. While it is being recommended worldwide to postpone all elective surgeries to a later date, certain emergency procedures must be undertaken promptly but in a manner that minimizes the exposure of the surgeon and health care staff to the SARS-CoV-2. This article is meant to provide an insight into the possible role of robotic surgery in Otolaryngology and Head and Neck during the Covid-19 pandemic along with providing a brief review of its pros and cons.

COVID-19 and ENT surgery: a brief review of essential precautions and triage.

PURPOSE: This study is a brief review of the existing knowledge on the ENT surgeon's approach towards management of patients during the COVID-19 pandemic. While it is being recommended to carry out only the emergent procedures and to postpone the non-urgent ones to a later date, this article is meant to provide an insight into triage of the ENT procedures and the various precautions to be taken into account by the ENT surgeons while carrying out a procedure during the COVID-19 pandemic. METHODS: The ENT Cochrane, Pubmed and Web of Science databases were searched without a time limit using the terms 'COVID-19 and SARS-CoV-2 in conjunction with ENT surgery. RESULTS: Elective and non urgent cases are best avoided during this time. Only absolutely essential and emergent procedures need to be carried out with the use of Personal protective equipment comprising of safety gown, N95 mask, safety goggles, disposable gloves and caps. There is a possibility of transmission of the SARS- CoV-2 through asymptomatic patients and hence all patients, even with an unknown COVID-19 status, need to undergo a preoperative screening. As all procedures under general anesthesia are aerosol generating, the use of Personal protective equipment (PPE) is recommended for all the health care workers present in the operation theater. CONCLUSION: A proper knowledge of triage would be of immense help to the ENT surgeon in minimizing the exposure to health care workers and patients during this pandemic. All patients with an unknown COVID-19 status should be considered suspects and essential precautions for their management be taken accordingly.

Meniscal tissue engineering via 3D printed PLA monolith with carbohydrate based self-healing interpenetrating network hydrogel.

Failure of bioengineered meniscus implant after transplantation is a major concern owing to mechanical failure, lack of chondrogenic capability and patient specific design. In this article, we have, for the first time, fabricated a 3D printed scaffold with carbohydrate based self-healing interpenetrating network (IPN) hydrogels-based monolith construct for load bearing meniscus tissue. 3D printed PLA scaffold was surface functionalized and embedded with self-healing IPN hydrogel for interfacial bonding further characterized by micro CT. Using collagen (C), alginate (A) and oxidized alginate (ADA), we developed self-healing IPN hydrogels with dual crosslinking (Ca2+ based ionic crosslinking and Schiff base (A-A, A-ADA)) capability and studied their physicochemical properties. Further, we studied human stem cells behaviour and chondrogenic differentiation potential within these IPN hydrogels. In-vivo heterotopic implantation confirmed biocompatibility of the monolith showing the feasibility of using carbohydrate based IPN hydrogel embedded in 3D printed scaffold for meniscal tissue development.

Organotypic cancer tissue models for drug screening: 3D constructs, bioprinting and microfluidic chips.

Successful translation of potential cancer chemotherapeutic drugs to the clinic depends on sufficient predictability of response in the human system through in vitro simulations. High expenditure and longer duration in preclinical and clinical research urge the enhancement of effective in vitro drug screening. 3D models emulate cell morphology, cell-cell and cell-matrix interactions and are physiologically more relevant for predicting drug responses for complex heterogenic cancers, widely replacing conventional cultures. Bioprinting and microfluidic technology facilitate tissue mimetic model construction and multifaceted simulation of physiology, respectively, promising more-appropriate predictability of drug interactions. Precisely, organotypic tissue constructs assembled using cell-laden matrices or organ-on-a-chip serve as realistic tissue models. This review projects the progress toward biomimetic tissue model development, highlighting the emergence of bioprinting and microfluidic technology in in vitro cancer drug screening and pertaining challenges.

Evaluation of Role of Mitomycin C in the Cases of Nasolacrimal Duct Blockage Undergoing Endoscopic Dacryocystorhinostomy.

Dacryocystorhinostomy is a common surgical procedure done for the treatment of obstruction of the lacrimal sac or nasolacrimal duct. Adjunctive use of a wound healing inhibitor like Mitomycin C is considered to minimize the risk of complications and increase the success rate of endoscopic endonasal DCR. The current study is aimed to compare the results of endoscopic DCR without silicon stents with or without Mitomycin C and to see for any complications resulting from the surgery. This was a prospective study carried out in the department of Otorhinolaryngology at Safdarjung Hospital, New Delhi from February 2015 to September 2017. Out of the 30 patients who were included in the study, 15 underwent endoscopic DCR without the application of Mitomycin C (Group I) and the remaining 15 with application of Mitomycin C without using stents (Group II). The main criteria for success were the resolution of epiphora and patency on lacrimal irrigation. Success rate in Group I was 86.67% as compared to Group II where the success rate was 93.33%. There were two failures in Group I (13.33%) whereas one failure in Group II (6.66%). More complications were noted in Group I (granulations 13.33%, synechiae 13.33%, persistent epiphora 13.33%) than in Group II (granulations 13.33%, synechiae 6.67%, persistent epiphora 6.67%). To conclude, we have found topical Mitomycin C as a safe and effective means of preventing adhesions and ostium closures in patients undergoing endoscopic DCR.