Conventional and Scientific uses of Rice-washed water: A Systematic Review.

Rice is considered the king of cereals. It is the only cereal that is being consumed by half of the population in the world. Rice and rice products have potential health benefits. One such rice aided product is rice washed water which is discussed in this article. Rice-washed water, which is commonly regarded as waste water and discarded, is a rich source of minerals and nutrients. The processing of rice washed water, nutritional analysis; edible fungi productions are detailed in this review. The article goes into detail about rice-washed water, which has been used for various purposes since our ancestors' time. The article provides a comprehensive report on the uses of rice-washed water in plant growth, Ayurveda, food, Cosmetics and a variety of other applications. Rice washed water is being utilized for various ailments since primitive times. The detailed report on the treatment utilizing rice washed water is also provided in this article. There are scarce researches with rice washed water, this article address the conventional uses of rice washed water, which can be taken up by the research community which needs more scientific validation. This review article also includes details about the composition and a variety of other important information about rice-washed water. Supplementary Information: The online version contains supplementary material available at 10.1007/s13197-023-05722-2.

Comparison of Cardiovascular Parameters and Cardiac Autonomic Activity of Obese and Normal Weight School Children in Puducherry.

Background and Aim: Worldwide, incidence of childhood obesity is on the rising trend and obese children are more vulnerable to various health disorders. This study was done to assess and compare the cardiovascular parameters and Heart rate variability (HRV) parameters of obese school children with children with normal Body Mass Index (BMI). Methods: Thirty obese children (BMI  95th percentile) aged 9-12 years and 30 age and sex matched children with normal BMI (BMI 5th to below 85th percentile) were included in test and control groups respectively. Mann Whitney U test was done to detect the difference between the two groups with respect to systolic blood pressure (SBP), diastolic blood pressure (DBP) and HRV parameters. Sub-analyses were also done to compare the data of boys of control and test groups and the data of girls of control and test groups. Results: SBP, DBP and Mean arterial pressure (MAP) were significantly high in the test group. However, there was no significant difference between test and control groups with respect to HRV parameters. Subanalyses revealed that the obese boys had a significantly high SBP, DBP, MAP, rate pressure product (RPP) and a significantly low total HRV while the obese girls had a significantly raised SDNN, RMSSD, pNN50, LF power, HF power and total HRV. Conclusion: The obese children had a significantly raised blood pressure. There was no difference in the HRV parameters of normal weight and obese children. However, obese boys had a significantly reduced total HRV when compared to normal weight boys while the obese girls had a significantly raised total HRV when compared to normal weight girls. The various physiological changes during puberty and the time of onset of puberty may have a varying impact on the cardiac autonomic status of obese male and female children.

Intra-class Correlation among Heart Rate Variability analysis softwares across different physiological postures.

Heart rate variability (HRV) is a simple technique which helps to assess the alterations in cardiac autonomic activity in healthy and diseased individuals. It is performed in various research centers using different hardwares and softwares. Hence, HRV reports generated from these centers cannot be compared unless their HRV data acquisition systems and the HRV analysis softwares correlate or agree with each other. In this study, Intra-class correlation coefficient test was done to see the extent of correlation among three HRV analysis softwares used by researchers in India, namely, (1). Kubios HRV version 2.0, Department of Physics, University of Kuopio, Finland, (2). HRV soft 1.1 Version, Autonomic Function Laboratory, Department of Physiology, All India Institute Of Medical Sciences (AIIMS), New Delhi and (3). Nevrokard aHRV 12.0.0. (Medistar Inc., Slovenia). Following standard guidelines, five minutes ECG data was acquired from twenty six healthy volunteers in supine, sitting and standing positions. The R-R intervals were computed from the ECG data and was subjected to short-term HRV analysis using the above three softwares. Statistical analysis revealed a highly significantly (p<0.001) perfect positive correlation (ICC values > 0.8) among the three softwares for both time domain and frequency domain parameters in the three different positions. Hence, it may be proposed that the interpretation of short-term HRV reports generated by the three softwares, across laboratories, can be equated.

An energy-aware heart disease prediction system using ESMO and optimal deep learning model for healthcare monitoring in IoT.

The Internet of Things (IoT), which provides seamless connectivity between people and things, improves our quality of life. In the medical field, predictive analytics can help transform a reactive healthcare (HC) strategy into a proactive one. The HC industry embraces cutting-edge artificial intelligence and machine learning (ML) technologies. ML's area of deep learning has the revolutionary potential to reliably analyze massive volumes of data quickly, produce insightful revelations and solve challenging issues. This article proposes an energy-aware heart disease prediction (HDP) system based on enhanced spider monkey optimization (ESMO) and a weight-optimized neural network for an IoT-based HC environment. The proposed work consists of two essential phases: energy-efficient data transmission and HDP. In energy-efficient transmission, the cluster leaders are optimally selected using ESMO and the cluster formation is done based on Euclidean distance. In HDP, the patient data are collected from the dataset, and essential features are extracted. After that, the dimensionality reduction is carried out using the modified linear discriminant analysis approach to reduce over-fitting issues. Finally, the HDP uses the enhanced Archimedes weight-optimized deep neural network (EAWO-DNN). The simulation findings demonstrate that the proposed optimal clustering mechanism enhances the network's lifespan by consuming minimal energy compared to the existing techniques. Also, the proposed EAWO-DNN classifier achieves higher prediction accuracy, precision, recall and f-measure than the conventional methods for predicting heart disease in IoT.Communicated by Ramaswamy H. Sarma.

Influence of deep breathing exercise on spontaneous respiratory rate and heart rate variability: a randomised controlled trial in healthy subjects.

Studies show that yogic type of breathing exercises reduces the spontaneous respiratory rate. However, there are no conclusive studies on the effects of breathing exercise on heart rate variability. We investigated the effects of non-yogic breathing exercise on respiratory rate and heart rate variability. Healthy subjects (21-33 years, both genders) were randomized into the intervention group (n=18), which performed daily deep breathing exercise at 6 breaths/min (0.1 Hz) for one month, and a control group (n=18) which did not perform any breathing exercise. Baseline respiratory rate and short-term heart rate variability indices were assessed in both groups. Reassessment was done after one month and the change in the parameters from baseline was computed for each group. Comparison of the absolute changes [median (inter-quartile ranges)] of the parameters between the intervention and control group showed a significant difference in the spontaneous respiratory rate [intervention group -2.50 (-4.00, -1.00), control group 0.00 (-1.00, 1.00), cycles/min, P<0.001], mean arterial pressure [intervention group -0.67 (-6.67, 1.33), control group 0.67 (0.00, 6.67), mmHg, (P<0.05)], high frequency power [intervention group 278.50 (17.00, 496.00), control group -1.00 (-341.00, 196.00), ms2 P<0.05] and sum of low and high frequency powers [intervention group 512.00 (-73.00, 999.00), control group 51.00 (-449.00, 324.00), ms2, P<0.05]. Neither the mean of the RR intervals nor the parameters reflecting sympatho-vagal balance were significantly different across the groups. In conclusion, the changes produced by simple deep slow breathing exercise in the respiratory rate and cardiac autonomic modulation of the intervention group were significant, when compared to the changes in the control group. Thus practice of deep slow breathing exercise improves heart rate variability in healthy subjects, without altering their cardiac autonomic balance. These findings have implications in the use of deep breathing exercises to improve cardiac autonomic control in subjects known to have reduced heart rate variability.

Role of Neural Stem Cells and Vitamin D Receptor (VDR)-Mediated Cellular Signaling in the Mitigation of Neurological Diseases.

Specific stem cell-based therapies for treating Alzheimer's disease, Parkinson's disease, and schizophrenia are gaining importance in recent years. Accumulating data is providing further support by demonstrating the efficacy of neural stem cells in enhancing the neurogenesis in the aging brain. In addition to stem cells, recent studies have shown the efficacy of supplementing vitamin D in promoting neurogenesis and neuronal survival. Studies have also demonstrated the presence of mutational variants and single-nucleotide polymorphisms of the vitamin D receptor (VDR) in neurological disorders; however, implications of these mutations in the pathophysiology and response to drug treatment are yet to be explored. Hence, in this article, we have reviewed recent reports pertaining to the role of neural stem cells and VDR-mediated cellular signaling cascades that are involved in enhancing the neurogenesis through Wnt/ß-catenin and Sonic Hedgehog pathways. This review benefits neurobiologists and pharmaceutical industry experts to develop stem cell-based and vitamin D-based therapies to better treat the patients suffering from neurological diseases.

Predominant peripheral lesions in patients with diabetic retinopathy and its association with systemic comorbidities.

Purpose: To determine the associations of predominant peripheral lesions (PPLs) with systemic comorbidities in individuals with diabetic retinopathy. Methods: This is a multicenter cross-sectional observational study conducted across three tertiary eye care centers in south India between January 2019 and July 2021. Ultra-widefield fundus images of consecutive patients with varying severity of diabetic retinopathy with data on systemic comorbidities were classified based on the presence or absence of PPL. Systemic comorbidities (hypertension, diabetic kidney disease, coronary artery disease, dyslipidemia, and anemia) were compared between the two groups. Results: A total of 879 participants (70.1% males) were included in the study, of which 443 (50.4%) patients had PPL. The mean age of the study participants was 56 ± 10 years, mean age of onset of diabetes was 41.24 ± 11.6 years, and mean duration of diabetes was 15.39 ± 7.6 years. The number of PPL increased with increasing severity of DR. Of all the systemic comorbidities analyzed, we found that coronary artery disease (CAD) had a significant association with PPL (Odds ratio [OR]-1.69; 95% confidence interval [CI], 1.12-2.55; P = 0.013) after adjusting for diabetic retinopathy severity, duration of diabetes, and age of onset of diabetes. Conclusion: The presence of PPL is a marker for coronary artery disease and early referral to cardiology is warranted.

Optimization of Leach Protocol in Wireless Sensor Network Using Machine Learning.

The Wireless Sensor Network is a network formed in areas human beings cannot access. The data need to be sensed by the sensor and transferred to the sink node. Many routing protocols are designed to route data from a single node to the sink node. One of the routing protocols is the hierarchical routing protocol, which passes on the sensed data hierarchically. The Low Energy Adaptive Clustering Hierarchy (LEACH) is one of the hierarchical methods in which communication happens in two steps: the setup phase and the steady-state phase. The efficiency of the LEACH has to be optimized to improve the network lifetime. Therefore, the k-means clustering algorithm, which comes under the unsupervised machine learning method, is incorporated with the LEACH algorithm and has shown better results. But the selection of cluster head needs to improvise because it will transfer the summed-up data to the sink node, so it is to be efficient enough. So, this paper proposes the modified k-means algorithm with LEACH protocol for optimizing the Wireless Sensor Network. In the modified k-means algorithm, the weight of the cluster head is tested and elected, and the clusters are formed using the Euclidean distance formula. The proposed work yields 48.85% efficiency compared to the existing protocol. It is also proven that the proposed work showed more successful data transfer to the sink node. The cluster head selection process elects the more efficient node as the head with less failure rate. The proposed work optimistically balanced the whole network in terms of energy and successful data transfer.

Development of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices.

BACKGROUND: There is increasing recognition that public health strategies to prevent childhood obesity need to start early in life. Any behavioural interventions need to target maternal attitudes and infant feeding practices, This paper describes the development and preliminary validation of a questionnaire to assess maternal attitudes towards infant growth and milk feeding practices. METHODS: We designed a 57-item (19 questions), self-administered questionnaire to measure the following four domains- 1) type of milk feeding, decision making and sources of advice; 2) frequency and quantity of milk feeds; 3) attitudes to infant feeding and growth; and 4) theory-based beliefs about following infant feeding recommendations. Forty mothers completed the questionnaire on two occasions six days apart (to assess test-retest reliability) and then participated in a semi-structured, open-ended telephone interview covering the same domains (to assess criterion validity). Percentage agreement, Cohen's Kappas (for categorical variables) and Spearman's correlation coefficients (for continuous variables) were used to quantify reliability and validity. Internal consistency between theory-based constructs (self-efficacy, outcome expectancy and intention) was quantified by Chronbach's alpha. RESULTS: Of the 57 questionnaire items 51 (89%) had percentage agreement above 70% indicating good test-retest reliability, and the remaining 6 items had moderate or substantial levels of agreement (kappa 0.41-0.68). Comparing questionnaire with interview coding (validity), percentage agreement was above 66% for 39/57 items (68%). Of the 16 items with percentage agreement below 66%, only five had kappa values below 0.20 (two items had insufficient interview responses). Internal consistency was 0.51, 0.79 and 0.90 for self-efficacy, outcome expectancy and intention respectively. CONCLUSIONS: This questionnaire could be a useful tool in understanding the determinants of infant feeding and the 'causal mechanism' of interventions that target infant feeding practices to prevent early obesity.

Blood pressure responses to steady treadmill exercise in overweight and obese young adults.

Overweight and obesity are major risk factors for chronic diseases. There exists an autonomic imbalance in these persons. The blood pressure response to exercise is an useful method to evaluate cardiac status. Hence this project was undertaken to study the blood pressure responses to steady treadmill exercise in overweight and obese persons. The study was carried out on 85 young healthy adults (Normal weight = 30, Overweight = 25 and Obese = 30) in the age group of 18-22 yrs. Steady dynamic exercise test was done on treadmill for 5 mins. Blood pressure and Pulse rate were recorded before, during 3rd min of exercise, immediately after cessation of exercise and after 5 mins of recovery. Statistical analysis was done using one way ANOVA followed by post-hoc tests for between group comparisons. The resting blood pressure was higher in overweight and obese group when compared to normal group. There was increased systolic pressure response to exercise in study groups where as the diastolic pressure decreased during exercise. Heart rate response was also higher in study groups. Over weight and obese young adults had elevated resting blood pressure and showed increased response to steady exercise which could be due to alterations in the autonomic activity in these persons.

Delineation of ischemic lesion from brain MRI using attention gated fully convolutional network.

Precise delineation of the ischemic lesion from unimodal Magnetic Resonance Imaging (MRI) is a challenging task due to the subtle intensity difference between the lesion and normal tissues. Hence, multispectral MRI modalities are used for characterizing the properties of brain tissues. Traditional lesion detection methods rely on extracting significant hand-engineered features to differentiate normal and abnormal brain tissues. But the identification of those discriminating features is quite complex, as the degree of differentiation varies according to each modality. This can be addressed well by Convolutional Neural Networks (CNN) which supports automatic feature extraction. It is capable of learning the global features from images effectively for image classification. But it loses the context of local information among the pixels that need to be retained for segmentation. Also, it must provide more emphasis on the features of the lesion region for precise reconstruction. The major contribution of this work is the integration of attention mechanism with a Fully Convolutional Network (FCN) to segment ischemic lesion. This attention model is applied to learn and concentrate only on salient features of the lesion region by suppressing the details of other regions. Hence the proposed FCN with attention mechanism was able to segment ischemic lesion of varying size and shape. To study the effectiveness of attention mechanism, various experiments were carried out on ISLES 2015 dataset and a mean dice coefficient of 0.7535 was obtained. Experimental results indicate that there is an improvement of 5% compared to the existing works.

Enhanced electrochemical activities of morphologically tuned MnFe2O4 nanoneedles and nanoparticles integrated on reduced graphene oxide for highly efficient supercapacitor electrodes.

The morphology of a nanoparticle strongly controls the path of electronic interaction, which directly correlates with the physicochemical properties and also the electrochemical comportment. Combining it with a two-dimensional (2D) material for a layer-by-layer approach will increase its possibilities in applications such as energy conversion and storage. Here, two different morphologies of MnFe2O4, nanoparticles and nanoneedles, are developed by a facile hydrothermal approach and sandwiched with reduced graphene oxide for constructing a 2D/3D sandwiched architecture. The rGO planar structure with abundant hierarchical short pores facilitates the thorough utilization of the utmost surface area to permeate the electrolyte within the structure to minimize the accumulation of rGO nanosheets laterally. The ferrite composited with rGO manifests high specific capacitance as the EDLC behaviour surpasses the faradaic pseudocapacitance boosting electrical conductivity compared to the as-synthesized MnFe2O4 structures. Benefiting from a 3D structure and the synergetic contribution of the MnFe2O4 nanoneedles and electrically conductive rGO layer, the MnFe2O4 nanoneedles@rGO electrode exhibits a high areal capacitance of 890 mF cm-2 and a remarkable specific capacitance of 1327 F g-1 at a current density of 5 mA cm-2. 93.36% of the initial capacitance was retained after 5000 cycles in 1 mol L-1 Na2SO4 indicating its high cycling stability. The synthesis route proves to be beneficial for a comprehensive yield of MnFe2O4@rGO nanosheets of different morphologies for use in the sophisticated design of energy-storing devices. This research strongly suggests that nanoparticle geometry, in addition to two-dimensional carbon-based materials, is a critical factor in a supercapacitor design.

A novel school-based intervention to improve nutrition knowledge in children: cluster randomised controlled trial.

BACKGROUND: Improving nutrition knowledge among children may help them to make healthier food choices. The aim of this study was to assess the effectiveness and acceptability of a novel educational intervention to increase nutrition knowledge among primary school children. METHODS: We developed a card game 'Top Grub' and a 'healthy eating' curriculum for use in primary schools. Thirty-eight state primary schools comprising 2519 children in years 5 and 6 (aged 9-11 years) were recruited in a pragmatic cluster randomised controlled trial. The main outcome measures were change in nutrition knowledge scores, attitudes to healthy eating and acceptability of the intervention by children and teachers. RESULTS: Twelve intervention and 13 control schools (comprising 1133 children) completed the trial. The main reason for non-completion was time pressure of the school curriculum. Mean total nutrition knowledge score increased by 1.1 in intervention (baseline to follow-up: 28.3 to 29.2) and 0.3 in control schools (27.3 to 27.6). Total nutrition knowledge score at follow-up, adjusted for baseline score, deprivation, and school size, was higher in intervention than in control schools (mean difference = 1.1; 95% CI: 0.05 to 2.16; p = 0.042). At follow-up, more children in the intervention schools said they 'are currently eating a healthy diet' (39.6%) or 'would try to eat a healthy diet' (35.7%) than in control schools (34.4% and 31.7% respectively; chi-square test p < 0.001). Most children (75.5%) enjoyed playing the game and teachers considered it a useful resource. CONCLUSIONS: The 'Top Grub' card game facilitated the enjoyable delivery of nutrition education in a sample of UK primary school age children. Further studies should determine whether improvements in nutrition knowledge are sustained and lead to changes in dietary behaviour.

Development of BiFeO3/MnFe2O4 ferrite nanocomposites with enhanced magnetic and electrical properties.

Herein we report the development of novel multiferroic nanocomposites for their enhanced magnetic and electrical properties by employing a simple cost-effective chemical process at low temperatures. Novel perovskite-mixed spinel nanocomposites of (1 - x)BiFeO3/xMnFe2O4 where x = 0.1-0.5 have been prepared by a sol-gel auto-combustion technique. The calcination temperature was optimized and the phase formation of BiFeO3/MnFe2O4 nanocomposites was confirmed from the X-ray diffraction patterns for the samples calcined at 500 °C for 2 h. The grain sizes have been found to vary from 60 to 90 nm. The vibrational modes of the prepared nanocomposites were studied using Raman spectroscopy and FESEM and EDX were used to carry out the microstructural and composition analysis respectively. The magnetic properties seemed to have a strong dependence on the concentration of the spinel ferrite in the composite system. Saturation magnetization and coercivity exhibit an increase with increase in the MnFe2O4 content. The electrical properties from solid state impedance analysis confirm the non-Debye characteristics and the maximum activation energy is 0.931 eV for the 0.5BiFeO3/0.5MnFe2O4 nanocomposite. Dispersion in the dielectric constant and dielectric loss in the low frequency range has also been determined, which decreases with increase in temperature at lower ac frequencies.

Corrigendum to "Protective role of Moringa oleifera leaf extract on cardiac antioxidant status and lipid peroxidation in streptozotocin induced diabetic rats" [Heliyon 5, (12), (December 2019), e02935].

[This corrects the article DOI: 10.1016/j.heliyon.2019.e02935.].

Spectrum of Eye Disease in Diabetes (SPEED) in India: A prospective facility-based study. Report # 4. Glaucoma in people with type 2 diabetes mellitus.

Purpose: To estimate the proportion of people with type 2 diabetes mellitus (T2DM) and glaucoma in a facility-based cross-sectional observational study in India. Methods: All people received a comprehensive eye examination. Glaucoma-specific examinations included applanation tonometry, optic disc and cup evaluation, and stereo biomicroscopy in all people; gonioscopy and visual field testing in glaucoma suspects. The International Society of Geographic and Epidemiologic Ophthalmology guidelines were used to diagnose and classify glaucoma. Results: The study recruited 11,182 people (average age: 58.2 ± 10.6; range 39-96 years). Glaucoma was diagnosed in 4.9% (n = 547) people. About 76.8% (n = 420) of those with glaucoma had bilateral disease, and 98.7% (n = 540) were >40 years. Among people with bilateral disease, 94.5% (n = 397) had primary glaucoma - open angle in 59.3% (n = 228) and angle closure in 40.2% (n = 169). Diabetes duration was ≤10 years in 71.5% (n = 300) people. On linear regression, the following were associated with glaucoma: advancing age [compared with < 40 years age group; odds ratio [OR] in 50-60 year age group: 1.36 [95% confidence interval (CI): 1.01-1.8], P < 0.035); >60 years age group (OR: 2.05, 95% CI: 1.57-2.67; P < 0.001), and diabetic neuropathy (OR: 2.62, 95% CI: 1.35-5.10, P < 0.003). Glycemic control did not have significant association (P = 0.425). Conclusion: Presence of glaucoma in people with T2DM in this cohort was similar to the general population prevalence studies in India. Glaucoma was invariably bilateral. A comprehensive eye examination in people age 40 years and older with diabetes and/or glaucoma is beneficial.

Spectrum of Eye Disease in Diabetes (SPEED) in India: A prospective facility-based study. Report # 3. Retinal vascular occlusion in patients with type 2 diabetes mellitus.

Purpose: To determine the proportion of people with type 2 diabetes mellitus (T2DM) attending large eye care facilities across India who have retinal vascular occlusion (RVO). Methods: A 6-month descriptive, multicenter, observational hospital-based study of people was being presented to the 14 eye care facilities in India. The retina-specific component of comprehensive eye examination included stereoscopic biomicroscopy, binocular indirect ophthalmoscopy, and fundus fluorescein angiography, and optical coherence tomography was also available when needed. Data recording of the duration of diabetes, hypertension (HTN), stroke, and other variables was obtained from the medical history. The statistical analysis included frequencies, mean, and standard deviations for continuous variables. Odds ratio (OR) and multivariate analysis were undertaken to assess the associations between risk factors and RVO. Results: The study recruited 11,182 consecutive patients (22,364 eyes) with T2DM. About 59.0% (n = 6697) were male. The mean age was 58.2 ± 10.6 years. In this cohort, RVO was detected in 3.4% (n = 380) of patients; 67.6% (n = 257) of them had branch retinal vein occlusion (BRVO) and the remaining 32.4% (n = 123) had central retinal vein occlusion (CRVO). The frequency of unilateral BRVO (n = 220, 85.6%) and unilateral CRVO (n = 106, 86.18%) was much common. Unilateral RVO was more frequent (n = 326, 85.8%) than bilateral diseases (n = 54, 14.2%) (χ2 = 126.95, P < 0.001). Ischemic CRVO was more common (n = 103, 73.6%) than nonischemic CRVO (n = 37, 26.4%). Macula-involving BRVO was found in 58.5% (n = 172) of cases, suggesting more than 50% of cases in RVO carries a risk of severe vision loss. The duration of diabetes apparently had no influence on the occurrence of RVO. On the multivariate analysis, a history of HTN [OR: 1.7; 95% confidence interval (CI): 1.3-2.1; P = 0.001) and stroke (OR: 5.1; 95% CI: 2.1-12.4; P < 0.001) was associated with RVO. Conclusion: RVO is a frequent finding in people with T2DM. History of stroke carries the highest risk followed by HTN. The management of people with T2DM and RVO must also include comanagement of all associated systemic conditions.

The ORNATE India Project: United Kingdom-India Research Collaboration to tackle visual impairment due to diabetic retinopathy.

INTRODUCTION: The ORNATE India project is funded by the UK Research and Innovation (UKRI) through the Global Challenges Research Fund. The aim is to build research capacity and capability in India and the UK to tackle global burden of diabetes-related visual impairment. As there are over 77 million people with diabetes in India, it is challenging to screen every person with diabetes annually for sight-threatening diabetic retinopathy (DR). Therefore, alternate safe approaches need to be developed so that those at-risk of visual impairment due to DR is identified promptly and treated. METHODS: The project team utilised diverse global health strategies and research methods to co-design work packages to build research capacity and capability to ensure effective, affordable and efficient DR services are made available for the population. The strategies and methods employed included health system strengthening; implementation science; establishing care pathways; co-designing collaborative studies on affordable technologies, developing quality standards and guidelines to decrease variations in care; economic analysis; risk modelling and stratification. Five integrated work packages have been developed to deal with all aspects of DR care. These included implementation of a DR screening programme in the public health system in a district in Kerala, evaluating regional prevalence of diabetes and DR and assessing ideal tests for holistic screening for diabetes and its complications in 20 areas in India, utilising artificial intelligence on retinal images to facilitate DR screening, exploring biomarker and biosensor research to detect people at risk of diabetes complications, estimating cost of blindness in India and risk modelling to develop risk-based screening models for diabetes and its complications. A large collaborative network will be formed to propagate research, promote shared learning and bilateral exchanges between high- and middle-income countries to tackle diabetes-related blindness.

Protective role of Moringa oleifera leaf extract on cardiac antioxidant status and lipid peroxidation in streptozotocin induced diabetic rats.

Moringa oleifera is a medicinal plant with great therapeutic potential. The leaves of Moringa oleifera are used by Indians in herbal medicines to treat diabetes. The present study is aimed to determine the protective role of Moringa oleifera in cardiac tissues under diabetic conditions. Diabetic rats were treated orally with methanolic extract of Moringa oleifera leaves at a dose of 300 mg/Kg body weight for 60 days. The effect of extract on serum glucose, glycated hemoglobin, plasma insulin and the levels of thiobarbituric acid reactive substances (TBARS), hydroperoxides (HP), conjugated dienes (D), activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-reductase (GRD) and reduced glutathione content (GSH) were estiated. Metformin and atorvastatin were used as standard drugs. A significant increase in plasma insulin, activities of superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione-reductase (GRD) and reduced glutathione content (GSH) and a significant decrease in serum glucose, glycated hemoglobin, thiobarbituric acid reactive substances (TBARS), hydroperoxides (HP) and conjugated dienes (CD) were observed in the treated groups. This study evaluated the antioxidant potential of methanolic extract of Moringa oleifera leaves. These findings suggest the protective role of Moringa oleifera against oxidative stress in the heart of diabetic rats.

Role of epidermal growth factor and other growth factors in the prevention of necrotizing enterocolitis.

Necrotizing enterocolitis (NEC) presents as the most common gastrointestinal emergency during the neonatal period and results in ulceration and necrosis of the distal small intestine and proximal colon. The etiology of NEC remains unknown. Based on the complexity of gut development, multiple growth factors and cytokines may be needed to synergistically support the developing gut. Epidermal growth factor (EGF) has been shown to play an important role in intestinal cell restitution, proliferation, and maturation. EGF is found in abundant quantities in many fluids, including the gastrointestinal tract, amniotic fluid, breast milk, and saliva. Preliminary clinical trials using EGF in neonates diagnosed with NEC have been shown to promote repair of intestinal epithelium. Additionally, other growth factors are also emerging as potential treatment modalities, including erythropoietin, granulocyte colony stimulating factor, and heparin-binding EGF. The role of EGF and other growth factors in the pathogenesis and prevention of NEC will be reviewed.