Orbital apex syndrome secondary to optic nerve cysticercosis.

A 22-year-old male presented to us with complaints of sudden painful loss of vision in left eye 10 days ago along with inward deviation of the left eye. Best-corrected visual acuity (BCVA) in right eye was 20/20 and 20/50 in left eye. Left eye showed limitation of abduction, a relative afferent pupillary defect, normal anterior segment with optic disc oedema. Contrast-enhanced MRI of the brain and orbit showed thickening of left optic nerve along with a cystic lesion near the orbital apex with a central iso- to hyperintense spot resembling a scolex. A diagnosis of left orbital apex syndrome secondary to optic nerve cysticercosis was made. Patient was treated with oral albendazole and intravenous corticosteroids for 3 days followed by oral corticosteroids. Ten weeks post-treatment, his BCVA in the left eye improved to 20/20 and colour vision and visual fields improved. Pallor of the left optic disc was noted, and ocular motility improved completely. MRI after treatment showed a decreased thickness of left optic nerve with disappearance of the cystic lesion.

Thermoresponsive, redox-polymerized cellulosic hydrogels undergo in situ gelation and restore intervertebral disc biomechanics post discectomy.

Back and neck pain are commonly associated with intervertebral disc (IVD) degeneration. Structural augmentation of diseased nucleus pulposus (NP) tissue with biomaterials could restore degeneration-related IVD height loss and degraded biomechanical behaviors; however, effective NP replacement biomaterials are not commercially available. This study developed a novel, crosslinked, dual-polymer network (DPN) hydrogel comprised of methacrylated carboxymethylcellulose (CMC) and methylcellulose (MC), and used in vitro, in situ and in vivo testing to assess its efficacy as an injectable, in situ gelling, biocompatible material that matches native NP properties and restores IVD biomechanical behaviors. Thermogelling MC was required to enable consistent and timely gelation of CMC in situ within whole IVDs. The CMC-MC hydrogel was tuned to match compressive and swelling NP tissue properties. When injected into whole IVDs after discectomy injury, CMC-MC restored IVD height and compressive biomechanical behaviors, including range of motion and neutral zone stiffness, to intact levels. Subcutaneous implantation of the hydrogels in rats further demonstrated good biocompatibility of CMC-MC with a relatively thin fibrous capsule, similar to comparable biomaterials. In conclusion, CMC-MC is an injectable, tunable and biocompatible hydrogel with strong potential to be used as an NP replacement biomaterial since it can gel in situ, match NP properties, and restore IVD height and biomechanical function. Future investigations will evaluate herniation risk under severe loading conditions and assess long-term in vivo performance.

Human resistin, a proinflammatory cytokine, shows chaperone-like activity.

Resistin, a cysteine-rich adipocytokine, proposed as a link between obesity and diabetes in mice, was shown as a proinflammatory molecule in humans. We earlier reported that human resistin (hRes), a trimer, was resistant to heat and urea denaturation, existed in an oligomeric polydispersed state, and showed a concentration-dependent conformational change. These properties and an intimate correlation of hRes expression with cellular stress prompted us to investigate hRes as a possible chaperone. Here, we show that recombinant human resistin was able to protect the heat-labile enzymes citrate synthase and Nde1 from thermal aggregation and inactivation and was able to refold and restore their enzymatic activities after heat/guanidinium chloride denaturation. Furthermore, recombinant human resistin could bind misfolded proteins only. Molecular dynamics-based association-dissociation kinetics of hRes subunits pointed to resistin being a molecular chaperone. Bis-ANS, which blocks surface hydrophobicity, abrogated the chaperone activity of hRes, establishing the importance of surface hydrophobicity for chaperone activity. Replacement of Phe49 with Tyr (F49YhRes), a critical residue within the hydrophobic patch of hRes, although it could prevent thermal aggregation of citrate synthase and Nde1, was unable to refold and restore their activities. Treatment of U937 cells with tunicamycin/thapsigargin resulted in reduced hRes secretion and concomitant localization in the endoplasmic reticulum. Escherichia coli transformants expressing hRes could be rescued from thermal stress, pointing to hRes's chaperone-like function in vivo. HeLa cells transfected with hRes showed protection from thapsigargin-induced apoptosis. In conclusion, hRes, an inflammatory protein, additionally exhibited chaperone-like properties, suggesting a possible link between inflammation and cellular stress.

Synthesis of small-sized, porous, and low-toxic magnetite nanoparticles by thin POSS silica coating.

In this communication, we report the synthesis of small-sized (<10 nm), water-soluble, magnetic nanoparticles (MNPs) coated with polyhedral oligomeric silsesquioxanes (POSS), which contain either polyethylene glycol (PEG) or octa(tetramethylammonium) (OctaTMA) as functional groups. The POSS-coated MNPs exhibit superparamagnetic behavior with saturation magnetic moments (51-53 emu g(-1)) comparable to silica-coated MNPs. They also provide good colloidal stability at different pH and salt concentrations, and low cytotoxicity to MCF-7 human breast epithelial cells. The relaxivity data and magnetic resonance (MR) phantom images demonstrate the potential application of these MNPs in bioimaging.

Comparison of innate immune activation after prolonged feeding of milk fermented with three species of Lactobacilli.

The present investigation aimed at identifying the abilities of three different species of probiotic lactobacilli to modulate cellular immune responses in mouse neutrophils and macrophages in vivo over a study period of 60 days. Neutrophil respiratory burst enzymes (cytochrome c reductase and MPO) showed remarkable increased activity (P ≤ 0.01) after consumption of milks fermented by different species of probiotics over 30 and 60 days of feeding trials. Enzyme activities (ß-galactosidase and ß-glucuronidase) and nitric oxide production also increased considerably (P ≤ 0.01) in macrophages, both in peritoneal fluid and in enriched cell cultures. The effects of enhanced enzyme activities were corroborated by simultaneous increases in the phagocytic activities of neutrophils and macrophages. The increases in cellular functions were invariably maximal during the first 30 days of study and were maintained, but did not increase, over the next 30 days. Further, Lactobacillus helveticus-fed groups were most effective at modulating neutrophil functions whereas Lactobacillus paracasei-fed groups were more potent at enhancing macrophage functions. Together, our results indicate that probiotics have strain specific effects on stimulating cellular functions while not causing excessive stimulation of the immune system over longer feeding periods, thereby resulting in maximum and stable health benefits.

Comparison of galvanic corrosion potential of metal injection molded brackets to that of conventional metal brackets with nickel-titanium and copper nickel-titanium archwire combinations.

AIM: The aim of the study is to investigate the galvanic corrosion potential of metal injection molding (MIM) brackets to that of conventional brackets under similar in vitro conditions with nickel-titanium and copper nickel-titanium archwires. MATERIALS AND METHODS: Twenty-five maxillary premolar MIM stainless steel brackets and 25 conventional stainless steel brackets and archwires, 0.16 inch, each 10 mm length, 25 nickeltitanium wires, 25 copper nickel-titanium wires were used. They were divided into four groups which had five samples each. Combination of MIM bracket with copper nickel-titanium wire, MIM bracket with nickel-titanium wire and conventional stainless steel brackets with copper nickel-titanium wire and conventional stainless steel brackets with nickel-titanium wires which later were suspended in 350 ml of 1 M lactic acid solution media. Galvanic corrosion potential of four groups were analyzed under similar in vitro conditions. Precorrosion and postcorrosion elemental composition of MIM and conventional stainless steel bracket by scanning electron microscope (SEM) with energy dispersive spectroscope (EDS) was done. RESULTS: MIM bracket showed decreased corrosion susceptibility than conventional bracket with copper nickeltitanium wire. Both MIM and conventional bracket showed similar corrosion resistance potential in association with nickel-titanium archwires. It seems that both brackets are more compatible with copper nickel-titanium archwires regarding the decrease in the consequences of galvanic reaction. The EDS analysis showed that the MIM brackets with copper nickel-titanium wires released less metal ions than conventional bracket with copper nickeltitanium wires. CONCLUSION: MIM brackets showed decreased corrosion susceptibility, copper nickel-titanium archwires are compatible with both the brackets than nickel-titanium archwires. CLINICAL SIGNIFICANCE: Clinically MIM and conventional brackets behaved more or less similarly in terms of corrosion resistance. In order to decrease the corrosion potential of MIM brackets, more precise manufacturing technique should be improved to get a more smoother surface finish.

The relationship between salivary alpha-amylase, nitric oxide, pain and anxiety-induced stress in patients during dental treatment.

Background: Pain and anxiety are the most reported negative effect of orthodontic treatment which can influence the quality of life and are responsible for the discontinuation of treatment. These unpleasant experiences raise the stress levels reflected by the increase in the concentration of salivary alpha-amylase and nitric oxide. These can be assessed through various subjective methods which have limited value as it depends on the patient's honesty, assessing whether using objective methods are reliable. Objectives: To assess pain and anxiety-induced stress levels using both physiological (Salivary alpha-amylase and Salivary nitric oxide) and psychological testing instruments (Visual analog scale and State Trait Anxiety Inventory Y6) during the initial phases of fixed orthodontic treatment. Materials and Methods: A total of 30 patients were included. Pain and anxiety instruments were applied and saliva samples were collected from patients before and after separator placement, before and 48 h after archwire insertion and 1 month after archwire insertion. Results: The mean values of alpha-amylase (235.3600), nitric oxide levels (2.060) and pain scores (7.8667) were higher 48 h after archwire insertion (T3) which are statistically significant, P = 0.00. Anxiety scores (57.7000) were high before separator placement (T0). No statistically significant correlation was found among pain and alpha-amylase, anxiety and nitric oxide levels. Conclusion: Initial alignment phases of fixed orthodontic treatment affect patients' anxiety and stress levels. The findings could be a result of the psychological stress due to procedures in the initial phases of the treatment.

Design of a low-cost, reconfigurable, standing wheelchair with easy and stable sit-stand-sit transition capability.

PURPOSE: Assistive devices like Standing Wheelchairs (SWC) have remained out of reach of the economically underprivileged even before the pandemic-induced financial downturn, and more so now. This paper describes the mechanical design of a manual user-actuated SWC that is cost-effective (equivalent of USD 210 in India, ex-factory) and has special features that minimise user effort and accommodates varying body weights (50-110 kg) and dimensions (1.52-1.83 m height). METHODS: The design includes a six-bar mechanism and spring balancing to optimise user effort during operation. The optimised gas spring incorporates adjustability to minimise each user's force for sit-stand-sit transitions. The handle shape is ergonomically designed using kinematic analysis to provide convenient gripping positions for actuation. The design has been customised based on parametric studies to suit varying body weights. RESULTS: Overall, the SWC design provides standing functionality with ease of operation, safety locks, customisability, affordability, outdoor mobility and is aesthetically pleasing. CONCLUSIONS: Customisability and the low cost of the device would enhance the accessibility of the SWC to a larger group of eligible users.Implications for rehabilitationManual user-operated standing wheelchair design using a six-bar mechanismSpring balancing used to reduce user effort to self-lift to the standing positionKinematic analysis used to determine convenient handle location for user easeCustomisability for wide range of users to ensure correct posture, optimal effortDesign refined through multiple iterations using inputs from users and cliniciansDesign commercialised at an affordable cost, making it accessible to a larger population.

Biomechanical and clinical considerations in correcting skeletal class II malocclusion with Forsus™.

AIM: The present case report describes the importance of understanding of biomechanical and clinical considerations in application of Forsus appliance in correction of class II skeletal malocclusion. BACKGROUND: Angle's class II malocclusion is one of the most prevailing that may be either skeletal or dental presenting with different clinical manifestations. There are number of appliances to treat such a malocclusion in a growing child. Fixed functional appliances are indicated for class II corrections in patients who report late with minimal residual growth left. CASE DESCRIPTION: A case of class II skeletal and dental malocclusion treated with preadjusted edgewise appliance supplemented with Forsus Fatigue Resistant Device (FRD) (3M Unitek Corp, California, USA) is reported. CONCLUSION: Forsus device is an effective alternative in treating moderate skeletal class II malocclusion. The Forsus FRD (3M Unitek Corp, California, USA) can be used instead of class II elastics in mild cases and in place of Herbst appliance in severe cases. Alteration of force vector by modifying the archwire as shown in this case report while applying Forsus and incorporation of 10 degree labial root torque in lower archwire will minimize the effects on dentition. Engaging modules or tubing on to the pushrod and leaving 1 to 2 mm clearance between distal end of the upper tube and L-pin as shown in this case report will significantly improve the patient compliance. CLINICAL SIGNIFICANCE: Much emphasis should be given to biomechanical considerations which were discussed in this article while treating patients with Forsus to prevent the unwanted effects. Clinical considerations and certain modifications advised in this case report should be utilized while treating class II skeletal malocclusions with Forsus appliance to eliminate the patient cooperation factor and make treatment time estimates much more accurate.

The influence of initial spinal cord haematoma and cord compression on neurological grade improvement in acute traumatic spinal cord injury: A prospective observational study.

STUDY DESIGN: Prospective observational cohort study linked with administrative data. OBJECTIVES: Magnetic Resonance Imaging (MRI) is routinely performed after traumatic spinal cord injury (TSCI), facilitating early, accurate diagnosis to optimize clinical management. Prognosis from early MRI post-injury remains unclear, yet if available could guide early intervention. The aim of this study was to determine the association of spinal cord intramedullary haematoma and/or extent of cord compression evident on initial spine MRI with neurological grade change after TSCI. METHODS: Individuals with acute TSCI ≥16 years of age; MRI review. Neurological gradings (American Spinal Injury Association Impairment Scale (AIS)) were compared with initial MRI findings. Various MRI parameters were evaluated for prediction of neurological improvement pre-discharge. RESULTS: 120 subjects; 79% male, mean (SD) age 51.0 (17.7) years. Motor vehicle crashes (42.5%) and falls (40.0%) were the most common injury mechanisms. Intramedullary spinal cord haematoma was identified by MRI in 40.0% of patients and was associated with more severe neurologic injury (58.3% initially AIS A). Generalised linear regression showed higher maximum spinal cord compression (MSCC) was associated with lower likelihood of neurological improvement from initial assessment to follow up prior to rehabilitation discharge. Combined thoracic level injury, intramedullary haematoma, and MSCC > 25% resulted in almost 90% probability of pre-discharge AIS (grade A) remaining unchanged from admission assessment. CONCLUSIONS: MRI is a vital tool for evaluating the severity and extent of TSCI, assisting in appropriate management decision-making early in TSCI patient care. This study adds to the body of knowledge assisting clinicians in prognostication.

Cephalometric evaluation-based on Steiner's analysis on young adults of Chhattisgarh, India.

AIM: The study was conducted to establish skeletal and dental parameters for Chhattisgarhi young adults, evaluation of variability between male and female Chhattisgarhi normal occlusion subjects and comparison of Cephalometric norms of Chhattisgarh population with Caucasians as well as other non- Caucasian groups. MATERIALS AND METHODS: A Cephalometric study of 80 Chhattisgarhi young adults (40 males and 40 females) with acceptable profile and occlusion was carried out by means of Steiner's analysis. RESULTS: In comparison to the Caucasian samples, the Chhattisgarhi samples were more protrusive skeletally and dentally and exhibited a more horizontal growth pattern than the Caucasians. The females reported with an increased incisor procumbency, prominent chin and prognathic maxilla than their male counterparts. CONCLUSION: The results of the study support the fact that a case of malocclusion cannot be treated to a template of norms which have been derived from mean values of a certain select group of subjects with excellent occlusion and harmonious facial proportions. CLINICAL SIGNIFICANCE: A case of malocclusion needs to be treated based on the individual merits and demerits of that case and not based on template of norms derived from mean values of select subject groups with ideal occlusion and proportion.

Effect of thermal recycling of metal brackets on shear and tensile bond strength.

AIM: The study was undertaken to measure the changes within the mesh pad associated with reconditioning process, measure the bond strength of new and reconditioned orthodontic brackets and correlate the changes in mesh strand diameter with changes in bond strength. MATERIAL AND METHODS: 120 clinically normal premolar teeth extracted for orthodontic reasons, were divided equally for bonding with new and recycled brackets using a no-mix type of adhesive. The mesh strand diameters of new and reconditioned brackets were evaluated with a binocular light microscope. Recycling of brackets was done using Esmadent® bracket and band reconditioner. RESULTS: The mesh strand diameter, tensile and shear bond strength of new and reconditioned brackets were evaluated statistically and the latter was found to show a significant reduction (p< 0.0001). However, the bond strength values of the reconditioned brackets were found to be well above the clinically required minimum. CONCLUSION: Reduction in mesh strand diameter, as a result of reconditioning process, does not correlate with the change in bond strength between initial and recycled bondings. CLINICAL SIGNIFICANCE: The bond strength of reconditioned brackets is adequate enough to resist the magnitude of forces generated in the mouth, throughout the duration of orthodontic treatment for successful treatment results.

Color Doppler Imaging Features of the Lacrimal Sac in Health and Diseased States.

PURPOSE: The objective of this study is to present Color Doppler imaging (CDI) features of the lacrimal sac in normal and diseased states. METHODS: Prospective study was performed on 20 lacrimal sacs of 20 eyes of 10 patients who underwent Color Doppler imaging at a tertiary care Dacryology service over a period of 6 months. All the patients were subjected to Duplex doppler scanning of the lacrimal sacs. Of the 20 lacrimal drainage systems studied, 8 were normal, 8 had primary acquired nasolacrimal duct obstruction (PANDO) and 4 were that of acute dacryocystitis (AcDac). Patient demographics, clinical presentation, duration of the disease and Color Doppler vascular characteristics like peri-sac vascular flow, peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI), arterial spectral waveforms and sac dimensions and wall thickness were analyzed. RESULTS: The vascular flow around the lacrimal sac was increased with higher flow velocities in PANDO as compared to normal and grossly enhanced in AcDac. Flow disturbances were also quite discernible in AcDac. The mean PSV and EDV were 9 & 3.87 cm/sec, 13.07 & 4.63 cm/sec and 18 & 8.5 cm/sec in normal, PANDO and AcDac, respectively. The mean vascular resistivity index increased in patients with PANDO (0.67) and decreased in AcDac (0.53) as compared to the normal (0.57). The arterial spectral waveforms in PANDO and AcDac showed low pulsatility, but the systolic peaks were sharper with more continuous forward flow through diastole in AcDac. This reflects vascular dilatation and reduced resistance to flow in AcDac. CONCLUSION: Characteristic Color Doppler flow parameters can be demonstrated in patients with PANDO and acute dacryocystitis. Color Doppler techniques have the potential to enhance the understanding of lacrimal drainage pathophysiology.

Ab initio chemical kinetics for the reaction of an H atom with Si3H8.

The kinetics and mechanism for the reaction of H with Si(3)H(8) have been investigated using various theoretical methods including CCSD(T)/6-311++G(3df,2p)//B3LYP/6-311++G(3df,2p), G2M(RCC2), and CCSD(T)/6-311++G(3df,2p)//CCSD/6-311+G(d,p). The results obtained by the latter method show that H abstraction from a primary Si-H bond and a secondary Si-H bond leads to the formation of n-Si(3)H(7) and i-Si(3)H(7) products, with 3.8 (TS1) and 3.2 (TS2) kcal/mol barriers, respectively. Significantly, the hydrogen substitution of SiH(3) and Si(2)H(5) groups by attacking at the central Si atom via TS3 (3.3 kcal/mol) and a terminal Si atom of Si(3)H(8) from side and end on (via TS4, 4.2 kcal/mol and TS5, 6.3 kcal/mol), were found to give SiH(3) + Si(2)H(6) and SiH(4) + Si(2)H(5) products, respectively. The heats of formation of Si(3)H(8), n-Si(3)H(7), and i-Si(3)H(7) at 0 K are predicted to be 32.3 +/- 1.2, 68.6, and 66.6 kcal/mol, respectively. These values are in good agreement with the experimental and other theoretical values. The rate constants and branching ratios for the four product channels of the title reaction have been calculated by the transition state theory with Eckart tunneling corrections over a wide temperature region of 250-2500 K. These results may be employed for simulations of catalytic and plasma-enhanced chemical vapor deposition processes of a-Si:H films.

Effects of exposure of parents to toxic gases in Bhopal on the offspring.

BACKGROUND: Exposure to methyl isocyanate and other toxic gases in Bhopal, India, on December 3, 1984 resulted in thousands of acute deaths, pregnancy loss and long-term effects. METHODS: From 1985 to 2007, we conducted successive surveys of vital status and health to determine whether the exposure of parents to toxic gases in the Bhopal incident affected the 5-year survival and anthropometric variables of their offspring. RESULTS: Initial 5-year mortality of offspring of exposed parents was very high. Male but not female offspring who were exposed to gases in utero or who were born to exposed parents were stunted in growth until puberty, which was followed by a period of accelerated growth. Results also suggest a post-puberty effect on head circumference of females exposed to gases in utero. CONCLUSION: Exposure of pregnant women to toxic gases in Bhopal in 1984 resulted in high pregnancy loss, increased first 5-year mortality and delayed development of male progeny.

Video-tube thoracostomy in trauma resuscitation: A pilot study.

BACKGROUND: Complications related to incorrect positioning of tube thoracostomy (TT) have been reported to be as high as 30%. The aim of this study was to assess the feasibility of flexible videoscope guided placement of a pre-loaded chest tube, permitting direct intrapleural visualization and placement (Video-Tube Thoracostomy [V-TT]). METHODS: A prospective, single centre, phase 1 pilot study with a parallel control group was undertaken. The population studied were adult thoracic trauma patients requiring emergency TT who were haemodynamically stable. The intervention performed was VTT. Patients in the control group underwent conventional TT. The primary outcome was tube position as defined by a consultant radiologist's interpretation of chest x-ray (CXR) or CT. The trial was registered with ANZCTR.org.au (ACTRN: 12,615,000,870,550). RESULTS: There were 37 patients enrolled in the study - 12 patients allocated to the VTT intervention group and 25 patients allocated to conventional TT. Mean age of participants was 48 years (SD 15) in intervention group and 46 years (SD 15) years in the control group. In the VTT group all patients were male; the indications were pneumothorax (83%), haemothorax (8%) and haemopneumothorax (8%). The median injury severity score was 23 (16-28). There were 1 positional and 1 insertional complications. In the control group 72% of patients were male, the indications were pneumothorax (56%), haemothorax (4%) and haemopneumothorax (40%). The median injury severity score was 24 (14-36). There were 8 (32%) positional complications and no insertional complications. CONCLUSION: V-TT was demonstrated to be a feasible alternative to conventional thoracostomy and merits further investigation.

A novel approach to improving the interpretation of CT brain in trauma.

BACKGROUND: Computed tomography of the brain (CTB) has a fundamental role in the diagnosis and management of traumatic brain injury (TBI). There may be substantial discordance between initial CTB interpretation by emergency clinicians and the final radiology report. This study aimed to assess the utility of a structured reporting template in improving the accuracy of CTB interpretation by emergency clinicians. METHOD: A prospective pre- and post-intervention cohort study was undertaken using a study population of emergency medicine trainees. The CTB reporting template was created with consultation from radiology, emergency medicine and trauma specialists. Participants reported on a set of randomly selected trauma CTBs first without, and then with, the reporting template. Each case was independently assessed for concordance with the radiology report by two blinded assessors (including a radiologist) and the proportion of concordant reports in each phase calculated. RESULTS: There were 26 participants recruited to the study who reported on a total of 320 CTBs. In the pre-intervention phase, 121 (76%) cases were concordant with the radiology report compared to 147 (92%) post-intervention (p<0.01). The AUROC was 0.84 (95% CI: 0.78-0.89) pre-intervention and improved to 0.94 (95% CI: 0.88-0.99) with the intervention (p=0.01). A higher level of baseline accuracy was observed in advanced trainees (78%) compared to basic trainees (72%), but both improved to a similar level of 92% with the use of the CTB reporting template. There was a marked reduction in false negative errors, with increased identification of critical diagnoses such as cerebral herniation and diffuse axonal injury. CONCLUSION: The use of the CTB reporting template significantly increased the accuracy of emergency medicine trainees and reduced the number of missed critical diagnoses. Reporting templates may represent an effective strategy to improve CTB interpretation and enhance the initial care of head injured patients.

A Review on SIRtuins in Diabetes.

BACKGROUND: Type-2 Diabetes is a long lasting disease characterized by high glucose concentration in the blood due to insulin resistance. One of the recent treatment strategies is using activators against SIRT-1, which has been in clinical trials. Hence, it is necessary to know the effects of the SIRT-1 modulators against various metabolic pathways. METHODS: Many cellular processes, including insulin secretion, cell cycle, and apoptosis are imperatively regulated by a family of mediators called SIRTuins. First known mammalian sirtuin, SIRT1 is a positive regulator of insulin secretion, which triggers glucose uptake and utilization. For the past decade, a major outstanding question is whether SIRT1 activation is a safe therapy for human diseases such as diabetes? RESULTS: This review summarizes and discusses the advances of the past decade and the challenges that will brazen out perplexity of this field. We also cover the physiological regulation of sirtuin (SIRT1) activity and how these modes of regulation may be exploited to manipulate SIRT1 activity in cells. Designing of drugs using advanced computational methods that specifically target SIRT1, and also, involvement of advanced biological methods for further understanding of sirtuin1 biology to afford new optimized treatments for diabetes and several age related human diseases. CONCLUSION: Hence, this review is a serial perspective of all the above topics.

Structural and functional changes to the retina and optic nerve following panretinal photocoagulation over a 2-year time period.

PurposeTo evaluate long-term structural and functional changes to the retina and optic nerve following panretinal photocoagulation (PRP) in diabetic retinopathy (DR) patients.MethodsParticipants were patients with DR requiring PRP and control patients with DR not requiring PRP. The Heidelberg retinal tomography (HRT) and optical coherence tomography (OCT) were performed to analyze the optic nerve and macula. Best-corrected visual acuity (BCVA) and visual field (VF) testing were done to measure central and peripheral vision. Wide-field fluorescein angiogram was performed to monitor the progression of diabetic ischemia. The primary outcome measure was to determine the degree of retinal and optic nerve changes before and after PRP.ResultsThere was a non-significant thickening of the macula and retinal nerve fiber layer at 6 months post laser that recovered by 24 months. Mean perfused ratio was significantly increased (P=0.02) at 12 and 24 months post laser. Independently grading patient stereophotographs, grader 1 indicated there was a non-significant increase in cup to disk ratio post laser, while grader 2 indicated a significant increase at 6 (P=0.04), 12 (P=0.02), and 24 months (P=0.005). There was a significant VF decrease (P≤0.02) at 12 and 24 months post laser with BCVA showing a non-significant trend of deteriorating results.ConclusionDespite an improvement in peripheral perfusion, there was a significant progressive decline of peripheral VF over the study period. Clinical grading of the optic nerve was more unreliable following PRP, despite the absence of significant morphological changes as detected by the OCT and HRT.