An overview of green synthesized silver nanoparticles towards bioactive antibacterial, antimicrobial and antifungal applications.

Present review emphatically introduces the synthesis, biocompatibility, and applications of silver nanoparticles (AgNPs), including their antibacterial, antimicrobial, and antifungal properties. A comprehensive discussion of various synthesis methods for AgNPs, with a particular focus on green chemistry mediated by plant extracts has been made. Recent research has revealed that the optical properties of AgNPs, including surface plasmon resonance (SPR), depend on the particle size, as well as the synthesis methods, preparation synthesis parameters, and used reducing agents. The significant emphasis on the use of synthesized AgNPs as antibacterial, antimicrobial, and antifungal agents in various applications has been reviewed. Furthermore, the application areas have been thoroughly examined, providing a detailed discussion of the underlying mechanisms, which aids in determining the optimal control parameters during the synthesis process of AgNPs. Furthermore, the challenges encountered while utilizing AgNPs and the corresponding advancements to overcome them have also been addressed. This review not only summarizes the achievements and current status of plant-mediated green synthesis of AgNPs but also explores the future prospects of these materials and technology in diverse areas, including bioactive applications.

Comparison of the Posterior Capsule Rupture Rates Associated with Conventional (Start to Finish) Versus Reverse Methods of Teaching Phacoemulsification.

PURPOSE: Comparison of the rates of posterior capsule rupture (PCR) associated with conventional versus a reverse method of teaching phacoemulsification. METHODS: Trainees were taught conventional (start-to-finish) phacoemulsification beginning with an incision (tunnel construction) to capsulorhexis, sculpting, nucleus cracking, segment removal, cortex aspiration, intraocular lens implantation, and viscoelastic removal. In the reverse method, after incision and capsulorhexis, the trainees were progressively taught viscoelastic wash, cortex aspiration, segment removal, nucleus cracking, sculpting, and intraocular lens implantation. Trainees from a Tertiary Eye Care Centre were classified as beginners, for their first 30 cases and then trainees for their next 70 surgeries. Data were collected on posterior capsular rent and vitreous loss during each step of training. RESULTS: Thirty-two ophthalmic surgeons learning phacoemulsification surgery on 609 cataracts cases were supervised by 3 trainers. Fifteen beginners performed 287 surgeries using the conventional method, and 17 beginners performed 322 surgeries with the reverse method. The incidence of PCR was 18/287 (6.2%) with the conventional method and 15/322 (4.6%) with the reverse method (P = 0.38). PCR occurred during cortex aspiration (8/287, 2.8%) and segment removal (5/287, 1.7%) in the conventional method. PCR occurred during nucleus cracking, segment removal, and cortex aspiration (4/322 surgeries for each step, 1.2%). In the follow, 70 cases (trainees) there was no difference in PCR with either method (4.7% vs. 4.3%, P = 0.705). CONCLUSION: Conventional and reverse method for training phacoemulsification were both safe in a supervised setting.

Prevalence, causes of blindness, visual impairment and cataract surgical services in Sindhudurg district on the western coastal strip of India.

BACKGROUND: Konkan coast of India is geographically distinct and its pattern of blindness has never been mapped. AIM: To study the prevalence and causes of blindness and cataract surgical services in Sindhudurg district of West Coast. SUBJECTS: Individual aged > 50 years. MATERIALS AND METHODS: Rapid assessment of avoidable blindness used to map blindness pattern in the district. STATISTICAL ANALYSIS: SPSS version 19. RESULTS: Amongst those examined 1415 (51.7%) had visual acuity (VA) >20/60, 924 (33.8%, confidence interval (C.I) 30.5%-36.8%) had VA 20/200-<20/60(visual impairment), 266 (9.7%, C.I. 6.1%-13.3%) had VA < 20/200-20/400 (severe visual impairment) and 132 (4.8%, C. I. 1.1%-8.5%) had VA < 20/400 (blindness by WHO standards). There was no significant gender difference in prevalence of blindness, but blindness and visual impairment was more in older and rural residing individuals. Amongst those with presenting vision < 20/200 in better eye, 309 (82.4%) had cataract, 36 (9.7%) had corneal scars, 13 (3.5%) had diabetic retinopathy and 3 (0.8%) had glaucoma. Cataract surgical coverage for the district was only 30.5%; 32% for males and 28.4% for females. Unable to afford, lack of knowledge and lack of access to services were the commonest barriers responsible for cataract patients not seeking care. Amongst those who had undergone cataract surgery, only 50% had visual acuity ≥ 20/60.46.9% of the population had spectacles for near, but only 53.3% of the population had presenting near vision < N10. CONCLUSION: Cataract, refractive errors and diabetes were significant causes of visual impairment and blindness.

Long term outcomes of bilateral congenital and developmental cataracts operated in Maharashtra, India. Miraj pediatric cataract study III.

AIM: To study long term outcome of bilateral congenital and developmental cataract surgery. SUBJECTS: 258 pediatric cataract operated eyes of 129 children. MATERIALS AND METHODS: Children who underwent pediatric cataract surgery in 2004-8 were traced and examined prospectively in 2010-11. Demographic and clinical factors were noted from retrospective chart readings. All children underwent visual acuity estimation and comprehensive ocular examination in a standardized manner. L. V. Prasad Child Vision Function scores (LVP-CVF) were noted for before and after surgery. STATISTICS: Statistical analysis was done with SPSS version 16 including multi-variate analysis. RESULTS: Children aged 9.1 years (std dev 4.6, range 7 weeks-15 years) at the time of surgery. 74/129 (57.4%) were boys. The average duration of follow-up was 4.4 years (stddev 1.6, range 3-8 years). 177 (68.6%) eyes had vision <3/60 before surgery, while 109 (42.2%) had best corrected visual acuity (BCVA) >6/18 and 157 (60.9%) had BCVA >6/60 3-8 years after surgery. 48 (37.2%) had binocular stereoacuity <480 sec of arc by TNO test. Visual outcome depended on type of cataract (P = 0.004), type of cataract surgery (P < 0.001), type of intra-ocular lens (P = 0.05), age at surgery (P = 0.004), absence of post-operative uveitis (P = 0.01) and pre-operative vision (P < 0.001), but did not depend on delay (0.612) between diagnosis and surgery. There was a statistically significant improvement for all the 20 questions of the LVP-CVF scale (P < 0.001). CONCLUSION: Pediatric cataract surgery improved the children's visual acuity, stereo acuity and vision function. Developmental cataract, use of phacoemulsification, older children and those with better pre-operative vision had betterlong-termoutcomes.