Surgical management of a case of giant retinal tear with closed funnel retinal detachment in a pediatric patient.

BACKGROUND: A 7-year-old male child was brought by his parents with a complaint of low vision in both eyes for 2 months. The child had low vision in both the eyes for 1.5 years, but the parents noticed when it worsened further 2 months back, leading to profound vision loss. On ophthalmic evaluation, the child did not perceive light in the right eye. Furthermore, anterior segment examination showed complicated cataract and open funnel retinal detachment with intra-retinal cysts in ultrasound (USG) B scan. In the left eye, he could appreciate light but with poor fixation. Fundus evaluation of the left eye showed total retinal detachment on indirect ophthalmoscopy, which was confirmed on USG B scan. Since the right eye had poor visual potential, no intervention was done. The left eye underwent pars plana vitrectomy with silicone oil tamponade, which led to successful anatomical outcomes. The immediate and late postoperative periods were uneventful, and the child was kept under follow-up and was observed closely. PURPOSE: To educate regarding the surgical management of giant retinal tears in a pediatric patient. SYNOPSIS: To inform regarding the surgical challenges faced and steps adopted to manage such cases. HIGHLIGHTS: Through this case, we want to highlight the challenges faced, such as delayed presentation, difficult preoperative evaluation, intraoperative difficulties such as mobile retina, absence of posterior vitreous detachment, and tenacious vitreous gel. We also want to emphasize on the steps taken to overcome the challenges. CONCLUSION: In such challenging situations, effective planning, careful manipulation, and persistence are essential for success. VIDEO LINK: https://youtu.be/T0Gy6Wj13zI.

Transcranial direct current stimulation (tDCS) for neurological disability among subacute stroke survivors to improve multiple domains in health-related quality of life: Randomized controlled trial protocol.

OBJECTIVES: The primary goal of the current proposal is to fill the gaps in the literature by studying the effectiveness of transcranial direct current stimulation (tDCS) on lifestyle parameters, and physical, behavioral, and cognitive functions among stroke survivors, and understanding the factors that mediate the effects of various domains related to Health-related Quality of life (HRQoL) improvements. METHODS: Anticipated 64 volunteer subacute stroke survivors (>7 days to 3 months post stroke) aged 40-75 years with National Institutes of Health stroke scale (NIHSS) score of >10 and Mini-Mental State Examination (MMSE) score between 18 and 23 will be randomly assigned at a ratio of 1:1 to receive either: (1) 20 sessions of anodal tDCS or (2) sham tDCS in addition to conventional rehabilitation. Battery driven tDCS will be applied at 2 mA intensity to the dorsolateral prefrontal cortex and primary motor cortex for 20 minutes. The primary endpoints of study will be 36-Item Short Form Survey (SF-36) post intervention at 4 weeks. The secondary outcomes will include Stroke Specific Quality of Life Scale (SS_QOL), Montreal cognitive assessment (MCA), Beck Anxiety Inventory (BAI), Fugl-Meyer Assessment (FMA), 10 m walk test and Modified Barthel Activities of daily living (ADL) Index. At 0.05 level of significance, data normality, within group and between group actual differences will be analyzed with a moderate scope software. DISCUSSION: Our knowledge of this technique and its use is expanding daily as tDCS motor recovery studies-mostly single-center studies-in either single session or many sessions have been completed and shown positive results. The field is prepared for a multi-center, carefully planned, sham-controlled, double-blinded tDCS study to comprehensively examine its feasibility and effectiveness in enhancing outcomes in stroke population. CONCLUSION: The function of Transcranial Direct Current Stimulation in aiding stroke recuperation will be ascertained.

Evaluating the Efficacy and Safety of Combined Administration of Systemic and Topical Tranexamic Acid in Total Knee Arthroplasty.

Introduction: Tranexamic acid (TXA) is an antifibrinolytic agent, thatagent that reduces substantial blood loss in total knee arthroplasty (TKA) surgeries without increasing the risk of thromboembolic complications. The purpose of our study was to assess the effectiveness and safety of the combined use of intravenousIV and topical TXAtranexamic acid in uncomplicated primary Total knee Arthroplasty (TKA) without complications. Materials and Methods: In this prospective study, we enrolled 61 patients who underwent unilateral primary TKR and were randomly divided into two groups: Group I received intravenous (IV) TXA and Group II received both IV and intraarticular (IA) TXA. Patients assigned to Group I received IV TXA preoperatively 30 mins before surgery and postoperatively at 3 and 6 hours after surgery, whereas in the combined group, in addition to IV doses, topical TXA was applied as mop 2 g of TXA diluted in 30 mL of isotonic sodium chloride solution) intraarticularly for about 5 minutes before closing the arthrotomy. We measured total blood loss (TBL), ) and mean reduction in haemoglobin (Hb) levels as primary outcomes. Transfusion rates, incidence of thromboembolic events (TE), and other adverse effects as secondary outcomes. Total blood loss TBL and Hb drops was were noted on the 3rd post-operative day. All the patients were followed-up for 6 months to note the incidence of deep venous thrombosisDVT and Thromboembolic Events (TE). An Iindependent t-test was used to evaluate between--group differences. P < 0.05 as is the cut-off for statistically significant differences. Results: The Total blood loss (TBL) in Group I was 780.05 ± 158.05 mL, compared to 660.80 ± 156.45 mL in Group II. (P < 0.001). The Hb drop was significantly lower in IV TXA group (2.3 ± 0.37) than the combined TXA group (1.40 ± 0.32). Furthermore, both groups required no transfusions. No thromboembolic complications was were noted postoperatively and at 6 6-month follow-up. Conclusion: TXATranexamic acid in total knee replacement surgery effectively decreases blood loss and significantly reduces the need for blood transfusions. Based on our study, the combined use of intravenous (IV) and IAintraarticular TXA in total knee replacement was found to be superior in reducing blood loss and significantly reducing the need for blood transfusions in TKA.

Role of ehealth literacy, learning styles, and patterns of web-based e-content access for seeking health information among dental university students in Vadodara, India.

BACKGROUND: Individual's learning style, ehealth literacy, and preferred web-based e-content and channel to access information determines how one makes sense of health information on the Internet. Understanding these dynamics will help design suitable e-contents and choose appropriate channels for effective health communication. To assess the relationship between ehealth literacy, learning styles, and web-based e-content accessed for receiving health information among dental college students in Vadodara, India. MATERIALS AND METHODS: A cross-sectional questionnaire study was conducted among all consenting Undergraduate Students (UGs), interns, and Postgraduate Students (PGs) of a dental college in Vadodara, India, from July to August 2022. The questionnaire used to collect data included questions on general information, eHealth literacy scale (eHEALS), Visual Auditory Reading/Writing Kinaesthetic (VARK) Questionnaire, and preferences of web-based e-content for receiving health information. Completely filled questionnaires were subject to statistical analysis: descriptive (means and percentages) and inferential (analysis of variance tests and odds ratio). RESULTS: 285 out of 380 students filled out the questionnaires completely (75% response rate). All reported using Internet for receiving health information. Majority preferred textual ehealth message (71%) and access websites (80%). Students were quadmodal (98.%) and trimodal (2%) learners who learned predominantly through kinaesthetic methods (46%). Mean eHEALS score of the group was 30.27 ± 3.41. There was a statistically significant association between preference for sharing channels and being a kinaesthetic learner (OR = 1.6; P = 0.04). CONCLUSIONS: Participants were multi-modal, predominantly kinaesthetic learners. The association between the preference for video-sharing channels and being kinaesthetic learner suggests the need and scope for demonstrative and interactive video-based health educational tools, with the endorsement of health authorities based on health policy.

Surgical management of a case of double optic disc pits with maculopathy.

BACKGROUND: Double optic disc pit maculopathy is a rare entity. It can be difficult to manage because of excessive leakage and chronic maculopathy. PURPOSE: To describe surgical management in a case of double optic disc pits with maculopathy. SYNOPSIS: A 42-year-old male presented with double optic disc pits with macular detachment in the left eye. The best-corrected visual acuity (BCVA) was 20/60, N12. Preoperative OCT showed the presence of two disc pits. The macular region had large retinoschisis and subretinal fluid (SRF) with a central foveal thickness of 879 microns and loss of the ellipsoid zone. A shallow communication from the temporal aspect of the disc to the submacular area was also noted. Among the options of observation, laser photocoagulation, and surgery, the patient opted for surgical management. SURGICAL TECHNIQUE: A standard-3 port 23-gauge pars plana vitrectomy was done. After staining the ILM with brilliant blue, ILM peeling was done with the help of forceps and Finesse loop. ILM flaps were inverted over to cover the optic disc pits and sealed with a drop of fibrin glue. Next, 20% SF6 gas was used for tamponade. Pre- and post-surgery parameters such as visual acuity and OCT were evaluated. POSTOPERATIVE EVALUATION: After 6 weeks, left eye BCVA was 20/40 with OCT showing reduced SRF and reduced intraretinal schisis with a foveal thickness of 546 microns. At 3 months of follow-up, the vision in the left eye had improved to 20/30 with further reduction in the retinoschisis and foveal thickness of 482 microns. HIGHLIGHTS: In this interesting case, we demonstrate a unique way of sealing the defect surgically by vitrectomy and inverted ILM flap with fibrin glue over the disc pits. Despite sealing the maculopathy is slow to resolve. VIDEO LINK: https://youtu.be/s9nY5UPe1s4.

Global warming impact of fluorinated gases in ophthalmic surgeries at a tertiary eye center in India.

PURPOSE: Global warming is one of the greatest health threats of the 21 st century. The ophthalmic sector contributes to the emission of greenhouse gases, thus altering the natural environment. There is currently no data on global emissions of fluorinated gases in ophthalmic surgery. This retrospective study from 2017 to 2021 aims to report the carbon dioxide (CO 2 ) equivalence of sulfur hexafluoride (SF 6 ), hexafluoroethane (C 2 F 6 ), and octafluoropropane (C 3 F 8 ) at a tertiary eye center. METHODS: Data collected from 1842 surgical procedures that used injections of fluorinated gases were analyzed. Environmental impact (global warming potential over 100 years) was calculated by converting milliliters to grams by using modified ideal gas law at standard temperature and pressure for the canisters and then to their CO 2 equivalence. RESULTS: Though 70% of surgeries used C 3 F 8 , the least greenhouse effect causing fluorinated gas, the total carbon emission was 1.4 metric tons. The most common indication was macular hole surgery (36.86%). CONCLUSION: This study paves a step toward analyzing the problem statement, thus awakening us to contemplate options to make ophthalmic surgeries greener.

Developing a Risk Stratification Model Based on Machine Learning for Targeted Screening of Diabetic Retinopathy in the Indian Population.

OBJECTIVE: This study aimed to develop a predictive risk score model based on deep learning (DL) independent of fundus photography, totally reliant on systemic data through targeted screening from a population-based study to diagnose diabetic retinopathy (DR) in the Indian population. METHODS: It involved machine learning application on datasets of a cross-sectional population-based study. A total of 1425 subjects (1175 subjects with known diabetes and 250 with newly diagnosed diabetes) were included in the study. We applied five machine learning algorithms, random forest (RF), logistic regression (LR), support vector machines (SVM), artificial neural networks (ANN), and decision trees (DT), to predict diabetic retinopathy in our datasets. We incorporated a percentage split in the first experiment and randomly divided our data set into 80% as a training set and 20% as a test set. We performed a three-way data split in the second experiment to prevent overestimating predictive performance. We randomly divided our data set into 60% as a training set, 20% as a validation set, and 20% as the test set. Furthermore, we integrated five-fold cross-validation to split the percentage to evaluate our method. We judged the predictive performance based on the receiver operating characteristic (ROC) curve, the area under the curve (AUC), accuracy (Acc), sensitivity, and specificity. RESULTS: The RF classifier achieved the best prediction performance with AUC, Acc, and sensitivity values of 0.91, 0.89, and 0.90, respectively, in the percentage split. Similarly, a three-way data split attained an outcome of 0.86 and 0.85 in AUC and Acc. Likewise, the five-fold cross-validation performed the best with results of 0.90, 0.97, 0.91, and 0.75 in AUC, Acc, sensitivity, and specificity, respectively. CONCLUSION: Since the RF classifier achieved the best performance, we propose it to identify diabetic retinopathy for targeted screening in the general population.

Distance and near vision changes after intravitreal anti-vascular endothelial growth factor injection in eyes with center-involving diabetic macular edema.

Purpose: To elucidate distance and near vision changes after intravitreal injections in center-involving diabetic macular edema (CIDME) in phakic and pseudophakic groups. Methods: A retrospective study was done on 148 eyes (72 phakic and 76 pseudophakic) with center-involving DME. All eyes were treated with intravitreal anti-vascular endothelial growth factor (VEGF) injection. All patients underwent distance best-corrected visual acuity (BCVA) testing, near BCVA testing, dilated fundus examination, and optical coherence tomography (OCT) at baseline and follow-up visits. Eyes that could not improve after the first injection were given 2nd, 3rd, and more injections in the subsequent visits. Results: On follow-up, post injections in the phakic group (n = 72), there were 65 eyes (90.3%) with stable/improved near vision and 59 eyes (81.9%) with stable/improved distance vision, whereas in the pseudophakic group (n = 76), 63 eyes (82.9%) and 60 eyes (78.9%), respectively. Both in phakic and pseudophakic eyes, 7.7%-13% of the cohort showed only near vision improvement. Conclusion: In DME, besides the changes in distance vision, there are also changes in near vision. These changes should be taken into account while determining the response to anti-VEGF in DME treatment.

Comparison of p63 immunohistochemistry and shear wave elastography in the diagnosis of indeterminate breast lesions: A prospective study.

Purpose: To evaluate the accuracy of breast shear wave elastography (SWE) and p63 immunohistochemistry (IHC) in the diagnosis of indeterminate breast lesions. Methods: Based on detailed clinical examination and a combination of X-ray mammography/B-mode ultrasound with SWE, a total of 40 patients with breast lumps (BI-RADS 4) were included. Patients with previous diagnosis of breast cancer and a previous history of surgery, chemotherapy, or radiotherapy in the same breast as the present lesion were excluded. Core needle biopsy of the breast lesion was performed, and p63 IHC staining was performed. A final histopathological report of the definitive procedure was considered as the gold standard. The sensitivity, specificity, positive (PPV) and negative predictive values (NPV), and accuracy were calculated for each modality. Results: The mean age of the patients included in the study was 50.85 ± 13.53 years. Of the 40 patients recruited, 23 were clinically malignant and 17 were benign. The sensitivity, specificity, PPV, NPV, and accuracy of SWE were 91.3%, 94.1%, 95.5%, 88.9%, and 92.5% and those of p63 IHC were 95.7%, 100%, 100%, 94.4%, and 97.5%, respectively. Overall, the parametric values were higher for p63 IHC as compared to clinical examination and elastography. The area under the ROC curve (AUC) for p63 IHC (.978) was higher than those for SWE (.927) and clinical examination (.898). Conclusion: SWE and p63 IHC are highly reliable novel modalities that demonstrate enhanced diagnostic accuracy of indeterminate breast lesions aiding in the early initiation of appropriate treatment and reducing the number of women subjected to biopsy or short-term follow-up for benign-appearing solid breast lesions.

Association of serum calcium levels with infarct volume and stroke scores in acute ischemic stroke patients: An observational study.

Background: Stroke vastly contributes to death and disability worldwide. Acute ischemic stroke (AIS) is caused by a reduction in supply of blood to the brain. Accumulation of unnecessary intracellular serum calcium in AIS induces the cytotoxic actions that activates enzymes involved in cell death. The present investigation assessed the relationship of total serum calcium level (at admission) and initial diffusion weighted imaging (DWI) infarct volume and correlated with National Institute of Health Stroke Scale (NIHSS) scores. Methods: A hospital-based observational study was conducted on 74 consecutive patients identified with AIS fulfilling the inclusion criteria. NIHSS scores and serum ionized calcium were calculated in every patient and compared with DWI infarct volume for assessing correlation between these three. Statistical software R Version 4.0.2 and Microsoft Excel were used for statistical analysis. Results: Out of the 74 patients, most of them were in age group of 50-69 years, with a male preponderance (68.9%). A significant association was noticed between diabetes and dyslipidemia with age (P=0.01499). A strong negative correlation was observed between NIHSS scores (at admission & discharge) with ionized calcium, while a strong positive correlation was noticed between stroke scores with infarct volume. A statistically significant negative correlation was recorded between serum calcium (on admission) and infarct size (r=-0.851755, P=0.0001). The mean of NIHSS scores on admission (8.24±5.19) has been remarkably higher when compared with NIHSS scores at discharge (5.25±3.89). Conclusion: In patients with AIS examined within 6-24 hours of symptoms onset, serum ionized calcium and volume of infarct on DWI showed inverse association. Serum calcium serves as a marker of severity and acts as prognostic factor in AIS.

Familiar Strategies Feel Fluent: The Role of Study Strategy Familiarity in the Misinterpreted-Effort Model of Self-Regulated Learning.

Why do learners not choose ideal study strategies when learning? Past research suggests that learners frequently misinterpret the effort affiliated with efficient strategies as being indicative of poor learning. Expanding on past findings, we explored the integration of study habits into this model. We conducted two experiments where learners experienced two contrasting strategies-blocked and interleaved schedules-to learn to discriminate between images of bird families. After experiencing each strategy, learners rated each according to its perceived effort, learning, and familiarity. Next, learners were asked to choose which strategy they would use in the future. Mediation analyses revealed, for both experiments, that the more mentally effortful interleaving felt, the less learners felt they learned, and the less likely learners were to use it in future learning. Further, in this study, strategy familiarity predicted strategy choice, also mediated by learners' perceived learning. Additionally, Study 2 verified that, in contrast to learners' judgments, the less familiar interleaving schedule resulted in better learning. Consequently, learners are making ineffective learning judgments based on their perceptions of effort and familiarity and, therefore, do not make use of optimal study strategies in self-regulated learning decisions.

Scleral cut-down technique of subretinal fluid drainage in scleral buckle surgery for rhegmatogenous retinal detachment.

Background: The art of scleral buckle (SB) surgery is being largely forgotten. However, it still remains a good option for selected cases of rhegmatogenous retinal detachment. Drainage of subretinal fluid (SRF) is one of the most crucial steps of the surgery. When performed correctly, it gives the advantage of immediate retinal reattachment, and it hastens recovery. However, it has its own set of complications. Purpose: To demonstrate, step by step, the scleral cut-down technique of SRF drainage in SB surgery for rhegmatogenous retinal detachment (RRD) and to discuss its indications, contraindications, and complications. Synopsis: Longstanding RRDs with bullous detachments, old age, inferior breaks, or multiple breaks are indications of SRF drainage. In shallow RDs or young patients, a non-drainage procedure may be preferred. It is safer to drain at the bed of the buckle. After the sclera is cut and dissected, it is essential to inspect the choroid for the presence of large vessels. Choroidal vessels are avoided from getting injured while perforating. The release of pigments indicates the end of the drainage. Various possible complications can be prevented by being careful in the surgical technique. Highlights: Diagrammatic illustrations explain the steps of the surgical technique. Intraoperative complications have been explained in an easy-to-understand manner with tips to manage such conditions and their prevention. The video highlights the correct way of performing SRF drainage. Online Video Link: https://youtu.be/L0TrdkCwk20.

Surgical management of complicated retinal detachment in a case of retinal hemangioblastoma.

Background: A 40-year-old male presented with a complaint of sudden onset diminution of vision in the left eye for 2 weeks. He was a follow-up case with retinal hemangioblastoma in both eyes. He underwent two sittings of fundus fluorescein angiography-guided trans-pupillary thermotherapy 2 years back. Since then, he was regularly followed up for 2 years with stable vision and stable retinal findings. At present, the best-corrected visual acuity (BCVA) in the right eye is 6/6, and in the left eye, it is counting fingers 2 meters. On fundus examination, he had one active hemangioblastoma in the right eye and total retinal detachment in the left eye with multiple active lesions. The right eye was treated with a single sitting of thermotherapy, and the left eye underwent pars plana vitrectomy and angioma excision, followed by silicone oil tamponade. The immediate and late post-operative periods were uneventful, with successful anatomical and functional outcomes. The left eye BCVA on late follow-up was 6/36, no further treatment was advised, and the patient was kept under follow-up and observed closely. Purpose: : To educate regarding the systemic workup, diagnosis, and surgical management of complicated retinal detachment in retinal hemangioblastoma. Synopsis: : Systemic workup, diagnosis, and surgical steps in the management of complicated retinal detachment in retinal hemangioblastoma were performed. Highlights: : Close follow-up, keen observation, and prompt treatment in the early stages of the disease are indispensable to prevent untoward sequelae of retinal hemangioblastoma. A thorough systemic workup is necessary to diagnose the systemic involvements early. Surgery, if indicated for the retinal hemangioblastoma or its associated sequelae, should be performed diligently and with careful handling of blood vessels and anomalous tissues. Online Video Link: https://youtu.be/CkoqWEnaPB8.

Strategies of Bioceramics, Bioactive Glasses in Endodontics: Future Perspectives of Restorative Dentistry.

Prevalently, there is a primary strategy to cure caries using restorative materials notably bioceramics. Existing synthetic materials stimulate natural tooth structure with acceptable interfacial bonding and esthetic and biomechanical qualities with better durability. Several bioceramics have been introduced and investigated for their potentialities as restorative materials. Biomineralization of tooth initiates repair and regeneration of natural dental tissue and reinstating the integrity of periodontium. In the evolution of bioceramics in the aspects of different essential composition for dental application, recent technology and modern strategies revolutionize the restorative dentistry. Bioglass is one among the important bioceramics as a restorative material, and by regulating the properties of the material, it is possible to construct improved formulation towards restoration. This article reviews the current revolution of endodontics, existing restorative materials, and technologies to be achieve for engineering materials with the better design.

Multiple tuberculomas and cavitating pulmonary tuberculosis in an infant.

A five-month-old infant presented with fever and cough for 3 weeks. She was diagnosed with multiple tuberculomas and cavitating pulmonary tuberculosis. She was a household contact of an open case of tuberculosis (TB) and developed severe disease, although she had received the Bacillus Calmette-Guérin (BCG) vaccine and had no primary or secondary immunodeficiency. In infants, due to low levels of cell mediated immunity, tuberculosis can be severe and dissemination of tuberculosis to the central nervous system (CNS) can occur very early without following the usual time frame. CNS TB may not have symptoms in the early stages in infants and may require neuroimaging for diagnosis. This is the youngest child that has been reported with multiple CNS tuberculomas.

Ethnic-Guided Soft Tissue Cephalometric Analysis on Lambani Indian Inhabitants for Forensic Facial Reconstruction.

BACKGROUND: Forensic craniofacial reconstruction is a combination of both scientific technique and artistic skill that assist facial soft tissue approximation on the skull to obtain an image of an individual that varies in the different ethnic groups depending on genetic and environmental factors such as soft tissue norms. OBJECTIVES: The present study was aimed to evaluate the soft tissue norms for Lambani Indian tribes spread across the state of Karnataka in India and compare them with the local inherent ethnolinguistic Kannadiga population. MATERIAL AND METHODS: Forty healthy individuals encompassing 20 Lambanis and 20 Kannadigas were selected using demographic information. Lateral cephalograms obtained were analyzed for various soft tissue landmarks that include facial angle, upper lip curvature, skeletal convexity, H angle, nose tip to H-line, upper sulcus depth, lower sulcus depth, upper lip thickness, upper lip strain, lower lip to H line, soft tissue chin thickness, and glabella. RESULTS: It was observed that glabella thickness, upper sulcus depth, and lower lip to H line showed a significant difference between Lambani and Kannadiga populations. Lambani's have a higher facial angle than the Kannadiga group though not statistically significant. Gender-wise comparison had shown a significant difference in variables on upper sulcus depth, glabella among females, and lower lip to H line, glabella among males. CONCLUSION: The differences obtained between the two ethnic groups in this study clearly suggest the need for separate soft tissue thickness norms for distinctive populations that could be vital in the facial reconstruction of an individual in the field of forensic investigation to narrow down the identification process.

Drug infused Al2O3-bioactive glass coatings toward the cure of orthopedic infection.

A unique implant coated substrate with dual-drug-eluting system exhibiting antibacterial, anti-inflammatory, and bone regenerative capacity has been fabricated using spray pyrolysis deposition (SPD) method. Bioglass (BG) and BG-alumina (BG-Al) composites coatings with different concentrations of Al incorporated on BG network over the Cp-Ti substrate were fabricated using SPD technique. Phase purity of BG and BG-Al composites were analyzed by XRD in which Na2Ca2Si3O9 and ß-Na2Ca4(PO4)2SiO4) and Na7.15(Al7.2Si8.8O32) phases were formed. Surface morphology of the coated substrates was analyzed by SEM. Uniformity of the coatings were evaluated by surface profilometer and the uniform distribution the nanoparticles were confirmed with Elemental mapping. Systematically, each apatite layer formation on coated substrate was confirmed by immersing the samples for 1, 3, and 7 days in simulated body fluid and the needle-like structure was characterized using SEM. Cumulative release of Tetracycline hydrochloride (Tet) antibiotic and Dexamethasone (Dex) anti-inflammatory drug-loaded BG-Al and BG-Al composite-coated substrate were studied for 24 h. Antibacterial activity of the coated substrates were evaluated by time-dependent growth inhibition and minimal inhibitory concentration (MIC) assays in which BG-Al and BG-Al composite loaded with Tet showed considerable growth inhibition against S. aureus. Osteoblast-like cells (MG-63) exhibited profound proliferation with no cytotoxic effects which was due to release of Dex drug-coated substrates. Thus, surface modification of Cp-Ti substrate with BG, BG-Al composites coatings loaded with Tet and Dex drug can be considered for post-operative orthopedic implant infection application.

Idiopathic lenticular surface neovascularization: An unusual presentation.

PURPOSE: To present a case of posterior lenticular surface neovascularization in the absence of any ocular or systemic pathology. OBSERVATIONS: A 29-year-old asymptomatic male was detected with the right eye (OD) posterior lenticular surface neovascularization extending for six-clock hours in the temporal portion along with the presence of mild posterior capsular haze. His best-corrected visual acuity was 20/25 in OD and 20/20 in the left eye (OS). No additional abnormality was identified in the remainder of the OD anterior segment and the fundus respectively. OS evaluation was unremarkable. OD imaging including B-scan ultrasonography and ultrasound biomicroscopy (UBM) were essentially normal. The anterior segment optical coherence tomography (AS-OCT) thickened lens capsule with a dense hyperreflective layer adhered to its posterior surface and separating from the capsule in the periphery. Few hyperreflective dots were visible posterior to the ciliary body although no CB thickening was noted. No systemic abnormality was detected. The patient is being managed conservatively and has shown no signs of progression of the neovascularization over six months. CONCLUSIONS AND IMPORTANCE: This is the first reported case of an isolated idiopathic posterior lenticular surface neovascularization occurring in an otherwise healthy patient. Although an unspecified breach in the posterior capsule or undetermined cyclitis can trigger such neovascularization, further histopathological studies of the capsular biopsy and ciliary body can provide better insight into its etiopathogenesis. Additionally, considering the asymptomatic nature of the condition, these patients can be observed and closely monitored.

Taxonomic notes on the genus Elaphromyia Bigot (Diptera: Tephritidae: Tephritinae: Pliomelaenini) in India, with description of a new species.

A new species of Elaphromyia, E. juncta David, Hancock Sachin, sp. n. is described from India. It can be differentiated from the morphologically similar E. siva Frey and E. pterocallaeformis (Bezzi) by the wing pattern, epandrial characters, morphology of spicules on the eversible membrane and spermathecal shape. Elaphromyia siva Frey and E. yunnanensis Wang are recorded for the first time from India. Records of E. pterocallaeformis (Bezzi) from southern India are regarded as misidentifications. A key to the 7 known non-African species is included.