Advancements in Retinoblastoma Treatment: Unraveling the Potential of Intravitreal Chemotherapy.

Retinoblastoma necessitates urgent attention due to its potential fatality if untreated. Multiple treatment options are available and should be employed according to size, location, and the extent of dissemination. This review emphasizes the need for increased awareness, advanced diagnostic tools, and innovative treatment approaches, especially intravitreal chemotherapy (IVitC) to address the diverse manifestations and aggressive nature of retinoblastoma. Timely diagnosis and commitment to treatment are pivotal, as delays and reluctance to undergo enucleation contribute to unfavorable outcomes. The evolving treatment landscape, spanning from traditional interventions to modern targeted therapies such as intravitreal melphalan, holds promise for improved outcomes. While the intravitreal approach presents challenges, ongoing research aims to establish its definitive role in retinoblastoma treatment. In the treatment of retinoblastoma, IVitC raises considerations about side effects. The risk of tumor spread beyond the eye is rare, emphasising the potential of IVitC in carefully selected cases. Intravitreal injections exhibit fewer local adverse effects compared to intra-arterial chemotherapy, with careful measures reducing significant ocular complications. The evaluation of ocular toxicity, particularly with melphalan, underscores the importance of a nuanced approach to achieve the right balance between therapeutic efficacy and ocular safety. This comprehensive analysis of studies on IVitC and its ocular and systemic complications provides valuable insights for enhanced patient care. The review concludes with a focus on balancing safety and efficacy in local chemotherapeutic drugs, highlighting the need for thoughtful measures and continued research to optimise treatment modalities globally.

Transient Intraocular Pressure Fluctuations After Intravitreal Bevacizumab Injection in Proliferative Diabetic Retinopathy Patients: A Prospective Study.

INTRODUCTION: The clinical use of intravitreal bevacizumab (IVB), a recombinant humanized monoclonal antibody that functions as an anti-vascular endothelial growth factor (anti-VEGF), has recently increased in patients with retinal ischemic diseases such as proliferative diabetic retinopathy (PDR). The short-term and long-term complications associated with this procedure have not been well established. We aimed to study the possible short-term complication of intraocular pressure (IOP) fluctuations shortly after IVB injection in patients with PDR. MATERIALS AND METHODS: A prospective case series of diabetic patients with PDR who underwent IVB injection was performed in the Department of Ophthalmology, Medical Teaching Institution, Khyber Teaching Hospital, Peshawar, Pakistan, from November 1, 2020, to May 1, 2021. The total number of PDR patients of both sexes included in the study was 101. A slit lamp examination was performed, and IOP readings were recorded before and 30 min after IVB injection using Goldmann applanation tonometry (GAT). IBM Statistical Package for the Social Sciences version 22 for Windows was used to analyze the data. Safety of the procedure, defined as IOP ≤20 mmHg 30 min after IVB injection, was determined and stratified according to sex, age, duration of diabetes, and baseline IOP. A post-stratification chi-square test was applied, and a p-value <0.05 was taken as statistically significant. RESULTS: In this study, 60.4% of the participants were male and 39.6% were female. The age of the patients ranged from 30 to 75 years, with a mean age of 55.66±6.37 years. The mean duration of diabetes among the participants was 7.73±2.94 years and the mean baseline IOP was 15.40±1.77 mmHg. Safety (IOP ≤20 mmHg 30 min after IVB injection) was observed in 90.1% of the patients. CONCLUSION: IVB injections are safe for use in patients with PDR in terms of immediate IOP changes. However, patients with higher baseline IOP (>15 mmHg) are more likely to develop increased IOP post-procedure and prophylaxis may be prudent in such cases.

Effect of long term exposure to sublethal concentration of imidacloprid on some biochemical and haematological parameters of Grass carp and Goldfish.

During the present research, C. idella and C. auratus fish were exposed to 2 ppm concentration of imidacloprid for 28 and 24 days, respectively, and the effect on biochemical and haematological parameters was investigated. During the study of biochemical parameters, there occurred significant increase (P<0.05) in the serum levels of ALT and creatinine of imidacloprid exposed groups of both species of fish. The level of serum albumin of imidacloprid exposed groups of both fish species was significantly lower as compared to control group (P<0.05). Serum globulin level in imidacloprid exposed group of C. idella was insignificantly lower as compared to control group, however the serum globulin level of C. auratus was significantly lower than the control group (P < 0.05). The level of total proteins in serum of imidacloprid exposed groups of both fish species was insignificantly lower as compared to control groups (P>0.05). During the study of haematological parameters, TLC of C. idella was insignificantly (P>0.05) higher than control group but the TLC of C. auratus was significantly (P<0.05) higher than control. There was also observed increasing trend in the percentage of neutrophils and lymphocytes of imidacloprid exposed group of each fish species. The platelets count of imidacloprid exposed group of each fish species was significantly (P<0.05) lower than control group. The haemoglobin concentration of imidacloprid exposed group of C. idella was significantly lower than control group (P<0.05). In case of C. auratus, the haemoglobin level of imidacloprid exposed group was insignificantly lower than control group (P>0.05). From the finding of the present research it was concluded that 28 days exposure of C. idella and 24 days exposure of C. auratus to 2 ppm concentration of imidacloprid does not cause mortality however the exposure causes alteration in the normal level of biochemical and haematological parameters.

Fungal biotransformation of ezetimibe.

Structural transformation of ezetimibe was performed by fungi Beauvaria bassiana and Cunninghamella blakesleeana. The metabolites were identified by different spectroscopic techniques as (3R,4S)-1-(4-fluorophenyl)-3-((E)-3-(4-fluorophenyl) allyl)-4-(4-hydroxyphenyl) azetidin-2-one (2), (3R, 4S)-1-(4-fluorophenyl)-3-(3-(4fluorophenyl)-3-oxopropyl)-4-(4-hydroxyphenyl) azetidin-2-one (3), (3R,4S) 1-(4-fluorophenyl)-3-(3-(4-fluorophenyl) propyl)-4-(4-hydroxyphenyl) azetidin-2-one (4) and (2R,5S)-N, 5-bis (4-fluorophenyl)-5-hydroxy-2-(4-hydroxybenzyl) pentanamide (5). This study displays two important features of these fungi, viz., their ability to metabolize halogenated compounds, and their capacity to metabolize drugs that are targets of the UDP-Glucuronyl Transferase System, a phenomenon not commonly observed.

Phytochemical studies and antibacterial activity of Centaurium pulchellum Druce.

Two isocoumarin derivatives, one new, erythricin (1) and a known erythrocentaurin (2) were isolated from the whole plant of Centaurium pulchellum Druce. The 13C-NMR data of compound 2 are described. The structures of compounds 1, 2 were elucidated on the basis of spectral analysis including 2D-NMR experiments. Antibacterial and brine shrimp lethality assays are also described on the fractions of the plant extract.