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Background: Lack of eyecare protective measures especially in unconscious and sedated critically ill patients, make them prone to ocular surface diseases (OSDs), e.g., exposure keratopathy. This study is aimed to frame an algorithm-based approach to eyecare via eyecare bundle to bring down the burden of OSDs in critically ill patients especially in resource-limited settings. Materials and methods: After clearance from institutional ethical committee, a quasi-experimental single center study was conducted over a period of 6 months. Incidence of exposure keratopathy was calculated before and after induction of eyecare bundle and was compared. Statistical analysis was done using SPSS software v20. p-value of less than 0.05 was considered significant. Results: A total of 218 patients were enrolled in the study after obtaining informed written consent and after fulfilling inclusion criteria. Patients were divided into control and experimental groups, with baseline characteristics similar in both the groups, respectively, in terms of gender, age (40 years), APACHE II score, and specialty distribution except predominantly medical patients in experimental group. In control group (n = 99), total 69 patients (41 medical and 28 surgical) developed exposure keratopathy, while in experimental group (n = 109) only 15 patients (6 medical and 9 surgical) developed exposure keratopathy, hence a significant reduction was observed. Further follow-up of patients in the experimental group was also done on Days 5 and 7, respectively. Conclusion: The proposed protocolized algorithm-based eyecare bundle significantly reduced the incidence of exposure keratopathy in sedated, mechanically ventilated, and vulnerable critically ill patients. How to cite this article: Sama S, Abrol R, Dhasmana R, Sharma N, Khandhuri S, Chauhan R, et al. Effect of Implementation of an Eyecare Bundle on Incidence of Exposure Keratopathy in Intensive Care Unit of Tertiary Care Center in North India. Indian J Crit Care Med 2023;27(6):426-432.
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The motion of biological swimmers in typical bodily fluids is modelled using a system of micellar solubilization driven active droplets in a viscoelastic polymeric solution. The viscoelastic nature of the medium, as perceived by the moving droplet, characterized by the Deborah number (De), is tuned by varying the surfactant (fuel) and polymer concentration in the ambient medium. At moderate De, the droplet exhibits a steady deformed shape, markedly different from the spherical shape observed in Newtonian media. A theoretical analysis based on the normal stress balance at the interface is shown to accurately predict the droplet shape. With a further increase in De, time-periodic deformation accompanied by an oscillatory transition in swimming mode is observed. The study unveils the hitherto unexplored rich complexity in the motion of active droplets in viscoelastic fluids.
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Typical bodily and environmental fluids encountered by biological swimmers consist of dissolved macromolecules such as proteins or polymers, rendering them even non-Newtonian at times. Active droplets mimic the essential propulsive characteristics of several biological swimmers, and serve as ideal model systems to widen our understanding of their locomotive strategies. Here, we investigate the motion of a micellar solubilization driven active oil droplet in an aqueous medium consisting of polymers as macromolecular solutes. Experiments reveal extreme sensitivity of the droplet motion to the presence of macromolecules in its ambient medium. Through in situ visualization of the self-generated chemical field around the droplet, we notice unexpectedly high diffusivity of the filled micelles in the presence of high molecular weight polymeric solutes. This highlights the breakdown of continuum approximation due to a significant size difference between the macromolecular solutes and the micelles. It is shown that the Péclet number, defined based on the experimentally determined filled micelle diffusivity (taking into account the local solvent viscosity) successfully captures the transition from smooth to jittery propulsion mode for both molecular and macromolecular solutes. With an increase in macromolecular solute concentration, particle image velocimetry reveals another mode switching from the conventional pusher mode to puller mode of propulsion, characterized by a more persistent droplet motion. By doping the ambient medium with suitable choice of macromolecules, our experiments unveil a novel route to orchestrate complex transitions in active droplet propulsion.
RESUMO
Understanding the motion of artificial active swimmers in complex surroundings, such as a dense bath of passive particulate matter, is essential for their successful utilization as cargo (drug) carriers and sensors or for medical imaging, under microscopic domains. In this study, we experimentally investigated the motion of active SiO2-Pt Janus particles (JPs) in a two-dimensional bath of smaller silica tracers dispersed with varying areal densities. Our observations indicate that when an active JP undergoes a collision with an isolated tracer, their interaction can have a significant impact on the swimmer's motion. However, the overall impact of tracers on the active JPs' motion (translation and rotation) depends on the frequency of collisions and also on the nature of the collision, which is marked by the time-duration for which the particles maintain contact during the collisions. Further, in the high-density tracer bath, our experiments reveal that the motion of the active JP results in a novel organizational behavior of the tracers on the trailing Pt (depletion of tracers) and the leading SiO2 (accumulation of tracers) side. In laboratory frame the emergence and the subsequent vanishing of the depletion zone are discussed in detail.
