Papilledema and retinopathy lead to diagnosis of IgA nephropathy: a case report.

This case features a young healthy male who was diagnosed with immunoglobulin A (IgA) nephropathy after presenting with blurry vision that was caused by hypertensive retinopathy and papilledema. In this report, we examine the relationship between hypertension and increased intracranial pressure (ICP), along with the ocular signs of IgA nephropathy that may present in the setting of kidney disease.

Immunoglobulin A (IgA) nephropathy is an immune-mediated inflammatory condition that affects the kidneys and is characterized by deposits of IgA antibodies across the body. Nephropathy in general is defined as the deterioration of kidney function. Hypertension is a common complication because of the resultant kidney damage. IgA can also deposit widely across the body, including within the eyes, and may lead to various inflammatory manifestations affecting the front and back of the eyes. We present a case of a 38-year-old male with 2 weeks of worsening vision and headaches. His blood pressure was extremely high (206/116 mmHg) and he was found to have acute kidney injury. Examination of his eye revealed hypertensive retinopathy but also significant swelling of both of his optic discs, concerning for increased intracranial pressure (ICP), which is unusual in a young, otherwise healthy male. The investigation for the cause of increased ICP led to the diagnosis of IgA nephropathy. Treatment of his increased ICP and blood pressure resulted in improvement of his vision. It is important to consider increased ICP as a cause of optic disc swelling in patients with very high blood pressures. Prompt evaluation and management of elevated ICP is important to preserve vision, prevent brain complications and diagnose the underlying disease process. Especially important is the communication and coordination across medical specialties to ensure safe treatment given the multisystem organ involvement. In this article, we also review the eye findings associated with IgA nephropathy, as well as other immune-mediated complications of this rare disease.

Optic neuropathy after COVID-19 vaccination: a report of two cases.

PURPOSE: We report two cases of optic nerve pathology after the administration of the Pfizer-BioNTech and AstraZeneca-Oxford COVID-19 vaccines, respectively, and describe the implications for management of post-vaccination central nervous system (CNS) inflammation. CASE REPORTS: A 69-year-old woman presented with bilateral optic nerve head oedema, 16 days after the second dose of the Pfizer-BioNTech vaccine. She was diagnosed with post-vaccination CNS inflammatory syndrome and was treated for five days with intravenous methylprednisolone at a dose of 1 gram per day. Her optic disc swelling improved, and her vision stabilised. A 32-year-old woman presented six days after her first dose of the AstraZeneca-Oxford vaccine with two days of sudden onset of progressive blurring of vision in her left eye. Posterior segment examination revealed left optic disc swelling, and an MRI of the brain, orbit, and cervical spine was significant for left optic nerve enhancement. The patient was diagnosed with a unilateral post-vaccination optic neuritis. She was treated with a three-day course of intravenous methylprednisolone followed by oral prednisone. Her optic disc swelling and visual field improved, and she recovered 6/6 vision. CONCLUSIONS: Clinicians and patients should be aware of the potential for post-vaccination CNS inflammatory syndromes associated with COVID-19 vaccine administration. Neuroimaging and cerebrospinal fluid analysis may aid in the diagnosis of the cause of vision loss. Further studies are needed to evaluate the spectrum and frequency of optic nerve involvement associated with COVID-19 vaccination.

Visual recovery after unilateral optic nerve sheath fenestration for pseudotumor cerebri syndrome.

PURPOSE: To evaluate the effect of optic nerve sheath fenestration (ONSF) on the rate of visual function improvement in patients with pseudotumor cerebri syndrome (PTCS). METHODS: Retrospective chart review of patients with PTCS who underwent ONSF between 1998 and 2017. Visual function was evaluated by evaluating visual field (VF), mean deviation (MD), retinal nerve fiber layer (RNFL) thickness, papilledema grade, and visual acuity (VA) prior to and after ONSF. RESULTS: Seventeen female patients aged 17 to 36 years underwent unilateral ONSF. Follow-up averaged 40.1 months. VF MD improved steadily in both eyes up to 12 months. Average RNFL thickness improved in the operated eye from 347 ± 166 mm to 92 ± 27 mm (p < .001) and the non-operated eyes from 306 ± 165 mm to 109 ± 46 mm (p < .001). The grade of papilledema improved in the operated eye from 3.3 ± 1.3 to 0.3 ± 0.7 and the non-operated eye from 3.0 ± 1.6 to 0.18 ± 0.4. There was an exponential rate of improvement in papilledema and RNFL thickness, with the greatest improvement occurring within the first 30 days. Average visual acuity remained intact in both eyes before and after surgery. CONCLUSIONS: ONSF in appropriately selected patients leads to rapid improvement in papilledema and a steady recovery in VF.

Effect of the green synthesis of CuO plate-like nanoparticles on their photodegradation and antibacterial activities.

Green synthesis of copper oxide nanoparticles and its effects on photocatalytic dye degradation and antibacterial activities are reported. The synthesis of nanoparticles by green routes provides many advantages over chemical routes, including simplicity, cost-effectiveness, and fast processing route without using any costly or harmful chemicals. Tridax procumbense (coat buttons) plant root extract was used to synthesize copper oxide nanoparticles. The synthesized Tridax procumbense-copper oxide nanoparticles (TP-CuO NPs) were characterized by UV-visible spectroscopy, Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), dynamic light scattering spectroscopy (DLS), and X-ray diffraction (XRD) techniques. The synthesized TP-CuO NPs were applied for photocatalytic dye degradation and antibacterial activity studies. The TP-CuO NPs exhibited a maximum antibacterial activity at 500 µg mL-1 concentration against Staphylococcus aureus and E. coli showing inhibition zones of 7.5 mm and 7.2 mm, respectively. The photocatalytic ability of the TP-CuO was also tested against the textile dye Trypan blue (TB), and showed about 55% degradation after 48 h for 500 µg mL-1 CuO NP concentration, showing a concentration-dependent degradation efficiency. This is the first work on TP-derived CuO nanoparticles and their photocatalytic and antimicrobial applications. Overall, this study supports the superiority of green-synthesized TP-CuO NPs as photocatalytic and antimicrobial agents.

Comparison of single-shot nebuliser protocol between dexmedetomidine and ketamine in children undergoing magnetic resonance imaging.

BACKGROUND: Sedation for magnetic resonance imaging mandates deep sedation to ensure patient immobility. The nebulised route of drug delivery carries the advantage of good bioavailability and safety profile. We aimed to compare the efficacy and safety of nebulised dexmedetomidine and ketamine for sedation in children undergoing magnetic resonance imaging. METHODS: A total of 71 children, aged two to eight years scheduled for outpatient magnetic resonance imaging were randomly allocated to receive nebulised dexmedetomidine 2 µg/kg (group D) or nebulised ketamine 2 mg/kg (group K) 30min before magnetic resonance imaging. RESULTS: Nebulised dexmedetomidine (2 µg/kg) resulted in faster onset and significantly better sedation scores with rapid clear-headed recovery. Ketamine resulted in better venepuncture scores but was associated with more neuropsychological events at recovery. CONCLUSION: Nebulised dexmedetomidine at 2 µg/kg provides rapid onset of satisfactory sedation, with good parental separation and a quicker and more clear-headed recovery, allowing for a smooth magnetic resonance imaging experience.

Variability in starch granular morphology of Tinospora cordifolia: an important species of Indian Systems of Medicine (ISM).

Tinospora cordifolia is an important medicinal plant species known for therapeutic action of starch along with other medicinal ingredients. The starch prepared from the aqueous extract of fresh stems is used in the Indian Systems of Medicines. The plant extract prepared from T. cordifolia is a  promising source for the treatment of COVID-19. This investigation explores for the first time, the morphological details of the starch granules and its accumulation pattern along with its variability among the germplasm of T. cordifolia collected from different parts of India. Starch content was 39.80% on dry weight basis and moisture content was about 28.21%. Starch granule recovery based on stem dry weight and starch content ranged from 14.70 to 20.28% and 52.02 to 71.76%, respectively in different starch settling methods. Starch accumulation pattern in the stem was also studied in the species. Even though wide variability in starch granule shapes was observed among the germplasm, majority of the genotypes had starch granules of round or oval shape. Similarly, starch granule size also varied greatly (38.32-88.03 µm) within and among the genotypes. Significantly small sized starch granules (p = 0.05) were present in the genotype, IC 283650 and biggest (p = 0.05) starch granules were present in the genotype, IC 310610. The information generated in the present study will have application in starch industry for the inclusion of T. cordifolia as an alternative source of starch in addition to its use in Traditional Systems of Medicine. Supplementary Information: The online version contains supplementary material available at 10.1007/s42535-021-00286-y.

Immunomodulation of T- and NK-cell Responses by a Bispecific Antibody Targeting CD28 Homolog and PD-L1.

Checkpoint blockade therapies targeting PD-1/PD-L1 and CTLA-4 are clinically successful but also evoke adverse events due to systemic T-cell activation. We engineered a bispecific, mAb targeting CD28 homolog (CD28H), a newly identified B7 family receptor that is constitutively expressed on T and natural killer (NK) cells, with a PD-L1 antibody to potentiate tumor-specific immune responses. The bispecific antibody led to T-cell costimulation, induced NK-cell cytotoxicity of PD-L1-expressing tumor cells, and activated tissue-resident memory CD8+ T cells. Mechanistically, the CD28H agonistic arm of the bispecific antibody reduced PD-L1/PD-1-induced SHP2 phosphorylation while simultaneously augmenting T-cell receptor signaling by activating the MAPK and AKT pathways. This bispecific approach could be used to target multiple immune cells, including CD8+ T cells, tissue-resident memory T cells, and NK cells, in a tumor-specific manner that may lead to induction of durable, therapeutic antitumor responses.

Porta hepatis in relation to portal vein among Indians.

The porta hepatis / hilum of liver is a transverse fissure located in the inferior surface, where the major vessels and ducts enter or leave the organ. The major structures traversing the porta hepatis are the portal vein, the hepatic artery and the hepatic duct. Porta hepatis is an area of surgical and radiological significance. The knowledge of variations in structures traversing the porta hepatitis will reduce the risk of surgeries involving this area. Study was conducted in the department of anatomy dissection lab after obtaining ethical clearance. 30 liver specimens were used for these studies which were removed from the cadaver during under graduate teaching. Anatomical knowledge of variations in relations of structures present in porta hepatis is of immense help to surgeons and radiologists when they engage patients for clinical procedures like liver transplant, cholecystectomy and diagnostic procedures. Hence this study was aimed to observe the relations of portal vein in porta hepatis.

Computational and experimental studies of Metallo organic framework on human epidermal cell line and anticancer potential.

The pentadentate ligand and the precursors were combined to form complexes by green approach. The ligand formation was confirmed by UV-Vis, FT-IR, 1H-NMR, and LC-MS. The optimised stable structure was obtained by molecular simulation studies and the complexes were interpreted by conductivity measurements, UV-Vis, FT-IR, magnetic susceptibility, VSM, and ESR spectral studies. The redox nature of the complexes was investigated by cyclic voltammetry. The cyclic voltammogram shows complexes exhibited single electron transfer from Cu+2/Cu+1. Complexes and penta-dentate ligand were screened for in vitro cytotoxicity by MTT assay method on A431 skin cancer cell line. The ligand structural stability and biological activity were confirmed by theoretical computational studies. The magnetic behaviour showed antiferromagnetic properties at low temperature. The complexes were used as high bar magnets. Similarly, the redox behaviour showed that the complexes could be used in electroplating techniques and sensors. Clinical application revealed that the complexes had effective cytotoxicity. From the data obtained, the complexes were in the form [MLR], where L was the penta-dentate ligand and R = [C6H5COO] & R = [C6H4COO (OH)].

Effect of Ce3+ Ions Doped NiFe2O4 Magnetic Nanoparticles on Photocatalytic Degradation of Rhodamine B and Antibacterial Activities.

In this study, spinel NiCexFe2-XO4 (x = 0.0 - 0.5) nanoparticles (NPs) was synthesized by microwave combustion technique (MCT) utilizing the fuel of Aloe vera plant extract. The establishment of spinel cubic crystal structure was ensured by powder X-ray diffraction (PXRD) technique. The particles like nanostructured morphology were confirmed by high-resolution scanning electron microscope (HRSEM). Energy dispersive X-ray (EDX) studies confirmed the formation of spinel ferrite structure and ensured that no other elements were present. Magnetic parameters such as remanant magnetisation (Mr), coercivity (He) and saturation magnetization (Ms) were calculated from the magnetic hysteresis (M-H) loops, which exhibited ferromagnetic behaviour. The photocatalytic behavior was investigated by visible light treatment for the photocatalytic degradation (PCD) of rhodamine B (Rh-B) dye and the sample NiCe0.3Fe1.7O4 exhibits higher PCD efficiency (93.88%) than other compositions. The antibacterial activities of gram-positive S. aureus, B. subtilis, gramnegative K. pneumonia and E. coli have been investigated using undoped and Ce3+ substituted NiFe2O4 NPs and observed higher activity, which indicated that, they can be used in the bio-medical applications.

Journey of Hydrocotyle sibthorpioides Lam.: From traditional utilization to modern therapeutics-A review.

Hydrocotyle sibthorpioides Lam. (Araliaceae) is a short and edible medicinal herb, which is used in the traditional system of medicines. The review aims to report the current information of H. sibthorpioides on the basis of its botanical and taxonomical description, traditional use, active phytoconstituents, pharmacological use and toxicity. The information on H. sibthorpioides with respect to its journey from traditional uses to scientific validation was gathered based on the online survey. The results from the review signify that the plant is used by the different tribes of the world for the treatment of patients suffering from fever, edema, dysentery, rheumatalgia, whooping cough, jaundice, throat pain, psoriasis, herpes zoster infection, hepatitis-B infection, soothing pain, dysmenorrhoea and carbunculosis. It is also used as a brain tonic, detoxifying agent and hepatoprotective agent. Scientific investigation reported that the plant has a significant pharmacological activity, viz. cognitive agent, anti-cancer, antiviral, antibacterial, anti-fungal and hepatoprotective. Moreover, based on the phytochemical aspects, a total of 50 phytoconstituents was identified and isolated from the plant. In conclusion, the outcome of this review will be useful for (a) developing a comprehensive plant profile; (b) assist investigators for exploring further research; and (c) to fulfil the gaps lacking in terms of clinical studies.

Albumin nanoparticles coated with polysorbate 80 for the targeted delivery of antiepileptic drug levetiracetam into the brain.

The aim of the study was to target levetiracetam (LEV) into the brain by albumin nanoparticles. The levetiracetam-loaded albumin nanoparticles (LEV-NPs) were formulated by desolvation. The particle size of LEV-NPs was 153.7 ± 44.8 nm and the zeta potential was - 10.8 mV. The in vitro LEV release, in pH 6.8 phosphate buffer, was determined by dialysis and showed a biphasic pattern of drug release and ranged in between 40.42 ± 2.6% w/w and 63.61 ± 2.12% w/w. The biodistribution study was conducted on male Wistar rats. The LEV was given as i.v. injection in tail vein, and the formulations were the free drug, LEV-NPs, and levetiracetam-loaded albumin nanoparticles further coated with 1% polysorbate 80 (LEV-NPs-PS 80). A significant increase in LEV concentration was achieved in the brain for LEV-NPs-PS 80 when compared with LEV free drug. The LEV concentration achieved in the brain after administering free drug and LEV-NPs-PS 80 was 5.28 ± 1.79 and 18.54 ± 2.38 µg/gm respectively. The LEV-NPs-PS 80 enhanced LEV concentration in the brain by 3.51-fold when compared with the free drug. Graphical abstract.

A novel transgenic mouse strain expressing PKCßII demonstrates expansion of B1 and marginal zone B cell populations.

Protein kinase Cß (PKCß) expressed in mammalian cells as two splice variants, PKCßI and PKCßII, functions in the B cell receptor (BCR) signaling pathway and contributes to B cell development. We investigated the relative role of PKCßII in B cells by generating transgenic mice where expression of the transgene is directed to these cells using the Eµ promoter (Eµ-PKCßIItg). Our findings demonstrate that homozygous Eµ-PKCßIItg mice displayed a shift from IgD+IgMdim toward IgDdimIgM+ B cell populations in spleen, peritoneum and peripheral blood. Closer examination of these tissues revealed respective expansion of marginal zone (MZ)-like B cells (IgD+IgM+CD43negCD21+CD24+), increased populations of B-1 cells (B220+IgDdimIgM+CD43+CD24+CD5+), and higher numbers of immature B cells (IgDdimIgMdimCD21neg) at the expense of mature B cells (IgD+IgM+CD21+). Therefore, the overexpression of PKCßII, which is a phenotypic feature of chronic lymphocytic leukaemia cells, can skew B cell development in mice, most likely as a result of a regulatory influence on BCR signaling.

Glycemic index of millet based food mix and its effect on pre diabetic subjects.

Diet plays an important role in management of diabetes and foods having low glycemic index are gaining more importance as they delay the release of glucose in the blood. It is essential to develop low glycemic food mix from regionally available ingredients for use in daily dietaries. Hence, the present study was undertaken to assess the glycemic index of the traditional recipes prepared from developed millet based food mix and their effect on pre diabetic subjects. The developed millet based food mix had appreciable amount of protein (19.41 g/100 g) and dietary fibre (21.11 g/100 g). The traditional recipes viz., roti, dosa and dumpling (mudde) prepared from developed mix exhibited higher acceptance with good sensory parameters and are comparable to regional preparations. The glycemic index was found to be 37, 48 and 53 for dosa, mudde and roti respectively with a glycemic load of 11.05, 18.43 and 18.09. However, all the three developed products showed the relatively lower glycemic index (< 55) and moderate glycemic load of < 20. Further, dietary intervention on pre diabetic subjects revealed that there was a significant reduction in FBS (120.50 ± 18.73 to 97.81 ± 20.00) and HbA1c (6.14 ± 0.30 to 5.67 ± 0.40) indicating their preferable option in the management of diabetes mellitus.

Nano zinc oxide - An alternate zinc supplement for livestock.

AIM: This study was aimed to investigate antimicrobial and cytotoxicity effect of nano ZnO in in vitro for the application of livestock feed supplement. MATERIALS AND METHODS: Nano ZnO was synthesized by wet chemical precipitation method using zinc acetate as a precursor and sodium hydroxide was used for reducing the precursor salt. The properties of synthesized powder were characterized using ultraviolet (UV)-visible spectroscopy, Fourier transform infrared (FTIR), scanning electron microscopy (SEM), and X-ray diffraction (XRD), respectively. In vitro antimicrobial activities were analyzed against the pathogenic bacteria in poultry Escherichia coli, Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus aeruginosa. 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was conducted to analyze the cytotoxicity effect of nano ZnO. RESULTS: SEM showed a spherical ZnO particle in the range of 70-100 nm. The size of the particle and purity of the sample were confirmed by XRD. The nano-sized ZnO particles exhibited the UV absorption peak at 335 nm. In FTIR spectroscopy, pure ZnO nanoparticles showed stretching vibrations at 4000-5000 cm-1. ZnO nanoparticles exhibited remarkable antibacterial activity against E. coli, S. aureus, K. pneumoniae, and S. aeruginosa bacterial strains. Cell viability was significantly reduced in a dose-dependent manner in the cytotoxicity study. CONCLUSION: From the broad-spectrum antibacterial activity and the lower cytotoxicity observed at the prescribed dose, it is concluded that nano ZnO powder is a potential alternate zinc supplement for livestock.

Correction to: India: Intruder Node Detection and Isolation Action in Mobile Ad Hoc Networks Using Feature Optimization and Classification Approach.

The article India: Intruder Node Detection and Isolation Action in Mobile Ad Hoc Networks Using Feature Optimization and Classification Approach, written by T. Kavitha, K. Geetha and R. Muthaiah, was originally published electronically on the publisher's internet portal (currently SpringerLink) on May 11, 2019 with open access.

India: Intruder Node Detection and Isolation Action in Mobile Ad Hoc Networks Using Feature Optimization and Classification Approach.

Due to lack of a central bureaucrat in mobile ad hoc networks, the security of the network becomes serious issue. During malicious attacks, according to the motivation of intruder the severity of the threat varies. It may lead to loss of data, energy or throughput. This paper proposes a lightweight Intruder Node Detection and Isolation Action mechanism (INDIA) using feature extraction, feature optimization and classification techniques. The indirect and direct trust features are extracted from each node and the total trust feature is computed by combining them. The trust features are extracted from each node of MANET and these features are optimized using Particle Swarm Optimization (PSO) algorithm as feature optimization technique. These optimized feature sets are then classified using Neural Networks (NN) classifier which identifies the intruder node. The performance of the proposed methodology is studied in terms of various parameters such as success rate in packet delivery, delay in communication and the amount of energy consumption for identifying and isolating the intruder.