Effect of beta blockers on optical coherence tomography angiography in normal, suspect, and glaucomatous eyes: A prospective study.

PURPOSE: The study aimed to assess the effect of hypertension, and use of systemic beta blockers (BB) and other antihypertensives on ocular perfusion by optical coherence tomography angiography (OCTA) in normal, suspect, and glaucomatous eyes. METHODS: Cross-sectional study in tertiary eye care center. Prospectively recruited consenting subjects between 18 and 90 years with or without glaucoma. Measured the optic nerve peripapillary perfusion and flux and macular vessel density (MVD: 6 × 6 and 3 × 3 mm) in the superficial retinal layer using OCTA. RESULTS: Included 200 eyes (112 patients). Compared to nonhypertensives or those on non-BB antihypertensives (NBB), hypertensives on BB had lower peripapillary perfusion (43.45,43.40, 42.05%, P = 0.003), and MVD (6 × 6 mm: 16.65, 16.70,15.75 mm/mm 2 , P = 0.002; 3 × 3 mm: 18.70, 18.50, 18.00 mm/mm 2 , P = 0.025). Those on systemic BB with vasodilatory properties had similar perfusion parameters as nonhypertensives and NBB. Those on systemic BB without vasodilating properties had significantly lower peripapillary perfusion (42.05 vs 43.30%, P = 0.011) and MVD (6 × 6 mm: 15.15 vs 16.60 mm/mm 2 , P < 0.001; 3 × 3 mm: 17.40 vs 18.70 mm/mm 2 , P = 0.005) compared to nonhypertensives. On multivariate analysis, peripapillary perfusion increased with increase in diastolic blood pressure (ß:0.051, p: 0.04) and increasing age was the only factor found to be significantly associated with decreased peripapillary and macular perfusion parameters. CONCLUSION: Systemic BB users have worse ocular perfusion parameters compared to those on other medications or nonhypertensives on univariate analysis but similar perfusion on multivariate analysis. Those on BB with vasodilation have better ocular perfusion parameters. All BB cannot be considered equally detrimental to ocular perfusion. Further well-controlled prospective studies are needed to reassess the effects of BB with or without vasodilation on ocular perfusion.

Exploring the mediating effect of personality traits in the relationship between entrepreneurial intentions and academic performance among students.

This study explores the mediating effect of personality traits in the relationship between entrepreneurial intentions and student academic performance. The sample comprised 175 students from a top-ranked Tamil Nadu, India university. Data was collected using a survey questionnaire as the research instrument. A descriptive research design was employed to understand the variables under investigation comprehensively. Partial Least Squares Structural Equation Modeling (PLS-SEM) and SPSS v25 was utilized as the statistical analysis tool. This study used the Theory of Planned Behaviour as a theoretical framework to explore the mediating effect of personality traits in the relationship between entrepreneurial intentions and academic performance among university students. The study's findings revealed essential insights into the relationship between entrepreneurial intentions, personality traits, and academic performance. The results showed that personality traits significantly mediate the relationship between entrepreneurial intentions and academic performance. This finding suggests that a student's personality traits influence the impact of entrepreneurial intentions on academic performance. Furthermore, the study found that while entrepreneurial intentions did not have a significant direct effect on academic performance, they did have a substantial indirect effect through personality traits. This indicates that personality traits act as a crucial mechanism through which entrepreneurial intentions can influence academic performance among students.

Phytoconstituents of Ashwagandha as potential inhibitors of human islet amyloid polypeptide (hIAPP): an in silico investigation.

Amylin or human islet amyloid polypeptide (hIAPP) is a small peptide co-secreted with insulin. Its peripheral aggregation on the lipid bilayer leads to fibril formation. The formation of hIAPP fibrils is hypothesized to rupture the membrane of ß -cells, which culminates in ß-cell death. Following additional studies, amylin fibril formation is a hallmark of T2DM and is also implicitly responsible for Alzheimer's disease. This study reports the virtual screening of 1000 phytoconstituents of traditional Indian medicinal plants to get potential inhibitors of amylin, which will likely restrict and block amyloid aggregation, preventing the progression of T2DM and Alzheimer's illness. The compounds having drug-likeness properties (acquired from ADMET calculations) and highest binding affinities (from molecular docking) are subjected to molecular dynamics (MD) simulation to investigate the temporal stability of the conformations of the complexes. This study discovers that Withaferin A and Withacoagulin have the highest binding affinity for amylin, and their stability with amylin was verified further by parameters such as RMSD, RMSF, number of H-bonds and MMPBSA. Individual principle component analysis (PCA) confirms the stable complex formation of amylin with Withaferin A and Withacoagulin. We strongly believe that wet-lab experiments and clinical trials will help to validate our computational findings.Communicated by Ramaswamy H. Sarma.

Assessment of Functioning of Health and Wellness Centers of Western Odisha: A Cross-Sectional Study.

Background The National Health Policy (NHP) 2017 of India recommends strengthening the delivery system of Primary Health Care through the establishment of Health & Wellness Centres (HWC) as the platform to deliver comprehensive primary health care services. HWCs are being set up as an upgraded version of existing sub-centers, primary health care centers, and urban primary health centers. This study was conducted to evaluate the functioning of health and wellness centers in Western Odisha. Objective  To assess the availability of human resources, health care services, drug availability, lab services, and IT services at the health and wellness centers of Western Odisha. Methods Out of 10 districts of Western Odisha, two districts (Sambalpur and Deogarh) were selected for convenience, and a cross-sectional study was conducted from January 2021 to December 2022. All 43 health and wellness centers (35 rural primary health centers (PHCs) and eight urban PHCs) of the above two districts were included in the study. All relevant data were collected using a predesigned, pretested, and semi-structured questionnaire. Results The study showed that all 43 HWCs had good availability of pharmacists and lab technicians but less availability of medical officers, AYUSH medical officers, and staff nurses. Maternal and childhood services, family planning, and non-communicable disease (NCD) services were conducted regularly in all health and wellness centers, but basic oral health services and palliative care services were inadequate. All laboratory services like blood grouping, differential count/total leucocyte count, rapid test for pregnancy, urine albumin, urine routine examination/microscopic examination along with culture/sensitivity and water quality testing were done at urban PHC HWCs, whereas these lab services were less available at rural PHC HWCs. Drug groups like antipyretics, antihistaminic, antifungal, antihypertensive, oral hypoglycemic agent (OHA), antispasmodics, and antiseptic ointments were adequately available (>80%) at all urban and rural PHC HWCs. For IT support, appliances like desktops, internet facilities, and telephone facilities were found to be present at all HWCs. Teleconsultation services were found to be available at 88% of urban PHC HWCs and 60% of rural PHC HWCs. ​Conclusion The study showed that infrastructure, human resources, and 12 service packages of health care and drugs should be addressed on a priority basis to achieve desired goals as envisaged by Ayushman Bharat to achieve the full potential of the health and wellness centers.

Comparison of conjunctiva-related complications between scleral and corneal patch grafts in Ahmed glaucoma valve implantation.

Purpose: Comparison of the conjunctiva related complication rates and success rates among eyes with Ahmed glaucoma valve (AGV) implantation in which eye bank derived scleral and corneal patch grafts had been used to cover the tube. Methods: Retrospective comparative study. Patients who underwent AGV implantation between January 2000 to December 2016 were included. Demographic, clinical data, intra and post operative data was obtained from electronic medical records. Conjunctiva related complications were divided into two groups: with and without implant exposure. Conjunctiva related complication rates, success rate, risk factors among eyes with corneal and scleral patch graft were compared. Results: Three hundred and twenty three eyes of 316 patients underwent AGV implantation. Scleral patch graft was used in 214 eyes of 210 patients (65.9%) and corneal patch graft was used in 109 eyes of 107 patients (34%). Median follow up was 14 months. There was no significant difference in the conjunctiva related complication rate (7.3 % in corneal patch graft versus 7.0% in scleral patch graft;p=0.5) and conjunctival dehiscence rate (3.7% versus 4.6%, P = 0.7) among the two groups. Success rate was significantly higher in the corneal patch graft group versus the scleral patch graft group (98% versus 72%; p=0.001). Eyes with corneal patch graft had a higher survival rate (P = 0.01). Conclusion: There was no significant difference in the rate of conjunctiva related complications following corneal and scleral patch grafts used to cover the AGV tube. Eyes with corneal patch graft had a higher success rate and survival rate.

Epidemiology of Suicide in Western Odisha During COVID Pandemic: A Cross-Sectional Analysis.

Introduction Suicide is the act of deliberately killing oneself. It is a leading cause of mortality worldwide. Each year, more than seven lakh people end their lives globally. India is the worst-affected country in Southeast Asia. Both the genders and all age groups are affected. The COVID pandemic has led to the disruption of routine life and business. The proportion of deaths due to suicide was 9.4% among all deaths reported for autopsies by a study in the same mortuary over a seven-year period. Increased stress and anxiety have been postulated to lead to suicide. Our study objective is to describe the epidemiology of suicide during the early COVID pandemic (lockdown period). Methods This is a record-based cross-sectional study. We have analyzed the post-mortem reports for six months starting from April 1, 2020. Descriptive analysis was performed with Epi Info version 7 (Centers for Disease Control and Prevention, CDC, Atlanta, GA, USA). Results During the study period, 340 cases were classified as deaths due to suicide, out of a total of 891 mortalities. The median age for females was 26.5 and for males, it was 30. The male to female ratio was 1.8:1. Most of the deceased (39.8%) were in their third decade, followed by the fourth decade (18.9%), second decade (15%), and fifth decade (12.98%), respectively. Poisoning was the leading method used for suicide, accounting for 238 (70.1%) deaths, followed by hanging (11.8%), burns (6.8%), jumping from a height (6.5%), and jumping in front of the train (4.13%). Self-immolation (burning) was a common mode of suicide for females. Most of the suicides (71.4%) took place from the evening to midnight. Conclusion There was a fourfold rise in suicides during the period compared to previous data. Productive age groups are affected more. A large-scale multi-centric study in community settings for estimation of the true burden is the need of the hour. A multi-sectorial public health approach is needed to prevent untimely death due to suicide.

Sour beer production in India using a coculture of Saccharomyces pastorianus and Lactobacillus plantarum: optimization, microbiological, and biochemical profiling.

The study's objective was to develop a co-fermentation process with appropriate fermentation parameters to produce a sour beer (similar to a Belgium sour beer) with an ethanol content of 6-8% (v/v) using a coculture of Saccharomyces pastorianus and Lactobacillus plantarum. Statistical optimization was conducted to determine fermentation conditions to produce a sour beer with ~ 3 mg/mL of lactic acid, similar to the traditional sour beer levels. Studies were conducted on the microbial dynamics and volatile compounds produced during this fermentation and aging process. GC-MS studies revealed the generation of novel bioactive compounds as well as the depletion of some volatile compounds during co-fermentation. The study detailed a 5-day co-fermentation process of S. pastorianus and L. plantarum and a 21-day aging process to prepare a sour beer with biochemical properties along the lines of traditional lambic beers. The interrelationship between the two microorganisms and the biochemical changes in the sour beer fermentation process was elucidated and the sensorial attributes have been described.

Blindness in glaucoma: primary open-angle glaucoma versus primary angle-closure glaucoma-a meta-analysis.

AIM: To estimate the risk of blindness with primary angle-closure glaucoma (PACG) compared to primary open-angle glaucoma (POAG) in those population-based studies that reported blindness rates for both PACG and POAG. METHOD: A systematic search was performed in PubMed for articles published in English between 2000 and 2020 reporting the prevalence of POAG as well as PACG among various ethnic populations. A study was included if it was (1) population-based (2) had published prevalence and blindness rates for both PACG and POAG in the same cohort. (3) Glaucoma was defined as per the International Society for Geographical and Epidemiological Ophthalmology (ISGEO) criteria. The proportion of blindness for both POAG and PACG for each study and the cumulative proportion taking all the studies were calculated. RESULTS: We included 23 studies with 78,434 participants. POAG was diagnosed in 1702 persons with 151 (8.9%) blind. There were 724 cases of PACG with 196 (27.0%) blind. The risk ratio of blindness in PACG to POAG varied from 0.73 to 10.6 among the studies. The cumulative risk ratio was 2.39 (95% confidence interval (CI); 1.99, 2.87). Risk ratios for studies including visual field restriction while defining blindness were similar to studies that did not (1.92 vs 2.64, P = 0.11). Risk ratios were also similar for studies that used greater than 2 instead of 3 or more quadrants of iridotrabecular contact to define angle closure (2.79 vs 2.25). CONCLUSION: Primary angle-closure disease is more likely to be associated with blindness.

Intravenous Acetaminophen vs Intravenous Diclofenac Sodium in Management of Skeletal Vaso-occlusive Crisis Among Children with Homozygous Sickle Cell Disease: A Randomized Controlled Trial.

OBJECTIVE: To compare the efficacy of intravenous acetaminophen and intravenous diclofenac sodium in the management of skeletal vaso-occlusive crisis among children with sickle cell disease. DESIGN: Single blind randomized controlled trial. SETTING: Tertiary care hospital. PARTICIPANTS: 104 children with sickle cell disease and skeletal vaso-occlusive crisis. INTERVENTION: Intravenous acetaminophen at 10mg/kg/dose 8 hourly and intravenous diclofenac sodium at 1mg/kg/dose 8 hourly in 1:1 ratio. MAIN OUTCOME MEASURES: Reduction in pain score (50%), number of doses needed to relieve pain after 24 hours of drug administration and decrease in pain score at 1 hour. RESULTS: A 50% reduction in pain score was seen in 35 (77.3%) and 10 (21.7%) children among acetaminophen and diclofenac sodium groups respectively (RR, 95% CI 3.6; 2.02-6.33, P< 0.001). The mean (SD) fall in pain score at 1 hour was significantly higher among intervention arm as compared to control arm [1.51 (0.5) and 1.06 (0.5); P<0.001]. Eight (17.4%) patients developed local phlebitis at the site of infusion among diclofenac group. CONCLUSIONS: Intravenous acetaminophen is a better alternative to intravenous diclofenac in children with skeletal vaso-occlusive crisis.

Outcomes of rhegmatogenous retinal detachment surgery in eyes with pre-existing glaucoma drainage devices.

PURPOSE: To evaluate the outcome of rhegmatogenous retinal detachment (RRD) surgery in eyes with preplaced glaucoma drainage device (GDD) with respect to intraocular pressure (IOP) control as well as success of retinal detachment (RD) surgery. METHODS: It is a retrospective case series. The case records of patients who underwent RD surgery after GDD implantation from 2000 to 2014 were screened. The demographic data, ocular examination findings at all visits, details pertaining to retinal detachment and its repair, and the postoperative course was documented. RESULTS: Twelve patients were included in study. The mean age of patients was 24.3 years (median 11 years; range 3-72 years). Male: Female ratio was 3:1. Mean duration between GDD and RD was 24 months (4 days-91 months). Of the ten eyes that underwent surgery, nine eyes underwent pars plana vitrectomy, and in one eye scleral buckling was done. GDD was removed only in one eye. At final follow-up, retina was attached with controlled IOP in 6 (60%) eyes, of which 5 (50%) had improvement in best corrected visual acuity. CONCLUSION: Pars plana vitrectomy was required in almost all cases for the management of RD in eyes with preplaced GDD. Retinal reattachment with good IOP control could be achieved in 60% of eyes. Removal of the drainage device was not essential for the effective management of the RRD in most cases. With multidisciplinary approach, close follow-up and timely intervention, vision can be preserved along with glaucoma control and successful retinal reattachment.

Production, optimization and probiotic characterization of potential lactic acid bacteria producing siderophores.

The aim of the study was to characterize the probiotic qualities and siderophore production of Enterococcus and Bacillus isolates for possible application for iron nutrition in human and animals strains were selectively isolated from different dairy sources and infant faecal matter. Isolates SB10, JC13 and IFM22 were found to produce maximum siderophore ranging from 65-90% at an optimum pH 7, incubation period of 96 h, agitation speed of 150 rpm and inoculum volume of 15%. SB10 and JC13 were found to show high homology with Enterococcus spp. and IFM22 with Bacillus spp., using partial 16S rRNA sequencing and biochemical characterization. All the three isolates produced hydroxymate type of siderophores under iron stressed conditions and screened for probiotic characters as per WHO guidelines. Strains have shown excellent tolerance to acid, bile salt, sodium chloride and phenol. They were non-haemolytic in nature and exhibited high hydrophobicity and autoaggregation. Our isolates proved to be potent probiotic strains due to their survival under highly acidic conditions and higher tolerance to bile salt. In addition, its colonization efficiency was proved by exhibiting high autoaggregation and hydrophobicity.

Lactic acid production from cassava fibrous residue using Lactobacillus plantarum MTCC 1407.

During extraction of starch from cassava, fibrous residue is a major waste released into the environment. Owing to the high starch content (60-65% on dry weight basis) and organic matter of cassava fibrous residue (CFR), an attempt has been made to utilize it for the production of lactic acid (LA) in semi solid state fermentation using Mann Rogassa Sharpe medium containing [5 % (wv(-1))] CFR in lieu of glucose [2% (wv(-1))] as the carbon source. Response Surface Methodology (RSM) was used to evaluate the effect of main variables, i.e. incubation period, temperature and pH on LA production. The experimental results showed that the optimum incubation period, temperature and pH were 120 hr 35 degrees C and 6.5, respectively. Maximum starch conversion by Lactobacillus plantarum MTCC 1407 to LA was 63.3%. The organism produced 29.86 g of (L+) LA from 60 g of starch present in 100 g of CFR. The LA production yield (i.e. mass LA produced mass starch present in CFR(-1) x 100) was 49.76%.

Statistical optimization of alpha-amylase production by probiotic Lactobacillus plantarum MTCC 1407 in submerged fermentation.

Production and purification of alpha-amylase by probiotic Lactobacillus plantarum MTCC 1407 has been investigated under submerged fermentation using Mann Rogassa Sharpe medium containing (1%) soluble starch in lieu of glucose (2%) as carbon source. Response Surface Methodology was used to evaluate the effect of main variables, i.e. incubation period, pH and temperature on enzyme production. A full factorial Central Composite Design was applied to study these main factors that affected alpha-amylase production. The experimental results showed that the optimum incubation period, pH and temperature were 36 h, 7.0 and 35 degrees C, respectively. The purified enzyme (by ammonium sulphate precipitation) had a molecular mass of 75 450 Da in SDS-PAGE.

Lactic acid fermentation of beta-carotene rich sweet potato (Ipomoea batatas L.) into lacto-juice.

Lacto-juices processed by lactic acid fermentation bring about a change in the beverage assortment for their high nutritive value, vitamins and minerals which are beneficial to human health when consumed. Sweet potato roots (non-boiled/ fully-boiled) were fermented with Lactobacillus plantarum MTCC 1407 at 28 +/- 2 degrees C for 48 h to make lacto- juice. During fermentation both analytical [pH, titratable acidity, lactic acid, starch, total sugar, reducing sugar (g/kg roots), total phenol and beta-carotene (mg/kg roots)] and sensory (texture, taste, aroma, flavour and after taste) analyses of sweet potato lacto-juice were evaluated. The fermented juice was subjected to panelist evaluation for acceptability. There were no significant variations in biochemical constituents (pH, 2.2-3.3; lactic acid, 1.19-1.27 g/kg root; titratable acidity, 1.23-1.46 g/kg root, etc.) of lacto-juices prepared from non-boiled and fully-boiled sweet potato roots except beta-carotene concentration [130 +/- 7.5 mg/kg (fully-boiled roots) and 165 +/- 8.1 mg/kg (non-boiled roots)]. The panelist evaluation scores ranged from 3-4.8 (in a hedonic scale of 1-5) from moderate liking to very much liking of sweet potato lacto-juice. Principal component analyses reduced the eight original analytical variables to three independent components (factors), which accounted for 99.9% of the total variations. Similarly, five original sensory variables were reduced to two independent components, which accounted for 83.1% of the total variations.