Influence of chemical modifications on dynamic rheological behaviour, thermal techno-functionalities, morpho-structural characteristics and prebiotic activity of banana starches.

Banana starch is explored for its use in food and pharmaceutical applications. In this study, in order to improve the techno-functional properties of native banana starch (NS), different chemical modifications namely acid thinning (AT), oxidation (OX), sodium-trimetaphosphate method (STMP), cross linking phosphorylation (CLP), hydroxypropylation (HYP) were employed. Among the modified starches, amylose content was higher in CLP starch and the least was observed in AT. Resistant starch (RS) of HYP (65.38 %) and CLP starches (62.76 %) were significantly higher than other modified starches. Lesser amylose, higher water solubility and lower swelling of AT starch resulted in inferior paste clarity and inability to make a firm gel. Non-Newtonian behaviour of starch gels were observed from static viscosity observations. The dynamic rheological behaviour of the starch gels affirmed the higher gel strength of STMP (0.46) and CLP (0.56) starches. Imperfection and exo-corrosion in starch morphology was observed through SEM and influence of chemicals on the starch structure was elucidated through FTIR and XRD analyses. Except AT starch, modified starches with higher RS resulted in lowering glycemic index (57-69 %). STMP starches recorded highest prebiotic activity score of 0.88. Chemical modifications enable to enhance the functionalities of banana starch and offers potential industrial uses.

Angiotensin-converting enzyme inhibitory peptides and isoflavonoids from soybean [Glycine max (L.) Merr.].

Angiotensin-converting enzyme I (ACE I) is a zinc-containing metallopeptidase involved in the renin-angiotensin system (RAAS) that helps in the regulation of hypertension and maintains fluid balance otherwise, which results in cardiovascular diseases (CVDs). One of the leading reasons of global deaths is due to CVDs. RAAS also plays a central role in maintaining homeostasis of the CV system. The commercial drugs available to treat CVDs possess several fatal side effects. Hence, phytochemicals like peptides having plant-based origin should be explored and utilized as alternative therapies. Soybean is an important leguminous crop that simultaneously possesses medicinal properties. Soybean extracts are used in many drug formulations for treating diabetes and other disorders and ailments. Soy proteins and its edible products such as tofu have shown potential inhibitory activity against ACE. Thus, this review briefly describes various soy proteins and products that can be used to inhibit ACE thereby providing new scope for the identification of potential candidates that can help in the design of safer and natural treatments for CVDs.

Infective Necrotizing Scleritis After XEN Gel Stent With Mitomycin-C.

PURPOSE: The purpose of this study was to report a case of infective necrotizing scleritis following XEN Gel Stent with mitomycin-C. METHODS: Case report. This is a case report of a 68-year-old woman. RESULTS: XEN Gel Stent glaucoma surgery enhanced with mitomycin-C 0.04% and combined with cataract surgery was performed at a regional center to manage the patient's primary open-angle glaucoma. Past medical history was significant for rheumatoid arthritis requiring treatment with methotrexate and adalimumab. Periocular pain and swelling developed 14 months after the initial operation, followed by a rapid deterioration of visual acuity to 20/60, intraocular pressure of 4 mm Hg, and worsening pain 5 months later. On initial presentation to Sydney Eye Hospital, 180 degrees of scleral necrosis was evident with a moderate anterior segment inflammatory reaction and a large temporal choroidal effusion due to hypotony. Empirical hourly topical ofloxacin and cephalothin 5% drops, with oral moxifloxacin, were initiated. Conjunctival swab grew Staphylococcus aureus and Staphylococcus lugdunensis. Significant clinical improvement occurred, but the XEN Gel Stent became exposed after 9 days of treatment with worsening hypotony. Urgent surgical revision was performed to remove the XEN Gel Stent and apply a tutoplast plug with overlying amniotic membrane graft. Intraocular pressure gradually improved over 6 weeks to 15 mm Hg with reversal of hypotonous changes, and visual acuity stabilized at 20/40. CONCLUSIONS: To our knowledge, this is the first reported case of necrotizing scleritis following XEN Gel Stent insertion. It is a reminder that infection should always be the primary differential diagnosis in patients with surgical-induced necrotizing scleritis.

The Association Between Visual Field Reliability Indices and Cognitive Impairment in Glaucoma Patients.

PRECIS: This prospective cross-sectional study found that patients with cognitive impairment (CI) are more likely to produce unreliable visual field (VF) tests, especially with higher false-negative (FN) responses and consequent overestimation of mean deviation (MD). AIM: Aging-associated CI can impair the ability of individuals to perform a VF test and compromise the reliability of the results. We evaluated the association between neurocognitive impairment and VF reliability indices in glaucoma patients. METHODS: This prospective, cross-sectional study was conducted in the Ophthalmology Department, Hospital Kuala Pilah, Malaysia, and included 113 eyes of 60 glaucoma patients with no prior diagnosis of dementia. Patients were monitored with the Humphrey Visual Field Analyzer using a 30-2 SITA, standard protocol, and CI was assessed using the clock drawing test (CDT). The relationships between the CDT score, MD, pattern standard deviation, Visual Field Index (VFI), fixation loss (FL), false-positive values, and FN values were analyzed using the ordinal regression model. RESULTS: Glaucoma patients older than 65 years had a higher prevalence of CI. There was a statistically significant correlation between CDT scores and glaucoma severity, FL, FN, and VFI values (rs=-0.20, P=0.03; rs=-0.20, P=0.04; rs=-0.28, P=0.003; rs=0.21, P=0.03, respectively). In a multivariate model adjusted for age and glaucoma severity, patients with lower FN were significantly less likely to have CI (odds ratio, 0.91; 95% confidence interval, 0.89-0.93) and patients with higher MD were more likely to have CI (odds ratio, 1.10; 95% confidence interval, 1.05-1.16); false positive, FL, pattern standard deviation, and VFI showed no significant correlation. CONCLUSION: Cognitive decline is associated with reduced VF reliability, especially with higher FN rate and overestimated MD. Screening and monitoring of CI may be important in the assessment of VF progression in glaucoma patients.

Low nocturnal diastolic ocular perfusion pressure as a risk factor for NTG progression: a 5-year prospective study.

OBJECTIVE: To assess the relationship between baseline intraocular pressure (IOP), blood pressure (BP) and ocular perfusion pressure (OPP), and the 5-year visual field progression in normal-tension glaucoma (NTG) patients. DESIGN: Prospective, longitudinal study. METHODS: Sixty-five NTG patients who were followed up for 5 years are included in this study. All the enrolled patients underwent baseline 24-h IOP and BP monitoring via 2-hourly measurements in their habitual position and were followed up for over 5 years with reliable VF tests. Modified Anderson criteria were used to assess VF progression. Univariable and multivariable analyses using Cox's proportional hazards model were used to identify the systemic and clinical risk factors that predict progression. Kaplan-Meier survival analyses were used to compare the time elapsed to confirmed VF progression in the presence or absence of each potential risk factor. RESULTS: At 5-year follow-up, 35.4% of the enrolled patients demonstrated visual field progression. There were statistically significant differences in the mean diastolic blood pressure (p < 0.05) and diastolic OPP (p < 0.05) between the progressing and the non-progressing group. There was no association between IOP parameters and NTG progression. Multivariable analysis identified low nocturnal DOPP at baseline as a significant predictive risk factor for glaucomatous visual field progression at 5 years. An mmHg decrease in nocturnal DOPP increases the hazard of progression by 1.4 times. Patients with DOPP < 35 mmHg have 2.3-fold higher probability of progressing compared to the patients with DOPP > 43.7 mmHg (log rank = 0.018). CONCLUSION: Diastolic parameters of BP and OPP were significantly lower in the NTG patients who progressed after 5 years. Low nocturnal DOPP is an independent predictor of glaucomatous visual field progression in NTG patients.