Investigation of calcium silicate as a natural clay-based sunblock: Formulation and characterization.

BACKGROUND: Sunlight exposure causes several types of health issues to humans, and in particular, it affects especially the skin. Among the most common harmful issues developed by UV exposure are erythema, pigmentation, and lesions in DNA, which may lead to cancer. These long-term effects can be minimized with the use of sunscreen. OBJECTIVE: The use of commercial UV filters causes severe side effects such as skin allergy and whitening of the skin. Therefore, in this study the effectiveness of Ca2 SiO4 , a compound abundantly present in the soils of certain South Asian regions, has been the first time explored as UV filter. This compound leaves a low amount of white residue on the skin and is highly stable. METHOD: The comparative study of a cosmetic formulation having 5% Ca2 SiO4 , and other formulations containing 5% TiO2 and 5% ZnO as inorganic UV filters, was performed to evaluate the physical and chemical stability. RESULT: The zeta potential and chemical stability of formulations containing these different UV filters were investigated by using UV-Vis spectroscopy, FTIR-ATR, and X-ray diffraction. Results indicated Ca2 SiO4 as a promising innovative UV filter with an SPF value of 37.94. One of the reasons is its low interaction with organic filter, that is, PABA, as compared to commercial ZnO and TiO2 inorganic UV filters. Biological absorption in organs was studied by ICP-MS on model mice. CONCLUSION: It also has a low photocatalytic activity; thus, formation of radicals is minimum. Moreover, Ca2 SiO4 showed a recognized ability to leave a low amount of white residue on the skin combined with great stability.

In-vitro bioassays of aqueous and ethanol extracts of Aseel dates.

Aseel is amongst the most vital date variety of Pakistan. Beside its nutritional value, it also got remedial uses therefore for the first time different in-vitro bioassays were performed to assess its medicinal value. Aqueous (DFAE) and ethanol (DFEE) extracts of fresh Aseel dates were used for the purpose. Microplate alamar blue assay was done for antibacterial activity, Brine shrimp lethality test for cytotoxicity and MTT assays with different cancer cell lines were used for anti-cancer activity. Antioxidant and anti-inflammatory activity were also evaluated by free radical scavenging bioassay and chemiluminescence technique. Alamar blue assay of both extracts exhibited weak antibacterial activity against E.coli, S, flexenari and S. aureus. Brine shrimp lethality revealed absence of cytotoxicity at 1000µ/mL concentration. DFEE 50 µ/mL was effective against MCF-7,MDA-MB-231, PC3, 3T3 and Hela cancer cell lines showing 17.59%, 20.90%, 37.60%, 22.35% and 36.70% inhibition whereas DFAE exhibits 20.46%, 30.86%, 15.21%, 29.70% and 16.40 % inhibition respectively. Similarly both extracts also showed varying degree of anti-oxidant and anti-inflammatory activity against standard drug. The results are suggestive of weak bioactivity of Aseel date extracts might because of reduced potency however further studies are required for better understanding of observed results and separation of active ingredients from Aseel dates.

Analysis of choroidal structure and vascularity indices with image binarization of swept source optical coherence tomography images: A prospective study of 460 eyes.

PURPOSE: To evaluate choroidal vascularity index (CVI) among normal subjects using image binarization of swept source optical coherence tomography (SS-OCT). MATERIALS AND METHODS: Four hundred and sixty eyes of 230 normal participants were included. Total circumscribed choroidal area, luminal area, stromal area (SA), and CVI were derived from SS-OCT scans using open-source software (ImageJ) with the modified Niblack method. Both CVI and subfoveal choroidal thickness (SFCT) were correlated with age, refractive error, intraocular pressure, and mean ocular perfusion pressure (MOPP) using mixed linear model analysis. Pearson's correlation coefficient was used to determine the relationship between age and each dependent factor. Analyses were performed using the SPSS software version 20.0 (IBM Corp., Armonk USA) and statistical significance was tested at 5%. RESULTS: The mean age was 42.1 (±17.6) years. Mean SFCT was 307 ± 79 µm. Mean CVI was 66.80 (±3.8)%. There was statistically significant positive correlation between CVI and increasing age (r = 0.259, P < 0.0001) and statistically significant negative correlation between SFCT and age (r = -0.361, P < 0.0001). There was positive linear correlation between refractive error and CVI (r = 0.220, P < 0.0001) and negative correlation between SFCT and refractive error. There was no significant effect of MOPP on both CVI (P = 0.07) and SFCT (P = 0.7). CONCLUSION: CVI and SFCT are significantly correlated with age and refractive error in normal Indian eyes.

Intravitreal Ozurdex has no short term influence on choroidal thickness and vascularity index in eyes with diabetic macular edema: A pilot study.

AIM: To analyze choroidal parameters in eyes with diabetic macular edema (DME) treated with intravitreal Ozurdex. PATIENTS AND METHODS: Twenty eyes of 14 patients were included in this prospective study. Optical coherence tomography images were obtained before and 8-10 weeks after intravitreal Ozurdex injection; binarized and subfoveal choroidal thickness (SFCT) and choroidal vascularity index (CVI) were calculated. RESULTS: Mean SFCT (treatment naïve; 242.22 ± 32.87 reduced to 218.10 ± 22.10, P = 0.158 and previously treated; 330.4 ± 56.72 reduced to 328.93 ± 50.55, P = 0.833) and mean CVI (treatment naïve; 0.64 ± 0.03 changed to 0.65 ± 0.04, P = 0.583 and previously treated; 0.65 ± 0.05 reduced to 0.64 ± 0.03, P = 0.208) showed no significant change. CONCLUSION: Intravitreal Ozurdex showed no significant effects on SFCT and CVI in eyes with DME over short term. Larger studies with longer follow-up may allow a better understanding.

Spine patients demystified: what are the predictive factors of poor surgical outcome in patients after elective cervical and lumbar spine surgery?

BACKGROUND CONTEXT: Pre-existing comorbid psychiatric mood disorders are a known risk factor for impaired health-related quality of life and poor long-term outcomes after spine surgery. PURPOSE: The purpose of this study was to investigate the effect of preexisting mood disorders on (1) pre- and postoperative patient-reported outcomes, (2) complications, and (3) pre- and postoperative opioid consumption in patients undergoing elective cervical or lumbar spine surgery. STUDY DESIGN/SETTING: Retrospective review at a single academic institution from 2014 to 2017. PATIENT SAMPLE: Consecutive adult patients who underwent cervical or lumbar surgery. OUTCOME MEASURES: Quantitative measurements of pain (visual analog scale [VAS]) and spinal region-specific disability scores (Neck Disability Index [NDI] and Oswestry Disability Index [ODI]). METHODS: This is a retrospective review of 435 consecutive patients (179 cervical, 256 lumbar) who underwent elective spine surgery at a single academic institution from 2014 to 2017. Patient preoperative diagnosis of psychiatric mood disorder (eg, depression, anxiety, schizophrenia, bipolar, or dementia), baseline characteristics, medical (nonpsychiatric) comorbidities, operative variables, and surgical complications (eg, superficial and deep infection, wound complication, emergency department [ED] visits, readmissions, and repeat operations) were recorded. Additionally, preoperative ED visits, pre- and postoperative opioid requirements, total opioid prescription quantities and most recent dateof opioid prescription were collected. VAS, NDI, and ODI scores were recorded preoperatively and at 2, 6, and 12 weeks after surgery. Continuous variables were compared between those with and without diagnosed psychiatric comorbidity using two-tailed independent t test, and categorical variables were compared using chi-square or Fisher's exact tests. Analyses of variance and analysis of covariance were used to compare patient-reported outcomes between groups. A multivariate approach was taken to account for contribution of potential covariates in significant findings. Multiple linear regressions were used to determine variables associated with the number of postoperative opioid prescriptions. RESULTS: Of the cervical and lumbar cohorts, 78 (43.6%) and 113 (44.1%), respectively, had a preoperative diagnosis of comorbid psychiatric mood disorder. Cervical patients with mood disorders received a significantly higher total number of opioid prescriptions post-operatively (4.6±5.2 vs. 2.8±3.9; p=.002). Patients with mood disorders had worse NDI scores at all time points (p=.04), however there were no differences in VAS pain scores (p=.5). There were no statistical differences between patients with and without mood disorders regarding baseline characteristics, medical (nonpsychiatric) comorbidities, operative variables, surgical complications, preoperative ED visits or prior opioid use (p>.05). For lumbar patients, patients with mood disorders were more commonly females (p=.04), tobacco users (p=.003), alcohol dependent (p=.01) and illicit-drug abusers (p=.03). There were no differences regarding surgical complications or opioid consumption. Tobacco use (p<.001) was the sole contributor to postoperative VAS pain scores. Patients with mood disorders had significantly higher VAS values both before and 3 months following surgery (p=.01), but there was no difference in ODI scores. CONCLUSIONS: Patients with preoperative psychiatric mood disorders undergoing elective cervical surgery had worse NDI scores and received more opioid prescriptions, despite similar VAS scores as those without mood disorders. Lumbar surgery patients with mood disorders were demographically different than those without mood disorders and had worse pain before and after surgery, though ODI scores were not different. Tobacco use was the sole contributor to postoperative VAS pain scores. This information can be useful in counseling patients with mood disorders before elective spinal surgery.

Subclinical Changes in Deceased Donor Kidney Proteomes Are Associated With 12-month Allograft Function Posttransplantation-A Preliminary Study.

BACKGROUND: Cerebral injury during donation after brain death may induce systemic damage affecting long-term kidney function posttransplantation. Conventional evaluation of donor organ quality as a triage for transplantation is of limited utility. METHODS: We compared donor kidneys yielding opposing extremes of the continuum of posttransplantation outcomes by several common kidney biopsy evaluation techniques, including Kidney Donor Profile Index and Remuzzi scoring, and analyzed tissue from a minimal sample cohort using label-free quantitation mass spectrometry. Further assessment of the proteomic results was performed by orthogonal quantitative comparisons of selected key proteins by immunoblotting. RESULTS: We show that common evaluation techniques of kidney biopsies were not predictive for posttransplantation outcomes. In contrast, despite the limited cohort size, the proteomic analysis was able to clearly differentiate between kidneys yielding extreme posttransplantation outcome differences. Pathway analysis of the proteomic data suggested that outcome-related variance in protein abundance associated with profibrotic, apoptosis, and antioxidant proteins. Immunoblotting confirmation further supported this observation. CONCLUSIONS: We present preliminary data indicating that there is scope for existing evaluation approaches to be supplemented by the analysis of proteomic differences. Furthermore, the observed outcome-related variance in a limited cohort was supported by immunoblotting and is consistent with mechanisms previously implicated in the development of injury and cytoprotection in kidney transplantation.

Choroidal thickness in normal Indian subjects using Swept source optical coherence tomography.

AIM: To determine choroidal thickness in healthy Indian subjects using Swept source optical coherence tomography (SS-OCT). METHODS: In this prospective, observational, cross-sectional study; healthy Indian subjects (n = 230) with no history of ocular and/or systemic disorders were enrolled in the study. Choroidal thickness was measured for 230 eyes using SS-OCT. Subjects were divided into six age groups. Main outcome measures were subfoveal choroidal thickness (SFCT) and macular choroidal thickness (MCT) up to 3 mm at 500-micron interval from the fovea was measured in eight different quadrants. RESULTS: The mean SFCT was 307±79 µm and mean MCT was 285±75 µm. No difference in the choroidal thickness was found among genders. Mean SFCT of the different age groups was 327±68 µm (12-18 years), 364±70 µm (18.1-30 years), 321±78 µm (30.1-40 years), 304±79 µm (40.1-50 years), 283±69 µm (50.1-60 years) and 262±72µm (above 60 years; p <0.001; One way ANOVA). Mean macular choroidal thickness was 305±60 µm, 342±61 µm, 306±72 µm, 282±79 µm, 261±66 µm, 238±68µm respectively (p<0.001; one way ANOVA). A significant weak negative correlation was found between age with SFCT (r = -0.368, p<0.001) and MCT (r = -0.40, p<0.001). No significant correlation was found with refractive error, axial length and ocular perfusion pressure. CONCLUSION: This study showed that mean SFCT and MCT was 307±79µm and 285±75 µm, respectively, among healthy Indian subjects. Mean CT was found to decrease with age, although there was no difference in CT between genders.

Abducens Nerve Palsy as Initial Presentation of Multiple Myeloma and Intracranial Plasmacytoma.

Central Nervous System (CNS) involvement in multiple myeloma and/or multifocal solitary plasmacytoma is rare. Although they are unique entities, multiple myeloma (MM) and plasmacytoma represent a spectrum of plasma cell neoplastic diseases that can sometimes occur concurrently. Plasmacytomas very often present as late-stage sequelae of MM. In this case report, we report a 53-year-old female presenting with right abducens cranial nerve (CN) VI palsy as an initial presentation secondary to lesion of the right clivus.