Low-tech intraocular ophthalmic microsurgery simulation: A low-cost model for home use

In order to maintain manual dexterity and surgical skills, trainees are encouraged to partake in regular simulation. Current options for intraocular surgical simulation require specialist microscopic equipment which is expensive and requires access to simulation facilities. A set of core simulation exercises and basic surgical skills of performing the corneal incisions, capsulorhexis, improving the manual dexterity, and suturing were identified, discussed, and agreed among authors before designing this simulation exercise. In this paper, we propose a smartphone-based, low-cost, low-tech model with corresponding exercises for intraocular simulation that can be used at home for the above-mentioned surgical skill set. This model provides an easy, portable, and reproducible method of simulation and can serve as an adjunct to patient-facing surgical training, especially in the current pandemic, where the excess to the simulation facilities or setup of these facilities may be difficult.     

Online Registry of COVID-19–Associated Mucormycosis Cases,India, 2021

We established an online registry of coronavirus disease–associated mucormycosis cases in India. We analyzed data from 65 cases diagnosed during April–June 2021, when the Delta variant predominated, and found that patients frequently received antibacterial drugs and zinc supplementation. Online registries rapidly provide relevant data for emerging infections.     

Aldosterone,inactive matrix gla-protein,and large artery stiffness in hypertension

Vascular calcification leads to increased large artery stiffness. Matrix gla-protein (MGP) is a vitamin K–dependent protein that inhibits arterial calcification. Aldosterone promotes vascular calcification and stiffness, but the relationships between aldosterone, MGP, and arterial stiffness are unknown. We studied 199 adults (predominantly older men) with hypertension. We assessed the relationship between levels of dephospho-uncarboxylated MGP (dp-ucMGP), aldosterone, and carotid-femoral pulse wave velocity (CF-PWV) using standard regression and mediation analyses. Plasma aldosterone was measured in a subgroup of subjects (n = 106). Aldosterone was strongly associated with dp-ucMGP (standardized β = 0.50, P < .001), which was independent of potential confounders (β = 0.37, P < .001). Levels of dp-ucMGP were significantly associated with CF-PWV (β = 0.30; P < .001), which persisted after adjustment for potential confounders (β = 0.25; P = .004). Plasma aldosterone was also significantly associated with CF-PWV (standardized β = 0.21; P = .035). However, in a model that included aldosterone and dp-ucMGP, only the latter was associated with CF-PWV. Mediation analyses demonstrated a significant dp-ucMGP–mediated effect of aldosterone on CF-PWV, without a significant direct (dp-ucMGP independent) effect. Our study demonstrates a novel independent association between high aldosterone levels and dp-ucMGP, suggesting that aldosterone may influence the MGP pathway. This relationship appears to underlie the previously documented relationship between aldosterone and increased arterial stiffness.     

Desmopressin for the prevention of bleeding in percutaneous kidney biopsy: efficacy and hyponatremia

International Urology and Nephrology - Desmopressin is used to reduce bleeding complications for kidney biopsies with azotemia but little is known about desmopressin-induced hyponatremia in these...     

Design and development of nevirapine loaded surfactant free chitosan microemulsion

Emulsification of liquid paraffin oil in aqueous solutions of chitosan without adding any additional surfactant is studied. The main objective of this study was to evaluate the dispersion of castor oil in aqueous phase in the presence of chitosan, and how this polymer promotes the stability of the obtained emulsions. Nevertheless, chitosan promotes emulsion production by increasing the matrix viscosity and provides stabilization of the oil-water interface by forming a dense hydrophilic polyelectrolytic brush on the water side of interface, which presents a significant barrier for coalescence--both steric and electrostatic. Chitosan stabilizes the emulsion mainly by the steric effect. These steric effects generate Van der Waals repulsion forces when two particles are too close. After loading with antiviral drug nevirapine, these emulsions were characterized in terms of phase contrast microscopy, hot stage microscopy, fluorescence microscopy, particle size, zeta potential, viscosity, entrapment efficiency and release studies using dialysis bag method. The prepared emulsions were stable in terms of mean globule size, change in drug content and retain they cationicity. The formulated emulsions are a promising carrier for nevirapine and other lipophilic drugs.     

Microwave-assisted synthesis of some novel and potent antibacterial and antifungal compounds with biological screening

Hydantoins have widely been used as antiarrythmic, anticonvulsant and antitumor agents but recent research has shown a different and novel cytotoxic activity of hydantoins and its derivatives, i.e. anti HIV, antibacterial and antifungal. The following research article deals with the synthesis of hydantoins and their derivatives by Mannich reaction viz., 3-(substituted)-5,5-diphenylimidazolidine-2,4-dione and 1-(substituted)-3,5,5-triphenylimidazolidine-2,4-dione. The synthesised compounds are novel and some of the compounds showed good antibacterial and antifungal activity equivalent to the standards used. All synthetic procedures were carried out in a microwave and not by conventional methods, which led to speedy process and high yield for the same.     

Update on carbonic anhydrase inhibitors: a patent review (2008 - 2011)

INTRODUCTION: Carbonic anhydrases (CA) are a family of zinc metalloenzymes (EC 4.2.1.1) found in all organisms, catalyzing the reversible reaction of CO(2) hydration to bicarbonate and a proton. CAs are involved in various physiological reactions including respiration, pH regulation, Na(+) retention, calcification, tumorigenesis, electrolyte secretion, gluconeogenesis, ureagenesis, and lipogenesis. Hence CA inhibitors (CAIs) have long been studied as various classes of systemic anticonvulsants, anti-obesity, anti-pain, anti-tumor and topically acting anti-glaucoma agents, and agents for treating altitude sickness. In addition, CA isozyme IX (CA IX) has been shown to play a critical role in cancer proliferation, with CA IX overexpression in certain types of cancers leading to its use as a biomarker for cancer diagnosis and prognosis. AREAS COVERED: Recently, the structures of all the catalytic α-CAs have been determined and with better understanding of gene-based RNA interference (RNAi) therapy, many patents on CA have been filed in the past few years. More new inhibitors are being tested in various labs around the world, in pursuit of designing high-affinity compounds that bind to specific isozymes of CA, thereby reducing side effects caused by off-target binding. This is a review on the patents filed related to CAs during 2008 - 2011. EXPERT OPINION: Structural knowledge regarding CA isozymes offers great opportunity to explore and design inhibitors that will specifically bind to CA IX, avoid off-target binding with other CA isozymes and thus reduce side effects. Various in silico and kinetic studies to test and characterize novel and preexisting inhibitors for isozyme specificity are currently being conducted. However, there remains a need for more research to be carried out to develop better and more specific CAIs with lesser off-target inhibition.