Deep sclerectomy and trabeculectomy augmented with Mitomycin C: 2-year post-operative outcomes

Graefe's Archive for Clinical and Experimental Ophthalmology - Two-year post-operative outcomes of both deep sclerectomy (DS) and trabeculectomy surgery (Trab) augmented with Mitomycin C (MMC)...     

Potential neuroprotective role of astroglial exosomes against smoking-induced oxidative stress and HIV-1 replication in the central nervous system

Introduction: HIV-1-infected smokers are at risk of oxidative damage to neuronal cells in the central nervous system by both HIV-1 and cigarette smoke. Since neurons have a weak antioxidant defense system, they mostly depend on glial cells, particularly astrocytes, for protection against oxidative damage and neurotoxicity. Astrocytes augment the neuronal antioxidant system by supplying cysteine-containing products for glutathione synthesis, antioxidant enzymes such as SOD and catalase, glucose for antioxidant regeneration via the pentose-phosphate pathway, and by recycling of ascorbic acid.

Areas covered: The transport of antioxidants and energy substrates from astrocytes to neurons could possibly occur via extracellular nanovesicles called exosomes. This review highlights the neuroprotective potential of exosomes derived from astrocytes against smoking-induced oxidative stress, HIV-1 replication, and subsequent neurotoxicity observed in HIV-1-positive smokers.

Expert opinion: During stress conditions, the antioxidants released from astrocytes either via extracellular fluid or exosomes to neurons may not be sufficient to provide neuroprotection. Therefore, we put forward a novel strategy to combat oxidative stress in the central nervous system, using synthetically developed exosomes loaded with antioxidants such as glutathione and the anti-aging protein Klotho.     

Ruptured sinus of valsalva presenting late following repair of tetralogy of fallot

Rupture of sinus of valsalva following repair of tetralogy of fallot (TOF) is very rare. It should be suspected as a cause of recurrent or prolonged pleural effusion and congestive cardiac failure in patients who have undergone repair of TOF. We report one such patient.     

Hybrid closed-loop therapy: Where are we in 2021?

Hybrid closed-loop systems are characterized by the coexistence of algorithm-driven automated insulin delivery combined with manual mealtime boluses. Used correctly, these insulin delivery systems offer better glucose control and reduced risk of hypoglycaemia and represent the most advanced form of insulin delivery available for people with type 1 diabetes. The aim of this paper was to compare the currently available commercial hybrid closed-loop systems in the UK: the Medtronic 670G/780G, Tandem t:slim X2 Control IQ and CamAPS FX systems. The Medtronic 670G/780G systems use Guardian 3 sensor (7-day use, two to four calibrations per day), while Tandem and CamAPS systems use the calibration-free Dexcom G6 sensor (10 days). The CamAPS system is available as an android app, whereas the other two systems have the algorithm embedded in the insulin pump. During pivotal studies, depending on the study population and baseline glycated haemoglobin level, these systems achieve a time spent in the target range 3.9 to 10 mmol/L (70 to 180 mg/dL) of 65% to 76% with low burden of hypoglycaemia. All three systems allow a higher glucose target for announced exercise, while the Tandem system offers an additional night-time tighter target. The CamAPS system offers fully customizable glucose targets and is the only system licensed for use during pregnancy. Additional education is required for both users and healthcare professionals to harness the best performance from these systems as well as to troubleshoot when “automode exits” occur. We provide consensus recommendations to develop pragmatic pathways to guide patients, clinicians and commissioners in making informed decisions on the appropriate use of the diabetes technology.     

Triphala inhibits alpha-synuclein fibrillization and their interaction study by NMR provides insights into the self-association of the protein

The process of assembly and accumulation of the intrinsically disordered protein (IDP), alpha-synuclein (αSyn) into amyloid fibrils is a pathogenic process leading to several neurodegenerative disorders such as Parkinson''s disease, multiple system atrophy and others. Although several molecules are known to inhibit αSyn fibrillization, the mechanism of inhibition is just beginning to emerge. Here, we report the inhibition of fibrillization of αSyn by Triphala, a herbal preparation in the traditional Indian medical system of Ayurveda. Triphala was found to be a rich source of polyphenols which are known to act as amyloid inhibitors. ThT fluorescence and TEM studies showed that Triphala inhibited the fibrillization of αSyn. However, it was observed that Triphala does not disaggregate preformed αSyn fibrils. Further, native-PAGE showed that Triphala reduces the propensity of αSyn to oligomerize during the lag phase of fibrillization. Our NMR results showed that certain stretches of residues in the N-terminal and NAC regions of αSyn play an anchor role in the self-association process of the protein, thereby providing mechanistic insights into the early events during αSyn fibrillization.

Triphala inhibits αSyn self-association by interacting with anchoring regions which are responsible for αSyn oligomerization.     

Electrolyte and Haemogram changes post large volume liposuction comparing two different tumescent solutions

Background:

The most common definitions of large volume liposuction refer to total 5 l volume aspiration during a single procedure (fat plus wetting solution). Profound haemodynamic and metabolic alterations can accompany large volume liposuction. Due to paucity of literature on the effect of different tumescent solutions on the electrolyte balance and haematological changes during large volume liposuction, we carried out this study using two different wetting solutions to study the same.

Materials and Methods:

Total 30 patients presenting with varying degrees of localized lipodystrophy in different body regions were enrolled for the study. Prospective randomized controlled trial was conducted by Department of Plastic and Cosmetic Surgery, Sir Ganga Ram Hospital, New Delhi from January 2011 to June 2012. Patients were randomized into two groups of 15 patients each by using computer generated random numbers. Tumescent formula used for Group A (normal saline [NS]) was our modification of Klein''s Formula and Tumescent formula used for Group B (ringer lactate [RL]) was our modification of Hunstadt''s formula. Serum electrolytes and hematocrit levels were done at preinduction, immediate postoperative period and postoperative day 1.

Result:

Statistical analysis was performed using SPSS software version 15.0. Which showed statistically significant electrolytes and hematocrit changes occur during large volume liposuction.

Conclusion:

Statistically significant electrolytes and hematocrit changes occur during large volume liposuction and patients should be kept under observation of anaesthesist for at least 24 h. Patients require strict monitoring of vital parameters and usually Intensive Care Unit is not required. There was no statistical difference in the electrolyte changes using NS or RL as tumescent solution and both solutions were found safe for large volume liposuction.KEY WORDS: Electrolyte changes during liposuction, haemogram changes during liposuction, large volume liposuction     

Duplex PCR Assay for Identification of Tissue of Cattle and Buffalo Origin Targeting Mitochondrial Cytochrome b Gene

Proceedings of the National Academy of Sciences, India Section B: Biological Sciences - The aim of this study was to develop PCR assay for simultaneous detection of tissues from cattle and buffalo...