MII RetCam assisted smartphone based fundus imaging for retinopathy of prematurity

Purpose:

The gold standard for evaluating Retinopathy of prematurity (ROP), a potentially blinding disease in preterm babies, is by indirect ophthalmoscopy which is quite subjective. Digital imaging with RetCam, an advanced wide field imaging system is more precise but it is not easily available or affordable. Smartphones are being explored as an alternate cost effective and accessible imaging tool. This is possible because of the good illumination and the built-in high resolution cameras available in modern smartphones. The aim of this study is to illustrate the utility of MII RetCam assisted smartphone based fundus imaging (MSFI) in the documentation and monitoring of ROP.

Methods:

Single-centre, retrospective observational study of all the preterm babies subjected to MSFI as part of ROP screening from September 2017 to November 2018. iPhone 4S and + 20 Diopter lens attached to the MII RetCam device was used for fundus imaging at baseline and during follow up. The statistical analysis used for the same is the SPSS statistical software.

Results:

Good quality images of central and peripheral retina could be captured in 33 out of 42 babies (78.57%) with ROP. Serial imaging done in 24 babies with ROP helped in precise monitoring of the disease and planning management. Incidentally detected non-ROP findings were also documented. Unique design of the device enabled imaging by a single examiner. Image database created was useful for academic and counselling purposes. Smaller field images which can cause difficulty in distinguishing the zones is a limitation.

Conclusion:

MSFI is a potential alternate imaging tool enabling objective documentation and monitoring of ROP in low resource settings.

A facile ultrasonic-aided biosynthesis of ZnO nanoparticles using Vaccinium arctostaphylos L. leaf extract and its antidiabetic, antibacterial, and oxidative activity evaluation

The synthesis of nanoparticles often result in the generation of harmful chemical pollutants. As such, many researchers have focused on developing green processes, which include the biosynthesis. In this research, ZnO nanoparticles were prepared using the leaf extract of whortleberry (Vaccinium arctostaphylos L.) via a simple ultrasonic-assisted method. The morphology, crystal size and structure, surface, thermal, and optical properties of the bio-mediated ZnO sample (ZnO_ext) were analyzed and compared with that produced without incorporating the extract (ZnO_chem). The ZnO samples were evaluated for their antidiabetic, antibacterial, as well as their sono- and photo-catalytic performances. Initially, the samples were intraperitoneal injected to alloxan-diabetic rats to examine their treatment efficiency in terms of effects on fasting blood glucose, insulin, cholesterol, high-density lipoprotein, and total triglyceride levels. The ZnO_ext showed significantly higher efficiency for improving the health status of alloxan-diabetic rats in contrast with other tested treatments, vis. ZnO_chem, insulin, and only leaf extract. In addition, both the ZnO samples were assessed against gram-negative and gram-positive bacteria and through sono- and photo-catalytic processes for removing rhodamine B, respectively. The results of this study indicated that not only the ZnO_ext sample was pollution free, it also exhibited higher potentials for treating diabetic rats, bacterial decontamination, and also oxidative removal of organic compounds under the influences of ultrasound and UV irradiations when compared with ZnO_chem sample.

Analysis of hematopoietic stem cells using a composite approach

Stem cells or Cancer stem cells (CSCs) have now been identified in different type of tissues by using surface markers. Functional assays such as ALDEFLUOR and side population which are marker independent have been additional approaches. However, whether all these approaches identify the same population of cells remain uncertain. To address this issue we have used hematopoietic stem cells as a model. Peripheral blood stem cells enumerated by CD34 are used routinely in bone marrow transplantation which supports the recovery of bone marrow after ablative chemotherapy or radiation. Hematopoietic stem cells (HSCs) were obtained from normal donor bone marrow (n = 5) and G-CSF stimulated peripheral blood stem cells (PBSCs) (n = 5) from patients undergoing leukapheresis prior to bone marrow transplantation. The stem cells were identified by combining CD34 expression with functional assays (ALDEFLUOR and side population). The cell cycle profile was further determined by simultaneous labeling of these cells with Hoechst and Pyronin Y. The simultaneous analysis showed that both CD34+ and CD34- cells co-exist with ALDH1A1+ cells but side population did not segregate with CD34+ cells. Though stem cell populations identified by functional assays were different, the cell cycle analysis showed that both ALDH1A1+ and CD34+ cells were in the G1 phase of cell cycle rather than in the quiescent (G0) phase.

Density functional theory simulation of cobalt oxide aggregation and facile synthesis of a cobalt oxide, gold and multiwalled carbon nanotube based ternary composite for a high performance supercapattery

A novel ternary composite consisting of cobalt oxide (Co₃O₄) nanoparticles (NPs) grown on multiwalled carbon nanotubes (MWCNTs) and mixed with gold (Au) NPs is synthesized by a single step hydrothermal route.

Urethral Duplication in Children: Experience of Twenty Cases

Background and Objective

Urethral duplication is a rare congenital anomaly having multiple anatomical variants and varied presentations. Multiple surgical techniques have been described for this anomaly, and no surgical technique is ideal. The aim of this study was to present our experience of twenty cases of urethral duplication in the management of this anomaly.

Materials and Methods

Retrospectively over a period of 10 years from 2006 to 2016, records of all urethral duplications were reviewed. All available records were evaluated for clinical presentation, imaging studies (micturating cystourethrogram, retrograde urethrogram, ultrasonography, and cystourethroscopy), and classified according to the Effmann's classification. The intraoperative details, outcome, and follow-up (including cystoscopy and contrast studies) were noted.

Results

There were 20 patients of urethral duplications. Age of patients ranged from 3 months to 9 years with a mean age of 4.6 years. The details of management, outcome, and follow-up were obtained.

Conclusion

Management varies with the symptoms and the severity of the anomaly. Y-type urethral duplication is more complex and challenging and requires extensive urethral reconstruction. Combined use of the bladder and buccal mucosa for reconstruction gives better results than bladder mucosa alone.

Pediatric Appropriate Evaluation Protocol for India (PAEP-India): Tool for Assessing Appropriateness of Pediatric Hospitalization

OBJECTIVE

To develop and assess Pediatric Appropriateness Evaluation Protocol for India (PAEP-India) for inter-rater reliability and appropriateness of hospitalization.

DESIGN

Cross-sectional study.

SETTING

The available PAEP tools were reviewed and adapted for Indian context by ten experienced pediatricians following semi-Delphi process. Two PAEP-India tools; newborn (≤28 days) and children (>28 days-18 years) were developed. These PAEP-India tools were applied to cases to assess appropriateness of admission and inter-rater reliability between assessors.

PARTICIPANTS

Two sets of case records were used: (i) 274 cases from five medical colleges in Delhi-NCR [≤28 days (n=51); >28 days to 18 years (n=223)]; (ii) 622 infants who were hospitalized in 146 health facilities and were part of a cohort (n= 30688) from two southern Indian states.

INTERVENTIONS

Each case-record was evaluated by two pediatricians in a blinded manner using the appropriate PAEP-India tools, and 'admission criteria' were categorized as appropriate, inappropriate or indeterminate.

OUTCOME MEASURES

The proportion of appropriate hospitalizations and inter-rater reliability between assessors (using kappa statistic) were estimated for the cases.

RESULTS

97.8% hospitalized cases from medical colleges were labelled as appropriate by both reviewers with inter-rater agreement of 98.9% (k=0.66). In the southerm Indian set of infants, both reviewers labelled 80.5% admissions as appropriate with inter-rater agreement of 96.1% (k= 0.89).

CONCLUSIONS

PAEP-India (newborn and child) tools are simple, objective and applicable in diverse settings and highly reliable. These tools can potentially be used for deciding admission appropriateness and hospital stay and may be evaluated later for usefulness for cost reimbursements for insurance proposes.

Laser Treatment of a Tracheal Inflammatory Myofibroblastic Tumor

BACKGROUND

Inflammatory myofibroblastic tumors of the trachea are rare childhood quasi-neoplastic lesions.

CASE CHARACTERISTICS

7-year-old boy with recurrent episodes of cough, breathing difficulty and wheeze, initially treated as asthma.

INTERVENTION

CT chest and flexible bronchoscopy revealed a mass lesion of the trachea, which was excised by diode laser through the ventilating bronchoscope. Histopathology confirmed it as the inflammatory myofibroblastic tumor.

MESSAGE

Use of laser ensured complete endotracheal excision of the tumor.

Corrosion Protection of Copper in 3% NaCl Solution by the Fabrication of Thiadiazole Monolayer

In this study, 2-mercapto-1,3,4-thiadiazole (2-MT) self-assembled monolayer (SAM) was formed on copper electrode surface and the resulting 2-MT SAM on copper has been characterized using surface analytical techniques such as Fourier transform infrared (FT-IR) spectroscopy, energy dispersive X-ray (EDX) analysis, atomic force microscopy (AFM) and contact angle measurement (CA). The existence of N and S in the EDX and FT-IR analysis showed that 2-MT molecules were self-assembled on the copper through N and S by chemisorption which indicates the formation of 2-MT SAM on copper surface. Corrosion protection performance of 2-MT SAM on copper was investigated using potentiodynamic polarization studies (PDS), cyclic voltammetry (CV) and scanning electron microscopy (SEM), respectively. Analysis of both electrochemical and SEM analysis results revealed excellent corrosion protection for the copper substrate.

Species-specific detection of Candida tropicalis using evolutionary conserved intein DNA sequences

Inteins (internal proteins) are self-splicing transportable genetic elements present in conserved regions of housekeeping genes. The study highlights the importance of intein as a potential diagnostic marker for species-specific identification of Candida tropicalis, a rapidly emerging opportunistic human pathogen. Initial steps of primer validation, sequence alignment, phylogenetic tree analysis, gel electrophoresis and real-time polymerase chain reaction (PCR) assays were performed to confirm the specificity of the designed primers. The primers were selective for C. tropicalis with 100% inclusivity and showed no cross-species or cross-genera matches. The established technique is a prototype for developing multifaceted PCR assays and for point-of-care testing in near future.

SIGNIFICANCE AND IMPACT OF THE STUDY

Development of molecular markers for specific detection of microbial pathogens using real-time polymerase chain reaction (PCR) is an appealing and challenging technique. A real-time PCR is an emerging technology frequently used to detect the aetiologic agents. In recent times, designing species-specific primers for pathogen detection is gaining momentum. The method offers rapid, accurate and cost-effective strategy to identify the target, thus providing sufficient time to instigate appropriate chemotherapy. The study highlights the use of intein DNA sequence as molecular markers for species-specific identification of Candida tropicalis. The study also offers a prototype model for developing multifaceted PCR assays using intein DNA sequences, and provides a developmental starting point for point-of-care testing in near future.

Electrocoagulation treatment of raw landfill leachate using iron-based electrodes: Effects of process parameters and optimization

The main problem of landfill leachate is its diverse composition comprising many persistent organic pollutants which must be removed before being discharge into the environment. This study investigated the treatment of raw landfill leachate using electrocoagulation process. An electrocoagulation system was designed with iron as both the anode and cathode. The effects of inter-electrode distance, initial pH and electrolyte concentration on colour and COD removals were investigated. All these factors were found to have significant effects on the colour removal. On the other hand, electrolyte concentration was the most significant parameter affecting the COD removal. Numerical optimization was also conducted to obtain the optimum process performance. Under optimum conditions (initial pH: 7.73, inter-electrode distance: 1.16 cm, and electrolyte concentration (NaCl): 2.00 g/L), the process could remove up to 82.7% colour and 45.1% COD. The process can be applied as a pre-treatment for raw leachates before applying other appropriate treatment technologies.