Duane Retraction Syndrome: The Role of Botulinum Toxin A Injection in Adults and Its Impact on Quality of Life in an Indian Population

PURPOSE

To evaluate the role of botulinum toxin A in the treatment of adults with Duane retraction syndrome and its impact on quality of life.

METHODS

A total of 25 adults with unilateral Duane retraction syndrome were selected for this interventional case series. Botulinum toxin was injected in the appropriate horizontal recti. The parameters assessed were ocular deviation (▵), overshoots, and abnormal head posture. Patients were followed up at 1 day, 10 days, and 3 months after the injection. The outcome was categorized on the basis of deviation/abnormal head posture/overshoots as: (1) significant improvement (< 8 prism diopters [PD]/< 5 degrees/≤ grade 1); (2) partial improvement (8 to 20 PD/5 to 15 degrees/≤ grade 2); and (3) no improvement (> 20 PD/> 15 degrees/≥ grade 3). Patients with partial/significant improvement were considered to have a favorable outcome. The impact on quality of life was assessed using the Adult Strabismus-20 Questionnaire scores 10 days after injection.

RESULTS

There was a significant reduction in ocular deviation in esotropic and exotropic Duane retraction syndrome at 10 days (P = .001) and 3 months (P = .04) after botulinum toxin injection. The abnormal head posture improved from 11.58 ± 7.43 to 7.86 ± 6.25 degrees at 10 days. Botulinum toxin had a positive impact on the Adult Strabismus-20 Questionnaire scores, which significantly improved (P < .05) at 10 days. A favorable outcome was noted in 21 patients at 10 days but only 4 patients at 3 months. Three patients developed ptosis and 1 patient with orthotropic Duane retraction syndrome developed transient exotropia.

CONCLUSIONS

In adults with Duane retraction syndrome, botulinum toxin can have a useful diagnostic role by providing insight to patients and setting realistic expectations. It can identify patients likely to benefit from further treatment and also has a positive impact on quality of life. [J Pediatr Ophthalmol Strabismus. 2023;60(1):46-51.].

Comparative Study of Bilateral Versus Unilateral Strabismus Surgery in the Management of Lateral Incomitance in Intermittent Exotropia

PURPOSE

To evaluate and compare bilateral asymmetric lateral rectus recession versus unilateral resection-recession surgery in the management of lateral incomitance in intermittent exotropia.

METHODS

A prospective randomized interventional comparative study was conducted consisting of 80 patients with intermittent exotropia (older than 7 years) having significant lateral incomitance. They were equally divided into two groups by a sealed envelope system. The bilateral group underwent bilateral asymmetric lateral rectus recession and the unilateral group underwent unilateral lateral rectus recession and medial rectus resection based on post-patch deviation. Parameters assessed were change in horizontal deviation, change in lateral incomitance, binocularity, motility limitation, and complications, if any. Surgical outcome was considered successful if the primary deviation was within ±8 prism diopters (PD) and lateral incomitance was less than 5 PD.

RESULTS

The mean lateral incomitance preoperatively and postoperatively was 8.3 ± 1.6 and 2.8 ± 2.4 PD in the bilateral group and 8.9 ± 1.4 and 3.7 ± 2.5 PD in the unilateral group, respectively. There was no statistically significant difference in the postoperative lateral incomitance between the two groups (P = .25), but a statistically significant difference was observed between preoperative and postoperative lateral incomitance in each group (P < .0001).

CONCLUSIONS

Both procedures are equally efficacious in achieving acceptable ocular alignment and improving significant lateral incomitance in patients with intermittent exotropia with deviations between 15 and 35 PD without causing significant motility limitation. [J Pediatr Ophthalmol Strabismus. 20XX;X(X):XX-XX.].

Double glassy states and large spontaneous and conventional exchange bias in La1.5Ca0.5CoFeO6ferrimagnetic double perovskite

The structural and magnetic properties of hole doped double perovskite La_1.5Ca_0.5CoFeO₆have been investigated by measuring x-ray photoemission spectroscopy, neutron powder diffraction and magnetization. A ferrimagnetic transition is observed atT_C∼ 167 K. The presence of anti-site disorder (ASD) in La_1.5Ca_0.5CoFeO₆has also been demonstrated. Double re-entrant cluster glass transitions (T₁∼ 11 K andT_S∼ 35 K) were observed which has been attributed to the ASD effect. The presence of both large spontaneous exchange biasH_SEB∼ 2.106 kOe and giant conventional exchange biasH_CEB∼ 1.56 T at 5 K has also been observed which can be attributed to the coexistence of long range magnetic ordering and glassy state. The experimental observations were explained with the results obtained by the density functional theory calculation. The presence of double glassy states, large exchange-bias effect and different magnetic phases make this system a potential candidate for spintronic applications.

Retropupillary iris claw lens versus Gore-Tex assisted scleral fixated intraocular lens in children with large lens subluxations

Purpose:

To compare the functional outcome of retropupillary iris claw lenses (RPIC-IOL) and scleral fixated intraocular lenses (SFIOL) in children with large lens subluxations.

Methods:

Sixty eyes of patients between 6 and 18 years of age having >7 clock hour lens subluxation were included and equally divided into group A (RPIC-IOL implantation) and group B (Gore-Tex sutured SFIOL implantation). Cases with anterior and posterior segment abnormalities, trauma and glaucoma were excluded. Primary outcome was improvement in best-corrected visual acuity (BCVA) at 1.5 years. Secondary outcomes were assessment of intraocular lens (IOL) tilt, mean change in astigmatism at 1.5 years, and median operating time. All surgeries were performed by the same surgeon.

Results:

The mean improvement in BCVA in group A was 0.28 ± 0.41 logMAR and group B was 0.44 ± 0.45 logMAR (P = 0.3). Significant IOL tilt was seen in 4 eyes in group A (13.33%) and 5 eyes in group B (16.66%) (P = 0.120). Mean change in astigmatism was 4.38 ± 5.9D in group A and 4.91 ± 4.4D in group B (P = 0.299). The median operating time was 40 min in group A and 90 min in group B (P < 0.001). No significant posterior segment complications were seen in either technique.

Conclusion:

Both procedures had comparable visual outcomes. RPIC-IOL implantation was relatively quick and comparatively easier; it may be preferred in cases with high risk of retinal detachment.

Ocular surface response to fibrin sealant versus vicryl suture for conjunctival closure after strabismus surgery: An objective assessment

PURPOPSE:

This study aims to evaluate the ocular surface response after strabismus surgery, using two different materials for conjunctival closure.

METHODS:

Randomized prospective comparative study was done. After performing strabismus surgery, conjunctival flap was apposed with fibrin sealant in Group 1 and 8-0 vicryl suture with buried knots in Group 2. Preoperative and postoperative measurement of tear film break up time and Schirmer test for tear secretion was done in both the groups of 30 patients each at regular follow-up visit up to 2 months. Postoperatively, both the groups were also compared for the resolution of discomfort and redness.

RESULTS:

Conjunctival recession was not seen in any group. Mean period was 5.8 days for resolution of discomfort (pain, lacrimation, and irritation) and 7.2 days for redness in Group 1 compared to 12 and 16 days in Group 2 (P < 0.05). During the study, we noticed significant decrease in tear film stability and increase in tear secretion in both the groups. However, in Group 2, the parameters were significantly more altered and even changes persisted for longer duration.

CONCLUSION:

Early rehabilitation of ocular surface might be related to unaltered healing process with the use of a biological substance (fibrin sealant) as compared to suture.

Tolosa-Hunt Syndrome: A Review of Diagnostic Criteria and Unresolved Issues

Purpose:

To review the diagnostic criteria for Tolosa–Hunt syndrome (THS) and utility of recent modifications.

Methods:

We searched PubMed for keywords Tolosa Hunt and magnetic resonance imaging. We compared the three editions of International Classification of Headache Disorders and isolated case reports and case series with the assessment of cavernous internal carotid artery (ICA) caliber to find the prevalence of vascular anomalies. We also evaluated cases of THS with the involvement of extracavernous structures and the possible role of idiopathic hypertrophic pachymeningitis (HP). Cases diagnosed falsely as THS were also reviewed for the presence of atypical features and relevance of criterion D. We assessed nonconforming cases (those with normal neuroimaging benign THS) and idiopathic inflammatory orbital pseudotumor (IIPO).

Results:

Vascular abnormalities were found in 36.36% of THS cases. Benign THS may also show changes in ICA caliber. Evidence suggestive of idiopathic HP could be found in 57% of cases with the involvement of extracavernous structures, such as facial nerve and pituitary gland. Both THS and IIPO are steroid-responsive pathologies with similar clinical and radiological features. False-positive diagnosis of THS results from early labeling, based solely on clinical features and symptom resolution after steroid therapy.

Conclusions:

Benign THS may be a result of limitation of resolution of available neuroimaging technique or early testing. Early and late vascular changes can be seen in both THS and its benign variant; some of them are not innocuous. THS may be considered a type of focal idiopathic HP. IIPO may represent an anterior variant of THS. In the absence of histopathological diagnosis, steroid-induced resolution of symptoms should be confirmed radiologically and followed-up.

Role of improved distance and near visual acuity with low vision aids to enhance stereopsis in retinal diseases

Purpose:

The purpose of this study was to examine role of improved distance and near best-corrected visual acuity (DBCVA and NBCVA) with use of magnification devices to enhance stereopsis in low vision (LV) subjects having retinal diseases.

Methods:

In a cross-sectional observational study without control, 84 subjects having LV due to retinal diseases were examined for an improvement of BCVA with use of magnifying low vision aids (LVAs) (2X for DBCVA and 3X for NBCVA). The stereopsis scores on titmus fly test were recorded with near refractive correction “on” and then with 3X magnification. The improvement in stereopsis for distance was however estimated through statistical correlation values.

Results:

The DBCVA (P < 0.001), NBCVA (P < 0.001) and stereopsis (P < 0.001) improved statistically significantly (SS) following magnifying LVA. There was no correlation between pre-LVA stereopsis and pre-LVA DBCVA (r = 0.059; P = 0.444;NSS) and post-LVA DBCVA (r = 0.054; P = 0.487;NSS); and no correlation between post-LVA stereopsis and pre-LVA DBCVA (r = 0.042; P = 0.592;NSS) and post-LVA DBCVA (r = 0.08; P = 0.920;NSS). There was no correlation between pre-LVA stereopsis and pre-LVA NBCVA (r = 0.044; P = 0.572;NSS) and no correlation between post-LVA stereopsis and pre-LVA NBCVA (r = 0.108; P = 0.165;NSS). But positive correlation between pre-LVA stereopsis and post-LVA NBCVA (r = 0.347; P < 0.001) and between post-LVA stereopsis and post-LVA NBCVA (r = 0.445; P < 0.001) was SS.

Conclusion:

The use of magnification as LVA improves both the BCVA and stereopsis. The increase in DBCVA with LVA improves the stereopsis for distance though it may not be SS while improvement in NBCVA with LVA enhances stereopsis for near objects in SS manner.

Comparison of conventional and Hang-back methods of inferior oblique recession in V-pattern strabismus with inferior oblique overaction

AIM

To compare outcomes of conventional and Hang-back methods of inferior oblique (IO) recession in V-pattern strabismus with inferior oblique overaction (IOOA).

METHODS

Comparative randomized study was conducted consisting of 50 patients, age 6 to 35y having V-pattern strabismus [>15 prism diopter (PD)] with IOOA. They were divided equally in two groups and underwent IO recession, group A by conventional method and group B by Hang-back method. Parameters evaluated were reduction in V-pattern and IOOA, shift in torsion, improvement in binocular status. Success was a residual V-pattern of less than 10 PD at 1y of follow up.

RESULTS

The mean V-pattern preoperatively and postoperatively at 1y was 24±5.4 PD and 4.2±3.51 PD in group A and 23.44±6.44 PD and 5.76±3.8 PD in group B respectively. The mean reduction in V-pattern was 20±6.78 PD in group A and 18.2±5.48 PD in group B. The mean correction of IOOA was 18.48±3.13 PD in group A and 16±2.93 PD in group B. Mean shift in extorsion was 3.08±1.8 degree in group A and 3.72±2.14 degree in group B.

CONCLUSION

Both the procedures achieve a significant and comparable reduction in V-pattern and IOOA. Hang-back recession being a landmark free surgery eliminates the need for intrascleral suturing thereby reducing the risk of scleral perforation with possible postoperative adjustment of muscle. It may be considered as a good alternative for IO recession in patients of V-pattern strabismus with mild to moderate amount of IOOA.

Surgical outcomes of plication versus resection in basic type of intermittent exotropia

OBJECTIVES

To compare the surgical outcomes of plication versus resection in basic type of intermittent exotropia.

DESIGN

Prospective interventional study.

PARTICIPANTS

60 patients above 6 years of age with diagnosis of basic type of intermittent exotropia.

METHODS

A randomized study was conducted in 60 patients above 6 years of age with diagnosis of basic type of intermittent exotropia. They were equally divided in two groups by computer generated random number table. Group A underwent recession and plication (RP) and group B underwent recession and resection (RR) based on post patch deviation with constant 8 mm lateral rectus recession in both groups. Parameters assessed were postoperative alignment, cosmetic outcome, improvement in binocularity & stereoacuity and dose effect. Successful outcome was defined as post patch deviation ≤ 10 Prism diopters (PD) of exophoria/exotropia to < 5 PD of esophoria/esotropia at 12 months follow up.

RESULTS

The mean preoperative and postoperative deviation was 44.67 ± 4.5 PD and 10.13 ± 3.6 PD respectively in group A and 43.17 ± 4.8 PD and 9.40 ± 3.3 PD respectively in group B (p = 0.423). The exodrift at 12 months follow up was 4.4 ± 2.8 PD in group A and 4.67 ± 3.29 PD in group B. There was statistically no significant difference in outcomes between the two groups. Mean effect of MR plication at last follow up was 5.91 PD/mm and MR resection was 5.5 PD/mm (p = 0.877).

CONCLUSION

Both procedures achieved acceptable ocular alignment and had a comparable dose effect. Plication has certain added advantages over resection hence may be preferred as an alternate tightening procedure.

Sunlight-Driven Photocatalytic Degradation of Methyl Orange Based on Bismuth Ferrite (BiFeO₃) Heterostructures Composed of Interconnected Nanosheets

Herein, we report the facile microwave-assisted synthesis, characterization and photocatalytic degradation applications of Bismuth ferrite heterostructures composed of interconnected nanosheets (BHNs). The synthesized materials were subjected to several analytical studies such as scanning electron microscopy (SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD), energy dispersive spectroscopy (EDS), Fourier transform infrared (FTIR) spectroscopy and UV-visible spectroscopy in order to examine the morphological, structural, optical and photo catalytic properties. The structural and morphological characterizations confirmed the rhombohedral perovskite crystal structure and the formation of heterostructures composed of interconnected nanosheets for the synthesized material. The compositional characterization revealed that the synthesized material is bismuth ferrite with high purity. The BHNs were further used as efficient photocatalyst for the photocatalytic degradation of highly hazardous pollutant methyl orange under sunlight irradiation. The sunlight driven photocatalytic experiments revealed ~86% photodegradation of methyl orange dye in 150 min. The presented work revealed that the synthesized BHNs are excellent material for the photocatalytic degradation of various organic contaminants and hazardous pollutants.

Evaluation of functional outcome and stability of sutureless scleral tunnel fixated IOLs in children with ectopia lentis

AIM

To evaluate functional outcome of sutureless scleral tunnel intraocular lens (SSTIOL) in children with crystalline lens subluxation of more than 7 clock hours.

METHODS

A prospective interventional study was conducted consisting of 45 eyes of 44 children in age group 6-18y having >7 clock hours of lens subluxation who underwent lensectomy-vitrectomy followed by SSTIOL implantation. Primary outcome was improvement in best corrected visual acuity (BCVA) and secondary outcomes were assessment of intraocular lens (IOL) tilt using ultrasound biomicroscopy (UBM), mean change in astigmatism at last follow-up of 1y and associated complications.

RESULTS

The mean preoperative and postoperative BCVA was 1.05±0.28 and 0.64±0.45 (logMAR) respectively (P=0.001) at last follow-up. The mean astigmatism preoperatively and postoperatively was -4.17±2.69 D and -1.86±1.25 D respectively (P=0.011). Significant IOL tilt (>5 degrees) was present in 5 cases. The mean percentage endothelial loss was 3.65%±1.92%. The most serious complication encountered was retinal detachment seen in 2 cases.

CONCLUSION

SSTIOL implantation provides efficient visual rehabilitation in children provided there is stringent case selection. We recommend caution in children having white-to-white distance >12 mm and presence of peripheral retinal degenerations.

Comparison of integrated sustainable biodiesel and antibacterial nano silver production by microalgal and yeast isolates

Microalgal isolates (Chlorella sp. and Spirulina sp.) and yeast isolates (Candida albicans and Saccharomyces sp.) were employed as the resources of biodiesel production and silver nanoparticle synthesis. The prominent peaks of the FTIR spectrum accustomed the efficient lipid property. The developed profile containing fatty acid methyl ester (FAME) displayed the elevated amount of both saturated (C15:0, C17:0, C21:0) and unsaturated (C17:1, C18:2, C20:4) fatty acids. The physicochemical properties analyzed by using Biodiesel analyzer V1.1.software, confirmed the competency of the isolates for sustainable biodiesel production. Biosynthesis of silvernanoparticles (AgNPs) were accomplished extracellularly by using supernatant of microalgal and yeast culture. The maximum absorbance at 420 and 421 nm under UV-visible spectra showed the presence of nanoparticles. The purity of the synthesized AgNPs were analyzed by XRD analysis. The elemental silver presence was affirmed by EDAX, SEM and AFM, the results revealed spherical crystalline shaped nanoparticles of size ranging from 2.0 to 7.3 nm. The antimicrobial efficacy of the silver nanoparticles (AgNPs) against various clinical pathogens which includes Bacillus sp., E. coli, Klebsiella sp., Proteus sp. and Staphylococcus aureus were observed. However, enhanced antimicrobial activity was displayed by the AgNPs, produced by Candida albicans (12 mm) against Bacillus sp., and E.coli, the nanoparticle produced by Chlorella sp. showed the least antagonistic activity (07 mm).

Catalytic synthesis of α-amino chromone phosphonates and their antimicrobial, toxicity and potential HIV-1 RT inhibitors based on silico screening

The α-amino phosphonates exhibit a wide range of biological properties which create demand for simple and efficient synthetic routes of new molecules. In this study synthesis of a new series of derivatives of α-amino chromone phosphonates (ACPs) was reported using RhBT catalyst. The RhBT was first prepared by simply mixing boron nitride in a solution of rhodium acetate, under inert atmosphere for a week followed by filtration (yield: 92%). The catalyst can be re-used for up to four times and showed minimal loss of activity. The ACPs was prepared in a one pot reaction containing chromone based aldehydes, aniline derivatives and diethyl phosphite. The structures of these compounds were characterized by IR, ¹H NMR, ¹³C NMR, ³¹P NMR and high resolution mass spectral analysis. The synthesized ACPs were evaluated for their antimicrobial activities against three bacteria B. cereus, M. luteus, E. coli and one fungus C. albicans. The ACPs displayed selective toxicity toward the brine shrimp (Artemia salina). Compounds 8j and 8m was found to be less toxic to the brine shrimp and may have more valuable biological application. Furthermore, molecular docking studies were conducted to predict the possible therapeutic potential of ACPs. The compounds (8i, 8j, 8k and 8m) were predicted as highly active HIV-1 reverse transcriptase inhibitors.

Feasibility and validity of using WHO adolescent job aid algorithms by health workers for reproductive morbidities among adolescent girls in rural North India

Background

High prevalence of reproductive morbidities is seen among adolescents in India. Health workers play an important role in providing health services in the community, including the adolescent reproductive health services. A study was done to assess the feasibility of training female health workers (FHWs) in the classification and management of selected adolescent girls’ reproductive health problems according to modified WHO algorithms.

Methods

The study was conducted between Jan-Sept 2011 in Northern India. Thirteen FHWs were trained regarding adolescent girls’ reproductive health as per WHO Adolescent Job-Aid booklet. A pre and post-test assessment of the knowledge of the FHWs was carried out. All FHWs were given five modified WHO algorithms to classify and manage common reproductive morbidities among adolescent girls. All the FHWs applied the algorithms on at least ten adolescent girls at their respective sub-centres. Simultaneously, a medical doctor independently applied the same algorithms in all girls. Classification of the condition was followed by relevant management and advice provided in the algorithm. Focus group discussion with the FHWs was carried out to receive their feedback.

Results

After training the median score of the FHWs increased from 19.2 to 25.2 (p – 0.0071). Out of 144 girls examined by the FHWs 108 were classified as true positives and 30 as true negatives and agreement as measured by kappa was 0.7 (0.5–0.9). Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 94.3 % (88.2–97.4), 78.9 % (63.6–88.9), 92.5 % (86.0–96.2), and 83.3 % (68.1–92.1) respectively.

Discussion

A consistent and significant difference between pre and post training knowledge scores of the FHWs were observed and hence it was possible to use the modified Job Aid algorithms with ease. Limitation of this study was the munber of FHWs trained was small. Issues such as time management during routine work, timing of training, overhead cost of training etc were not taken into account.

Conclusions

Training was successful in increasing the knowledge of the FHWs about adolescent girls’ reproductive health issues. The FHWs were able to satisfactorily classify the common adolescent girls’ problems using the modified WHO algorithms.

Electronic supplementary material

The online version of this article (doi:10.1186/s12913-015-1067-x) contains supplementary material, which is available to authorized users.

Synthesis and characterization studies of MgO:CuO nanocrystals by wet-chemical method

In this report, we examine the progress in adapting these nanomaterials for several predominantly photonics device fabrication by wet-chemical method. Nanocomposite of magnesium oxide (MgO) with copper oxide (CuO) doped nanoparticles were characterized by X-ray powder diffraction (XRD) and the observed peaks are quite agreeable with the pure phase cubic structure. High-resolution transmission electron microscopic (HR-TEM) results reveal that the resultant nanopowders are porous and agglomerated with polycrystalline nano-entities. Field emission of selected-area electron diffraction (SAED) studies showed that the average size of the nanoparticles were 20nm. Photoluminescence spectra of MgO:CuO were investigated, showing emission peaks around 375nm relating to new energy levels induced by defects or defect levels generation and confocal micro-Raman images indicated that the chemical molecular vibrational band structure and morphology of the product which is spherical shaped nanoparticles with an average particle size of ∼25nm with standard deviation. The electrochemical response of MgO:CuO which is proves that the nano-copper/magnesium has high functionality due to the small size and it has higher electrochemical activity without any modifications.

Unexpected regiospecific Michael addition product: synthesis of 5,6-dihydrobenzo[1,7]phenanthrolines

The unexpected formation of 5,6-dihydrobenzo[1,7]phenanthroline instead of 5,6-dihydrobenzo[1,7]phenanthroline-3-carbonitrile in acridine molecules using Michael addition has been observed for the first time.

Radial arterial compliance measurement by fiber Bragg grating pulse recorder

In the present work, we report a novel, in vivo, noninvasive technique to determine radial arterial compliance using the radial arterial pressure pulse waveform (RAPPW) acquired by fiber Bragg grating pulse recorder (FBGPR). The radial arterial compliance of the subject can be measured during sphygmomanometric examination by the unique signatures of arterial diametrical variations and the beat-to-beat pulse pressure acquired simultaneously from the RAPPW recorded using FBGPR. This proposed technique has been validated against the radial arterial diametrical measurements obtained from the color Doppler ultrasound. Two distinct trials have been illustrated in this work and the results from both techniques have been found to be in good agreement with each other.

Public health approach to address maternal mortality

Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC) would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY) that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women's health.

Congenital cystic lung diseases

Congenital cystic diseases of the lung are a rare but significant cause of morbidity in children and young adults presenting with respiratory distress and repeated chest infections. They consist of cystic adenomatoid malformation, bronchogenic cyst, pulmonary sequestration, and congenital lobar emphysema. Surgical treatment is a safe and an effective method of treatment. Chest X-ray and computed tomography are the key imaging modalities used for diagnosis.

A549 lung cell line activity of biosynthesized silver nanoparticles using Albizia adianthifolia leaf

Stable AgNPs were formed in vitro by reacting AgNO3 (aq) solution with the aqueous plant leaf extract. UV-vis revealed the surface plasmon resonance λmax at 448 nm and the absorbance steadily increased in intensity as a function of reaction time. Transmission electron microscope (TEM) and XRD studies were used to characterize the AgNPs; the size was 4-35 nm. Dynamic light scattering (DLS) was used as supporting evidence to determine hydrodynamic size and zeta potential recorded as 80.27 nm and -24.7 mV, respectively. FT-IR spectra suggest that AgNPs are capped with protein molecules and other water soluble phytocompounds such as saponins and glycosides which also behave as stabilizing agents; TEM images indicate a visible layer surrounding the AgNPs. Prominent absorption bands at 3380 and 1642 cm(-1) are assigned to alcohol and carbonyl groups, respectively. (1)H NMR of the neat aqueous plant extract indicates presence of a complex mixture of compounds; however the chemical shift at δ 6.0-8.0 and 1.0-4.0 ppm indicates the presence of few aromatic but abundant aliphatic compounds, respectively. Toxicity of AgNPs on lung cancer cells (A549) and normal healthy peripheral lymphocytes (PLs) at 10 μg/ml and 50 μg/ml was assessed using the MTT, ATP and lactate dehydrogenase assays. Viability data for A549 cells showed a 21% (10 μg/ml) and 73% (50 μg/ml) cell viability after 6h exposure to AgNPs compared to 117% (10 μg/ml) and 109% (50 μg/ml) cell viability of normal peripheral lymphocytes. Lactate dehydrogenase was only significantly altered at 50 μg/ml AgNPs treated cells from 2.43±0.04 units to 0.77±0.04 units.

Rotenone-induced parkinsonism elicits behavioral impairments and differential expression of parkin, heat shock proteins and caspases in the rat

Rotenone is a pesticide that inhibits mitochondrial complex I activity, thus creating an environment of oxidative stress in the cell. Many studies have employed rotenone to generate an experimental animal model of Parkinson's disease (PD) that mimics and elicits PD-like symptoms, such as motor and cognitive decline. Cytoprotective proteins including parkin and heat shock proteins (HSPs) play major roles in slowing PD progression. Moreover, evidence suggests that mitochondrial dysfunction and oxidative stress-dependent apoptotic pathways contribute to dopaminergic neuron degeneration in PD. Here, rats were chronically exposed to rotenone to confirm that it causes a debilitating phenotype and various behavioral defects. We also performed histopathological examinations of nigrostriatal, cortical and cerebellar regions of rotenone-treated brain to elucidate a plausible neurodegenerative mechanism. The results of silver, tyrosine hydroxylase (TH), parkin, ubiquitin and caspase staining of brain tissue sections further validated our findings. The stress response is known to trigger HSP in response to pharmacological insult. These protective proteins help maintain cellular homeostasis and may be capable of rescuing cells from death. Therefore, we assessed the levels of different HSPs in the rotenone-treated animals. Collectively, our studies indicated the following findings in the striatum and substantia nigra following chronic rotenone exposure in an experimental PD model: (i) behavioral deficit that correlated with histopathological changes and down regulation of TH signaling, (ii) decreased levels of the cytoprotective proteins parkin, DJ1 and Hsp70 and robust expression of mitochondrial chaperone Hsp60 according to Western blot, (iii) increased immunoreactivity for caspase 9, caspase 3 and ubiquitin and decreased parkin immunoreactivity.