Surgical management of oculomotor nerve palsy: a comparison of lateral rectus deactivation combined with either medial rectus resection or medial rectus fixation to the medial palpebral ligament

PURPOSE

To analyze and compare the outcome of two different surgical procedures in patients with complete oculomotor nerve palsy with large-angle exotropia.

METHODS

The medical records of patients with total oculomotor nerve palsy and large-angle exotropia operated on at a single center from January 2006 to June 2020 were reviewed retrospectively. One group underwent lateral rectus deactivation with medial rectus resection (resection group); the other group underwent lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament (fixation group). Surgical outcomes on the first postoperative day and at 6 months postoperatively were analyzed, including alignment and postoperative complications. All statistical analyses were performed using STATA version 14. A P value of <0.05 was considered significant.

RESULTS

A total of 35 patients were included. There was a trend toward greater surgical success in the fixation group (93%) than in the resection group (65%), but these results were not statistically significant. Postoperative exotropic drifts were noted in both the procedures but tended to be more with patients in the resection group. Postoperative complications were noted only in the fixation group.

CONCLUSIONS

Lateral rectus deactivation with medial rectus fixation to the medial palpebral ligament requires more time and greater surgical expertise but appears to better prevent postoperative exotropic drift compared with lateral rectus deactivation combined with medial rectus resection.

Impact of special software training on quality of life among people with visual impairment

Purpose

To evaluate the impact of special software training in computer and smartphone apps as a form of rehabilitation to improve the quality of life of individuals with visual impairment (VI).

Methods

The study utilized a one-group pretest-posttest design. A total of 50 individuals aged 15 years and older with VI participated in the training, which included special software (NVDA) and mobile app training for 60 hours at the Visual Rehabilitation Center. The Low Vision Quality of Life Questionnaire was administered before the start of training and six months after completion. The questionnaire covered the following domains: (1) mobility, distance vision, and lighting; (2) reading and fine work; (3) social well-being; (4) economic impact; (5) attitude toward life; and (6) activities of daily living. Statistical software STATA 14.0 (Texas, USA) was used for data analysis. Paired t-tests and Wilcoxon signed-rank tests were conducted to compare the mean differences before and after training.

Results

Significant improvements were observed in five dimensions, namely mobility, distance vision and lighting, reading and fine work, and attitude toward life, at a highly significant level of 1% probability. The dimensions of social well-being and economic impact showed significant improvement at a 5% level of probability.

Conclusion

Visual impairment, whether congenital or acquired later in life, affects independence in all aspects of life. To the best of our knowledge, this is the first study to investigate the impact of special software training on the quality of life of visually impaired individuals. The authors suggest that this form of rehabilitation enhances accessibility to mainstream living, promotes independence, and ultimately improves quality of life. Participants experienced an improved quality of life through increased access to mainstream resources, enhanced ability to navigate and manage daily activities independently, and reduced reliance on multiple low vision aids or assistance from sighted individuals.

Synthesis and investigation on synergetic effect of activated carbon loaded silver nanoparticles with enhanced photocatalytic and antibacterial activities

In this study, we synthesized silver nanoparticle-loaded cashew nut shell activated carbon (Ag/CNSAC). The synthesized samples were characterized by XRD, XPS, SEM with EDS, FT-IR, and BET analysis. The XRD, XPS, and EDS data provided convincing proof that Ag loaded on CNSAC is formed. The energy dispersive spectrum analysis and X-ray diffraction pattern both supported the face-centered cubic and amorphous structures of Ag/CNSAC. The SEM micrographs showed the inner surface development of Ag NPs and many tiny pores in CNSAC. The photodegradation of methylene blue (MB) dye by the Ag/CNSAC photocatalyst was investigated. This effective degradation of MB dye by Ag/CNSAC is attributed to the cooperative action of Ag as a photocatalyst and CNSAC as a catalytic support and adsorbent. In tests with gram-positive and negative bacteria including Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus), the as-synthesized Ag/CNSAC showed outstanding antibacterial efficiency. Additionally, this study demonstrates a workable procedure for creating an affordable and efficient Ag/CNSAC for the photocatalytic eradication of organic contaminants.

MTMC-AUR2CNet: Multi-textural multi-class attention recurrent residual convolutional neural network for COVID-19 classification using chest X-ray images

Coronavirus disease (COVID-19) has infected over 603 million confirmed cases as of September 2022, and its rapid spread has raised concerns worldwide. More than 6.4 million fatalities in confirmed patients have been reported. According to reports, the COVID-19 virus causes lung damage and rapidly mutates before the patient receives any diagnosis-specific medicine. Daily increasing COVID-19 cases and the limited number of diagnosis tool kits encourage the use of deep learning (DL) models to assist health care practitioners using chest X-ray (CXR) images. The CXR is a low radiation radiography tool available in hospitals to diagnose COVID-19 and combat this spread. We propose a Multi-Textural Multi-Class (MTMC) UNet-based Recurrent Residual Convolutional Neural Network (MTMC-UR2CNet) and MTMC-UR2CNet with attention mechanism (MTMC-AUR2CNet) for multi-class lung lobe segmentation of CXR images. The lung lobe segmentation output of MTMC-UR2CNet and MTMC-AUR2CNet are mapped individually with their input CXRs to generate the region of interest (ROI). The multi-textural features are extracted from the ROI of each proposed MTMC network. The extracted multi-textural features from ROI are fused and are trained to the Whale optimization algorithm (WOA) based DeepCNN classifier on classifying the CXR images into normal (healthy), COVID-19, viral pneumonia, and lung opacity. The experimental result shows that the MTMC-AUR2CNet has superior performance in multi-class lung lobe segmentation of CXR images with an accuracy of 99.47%, followed by MTMC-UR2CNet with an accuracy of 98.39%. Also, MTMC-AUR2CNet improves the multi-textural multi-class classification accuracy of the WOA-based DeepCNN classifier to 97.60% compared to MTMC-UR2CNet.

Augmented loop myopexy with concurrent intraocular lens implantation for myopic strabismus fixus

Purpose

To evaluate safety profile and surgical outcomes of loop myopexy with concurrent intra-ocular lens implantation in cases of myopic strabismus fixus (MSF).

Methods

A retrospective chart review of patients who underwent loop myopexy with concurrent small incision cataract surgery with intra-ocular lens implantation between January 2017 and July 2021 for MSF at a tertiary eye care centre was undertaken. A minimum of 6 months of follow-up after surgery was required for inclusion. The main outcome measures were improvement in alignment postoperatively, improvement in extra-ocular motility postoperatively, intraoperative and postoperative complications and post-operative visual acuity.

Results

12 eyes of 7 patients (male (6): female (1)) underwent modified loop myopexy at a mean age of 46.86 years (range 32-65 years). 5 patients underwent bilateral loop myopexy with intra-ocular lens implantation whereas 2 patients underwent unilateral loop with intra-ocular lens implantation. All eyes underwent additional medial rectus (MR) recession with lateral rectus (LR) plication. At the last follow-up, mean esotropia improved to 16 prism dioptres (PD) (Range: 10-20 PD) from 80 PD (Range:60-90PD), P = 0.016; and success (deviation ≤20PD) was achieved in 73% (95% CI 48 to 89%). Mean hypotropia at presentation was 10 PD (range 6-14 PD), which improved to 0 PD (range 0-9 PD), P = 0.063. Mean BCVA improved from 1.08 LogMar to 0.3 LogMar units.

Conclusion

Loop myopexy combined with intra-ocular lens implantation is a safe and effective procedure in the management of patients who have Myopic Strabismus Fixus with visually significant cataract and improves both visual acuity and ocular alignment significantly.

Implicit spatio-temporal based hybrid recommendation model to discover malicious wireless access points

Recent technological advancements have enabled users to conduct more sophisticated business transactions via Wi-Fi enabled networks. Typically, a compromised access point (CAP) can handle all traffic between a user and an Internet server, thus becoming a serious security hazard. In addition, an attacker can easily control the entire network using the CAP remotely and compromise as many victims as possible to form a botnet. This paper presents a hybrid recommendation prediction model for forecasting CAP attacks based on network traffic in a private network. This model combines various prediction techniques likethe time-series model, the kNN model and cross association algorithm for attack prediction. This hybrid blacklisting recommendation system effectively improves the prediction rate significantly as well as the robustness against poisoning attacks.

Resilience as a protective factor on the quality of life (QoL) of Indian nursing students during the COVID-19 pandemic

BACKGROUND

The COVID-19 pandemic negatively impacted the quality of life of individuals around the world, including health care professionals. There has been little research that examines the role of resilience concerning the impact of COVID-19 on the quality of life of nursing students. This study aimed to determine how resilience influenced the quality of life among nursing students during the COVID-19 pandemic.

METHODS

A cross-sectional research design was adopted for this study. A total of two hundred sixty-eight nursing students from three universities, South India responded in the web-based survey. Data was collected using self-reported questionnaires in June 2021.

RESULTS

Our findings revealed that the participants' resilience was normal, which had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. The COVID-19 impact on QoL significantly differed with year of education (F = 3.087; p < 0.02) and university (F = 6.697, p < 0.001). Bivariate analysis revealed significant inverse relationships between the impact of COVID-19 on quality of life with resilience (r = -0.259; p < 0.001) and perceived knowledge on COVID-19(r = -0.168; p < 0.006).

CONCLUSION

In our study, we found that resilience had a moderate impact on the quality of life of nursing students during the COVID-19 pandemic. Therefore, it is important to promote students' resilience and improve their quality of life during stressful situations.

CXGNet: A tri-phase chest X-ray image classification for COVID-19 diagnosis using deep CNN with enhanced grey-wolf optimizer

The coronavirus disease 2019 (COVID-19) epidemic had a significant impact on daily life in many nations and global public health. COVID's quick spread has become one of the biggest disruptive calamities in the world. In the fight against COVID-19, it's critical to keep a close eye on the initial stage of infection in patients. Furthermore, early COVID-19 discovery by precise diagnosis, especially in patients with no evident symptoms, may reduce the patient's death rate and can stop the spread of COVID-19. When compared to CT images, chest X-ray (CXR) images are now widely employed for COVID-19 diagnosis since CXR images contain more robust features of the lung. Furthermore, radiologists can easily diagnose CXR images because of its operating speed and low cost, and it is promising for emergency situations and therapy. This work proposes a tri-stage CXR image based COVID-19 classification model using deep learning convolutional neural networks (DLCNN) with an optimal feature selection technique named as enhanced grey-wolf optimizer with genetic algorithm (EGWO-GA), which is denoted as CXGNet. The proposed CXGNet is implemented as multiple classes, such as 4-class, 3-class, and 2-class models based on the diseases. Extensive simulation outcome discloses the superiority of the proposed CXGNet model with enhanced classification accuracy of 94.00% for the 4-class model, 97.05% of accuracy for the 3-class model, and 100% accuracy for the 2-class model as compared to conventional methods.

The art of tackling strabismus skillfully by sparing vessels

Background

Detaching a rectus muscle irreparably destroys its ciliary artery circulation which also supplies the anterior segment of the eye.

Purpose

To educate strabismus surgeons about a method of detaching a muscle without compromising anterior segment circulation.

Synopsis

A limbal based conjunctival incision is made. The muscle is identified, separated from its attachments and secured with 6-0 Vicryl. The anterior ciliary vessel supplying it is isolated by making a small snip incision in the muscle capsule with delicate blunt dissection parallel to the anterior ciliary artery The muscle is detached from its original insertion. The muscle is tied to sclera at the intended point of recession. The intact anterior ciliary artery, thus will continue to function, untouched.

Highlights

We recommend pre-placing the sutures in the muscle and also in the sclera at the point of reattachment to avoid possible stretching and breaking of anterior ciliary vessels at the time of muscle detachment and also to dissect the artery free from muscle several millimeters more than the intended recession in order to spare the anterior ciliary circulation in strabismus surgery.

Video link

https://youtu.be/Bn050Ihu9rU.

Ocular signs, visual and general developmental outcome in Indian children with radiologically proven periventricular leukomalacia

Purpose

Owing to the paucity of literature on Indian children with periventricular leukomalacia (PVL), this retrospective study aimed to describe the visual and associated developmental abnormalities in a series of affected children attending a tertiary level eye care facility.

Methods

Children with radiologically confirmed PVL who attended the Pediatric Department of a tertiary eye hospital were included and underwent a detailed ocular and general developmental assessment.

Results

Of the 75 children, the mean age was 2.3 years, the mean follow-up was 3.1 years, 68% were males and 43% were born preterm. Grade I PVL was identified in 13 children (17%), Grade 2 PVL in 39 (52%), and Grade 3 PVL in 23 (31%). Premies with ≤2 kg (72.5%) and term babies with >2 kg (75%) had a greater association of PVL occurrence with a preponderance to severe PVL; 46% of the children were visually impaired which was significantly higher in the children with Grade 3 PVL (74%) than those with Grade 2 PVL (15%). Strabismus was common (80%) with a change in deviation over time. Seventy-one percent of the children had a refractive error, frequently myopic astigmatism. All the children except two had a delay in one or more general developmental milestones.

Conclusion

PVL occurrence is observed both in the babies born at term and premies, resulting in significant ocular and systemic morbidities. We recommend a system in place for early identification and referral to initiate an early intervention program which goes a long way toward improving the quality of life in these children.

Diagnosis of infertility from adenomyosis and endometriosis through entroxon based intelligent water drop back propagation neural networks

Adenomyosis is an abnormality in the uterine wall of women that adversely affects their normal life style. If not treated properly, it may lead to severe health issues. The symptoms of adenomyosis are identified from MRI images. It is a gynaecological disease that may lead to infertility. The presence of red dots in the uterus is the major symptom of adenomyosis. The difference in the extent of these red dots extracted from MRI images shows how significant the deviation from normality is. Thus, we proposed an entroxon-based bio-inspired intelligent water drop back-propagation neural network (BIWDNN) model to discover the probability of infertility being caused by adenomyosis and endometriosis. First, vital features from the images are extracted and segmented, and then they are classified using the fuzzy C-means clustering algorithm. The extracted features are then attributed and compared with a normal person’s extracted attributes. The proposed BIWDNN model is evaluated using training and testing datasets and the predictions are estimated using the testing dataset. The proposed model produces an improved diagnostic precision rate on infertility.

Optimized chest X-ray image semantic segmentation networks for COVID-19 early detection

BACKGROUND

Although detection of COVID-19 from chest X-ray radiography (CXR) images is faster than PCR sputum testing, the accuracy of detecting COVID-19 from CXR images is lacking in the existing deep learning models.

OBJECTIVE

This study aims to classify COVID-19 and normal patients from CXR images using semantic segmentation networks for detecting and labeling COVID-19 infected lung lobes in CXR images.

METHODS

For semantically segmenting infected lung lobes in CXR images for COVID-19 early detection, three structurally different deep learning (DL) networks such as SegNet, U-Net and hybrid CNN with SegNet plus U-Net, are proposed and investigated. Further, the optimized CXR image semantic segmentation networks such as GWO SegNet, GWO U-Net, and GWO hybrid CNN are developed with the grey wolf optimization (GWO) algorithm. The proposed DL networks are trained, tested, and validated without and with optimization on the openly available dataset that contains 2,572 COVID-19 CXR images including 2,174 training images and 398 testing images. The DL networks and their GWO optimized networks are also compared with other state-of-the-art models used to detect COVID-19 CXR images.

RESULTS

All optimized CXR image semantic segmentation networks for COVID-19 image detection developed in this study achieved detection accuracy higher than 92%. The result shows the superiority of optimized SegNet in segmenting COVID-19 infected lung lobes and classifying with an accuracy of 98.08% compared to optimized U-Net and hybrid CNN.

CONCLUSION

The optimized DL networks has potential to be utilised to more objectively and accurately identify COVID-19 disease using semantic segmentation of COVID-19 CXR images of the lungs.

Down syndrome with bilateral posterior lenticonus

We present a case of bilateral posterior lenticonus in a young boy with Down syndrome. Association of posterior lenticonus in Down syndrome is rarely reported in the literature. We have discussed the clinical features and management of this patient at our hospital.

Identification of bacteriological quality and antimicrobial resistance of microorganisms isolated from animal foods collected from the abattoir, butcher shops and local seafood market

The current study aimed to isolate bacteria that harbour various animal food products like meat, chicken and seafoods collected from the abattoir, butcher shops and local seafood market and to determine the antimicrobial resistance pattern of isolated pathogens which are responsible for various foodborne illnesses in human beings. A total of forty raw animal product samples were collected from the abattoir, butcher shops and local seafood market of Visakhapatnam. The samples selected for the study include raw chicken, meat, crab, prawns and different varieties of fish. A classic random sampling technique was employed to collect the study samples. All the samples were processed immediately using standard microbiological protocols. The bacteria isolation and characterization were done by studying morphological characteristics with staining methods, cultural characteristics by isolating and growing the pathogenic microorganisms in various selective and differential culture media. Antimicrobial susceptibility testing was performed by the Kirby -Bauer method by following Clinical and Laboratory Standards Institute (CLSI) guidelines. EDTA-Disc Potentiation Test and Imipenem-EDTA Double disc synergy test are used to detect the metallo beta-lactamase production of isolated pathogens. The highest number of isolates belong to Salmonella species (18), Pseudomonas aeruginosa (18) followed by Vibrio species (14) and few isolates belong to Enterobacter species (4). Majority of the microbial isolates obtained in the current study were multidrug resistant. The isolates from the abattoir environments, slaughterhouses, fish markets were found to exhibit variable resistance pattern to aminoglycosides, macrolides, β-lactams, cephalosporins, quinolone antibiotics used in the present study and at the same time most of them were sensitive to carbapenem antibiotic imipenem. Antimicrobial resistance (AMR) prevents the designing and assessment of effective interventions. If such a link can be established, then the tracking of antibiotic use and consumption data could be furthermore used as a surrogate indicator for the risk of potential antibiotic resistance (ABR) emergence.

A major pleiotropic QTL identified for yield components and nitrogen content in rice (Oryza sativa L.) under differential nitrogen field conditions

To identify the genomic regions for yield and NUE of rice genotypes and lines with promising yield under low N, a recombinant inbred population (RIL) developed between BPT5204 (a mega variety known for its quality) and PTB1 (variety with high NUE) was evaluated for consecutive wet and dry seasons under low nitrogen (LN) and recommended nitrogen (RN) field conditions. A set of 291 RILs were characterized for 24 traits related to leaf, agro-morphological, yield, N content and nitrogen use efficiency indices. More than 50 RILs were found promising with grain yield >10 g under LN. Parental polymorphism survey with 297 SSRs and selective genotyping revealed five genomic regions associated with yield under LN, which were further saturated with polymorphic SSRs. Thirteen promising SSRs were identified out of 144 marker trait associations under LN using single marker analysis. Composite interval mapping showed 37 QTL under LN with five pleiotropic QTL. A major stable pleiotropic (RM13201—RM13209) from PTB1 spanning 825.4 kb region associated with straw N % (SNP) in both treatments across seasons and yield and yield related traits in WS appears to be promising for the MAS. Another major QTL (RM13181-RM13201) was found to be associated with only relative trait parameters of biomass, grain and grain nitrogen. These two major pleiotropic QTL (RM13201-RM13209 and RM13181-RM13201) on chromosome 2 were characterized for their positive allele effect and could be deployed for the development of rice varieties with NUE.

Pause-Based Phrase Extraction and Effective OOV Handling for Low-Resource Machine Translation Systems

Machine translation is the core problem for several natural language processing research across the globe. However, building a translation system involving low-resource languages remains a challenge with respect to statistical machine translation (SMT). This work proposes and studies the effect of a phrase-induced hybrid machine translation system for translation from English to Tamil, under a low-resource setting. Unlike conventional hybrid MT systems, the free-word ordering feature of the target language Tamil is exploited to form a re-ordered target language model and to extend the parallel text corpus for training the SMT. In the current work, a novel rule-based phrase-extraction method, implemented using parts-of-speech (POS) and place-of-pause in both languages is proposed, which is used to pre-process the training corpus for developing the back-off phrase-induced SMT. Further, out-of-vocabulary (OOV) words are handled using speech-based transliteration and two-level thesaurus intersection techniques based on the POS tag of the OOV word. To ensure that the input with OOV words does not skip phrase-level translation in the hierarchical model, a phrase-level example-based machine translation approach is adopted to find the closest matching phrase and perform translation followed by OOV replacement. The proposed system results in a bilingual evaluation understudy score of 84.78 and a translation edit rate of 19.12. The performance of the system is compared in terms of adequacy and fluency, with existing translation systems for this specific language pair, and it is observed that the proposed system outperforms its counterparts.

In silico and in vivo analysis to identify the antidiabetic activity of beta sitosterol in adipose tissue of high fat diet and sucrose induced type-2 diabetic experimental rats

Adipose tissue is the primary site of storage for excess energy as triglyceride and it helps in synthesizing a number of biologically active compounds that regulate metabolic homeostasis. Consumption of high dietary fat increases stored fat mass and is considered as a main risk factor for metabolic diseases. Beta-sitosterol (β-sitosterol) is a plant sterol. It has the similar chemical structure like cholesterol. Clinical and experimental studies have shown that β-sitosterol has anti-diabetic, hypolipidemic, anti-cancer, anti-arthritic, and hepatoprotective role. However, effect of β-sitosterol on insulin signaling molecules and glucose oxidation has not been explored. Hence in the present study we aimed to discover the protective role of β-sitosterol on the expression of insulin signaling molecules in the adipose tissue of high-fat diet and sucrose-induced type-2 diabetic experimental rats. Effect dose of β-sitosterol (20 mg/kg b.wt, orally for 30 days) was given to high fat diet and sucrose-induced type-2 diabetic rats to study its anti-diabetic activity. Results of the study showed that the treatment with β-sitosterol to diabetes-induced rats normalized the altered levels of blood glucose, serum insulin and testosterone, lipid profile, oxidative stress markers, antioxidant enzymes, insulin receptor (IR), and glucose transporter 4 (GLUT4) proteins. Our present findings indicate that β-sitosterol improves glycemic control through activation of IR and GLUT4 in the adipose tissue of high fat and sucrose-induced type-2 diabetic rats. Insilico analysis also coincides with invivo results. Hence it is very clear that β-sitosterol can act as potent antidiabetic agent.

Sensitivity and specificity of teachers for vision screening among primary school children in South India

AIMS:

This study aims to determine the sensitivity and specificity of vision screening by school teachers among primary school children.

SETTINGS AND DESIGN:

Prospective nonrandomized clinical trial.

SUBJECTS AND METHODS:

The study was carried in primary school children of Madurai, Tamil Nadu from April 2007 to October 2007. Sixty-five primary school teachers from 57 schools around Madurai, Tamil Nadu, India, underwent a half-day training programme at the hospital. Each teacher on return to the school screened around a hundred children using the tumbling E. All screened children were subsequently screened by a team from the hospital. The optometrists used tumbling E (Snellen's 20/30 and Early Treatment of Diabetic Retinopathy Study (ETDRS) 20/32) to check the vision of all children. Any child complaining of defective vision or noted to have defective vision on screening underwent a comprehensive ophthalmic evaluation. The sensitivity and specificity of teacher screening was assessed based on the data obtained.

RESULTS:

Screening was completed for 5150 children. The prevalence of vision <20/30 was 2.82%. Teacher screening was noted to have a sensitivity of 24.8% and a specificity of 98.65%. Tumbling E ETDRS screening by the optometrist had the highest sensitivity of 94.48% and specificity of 97.09%.

CONCLUSIONS:

Our study shows that vision screening by trained optometrists is a very useful tool to identify visual impairment in primary school children. Measures need to be taken to improve the sensitivity of teacher screening before recommending its generalized use.

A Weighted Speaker-Specific Confusion Transducer-Based Augmentative and Alternative Speech Communication Aid for Dysarthric Speakers

An augmentative and alternative speech communication (AASC) aid comprises a speech recognition system and a speech synthesis system. The main challenge in developing such an aid for dysarthric speakers lies in handling errors in the text derived from the recognition system. These errors (substitution, deletion, and insertion) may be due to inability of a dysarthric speaker to utter certain phones (articulatory error) or due to inaccuracy of the models trained (modeling error). Most existing AASC approaches only focus on the articulatory errors and the ones that do address both errors, and do not differentiate between them. However, this paper performs a three-level cascaded analysis to identify and distinguish between these errors, as differentiating these errors will aid in appropriately handling them. Furthermore, analyses in the paper are independent of the syntax of utterances. Based on these analyses, weighted phone confusion transducers are formulated and used to correct erroneous text from the recognition system. The corrected text is finally synthesized by a text-to-speech synthesis system. The proposed AASC is observed to significantly reduce a word error rate of severe dysarthric speakers from 100% to 41.52%, moderate from 61.85% to 18.08%, and mild from 12.23% to 8.55%.

Identification of rice landraces with promising yield and the associated genomic regions under low nitrogen

With the priority of the low input sustainable rice cultivation for environment friendly agriculture, NUE of rice becomes the need of the hour. A set of 472 rice genotypes comprising landraces and breeding lines were evaluated for two seasons under field conditions with low and recommended nitrogen and >100 landraces were identified with relative higher yield under low nitrogen. Donors were identified for higher N uptake, N translocation into grains and grain yield under low N. Grains on secondary branches, N content in grain and yield appears to be the selection criterion under low N. Through association mapping, using minimum marker set of 50 rice SSR markers, 12 genomic regions were identified for yield and yield associated traits under low nitrogen. Four associated genomic regions on chromosomes 5, 7 and 10 were fine mapped and QTL for yield under low N were identified from the marker delimited regions. Three candidate genes viz., 2-oxoglutarate /malate translocator (Os05g0208000), alanine aminotransferase (Os07g0617800) and pyridoxal phosphate-dependent transferase (Os10g0189600) from QTL regions showed enhanced expression in the genotypes with promising yield under low N. Marker assisted selection using SSR markers associated with three candidate genes identified two stable breeding lines confirmed through multi-location evaluation.

The Evaluation of the virulence factors of clinical Candida isolates and the anti-biofilm activity of Elettaria cardamomum against multi-drug resistant Candida albicans

Background and Purpose:

Today, treatment of life-threatening fungal infections, caused by Candida species, has become a major problem. In the present study, we aimed to evaluate the antifungal susceptibility patterns of different clinical Candida isolates, determine the virulence factors in multi-drug resistant (MDR) Candida species, and assess the anti-biofilm activity of Elettaria cardamomum against MDR Candida species.

Materials and Methods:

A total of 202 isolates from different Candida species were obtained from three governmental hospitals in Senthamangalam, Tiruchengode, and Namakkal, Tamil Nadu, India. The isolates were identified, using conventional methods. Candida species were tested for virulence factors such as biofilm, protease, and phospholipase activity. The minimum inhibitory concentration (MIC) of Elettaria cardamomum against MDR biofilm-forming C. albicans was determined, using plate and tube methods.

Results:

The identified Candida isolates (n=202) were C. albicans (74/202), C. glabrata (53/202), C. parapsilosis (44/202), C. tropicalis (15/202), and C. dubliniensis (16/202). The isolates were subjected to antifungal susceptibility testing and the virulence factors were determined. In terms of biofilm production, non-C. albicans species such as C. dubliniensis showed 75% activity. Also, regarding protease activity, C. parapsilosis (75%) showed the highest percentage of protease production. In addition, Candida species showed strong positivity for phospholipase activity (62.87%). In the MIC method, the acetonic extract completely inhibited biofilm production at a concentration of 125 µl (56.25 µg). In comparison with the ethanolic extract, the acetonic extract showed major activity against biofilm production.

Conclusion:

Based on the findings, pathogenic C. albicans species were inhibited by the ethanolic and acetonic extracts of E. cardamomum. In recent years, MDR and biofilm-forming pathogenic Candida species have been increasingly detected in clinical settings. Therefore, herbal derivatives might contribute to the treatment of infections without causing any side-effects and prevent the associated mortality.

Indian Nurses’ Attitudes Toward Euthanasia

The debate about euthanasia continues worldwide, with nurses’ attitudes becoming increasingly more important. The aim of this study is to investigate gender differences among nurses’ perceptions of attitudes toward euthanasia. A nonprobability quantitative, cross-sectional design was carried out among nurses working at a tertiary care center. Data were collected through self-reported questionnaires at their work place. Significant differences were found between men and women to the items such as “Fear of death shows differences due to religious beliefs” (χ2 = 10.550, p < 0.05), “If patient wants euthanasia, nutrition support should be stopped” (χ2 = 12.209, p < 0.05), “CPR should not be applied in case of sudden respiration and heart stop” (χ2 = 9.591, p < 0.05), and “burden for relatives to take care of a patient who is in terminal period and who will die” (χ2 = 9.069, p < 0.05). The present study depicts that gender plays an important role in euthanasia; hence, the researchers strongly suggest that there is an urgent need to draft uniform guidelines after wide consultation with all the stake holders regarding nurses’ role in taking care of patients who request euthanasia, to face these situations effectively and competently within professional boundaries.

Periventricular leukomalacia with −16 DS high myopia in a 2½ months old infant: A rare case presentation

Periventricular leukomalacia (PVL) is coagulation necrosis of white matter seen in preterm, low birth weight (LBW) infants and associated with a range of ocular manifestations. We report a case of 2½ months old (47 weeks gestational age) female infant with PVL associated with bilateral high myopia (−16 DS). On examination, child had difficulty in tracking objects and inferior field defect with preference for superior gaze. She was prescribed spectacles and visual stimulation exercises to preserve existing vision and prevent amblyopia. Periventricular leukomalacia can affect full-term infants although it is more common in preterm and LBW infants. All preterm, LBW infants, and those with positive neuroradiological findings must be assessed by an ophthalmologist as early as possible to detect the associated ocular manifestations.

Ocular Morbidity Associated With Retinopathy of Prematurity in Treated and Untreated Eyes: A Review of the Literature and Data From a Tertiary Eye-care Center in Southern India

Retinopathy of prematurity (ROP) is an emerging cause of childhood blindness in low- and middle-income countries. We review the magnitude, causes, prevention and treatment of visual impairment caused by ROP over a time span. A review of literature on short and long term structural and functional outcomes of ROP was conducted through PubMed search primarily focusing on studies published during the last decade. Additionally, we have shared data from our institute located in Southern India. Visual Impairment in ROP-treated children ranged from 4.1% to 30% in various settings, attributable mainly to refractive errors, amblyopia, strabismus and perinatal neurological events followed by structural changes like macular scarring and retinal detachment. We conclude that towards an early detection and a proper management of all the above mentioned conditions, these children need to be followed-up for a long time by a committed pediatric ophthalmologist at a specifically scheduled interval. The overall success depends upon the strength of the networking system between parents/neonatologists/pediatricians/pediatric ophthalmologist and a retina specialist.

Double Augmented Vertical Rectus Transposition for Large-Angle Esotropia Due to Sixth Nerve Palsy

PURPOSE

To study the binocular alignment and ocular motility in patients with large-angle esotropia due to sixth nerve palsy treated with double augmented vertical recti transposition.

METHODS

This was a prospective interventional study. Fifteen patients with non-resolving sixth nerve palsy who underwent surgical correction were included in the study. Fourteen patients also underwent an additional medial rectus recession. Two patients with an associated small vertical deviation had a selective augmentation of one vertical rectus muscle. Binocular alignment, ocular motility, duction limitation, improvement in head posture, induced vertical deviations, and field of diplopia-free binocular single vision (when possible) were analyzed. Successful outcome was defined as a residual horizontal deviation of 10 prism diopters (PD) or less with no vertical deviation at final follow-up (6 months).

RESULTS

The double augmented Hummelsheim procedure improved esotropia from 58.3 ± 10.8 PD preoperatively to 7.2 ± 5.1 PD postoperatively (P = .001). Three (20%) patients had residual deviation of greater than 10 PD, of which 1 patient had diplopia and was treated with prisms. Postoperative binocular field of vision was performed in 6 patients, the mean of which was 20° for abduction and 45° for adduction. Three of 6 patients had elimination of face turn and the rest had residual head posture of less than 5°. Two patients had an induced vertical deviation of less than 4 PD. In patients who had selective augmentation, the vertical deviation was completely corrected.

CONCLUSIONS

The patients operated on with double augmentation of the Hummelsheim procedure combined with medial rectus recession had reduced mean primary esotropia and improved diplopia-free field of vision postoperatively. [J Pediatr Ophthalmol Strabismus. 2016;53(6):369-374.].

Situational Restriction of Elevation in Adduction Relieved by Faden on the Medial Rectus

We describe a patient with situational restriction of elevation in adduction in his left eye. Clinical examination pointed to instability of the left medial rectus pulley. This was corrected by Faden on the medial rectus. The importance of this relatively new concept in identifying and treating orbital pulley instability is discussed.

High Permeate Recovery for Concentrate Reduction by Integrated Membrane Process in Textile Effluent

  The textile dyeing industry consumes a significant amount of high-quality water for processing, which stresses water resources. In recent decades, technologies have been developed to recover water from wastewater. This study describes the high recovery (greater than 92%) of reusable water from an industrial-scale hosiery dye-water recovery facility, consisting of three stages of reverse osmosis and ultrafiltration. The effluent was pre-treated before the membrane process was performed to prevent biofouling. The process performance results in the generation of a consistent water quality that is required for dyeing operations. An average feed flux of 15 l/m²h was maintained in the reverse osmosis membrane by regular chemical dosing and cleaning. The integrated membrane process achieved a permeate with a pH of 6.5 and total dissolved solids (TDS) of 160 mg/l, with no other contaminants, which is of sufficient quality for reuse in the cotton hosiery dyeing process.

Effect of Uoncept Mapping in Improving Nursing Students' Knowledge and Attitudes Related to Care of HIV/AIDS Patients

This one group pre- and post-test study evaluated the effectiveness of concept mapping and lecture method of teaching among 73 under graduate nursing students. One group was exposed to concept mapping technique and the other group was exposed to lecture method of teaching about HIV/AIDS. Findings indicated a statistically significant increase in the knowledge and attitude of students towards HIV/ AIDS among students exposed to concept mapping than students who underwent lecture method. The results of this study indicated that moden teaching strategies may enhance learning among nursing students. However further evaluation is needed.

Mutational analysis and genotype-phenotype correlations in southern Indian patients with sporadic and familial aniridia

PURPOSE

Aniridia is a rare panocular disorder characterized by iris hypoplasia and other associated eye anomalies. Heterozygous null mutations in paired box gene 6 (PAX6) are the major cause of the classic aniridia phenotype. This study aims to detect the mutational spectrum of PAX6 and associated phenotypes in southern Indian patients with sporadic and familial aniridia.

METHODS

Genomic DNA was isolated from peripheral blood from all participants. The coding regions and flanking intronic sequences of PAX6 were screened with Sanger sequencing in 30 probands with aniridia. The identified variations were further evaluated in available family members and 150 healthy controls. The pathogenic potential of the mutations were assessed using bioinformatics tools.

RESULTS

Thirteen different mutations were detected in eight sporadic and five familial cases. Eleven novel mutations, including five insertions (c.7_10dupAACA, c.567dupC, c.704dupC, c.868dupA and c.753_754insTA), two deletions (c.242delC and c.249delT), and four splicing variants (c.10+1G>A, c.141G>A, c.141+4A>G and c.764A>G) were identified in this study. Clinical findings of the patients revealed phenotypic heterogeneity with the same or different mutations.

CONCLUSIONS

This study reported 11 novel mutations and thus expanded the spectrum of PAX6 mutations. Interestingly, all mutations reported in this study were truncations, which confirms the hypothesis that haploinsufficiency of PAX6 causes the aniridia phenotype. Our observations revealed inter- and intrafamilial phenotypic variability with PAX6 mutations. The common ocular findings associated with PAX6 mutations were iris hypoplasia, nystagmus, and foveal hypoplasia reported in almost all cases, with cataract, glaucoma, and keratopathy reported in approximately 50% of the patients.

Congenital oculomotor nerve palsy due to effects of carotid artery agenesis

Isolated carotid artery agenesis is not generally recognized as a cause of congenital oculomotor nerve palsy. We report this rare association in 2 children and examine the underlying mechanism.