Assessment of Safety, Efficacy and Predictability of a Trifocal Intraocular Lens

Purpose:  To evaluate the performance and the visual outcomes of Acrysof PanOptix trifocal IOL in terms of safety, efficacy, predictability and assessment of the quality of vision after implantation as regards; contrast sensitivity and ocular aberrations. Study Design:  Quasi experimental study. Place and Duration of Study:  Dar el Ouyon hospital and Rowad Correction Center, Egypt, from September 2019 and January 2020. Methods:  Forty eyes of twenty-one patients with senile cataract were included by convenient sampling. All eyes underwent phacoemulsification with IOL implantation. They were divided into two groups; group A included twenty eyes of eleven patients who were implanted AcrySof IQ PanOptix trifocal IOL Model TFNT00. Group B included twenty eyes of ten patients who were implanted monofocal AcrySof IOLs as a control group. A questionnaire was given to every patient after explaining to him\her the questions in Arabic, and clarifying the aim of evaluation. Results:  Mean age was 56.6 ± 6.9 years in group A and 62.8 ± 7.1 years in group B, range 50 – 70 (P = 0.861). We found statistical significant difference between both groups with group A showing better post operative uncorrected distance, intermediate, near, and best corrected near visual acuity (P values were 0.001, 0.556, 0.001, 0.177, 0.001, 0.001 respectively). Group B showed statistically significant better post operative contrast sensitivity compared to group A. Conclusion:  In this study, Acrysof PanOptix trifocal IOL showed excellent safety, efficacy, predictability and spectacle independence at all distances, However, contrast sensitivity was compromised in comparison to the monofocal group.

Sustainable development goals under threat? Multidimensional impact of COVID-19 on our planet and society outweigh short term global pollution reduction

The Sustainable Development Goals (SDGs) call on all nations to accomplish 17 broad global development goals by 2030. However, the COVID-19 pandemic presents a challenging period in human history, causing large-scale impacts on society and the environment as governments shift priorities and divert funding in response to this pandemic. Through a literature survey and data acquirement from various international organizations (e.g. United Nations and European Space Agency), this manuscript is intended to provide critical insights into the impacts of the COVID-19 pandemic on the SDGs. We briefly describe this pandemic's positive and short-term effects on the environment, followed by a critical evaluation of its potential long-term impacts on the environment, society, and the SDGs. On the basis of COVID-19 effects, the SDGs are classified into three categories: directly-affected SDGs, indirectly-affected SDGs, and a stand-alone category. The COVID-19-induced lockdowns and restrictions resulted in a short-term decline in environmental pollution and greenhouse gases (GHG) emissions, providing valuable data for climate advocates and researchers. These positive impacts were essentially temporary due to the synchronized global response to the pandemic. The halted focus on the progress of the SDGs greatly impacts the global green transition to a healthy and sustainable world. COVID-19 threatens to impede the progress toward a prosperous, environment-friendly, and sustainable global development in multiple ways. These multi-dimensional threats have been critically evaluated, along with a description of potential solutions to curtail the adverse effects of COVID-19 on the SDGs. Considering the limited data regarding the impacts of the pandemic on the SDGs, diverse collaborative studies at the regional and global levels are recommended.

Prophylaxis of macular edema after cataract surgery in diabetic patients, topical Nepafenac versus intravitreal Ranibizumab

PURPOSE

To compare effect of topical Nepafenac versus intravitreal Ranibizumab on macular thickness after cataract surgery in diabetic patients with no preoperative macular edema.

PATIENTS AND METHODS

A prospective randomized controlled study recruited diabetic patients with visually significant cataract and no diabetic macular edema (DME). Patient underwent uncomplicated phacoemulsification with IOL implantation and were randomly assigned to receive post-operative topical Nepafenac, intra-operative intravitreal Ranibizumab, or no prophylactic treatment. Changes in subfoveal and perifoveal macular thickness were assessed by SD-OCT.

RESULTS

The mean central macular thickness showed a significant increase in all study groups 1 week and 1 month postoperative when compared to baseline. At 3 months postoperative, there was a significant difference between Nepafenac and Control group (p = 0.017), Ranibizumab and Control groups (p = 0.009) with no significant difference between Nepafenac and Ranibizumab group (p = 0.545) regarding CMT. Comparable results could be detected as regarding peri-foveal macular thickness changes. Concerning BCVA, there was a significant difference between topical Nepafenac/control (p = 0.001) and intravitreal Ranibizumab/control (p = 0.004) at 1-week visit. No significant difference in BCVA was observed between Nepafenac and Ranibizumab group throughout the whole study period. In postoperative visits, cystoid macular edema occurred in three patients (7.9%) in Nepafenac group, one patient (2.7%) in Ranibizumab group, and seven patients (17.07%) in control group.

CONCLUSION

Both postoperative topical Nepafenac and intra-operative intra-vitreal Ranibizumab are effective adjunctive to phacoemulsification in diabetic patients for prophylaxis of macular edema.

Primary Topography-Guided LASIK: A Comparative Study Comparing Treating the Manifest versus the Topographic Astigmatism

Purpose

To investigate if topography-guided laser in situ keratomileusis (LASIK) depending on the topographic astigmatism which is measured using the Topolyzer leads to a better refractive outcome when compared to treatment of the manifest refractive astigmatism in cases of myopic astigmatism.

Methods

This was a prospective non-masked, randomized study (block randomization) of postoperative vision and refraction of patients with myopic astigmatism that had LASIK using Contoura vision software. They were divided into three groups according to the treatment strategy, treating the manifest astigmatism in one group, the topographic astigmatism with compensation for the spherical power in the second group and treating the topographic astigmatism without changing the spherical power in the third group. It was conducted at Kasr Alainy Hospital and Dar Eloyon Hospital.

Results

The postoperative uncorrected distant visual acuity (UDVA) in each group separately was better than the preoperative corrected distant visual acuity (CDVA) (58% (n=35) had UDVA better than 20/20 and gained 1 line or more); however, eyes treated with the topographic astigmatism without changing the spherical power showed the statistically best results (75% (n=15) had UDVA better than 20/20). The residual anterior corneal astigmatism was lower in this group (the mean 0.47 vs 0.95 and 0.59). No significant difference was noted in the residual refractive astigmatism, but it was also the least in that group.

Conclusion

Topography-guided LASIK is a safe and effective ablation profile for treatment of myopic astigmatism. Treating according to the topographic astigmatism shows the best outcome as regards the vision and residual astigmatism.

Contribution of Posterior Corneal Astigmatism to Total Corneal Astigmatism in a Sample of Egyptian Population

Purpose

To determine the percentage of contribution of the magnitude of posterior corneal astigmatism to total corneal astigmatism using Scheimpflug imaging.

Methods

This prospective cross-sectional study was conducted on 356 eyes of 356 patients, where the total corneal astigmatism was calculated by addition of anterior and posterior corneal astigmatism using vector analysis and then the percentage of posterior to total corneal astigmatism was calculated.

Results

The percentage of contribution of posterior to total corneal astigmatism was about 30% in patients with With The Rule astigmatism and about 8% in patients with Against The Rule astigmatism.

Conclusion

Posterior corneal astigmatism should not be neglected during calculation of total corneal astigmatism as neglecting posterior corneal astigmatism can result in errors during calculation and correction of astigmatism.

Verification and measurement of the side-cut angle of corneal flap in patients undergoing LASIK surgery using FS 200 kHz femtosecond laser system versus conventional mechanical microkeratome

Introduction: This is a prospective nonrandomized interventional clinical trial conducted to measure and verify the intended versus the achieved LASIK flap side-cut angle in two groups of patients, Femtosecond laser-assisted in-situ keratomileusis (FS-LASIK) using Wavelight FS200 (Alcon Laboratories Inc. Fort Worth, TX, USA) and the conventional mechanical microkeratme (Moria M₂ 90).

Methods: This prospective clinical trial was conducted on 40 eyes of 20 patients (20 eyes in each group) in the interval between December 2017 and August 2018. Heidelberg anterior segment OCT was done for the patients 2 weeks postoperatively to measure the corneal flap side cut angle.

Results: The achieved side-cut angles of all the patients in the first group (the femtosecond laser-assisted in-situ keratomileusis group) were equal to or more inverted than the intended angle (110–115°) in all the study candidates with a minimum angle (110°) and maximum angle (155°). Unlike the achieved side-cut angle in the second group (the mechanical microkeratome group) in which all the achieved side-cut angle were acute with a minimum angle (30°) and maximum angle (65°) which is more acute than the intended side-cut angle (70°).

Conclusion: In our study we found that the femtoLASIK technology was capable of making the flap side-cut angle more obtuse than the intended angle, unlike the achieved flap side-cut angle done using the mechanical microkeratome which was more acute than the intended angle in 100% of cases.

Contrast echocardiogram in diagnosing rare type of persistent left superior vena cava

We report a rare case of persistent left superior vena cava (PLSVC) with direct drainage into the left atrium in a 3-yearsold boy who had been electively admitted for hypospadias repair, when he was noticed to have finger clubbing and mild hypoxia but was otherwise asymptomatic. The diagnosis of PLSVC can be made without an invasive tool as direct drainage of PLSVC into the left atrium be visualised using transthoracic echocardiography (TTE) by injecting agitated saline into the left arm.

BCN–Co3O4 hybrid – a highly efficient catalyst for the oxygen evolution reaction and dye degradation

The as-prepared Co₃O₄–BCN shows excellent activity towards the OER and dye degradation as compared to pristine Co₃O₄.

Femtosecond laser-assisted implantation of complete versus incomplete rings for keratoconus treatment

Purpose

To compare complete versus incomplete ring implantation for keratoconus correction.

Methods

We investigated 25 eyes of keratoconic patients, of which 15 had femtosecond-assisted MyoRing corneal implantation (Group 1) and 10 had femtosecond-assisted Keraring segments (Group 2). Uncorrected distance visual acuity (UCVA), best corrected distance visual acuity (BCVA), mean K (K_m), sphere, topographic cylinder, and corneal asphericity value (Q-value) were measured in all eyes preoperatively and at 4 weeks postoperatively (1 month).

Results

In Group 1, the K_m change was −6.15±2.16 D, with a mean change in sphere of 4.45±2.18 D and a mean change in refractive cylinder of 2.32±3 D. UCVA change was −0.57±0.273 logarithm of the minimum angle of resolution (LogMAR), BCVA change was −0.2±0.27 (LogMAR), and the Q-value change was 0.43±2.6. In Group 2, the K_m change was −3.15±1.68 D, UCVA change was −0.48±0.37 (LogMAR), BCVA change was −0.09±0.15 (LogMAR), and the Q-value change was 0.5±0.21. Changes in the means did not significantly differ between groups, except for the K_m change, which was significantly greater in Group 1 than in Group 2 (P=0.05).

Conclusion

Both complete ring and ring segment implantation are effective for improving corneal and visual parameters in keratoconus. Complete ring implantation may have a greater flattening effect on the anterior corneal surface.

Pre-culturing of nodal explants in thidiazuron supplemented liquid medium improves in vitro shoot multiplication of Cassia angustifolia

An in vitro propagation system for Cassia angustifolia Vahl. has been developed. Due to the presence of sennosides, the demand of this plant has increased manyfold in global market. Multiple shoots were induced by culturing nodal explants excised from mature plants on a liquid Murashige and Skoog [8] medium supplemented with 5-100 μM of thidiazuron (TDZ) for different treatment duration (4, 8, 12 and 16 d). The optimal level of TDZ supplemented to the culture medium was 75 μM for 12 d induction period followed by subculturing in MS medium devoid of TDZ as it produced maximum regeneration frequency (87%), mean number of shoots (9.6 ± 0.33) and shoot length (4.4 ± 0.46 cm) per explant. A culture period longer than 12 d with TDZ resulted in the formation of fasciated or distorted shoots. Ex vitro rooting was achieved when the basal cut end of regenerated shoots was dipped in 200 μM indole-3-butyric acid (IBA) for half an hour followed by their transplantation in plastic pots filled with sterile soilrite where 85% plantlets grew well and all exhibited normal development. The present findings describe an efficient and rapid plant regeneration protocol that can further be used for genetic transformation studies.

Assessment of the potentiality of TDZ on multiple shoot induction in Bauhinia tomentosa L., a woody legume

An efficient and reproducible protocol for in vitro multiplication of Bauhinia tomentosa L. was developed. Multiple shoots were regenerated from cotyledonary node and stem nodal segments excised from in vitro raised seedlings on Murashige and Skoog (MS) medium supplemented with different concentrations (0.1, 0.3, 0.5, 0.8 and 1.0 μM) of thidiazuron (TDZ). The maximum response (62.6%) was recorded on MS medium amended with 0.8 μM TDZ. A long exposure to TDZ for 8 weeks showed abnormalities such as fasciation and compact shoots formation. To avoid adverse effects of prolonged exposure to TDZ in long-term establishment, the culture were transferred to TDZ free MS medium for further multiplication and elongation. The highest number of shoots and shoot length were recorded at the end of fourth subculture passage. Ex vitro rooting was achieved when the basal cut end of regenerated shoots were dipped in 200 μM indole-3-butyric acid (IBA) for half an hour followed by their transplantation in plastic pots filled with sterile Soilrite™ where 60% plantlets grew well and all expressed normal development.

Fermentation and recovery of glutamic acid from palm waste hydrolysate by Ion-exchange resin column

Glutamic acid produced from palm waste hydrolysate by fermentation with Brevibacterium lactofermentum ATCC 13869 is produced with a remarkably high yield compared with that produced from pure glucose as a carbon source. The produce yield is 70 g/L with glucose, wherease, when palm waste hydrolysate is the fermentation medium in the same bioreactor under same conditions, it is 88 g/L. The higher yield may be attributed to the fact that this organism has the ability to convert sugars other than only glucose present in the hydrolysate. Bioreactor conditions most conducive for maximum production are pH 7.5, temperature of 30 degrees rmentation period of 48 h, inoculum size 6%, substrate concentration of 10 g per 100 mL, yeast extract 0.5 g per 100 mL as a suitable N source, and biotin at a concentration of 10 pg/L. Palm waste hydrolysate used in this study was prepared by enzymic saccharification of treated palm press fiber under conditions that yielded a maximum of 30 g/L total reducing sugars. Glutamic acid from fermentation broth was recovered by using a chromatographic column (5cm x 60 cm) packed with a strong ion-exchange resin. The filtered broth containing glutamic acid and other inorganic ions was fed to the fully charged column. The broth was continuously recycled at a flow rate of 50 mL/min (retention time of 55 min) until glutamic acid was fully adsorbed on the column leaving other ions in the effluent. Recovery was done by eluting with urea and sodium hydroxide for total displacement of glutamic acid from the resin. The eluent containing 88 g/L of glutamic acid was concentrated by evaporation to obtain solid crystals of the product. (c) 1995 John Wiley & Sons, Inc.

Assessment of factors affecting micropropagation and ex vitro acclimatization of Nyctanthes arbor-tristis L

Rapid differentiation of multiple shoots was observed in 94% of nodal explants of one year old Nyctanthes arbor-tristis L. plants. Shoot bud induction and multiplication took place on Murashige and Skoog (MS) medium supplemented with two cytokinins, i.e. Benzyladenine (BA) or Kinetin (Kn) either alone or in combination with different auxins, indole-3-butyric acid (IBA), indole-3-acetic acid (IAA) or α-naphthalene acetic acid (NAA). Between different media, pH levels and growth regulators tried, the optimum condition for maximum regenerative response was obtained on MS + Kn (2.5 μM) + N AA (0.5 μM) media at 5.8 pH, forming cultures with 23.26 ± 0.89 number of shoots and 6.36 ± 0.80 cm shoot length after 8 weeks of culture. Histological sections confirmed the formation of multiple buds from nodal explants. Rooting was achieved ex vitro by dipping the basal ends of microshoots in 200 μM IBA for 30 min followed by their transplantation in sterile soilrite. The plantlets with well-developed shoot and root system were successfully established in garden soil and grown outside in a greenhouse with a 80% survival rate.

Antibacterial activity of aerial parts as well as in vitro raised calli of the medicinal plant Saraca asoca (Roxb.) de Wilde

Leaves, stem, and flowers of Saraca asoca, an endangered medicinal plant in India, and young explants cultivated on Murashige & Skoog's medium containing 6-benzylaminopurine were analyzed for antibacterial potential. Alcoholic and aqueous extracts from parent explants and their in vitro raised calli were tested by an agar well diffusion method. Minimal inhibitory concentrations (MICs) of the extracts were determined by broth microdilution method. Aqueous extracts showed antibacterial activity against limited bacterial species, whereas alcoholic extracts were active against a wider range of bacteria. Although the alcoholic extracts of all the explants and calli showed antibacterial activity, the extracts derived from flowers and their calli showed better results. Extracts derived from calli showed comparable results to the extracts from explants. Overall, the MICs of the extracts ranged from 0.039 to 1.25 mg/mL. MICs against gram-positive bacteria ranged from 0.078 to 1.25 mg/mL, whereas they ranged between 0.039 and 0.625 mg/mL against gram-negative bacteria. A MIC distribution plot showed that gram-negative bacteria were more susceptible to the extracts than gram-positive bacteria. It is concluded that extracts of S. asoca contain antibacterial agent, and as the calli gave good results, in vitro cultivation of the explants may be used to obtain antibacterial compounds. This is the first report on antibacterial activity of S. asoca, especially through in vitro raised calli.

Comparative analysis of mitotic aberrations induced by diethyl sulphate (DES) and sodium azide (SA) in Vicia faba L. (Fabaceae)

The present investigation provides a comparative account of different concentrations (0.01, 0.02, 0.03, 0.04, 0.05 and 0.06%) of diethylsulphate (DES) and Sodium Azide (SA) on mitotic aberrations, seed germination, seedling survival, plant height and mitotic index in Vicia faba L. variety major. The control plants were normal while as treated ones showed significant alterations. The mutagens caused dose dependent decrease in seed germination, seedling survival, plant height and mitotic index. All the parameters were found negatively affected and were positively correlated with mutagenic concentrations. The cytological study revealed various types of mitotic aberrations, among them the dominant were fragments, stickiness, precocious separation, c-metaphase, ring chromosomes, unequal separation, laggards, bridges, micronuclei, disturbed anaphase etc. Stickiness and fragments were more frequent as compared to other types.

Herbal ethnomedicine of the gwalior forest division in madhya pradesh, India

Ethnomedicinal studies carried out in the Gwalior Forest Division, Madhya Pradesh, India, led to interesting therapeutic applications of 102 plant species. Information on medicinal claims was collected from the tribal people called 'Sahariya' and the traditional healers who had knowledge of the traditional uses of medicinal plants. This study describes details of botanical identity, local name, parts of the plants used, mode of preparation, administration of the drug, and diseases for which the given plants are used.

Growth characteristics and transformability of soybean embryogenic cultures

Embryogenic cultures of soybean [Glycine max (L.) Merr. cv. Jack and Asgrow A2872] were established in liquid Finer and Nagasawa medium, maintained by transfer to fresh medium at biweekly intervals, and subjected to microprojectile bombardment over time. Cultures were not amenable to transformation until they were at least 6 months old. Over time, different cell lines of the same genotype acquired very different culture phenotypes. Histological analysis of cell lines differing in transformation ability showed that the most transformable cultures had cytoplasmic-rich cells in the outermost layers of the tissue. In contrast, the outer layers of less transformable cultures contained cells with prominent vacuoles. Although fresh weight accumulation of the cultures was curvilinear during the 2-week subculture period, a burst of mitotic activity was evident shortly after transfer to fresh medium. This activity usually lasted from the 2nd to the 6th day following subculture, and peaked on the 4th day. Tissues at or near this stage always produced more transient expression of a reporter gene than did bombardments at other times. In addition, the cell lines most amenable to transformation also exhibited the highest mitotic index. Thus any treatment to increase the mitotic index, especially when the cell lines are less than 6 months old, may facilitate the transformation of cell lines from which efficient recovery of transgenic plants is still possible.