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Hyperreflective foci (HRF) are biomarkers in detection of diabetic retinopathy (DR). Presence of HRF on spectral domain optical coherence tomography (SD-OCT) can give a correlation with visual acuity change and grades of DR. Purpose of this study is to determine the presence, location, and role of HRF in the retina of DM patients with and without retinopathy. A total of 192 eyes of patients suffering from type II DM were evaluated. Patients were divided into 2 groups, with Group A having diabetes without retinopathy (20 patients) and group B (76 patients) having diabetes and various grades of retinopathy. SD-OCT was performed in all patients, passing through the center of fovea. On OCT, presence and absence of HRF were noted. Characteristics of the hyper-reflective spots were evaluated: location, shape, size, back shadowing and association with central macular thickness (CMT), visual acuity, and grades of retinopathy. HRF were present in 169 eyes (88%) out of 192 eyes. The shape and location of HRF tend to change with disease progression. HRF were significantly associated with increasing grades of retinopathy (χ2 = 57.586, p < 0.01) Association of macular edema was significant with both retinopathy (χ2 = 8.895, p < 0.05) and HRF (χ2 = 34.720, p < 0.01). Association of best-corrected visual acuity with HRF (χ2 = 21.232, p < 0.01), macular edema (χ2 = 86.960, p < 0.01), and CMT (χ2 = 47.959, p< 0.01) was significant. HRF is a great indicator for early diagnosis of subclinical retinopathy and can be used to monitor the progression of disease and development of macular edema. Significant difference is present in HRF distribution and morphology. [ABSTRACT FROM AUTHOR]

Narrow band imaging (NBI) is an emerging modality that enhances the accuracy of detection of head and neck malignancies by visualisation of aberrant neoangiogenesis in malignant tissue using narrow bandwidth light in blue and green spectrum. The purpose of this study was to assess the role of NBI in detecting recurrence in patients with Squamous cell carcinoma larynx and hypopharynx who have undergone Radiotherapy/Chemoradiotherapy (RT/CTRT). The aim of the study was to (a) determine the role of NBI in follow-up of patients with carcinoma of larynx and hypopharynx previously treated with radiotherapy or chemotherapy, (b) determine the role of NBI as the initial investigatory tool of choice in detecting local recurrence and compare with other modalities like fibreoptic laryngoscopy (FOL), Magnetic Resonance Imaging (MRI) and Positron Emission Tomography- Computed Tomography (PETCT). Prospective multicentric study at ENT departments of tertiary care centres in Delhi, Bangalore and Pune in India was conducted from Jan 2019 to Sep 2022. Thirty-four consecutive patients diagnosed as squamous cell carcinoma (SCC) larynx/hypopharynx who underwent chemo/radiotherapy were scheduled for NBI 12 weeks after completion of therapy with FOL and PETCT/MRI and followed up 03 monthly for 02 years. NBI/FOL/PETCT or MRI and Histopathological Examination (HPE) were compared. NBI was found to be 100% sensitive and 96% specific with a positive predictive value of 85% and negative predictive value of 100% respectively with a diagnostic accuracy of 97%. NBI along with FOL increases the sensitivity of detection of recurrence in patients of laryngeal/hypopharyngeal cancer post-chemo/radiotherapy. [ABSTRACT FROM AUTHOR]

The relative efficacy of 532 nm subthreshold micropulse laser in comparison to the 810 nm subthreshold micropulse laser, in the treatment of central serous chorioretinopathy is not known. This randomized controlled trial included 99 eyes each in groups A and B. Key inclusion criteria were: (i) vision loss for minimum three months due to persistent central serous chorioretinopathy; (ii) focal leaks (upto two leaks) on fundus fluorescein angiography. Key exclusion criteria were: (i) history of prior treatment for central serous chorioretinopathy; (ii) absence of any leak/ presence of diffuse leaks/ >2 leaks on fundus fluorescein angiography; (iii) chronic central serous chorioretinopathy. All eyes were treated with subthreshold micropulse laser (group A: 532 nm green laser; group B: 810 nm diode laser). Best-corrected visual acuity, autofluorescence, spectral domain optical coherence tomography, and fundus fluorescein angiography, were evaluated at baseline and at 1, 3, and 6 months. Laser was repeated in nor-responders at 3 months. There was a statistically significant improvement in BCVA in both groups six months post laser. Between the two groups, a comparable proportion of eyes showed complete resolution of subretinal fluid at one month, three months and at six months. No adverse effect of laser was observed in either group. Both 532 nm STMP laser and 810 nm STMP laser have comparable structural and functional outcomes in the treatment of non-resolving CSC. There are no adverse effects related to either of the two wavelengths. [ABSTRACT FROM AUTHOR]

Iris fixated intraocular lens (IOLs) have been used for Aphakia and capsular bag instability. The IOLs cause a postoperative non dilating pupil in most cases. We encountered such a case which presented with rhegmatogenous retinal detachment. We describe a novel technique of operating for retinal reattachment in such a case using iris hooks passing in the potential plane between the IOL optic and the iris. The technique had advantages of obviating the need for IOL explantation, associated large corneal entry wound, allowing silicone oil tamponade by retaining an IOL-iris diaphragm, early visual rehabilitation, reduced surgical time, and avoiding multiple surgeries. [ABSTRACT FROM AUTHOR]

Ocular dirofilariasis is no longer a rare disease as more cases are being reported across the world and in India as awareness about this disease among health care professionals has increased. It is a helminthic infection which is caused by filarial parasite of the genus dirofilaria. It has a varied clinical presentation and the definitive diagnosis is based on microbiological and histopathological examination of the parasite. Herein, we report a unique case of ocular dirofilariasis in which a patient initially presented with features mimicking orbital cellulitis. Subsequently, the patient developed a subconjunctival lesion when orbital cellulitis subsided after three days of broad-spectrum antibiotics. The live worm was found when the lesion was incised, which was removed in toto and sent for microbiological examination. The nematode in our case was identified as dirofilaria repens. There was complete resolution of symptoms following surgical extraction of worm and no sign of recurrence was seen at 6 months follow-up. [ABSTRACT FROM AUTHOR]

The high spatial resolution data presents a problem when it comes to mapping and identifying distinct tree species based on the characteristics of their canopies. The deep learning Semantic Segmentation approach based on U-Network (U-Net.) artificial intelligence model that we provide here can recognize, and map Azadirachta indica trees canopy cover. This method trains its model by making use of image chips and labels of the item being segmented. The new testing images processed for multiple stages of pixel level of convolution and pooling operations. The sampling methods allow increase to make complete to make the recognized object on the image. The model's ability to identify items based on canopy shape, structure, and pixel data makes it very useful for mapping and recognizing a single tree species as well as several tree species. The model validation results indicated an accuracy of 84–89 percent, which is regarded to be rather good. Based on ground census data, the overall accuracy of identification is 89 percent, F1 score 0.91–0.94, while the complete tree canopy validation (Intersection to Union) for canopy matching area is 0.79–0.89. The method has the potential to be utilised for identification, mapping of tree canopy. The approach has the potential to be used for important research initiatives i.e tree censuses and the identification and mapping of crop plant identification. The deep learning model used as inferences for automatization of the identification of the tree species helps to resolve identification and mapping based complex problems in agro-forestry allied fields. [ABSTRACT FROM AUTHOR]

Arc weaving is a feasible technique for making thick-walled components in the arc-based directed energy deposition process (DED-Arc). In the current study, four different arc weaving strategies, namely, triangle, square, semi-circle, and helix, are used to fabricate the walls. For this, gas tungsten arc welding (GTAW) based DED-Arc set-up using aluminium alloy wire (ER4043) as a filler material is used for different printing strategies. The fabricated walls were investigated for their surface characteristics, microstructure, mechanical properties and residual stress. The weld-bead and wall geometry study revealed that for the same number of layers, the semi-circular arc-weaving strategy had the maximum height among all, with an effective area of 65.77 %. The waviness of the side surface of the walls was maximum for the semi-circle (714 ± 35 µm), indicating the semi-circle will require almost twice the amount of machining than the helix, square, and triangle in postprocessing operation. The optical micrographs showed that the semi-circular weaving pattern exhibited a coarser gain with thicker grain boundaries with an average grain size of 46.4 ± 23.7 µm as compared to other weaving patterns. The triangle weaving pattern demonstrated the smallest grain size among all, resulting in high hardness and superior wear resistance. The residual stress (RS) results revealed that the RS is in tension (22–24 MPa) in the bottom layers for all the walls and becomes almost zero (−1.5 to −2.5 MPa) in the top layers except for the walls formed by helix strategy. The square weaving strategy strikes a balance between surface characteristics, microstructure, and mechanical properties, making it a highly viable option for thick wall fabrication. [Display omitted] [ABSTRACT FROM AUTHOR]

Non-alcoholic steatohepatitis (NASH), an advanced form of non-alcoholic fatty liver disease (NAFLD), has emerged as the leading cause of liver failure and related death. Currently, no medication is specifically approved to treat NAFLD or NASH. Here we report that oral administration of honey vesicle-like nanoparticles (H-VLNs) to naturally aged mice protects the liver from NASH development. H-VLNs are dominantly taken up by Kupffer cells in the liver and suppress hepatic chronic inflammation and further development of fibrosis and nodule formation in aged mice. Besides their reported anti-inflammasome function, H-VLNs are found to inhibit the transcriptional activities of C-JUN and nuclear factor-kappa B (NF- κ B). MicroRNAs miR5119 and miR5108 and phenolic compound luteolin in H-VLNs are identified in suppressing both the C-JUN and NF- κ B pathways. Collectively, oral intake of H-VLNs represents a promising new user-friendly modality to prevent the development of NASH. Oral administered H-VLNs alleviated inflammation, fibrosis development, and nodule formation in naturally aged liver. Their bioactive cargos inhibited the activities of the NLRP3 inflammasome, NF- κ B, and c-Jun in Kupffer cells/macrophages. [Display omitted] [ABSTRACT FROM AUTHOR]

The study aimed to compare the analgesic effect of USG-guided PENG (Peri capsular nerve group) block with Intravenous Nalbuphine hydrochloride (IVN) in patients with hip fracture coming to the emergency department (ED). The purpose was also to monitor the adverse effects and rescue analgesic requirements in both treatment modalities. The study was an open-label randomised controlled trial (RCT) comparing PENG block versus IVN in treating patients with femoral head and neck fractures, as well as pubic rami fracture of the hip (HF). The participants in the PENG group received a USG-guided PENG block by injection of 25 ml of 0.25% bupivacaine, whereas the IVN group received 0.15 mg/kg of nalbuphine. An emergency physician with expertise in ultrasound-guided nerve blocks performed the PENG blocks. The primary outcome was to measure the improvement of the NRS (Numerical rating scale) score at 30 min in both static position (Patient-chosen position for the best comfort) and dynamic position (15-degree passive affected lower limb elevation). Secondary outcomes were to measure static and dynamic NRS pain scores at 2 h, 4 h, and 6 h after intervention in both groups. The requirement for rescue analgesia, adverse events and any block-related complications were also recorded. A total of 60 patients with HF were included in the final analysis. The static and dynamic NRS score was significantly lower in the PENG group compared to the IVN group at 30 min, 2 h, 4 h, and 6 h post-intervention. In the PENG group, the static NRS score was improved by 5.73 ± 1.17, while In the IVN group, the static NRS score was just improved by 2.13 ± 0.97 at 30 min. In the same duration, the Dynamic NRS score in the PENG group was improved by 6.13 ± 1.38, while In the IVN group, it improved just by 2.43 ± 1.28. Rescue analgesia was required in 50.0% of patients in the IVN group but none in the PENG group. Further, no block-related complications or adverse events were observed in the patients of the PENG group. The study provides evidence that the ultrasound-guided PENG block has a better analgesic effect and has fewer adverse events than IV opioids in patients with HF. [ABSTRACT FROM AUTHOR]

The administration of dose-escalated radiation for pancreatic adenocarcinoma remains challenging because of the proximity of dose-limiting stomach and bowel, particularly the duodenum for pancreatic head tumors. We explore whether endoscopic injection of a temporary, absorbable hydrogel into the pancreatico-duodenal (PD) groove is safe and feasible for the purpose of increasing spatial separation between pancreatic head tumors and the duodenum. Six patients with localized pancreatic adenocarcinoma underwent endoscopic injection of hydrogel into the PD groove. Safety was assessed based on the incidence of procedure-related adverse events resulting in a delay of radiation therapy initiation. Feasibility was defined as the ability to create spatial separation between the pancreas and duodenum, as assessed on simulation CT. All 6 patients were able to undergo endoscopic injection of hydrogel into the PD groove. No device-related events were experienced at any point in follow-up. Presence of hydrogel in the PD groove was apparent on simulation CT in all 6 patients. Mean space created by the hydrogel was 7.7 mm +/- 2.4 mm. In 3 patients who underwent Whipple resection, presence of hydrogel in the PD groove was pathologically confirmed with no evidence of damage to the duodenum. Endoscopic injection of hydrogel into the PD groove is safe and feasible. Characterization of the dosimetric benefit that this technique may offer in the setting of dose-escalated radiation should also be pursued, as should the ability of such dosimetric benefit to translate into clinically improved tumor control. [ABSTRACT FROM AUTHOR]

Orthognathic surgery results in the positional change of the maxilla and mandible that may affect speech. The present study evaluated the effect of combined maxillary advancement and mandibular setback surgery on articulation proficiency and speech intelligibility in patients with non-syndromic skeletal Class III malocclusion. In this prospective study, twenty-five patients with skeletal class III malocclusion and consecutively treated with Lefort-1 maxillary advancement and mandibular setback (BSSO) orthognathic surgery were included in this study. The speech sample was recorded with a digital audio tape recorder one day before surgery and at 3, 6, 9, 12 and 18 months after surgery. Three qualified and experienced speech and language pathologists evaluated articulation errors and intelligibility of speech samples. Repeated One-way analysis of variance was used to compare articulation proficiency and speech intelligibility at different time intervals. The substitution, omission, distortion and addition errors showed no significant changes at 3 months and 6 months. The total articulation errors decreased to zero at 9 months and no significant increase was observed till 18 months (P < 0.05). Speech intelligibility showed statistically non-significant improvement at any time interval. Cephalometric skeletal parameters SNA and N ḻ A°. were significantly correlated with addition and total articulation errors at 18 months follow up. The ortho-surgical treatment improves speech (decreases. articulation errors) in most of the patients usually 6–9 months post-surgery. Speech intelligibility is not affected by bimaxillary orthognathic surgery in skeletal class III patients. The articulation errors were correlated to changes in position of maxilla. [Display omitted] [ABSTRACT FROM AUTHOR]

Muscle strength is impaired in obese persons due to low physical activity, obesity-related modifications in muscle morphology and as a consequence of calorie regulation (where applicable). Previously decreased BMI and increased hand grip strength was reported following a short duration yoga intervention in obese adults. The present comparative controlled study was conducted on two hundred and ninety seven obese adults (BMI ≥25 Kg/M2) aged between 20 and 59 years, to determine the effects of nine months of yoga or nutrition advice on muscle strength and body composition. Participants were assessed for bilateral hand grip strength, leg and back strength, and body composition at baseline, after 3 months, 6 months and 9 months of yoga or nutrition advice. BMI-adjusted bilateral hand grip strength and leg and back strength were calculated. In the linear mixed model analyses, there was a significant interaction effect of Time X Groups for (i) right hand grip strength (F 3,668.465 = 9.297, p < 0.001), (ii) left hand grip strength (F 3,673.408 = 14.469, p < 0.001), (iii) BMI-adjusted right hand grip strength (F 3,650.542 = 9.954, p < 0.001) and (iv) BMI-adjusted left hand grip strength (F 3,655.518 = 13.853, p < 0.001). Bonferroni corrected post-ho c analyses (p adj < 0.05; in all cases) showed a significant increase in (i) bilateral hand grip strength and (ii) BMI-adjusted right and left hand grip strength in the yoga group while a decrease in (i) bilateral hand grip strength and (ii) BMI-adjusted right and left hand grip strength in the nutrition advice group. Yoga practice appears to protect and increase upper limb muscle strength in obese adults. • Muscle strength checked in obese after yoga (YG) or nutritional advice (NA). • YG had postures, breathing and relaxation while NA had lectures on nutrition. • YG (nine months) increased leg, back, bilateral hand grip strength and reduced BMI. • NA (nine months) decreased bilateral hand grip strength and reduced BMI. • Weight reduction with yoga practice preserves and increases muscle strength. [ABSTRACT FROM AUTHOR]