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AIM: The aim of the study was to assess knowledge, awareness, and practices about eye donation in medical students of medical colleges. Setting: Tertiary Care Centre. Design: This study involves a cross-sectional study. MATERIALS AND METHODS: A cross-sectional study at a tertiary care center in Western Vidarbha from August 2023 to October 2023, among medical students. Approval from the institutional ethical committee was taken. A total of 538 students participated in the study. After taking consent, data were collected in self-reported questionnaire consisting of questions about the knowledge and awareness of eye donation, the source of their information, willingness for donation, and respective reasons for willingness and nonwillingness. Data were analyzed. Results: Majority of students belonged to the age group between 21 and 30 years. Most were undergraduates, followed by interns and post-graduates. Five hundred and twenty-nine had heard about eye donation mainly through medical personnel. The majority of students believed that eye donation means giving sight to the blind. Most knew the nearest point of contact for eye donation. The answer given by most to the question “What is removed for transplantation?,” was cornea. The most common response to questions about a site for the removal of eyes was the hospital. The majority knew that no monetary benefits were given for donations. Those willing to pledge their eyes wanted to do so to help the blind, and those not willing said objection by family as the main reason among others. Conclusion: After the study, we concluded that awareness about eye donation was good in the students, while knowledge regarding eye donation varied among the students. Willingness to donate showed mixed responses.

Context: Road traffic accidents (RTAs) are one of the leading and most common causes of ocular injuries, especially in developing countries like India. AIMS: The aim of the study was to study the incidence and clinical presentation of ophthalmic injuries in RTAs. Settings and Design: This was a prospective hospital-based study observational study. Subjects and Methods: A prospective cross-sectional study was conducted among 300 patients in the department of ophthalmology of a tertiary hospital in Western India from October 2021 to October 2023. Detailed ocular examination and investigations were done. Various parameters, including demographics, type of vehicle, type and severity of the injury, and visual acuity at presentation, were studied. The data obtained from the results were expressed in frequency and percentages. Statistical Analysis Used: Not applicable. Results: A total of 300 patients were included in the study. The right eye was affected in 177 out of 320 cases. Male preponderance was noted. The most common ocular finding was ecchymosis 168 (56%) followed by lid lacerations 81 (27%). Majority of the cases were in the age group of 31–40 years (31.67%). The incidence of injuries in two-wheeler riders was 283 (94.33%), of which people who were driving without a helmet were 256 (90.5%). Conclusion: We concluded from our study that the most common age group, 31–40 years, was involved in ocular injuries due to RTAs with male preponderance. Most of those who sustained injuries were riding two-wheeler vehicles without helmets. The involvement of the right eye was more common in unilateral cases. The most common injury found was blunt trauma presenting as preorbital edema and ecchymosis.

Background and Aims: Vasoactive-ventilation-renal (VVR) score has been validated in predicting postoperative outcomes in pediatric cardiac surgery. The aim was to evaluate its potential in predicting early postoperative outcomes in adult patients undergoing mitral valve surgery. Material and Methods: A single-center prospective observational study involved 100 patients undergoing mitral valve surgery. We evaluated preoperative variables (Ambler score), VVR, and vasoactive-inotropic score (VIS) on admission to the intensive care unit (ICU) and then at 12, 24, and 48 hrs postoperatively. Outcomes assessed were length of stay in ICU (LOS-ICU), length of hospital stay (LOHS), and mortality. The data were analyzed using multivariable logistic regression model, receiver operating characteristic (ROC) curves, and areas under curve (AUC). Conclusion: Our study showed the potential utility of the VVR score as a powerful tool for predicting early outcomes after mitral valve surgery, with VVR at 48 hrs having superior predictive capability.

Background and Aims: Vasopressor usage can affect the rostral spread of intrathecal drug and, hence, its requirement during cesarean delivery. Although a decreased spread is evidenced with phenylephrine, there is no data for norepinephrine usage. The present study aimed to evaluate the minimum effective dose of intrathecal hyperbaric bupivacaine for cesarean section with and without prophylactic norepinephrine infusion. Material and Methods: Patients scheduled for elective cesarean section under combined spinal–epidural block were randomized to receive intravenous infusion of norepinephrine (0.05 μg/kg/min) or normal saline (placebo), initiated immediately after intrathecal injection. Postspinal hypotension in either group (systolic arterial pressure ≤0.8 baseline) was treated with norepinephrine 4 μg rescue. Dose of intrathecal hyperbaric bupivacaine (0.5%) was decided for individual patients using up-and-down sequential allocation method. Primary outcome measure was the minimum effective dose of intrathecal hyperbaric bupivacaine (0.5%) defined as ED50, while secondary observations included spinal block characteristics and neonatal outcomes. Results: Demographic parameters were statistically similar between both groups (P > 0.05). ED50 of intrathecal hyperbaric bupivacaine was 7.8 mg (95% confidence interval [CI]: 6.7–8.8) and 7.4 mg (95% CI: 6.1–8.7) for normal saline and norepinephrine group respectively (P = 0.810). Block characteristics were similar between both groups as was neonatal APGAR score, but umbilical artery base excess was greater for norepinephrine versus normal saline group (−4.4 ± 3.6 vs. −6.5 ± 2.4, P = 0.038). Conclusion: Use of prophylactic norepinephrine (0.05 μg/kg/min) during cesarean delivery does not require adjustment of intrathecal hyperbaric bupivacaine.

Aim: To compare the Subfoveal Choroidal Thickness (SFCT) measured by Enhanced Depth Imaging (EDI) technique of Spectral Domain Optical Coherence Tomography (SD-OCT) in healthy pregnant and preeclamptic women. Methods: Our study was cross-sectional hospital-based study in which healthy pregnant women and women having preeclampsia were selected from Obstetrics and Gynecology department and enrolled in it. The guidelines of the American College of Obstetricians and Gynecologists were used to diagnose the cases of preeclampsia. The study included 100 women (200 eyes) which were grouped into 50 healthy pregnant women (group 1), i.e., n = 100 eyes and 50 preeclamptic women (group 2), i.e., n = 100 eyes. SFCT was measured using the EDI technique of SD-OCT and data were entered in a Microsoft Excel sheet. Statistical analysis was done using Epi Info. Software version 7.2.1.0 (Atlanta, Georgia, US) and the results of both the groups were compared. Results: The mean SFCT in both the eyes of the healthy pregnant group and the preeclamptic group was 318.12 ± 37.12 µm and 209.04 ± 26.73 µm, respectively, with a P-value 0.001 showing a statistically significant difference between both the groups. Conclusion: The SFCT is significantly decreased in preeclamptic pregnant women than in healthy pregnant women.

Abstract Background Globally, the cultivation of cotton is constrained by its tendency for extended periods of growth. Early maturity plays a potential role in rainfed-based multiple cropping system especially in the current era of climate change. In the current study, a set of 20 diverse Gossypium hirsutum genotypes were evaluated in two crop seasons with three planting densities and assessed for 11 morphological traits related to early maturity. The study aimed to identify genotype(s) that mature rapidly and accomplish well under diverse environmental conditions based on the two robust multivariate techniques called multi-trait stability index (MTSI) and multi-trait genotype-ideotype distance index (MGIDI). Results MTSI analysis revealed that out of the 20 genotypes, three genotypes, viz., NNDC-30, A-2, and S-32 accomplished well in terms of early maturity traits in two seasons. Furthermore, three genotypes were selected using MGIDI method for each planting densities with a selection intensity of 15%. The strengths and weaknesses of the genotypes selected based on MGIDI method highlighted that the breeders could focus on developing early-maturing genotypes with specific traits such as days to first flower and boll opening. The selected genotypes exhibited positive genetic gains for traits related to earliness and a successful harvest during the first and second pickings. However, there were negative gains for traits related to flowering and boll opening. Conclusion The study identified three genotypes exhibiting early maturity and accomplished well under different planting densities. The multivariate methods (MTSI and MGIDI) serve as novel approaches for selecting desired genotypes in plant breeding programs, especially across various growing environments. These methods offer exclusive benefits and can easily construe and minimize multicollinearity issues.

Abstract Background Cleft lip and palate (CLP) are among the most common congenital anomaly that affects up to 33,000 newborns in India every year. Nasoalveolar moulding (NAM) is a non-surgical treatment performed between 0 and 6 months of age to reduce the cleft and improve nasal aesthetics prior to lip surgery. The NAM treatment has been a controversial treatment option with 51% of the cleft teams in Europe, 37% of teams in the USA and 25 of cleft teams in India adopting this methodology. This treatment adds to the already existing high burden of care for these patients. Furthermore, the supporting evidence for this technique is limited with no high-quality long-term clinical trials available on the effectiveness of this treatment. Method The NAMUC study is an investigator-initiated, multi-centre, single-blinded randomized controlled trial with a parallel group design. The study will compare the effectiveness of NAM treatment provided prior to lip surgery against the no-treatment control group in 274 patients with non-syndromic unilateral complete cleft lip and palate. The primary endpoint of the trial is the nasolabial aesthetics measured using the Asher McDade index at 5 years of age. The secondary outcomes include dentofacial development, speech, hearing, cost-effectiveness, quality of life, patient perception, feeding and intangible benefits. Randomization will be carried out via central online system and stratified based on cleft width, birth weight and clinical trial site. Discussion We expect the results from this study on the effectiveness of treatment with NAM appliance in the long term along with the cost-effectiveness evaluation can eliminate the dilemma and differences in clinical care across the globe. Trial registration ClinicalTrials.gov CTRI/2022/11/047426 (Clinical Trials Registry India). Registered on 18 November 2022. The first patient was recruited on 11 December 2022. CTR India does not pick up on Google search with just the trial number. The following steps have to be carried out to pick up. How to search: ( https://ctri.nic.in/Clinicaltrials/advsearch.php —use the search boxes by entering the following details: Interventional trial > November 2022 > NAMUC).

The ultraviolet (UV) radiation triggers a pigmentation response in human skin, wherein, melanocytes rapidly activate divergent maturation and proliferation programs. Using single-cell sequencing, we demonstrate that these 2 programs are segregated in distinct subpopulations in melanocytes of human and zebrafish skin. The coexistence of these 2 cell states in cultured melanocytes suggests possible cell autonomy. Luria-Delbrück fluctuation test reveals that the initial establishment of these states is stochastic. Tracking of pigmenting cells ascertains that the stochastically acquired state is faithfully propagated in the progeny. A systemic approach combining single-cell multi-omics (RNA+ATAC) coupled to enhancer mapping with H3K27 acetylation successfully identified state-specific transcriptional networks. This comprehensive analysis led to the construction of a gene regulatory network (GRN) that under the influence of noise, establishes a bistable system of pigmentation and proliferation at the population level. This GRN recapitulates melanocyte behaviour in response to external cues that reinforce either of the states. Our work highlights that inherent stochasticity within melanocytes establishes dedicated states, and the mature state is sustained by selective enhancers mark through histone acetylation. While the initial cue triggers a proliferation response, the continued signal activates and maintains the pigmenting subpopulation via epigenetic imprinting. Thereby our study provides the basis of coexistence of distinct populations which ensures effective pigmentation response while preserving the self-renewal capacity.

Hepatic factors secreted by the liver promote homeostasis and are pivotal for maintaining the liver-gut axis. Bile acid metabolism is one such example wherein, bile acid synthesis occurs in the liver and its biotransformation happens in the intestine. Dysfunctional interactions between the liver and the intestine stimulate varied pathological outcomes through its bidirectional portal communication. Indeed, aberrant bile acid metabolism has been reported in inflammatory bowel disease (IBD). However, the molecular mechanisms underlying these crosstalks that perpetuate intestinal permeability and inflammation remain obscure. Here, we identify a novel hepatic gene program regulated by Rela and Stat3 that accentuates the inflammation in an acute experimental colitis model. Hepatocyte-specific ablation of Rela and Stat3 reduces the levels of primary bile acids in both the liver and the gut and shows a restricted colitogenic phenotype. On supplementation of chenodeoxycholic acid (CDCA), knock-out mice exhibit enhanced colitis-induced alterations. This study provides persuasive evidence for the development of multi-organ strategies for treating IBD and identifies a hepatocyte-specific Rela-Stat3 network as a promising therapeutic target.

Context: Split thickness skin grafting (STSG) restores cutaneous cover over wounds thus protecting the underlying surface from contamination, fluid loss and stimulates healing. Autologous platelet rich plasma (PRP) provides a large number of platelets and high concentration of growth factors which promote overall uptake of STSG. Aims: The aim of this study was to assess the immediate, subsequent adhesion and final take of STSG with application of PRP over recipient site. Methods and Material: 1 year Randomised Control Trial where 80 wounds of various aetiologies were randomised into intervention group (n=40) which received PRP before placing STSG on recipient site and control group (n=40) in which the graft was fixed in place with sutures alone. Immediate graft adhesion and subsequent graft uptake were compared between the two groups and statistical analysis was done with: SPSS Version 20. Results: Irrespective of aetiology, and size, among a total of 80 wounds 87.5% grafts had adhered by 1st minute of application in the intervention group compared to nil in control group (p< 0.0001). Graft uptake was assessed on first three consecutive dressings. There was significantly better graft uptake in intervention group compared to control group [third dressing uptake (98.29%, 93%, p< 0.0001) respectively].Difference in seroma and haematoma formation were also compared between the two groups and found to be not significant. (p>0.05) Conclusions: Application of topical PRP facilitates STSG uptake. It decreases operative time by decreasing mobility of graft over the wound bed. Thus, use of PRP improves outcome of split thickness skin graft in wounds of various aetiologies and we recommend use of the same at recipient site of STSG. CTRI/2021/06/034401