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Damien F Goldberg,1 Claudio Orlich,2 Brian E Flowers,3 Inder P Singh,4 Sydney Tyson,5 Leonard K Seibold,6 Mohammed K ElMallah,7 Elysia M Ison,8 Med Harbin,8 Heather Reynolds,8 Malik Y Kahook9 1Wolstan & Goldberg Eye Associates, Torrance, CA, USA; 2Clinica 20/20, San Jose, Costa Rica; 3Ophthalmology Associates, Fort Worth, TX, USA; 4The Eye Centers of Racine & Kenosha, Racine, WI, USA; 5Eye Associates & SurgiCenter of Vineland, Vineland, NJ, USA; 6Department of Ophthalmology, University of Colorado Eye Center, Aurora, Colorado, USA; 7Ocala Eye, Ocala, FL, USA; 8New World Medical, Rancho Cucamonga, CA, USA; 9Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USACorrespondence: Malik Y Kahook, Department of Ophthalmology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA, Tel +1 720 848 2501, Email Malik.Kahook@cuanschutz.eduPurpose: To report interim results of the VENICE study, a multi-center, randomized, controlled trial (RCT) comparing STREAMLINE Surgical System (STREAMLINE) canaloplasty with iStent inject W (iStent W) implantation in patients with mild-to-moderate primary open-angle glaucoma (POAG) undergoing phacoemulsification.Patients and Methods: Safety and efficacy analyses involving the first 72 randomized eyes are included in this report. Following pre- (Screening) and post-medication washout (Eligibility) visits, one eye per subject was randomized 1:1 to STREAMLINE or iStent W after undergoing uncomplicated phacoemulsification. Subjects were evaluated postoperatively at Day 1, Week 1, Month 1, 3, and 6. Intraocular pressure (IOP) measurements, number of IOP-lowering medications, and adverse events (AEs) were assessed at each follow-up visit.Results: Seventy-two eyes were randomized; 35 underwent STREAMLINE canaloplasty and 37 were implanted with the iStent W. Seventy eyes completed their 6-month follow-up. Both the mean morning post-washout Baseline IOP between STREAMLINE 24.86± 3.05 mmHg and iStent W 25.16± 3.41 mmHg and the mean IOP at 6 months between STREAMLINE eyes 16.52± 3.63 mmHg and iStent W eyes 16.08± 3.19 mmHg were not statistically significantly different (p=0.691 and 0.596, respectively). At 6 months, more eyes were on zero glaucoma medications in the STREAMLINE group (81.8%) compared to the iStent W group (78.4%). In medication-free eyes, the mean IOP was reduced from 24.80± 2.79 mmHg to 16.00± 3.40 mmHg and 24.60± 3.18 mmHg to 15.80± 2.21 mmHg in the STREAMLINE and iStent W groups, respectively (p=0.752). Both groups showed reduction in IOP-lowering medications at every visit, compared to pre-washout (Screening), with STREAMLINE resulting in numerically fewer medications 0.20± 0.48 compared to iStent W 0.40± 0.79 at 6 months (P=0.384). AEs were mild and self-limited.Conclusion: To our knowledge, the VENICE trial is the first RCT involving canaloplasty. These interim findings demonstrated comparable IOP and medication reduction between STREAMLINE canaloplasty and iStent W implantation, when combined with phacoemulsification.Keywords: primary open-angle glaucoma, POAG, STREAMLINE, iStent inject W, canaloplasty, microinvasive glaucoma surgery, MIGS

Sahar Bedrood,1 John Berdahl,2 Arsham Sheybani,3,4 Inder Paul Singh5 1Advanced Vision Care, Los Angeles, CA, USA; 2Vance Thompson Vision, Sioux Falls, SD, USA; 3John A. Moran Eye Center, University of Utah, Salt Lake City, UT, USA; 4Department of Ophthalmology and Visual Sciences, Washington University in St. Louis School of Medicine, St. Louis, MO, USA; 5Eye Centers of Racine and Kenosha, Kenosha, WI, USACorrespondence: Sahar Bedrood, Advanced Vision Care, 2080 Century Park East Suite 911, Los Angeles, CA, 90067, USA, Tel +1 (310) 229-1220, Email saharbedrood@gmail.comAbstract: Topical glaucoma medications have favorable safety and efficacy, but their use is limited by factors such as side effects, nonadherence, costs, ocular surface disease, intraocular pressure fluctuations, diminished quality of life, and the inherent difficulty of penetrating the corneal surface. Although traditionally these limitations have been accepted as an inevitable part of glaucoma treatment, a rapidly-evolving arena of minimally invasive surgical and laser interventions has initiated the beginnings of a reevaluation of the glaucoma treatment paradigm. This reevaluation encompasses an overall shift away from the reactive, topical-medication-first default and a shift toward earlier intervention with laser or surgical therapies such as selective laser trabeculoplasty, sustained-release drug delivery, and micro-invasive glaucoma surgery. Aside from favorable safety, these interventions may have clinically important attributes such as consistent IOP control, cost-effectiveness, independence from patient adherence, prevention of disease progression, and improved quality of life.Keywords: intervention, treatment, sustained release drug delivery, MIGS, medication, selective laser trabeculoplasty

Jason Bacharach,1 Cathleen McCabe,2 Mitchell Jackson,3 Sanjay Rao,4 I Paul Singh,5 Sebastian Heersink,6 Nathan Radcliffe,7 Robert Weinstock,8 Dario Paggiarino,9 Keyur Patel9 1North Bay Eye Associates Petaluma, Petaluma, CA, USA; 2The Eye Associates, Bradenton, FL, USA; 3Jacksoneye Ophthalmology, Lake Villa, IL, USA; 4DeKalb Eye Consultants - Hauser-Ross Eye Institute, Sycamore, IL, USA; 5The Eye Centers of Racine & Kenosha, Racine, WI, USA; 6Eye Center South, Dothan, AL, USA; 7New York Eye Surgery Center, Bronx, NY, USA; 8The Eye Institute of West Florida, Largo, FL, USA; 9EyePoint Pharmaceuticals, Watertown, MA, USACorrespondence: Jason Bacharach, North Bay Eye Associates, 104 Lynch Creek Way, Suite 15, Petaluma, CA, 94954, USA, Email jbacharach@northbayeye.comPurpose: To evaluate dexamethasone intraocular suspension 9% (intraocular DXM) in real-world clinical use to manage inflammation associated with cataract surgery.Setting: Patients who underwent cataract surgery and received intraocular DXM at 22 outpatient eye surgery centers in the US.Design: Retrospective, observational chart review.Methods: Records of all patients who received intraocular DXM from March to December 2019 at participating centers were reviewed.Main Outcome Measures: Outcomes included anterior chamber cell (ACC) grades, anterior chamber flare (ACF) grades, and visual acuity, as well as intraocular pressure (IOP) and adverse events (AEs) at postoperative days (PODs) 1, 8, 14, 30. Descriptive statistics were generated.Results: The study population included 527 patients (641 eyes), with glaucoma history in 66 patients (80 eyes). Among eyes with recorded ACC grades, the percentage with grade 0 increased from 40% at POD 1 to 89.7% at POD 30, with similar results in eyes with glaucoma history. Among eyes with recorded ACF grades, the percentage with grade 0 increased from 78.4% at POD 1 to 97.1% at POD 30. At POD 30, 96.6% eyes with recorded results achieved target acuity. Mean IOP was 18.6 mmHg at POD 1 but declined to ≤ 15.2 mmHg thereafter. Investigators reported 22 AEs in 20 patients, all reported mild or moderate, the most common: IOP increase (7 events).Conclusion: Patients undergoing cataract surgery and treated with intraocular DXM showed favorable inflammatory and visual outcomes, without unanticipated safety problems, consistent with results of previous controlled clinical trials.Keywords: cataract surgery, corticosteroids, dexamethasone, inflammation, intraocular suspension, ocular drug delivery systems

Mark J Gallardo,1 Mark F Pyfer,2 Steven D Vold,3 Steven R Sarkisian Jr,4 Anita Campbell,5 Inder Paul Singh,6 Brian Flowers,7 Kavita Dhamdhere8 On behalf of the GEMINI study group1El Paso Eye Surgeons, PA, El Paso, TX, USA; 2Northern Ophthalmic Associates, Jenkintown, PA, USA; 3Vold Vision, Fayetteville, AR, USA; 4Oklahoma Eye Surgeons, PLLC, Oklahoma City, OK, USA; 5Grene Vision Group, Wichita, KS, USA; 6Eye Centers of Racine & Kenosha, Racine, WI, USA; 7Ophthalmology Associates, Fort Worth, TX, USA; 8Clinical Development, Sight Sciences, Menlo Park, CA, USACorrespondence: Kavita Dhamdhere, Email kdhamdhere@sightsciences.comPurpose: To report 12-month efficacy outcomes of 360° canaloplasty and 180° trabeculotomy using the OMNI surgical system in combination with phacoemulsification in patients with mild-moderate open-angle glaucoma (OAG) and visually significant cataract.Setting: Fifteen multi-subspecialty ophthalmology practices and surgery centers located in 14 US states.Design: Prospective, multicenter, IRB approved study of patients treated with canaloplasty (360°) and trabeculotomy (180°). Eligible patients had cataract and mild-moderate OAG with intraocular pressure (IOP) ≤ 33 mmHg on 1 to 4 hypotensive medications. Unmedicated post-washout mean diurnal IOP (DIOP) ≥ 21 and ≤ 36 mmHg.Methods: Medication washout preoperatively and prior to month 12 DIOP. Effectiveness outcomes were IOP and IOP lowering medication use. Safety outcomes included adverse events and secondary surgical interventions (SSIs). Evaluations at 1, 3, 6, and 12 months.Results: A total of 149 subjects underwent surgery and 120 were included in the final effectiveness analysis. Mean (standard deviation) unmedicated diurnal IOP was reduced from 23.8 (3.1) mmHg at baseline to 15.6 (4.0) at month 12 (− 35%) and medications (before washout) were reduced from 1.8 (0.9) at baseline to 0.4 (0.9) at month 12 (− 80%). At month 12, 84.2% of eyes achieved IOP reductions > 20% from baseline, 80% of eyes were medication-free, and 76% of eyes achieved IOP between 6– 18 mmHg inclusive. Adverse events were uncommon. Most were mild and self-limited including transient hyphema (9 of 149; 6%) and transient IOP elevations (3 of 149; 2.0%). No eyes required SSIs or experienced loss of VA that was attributable to the device or procedure.Conclusion: Canaloplasty and trabeculotomy performed with the OMNI surgical system at the time of phacoemulsification significantly reduces unmedicated mean diurnal IOP and medication use 12 months postoperatively, with an excellent safety profile. This procedure should be considered for eyes with mild-moderate OAG to reduce IOP, medication burden, or both.Keywords: viscodilation, MIGS, open-angle glaucoma, glaucoma surgery, canaloplasty, trabeculotomy, OMNI

Inder Paul Singh,1 Steven Sarkisian Jnr,2 Dana Hornbeak,3 L Jay Katz,3,4 Thomas Samuelson5 for the iStent inject Study Group1The Eyes Centers of Racine & Kenosha, Racine, WI, USA; 2Oklahoma Eye Surgeons, Oklahoma City, OK, USA; 3Glaukos Corporation, San Clemente, CA, USA; 4Wills Eye Hospital, Philadelphia, PA, USA; 5Minnesota Eye Consultants, Minneapolis, MN, USACorrespondence: Inder Paul SinghThe Eye Center of Racine, 3805 B Spring Street, Suite 140, Racine, WI, 53405, USA Tel +1 262 637 0500Fax +1 262 637 7650Email inderspeak@gmail.comPurpose: To examine effectiveness outcomes stratified by preoperative disease burden in the pivotal trial of iStent inject® with cataract surgery (INJ) vs cataract surgery alone (CS).Materials and Methods: Prospective, 3:1 randomized, single-masked, concurrently-controlled, multicenter trial enrolling 505 subjects with cataract and mild-to-moderate primary open-angle glaucoma who underwent iStent inject implantation with phacoemulsification or phacoemulsification alone, and were followed for 2 years including annual medication washouts. Post hoc stratification was completed for baseline mean diurnal intraocular pressure (BL DIOP; Low-DIOP < 25mmHg, Mid-DIOP ≥ 25 to < 30 mmHg, High-DIOP ≥ 30mmHg) and preoperative medication burden (Low-Med 1 medication, Mid-Med 2 medications, High-Med ≥ 3 medications).Results: The 24-month primary and secondary effectiveness endpoints were met, with significant treatment-over-control differences in percent of eyes achieving ≥ 20% unmedicated DIOP reduction and in unmedicated DIOP reduction, respectively. In subgroup analyses, the proportions of INJ eyes achieving the primary endpoint remained steady across all BL DIOP (75.4%, 77.1%, 74.4% in Low/Mid/High-DIOP strata, respectively) and preoperative medication levels (76.8%, 70.8%, 79.7% in Low/Mid/High-Med strata, respectively); meanwhile, the proportions of CS eyes diminished with higher BL DIOP (64.5%, 63.6%, 33.3%, respectively) and more medications (69.0%, 63.3%, 29.4%, respectively). Regarding secondary effectiveness, postoperative DIOP reduction increased with higher BL DIOP in INJ eyes (6.2mmHg, 7.8mmHg, 9.8mmHg, respectively) but plateaued in CS eyes (5.2mmHg, 5.8mmHg, 5.4mmHg, respectively). INJ eyes also had consistent DIOP reduction regardless of preoperative medication burden (6.8mmHg, 6.7mmHg, 7.8mmHg, respectively), while DIOP reduction diminished with more medications in CS eyes (6.1mmHg, 5.0mmHg, 3.3mmHg, respectively). Safety was favorable, comparable to phacoemulsification alone.Conclusion: Significant IOP reductions occurred across all levels of BL DIOP and preoperative medication burden in iStent inject eyes. DIOP reductions increased with higher BL DIOP and remained stable across all levels of preoperative medication burden, suggesting the device’s potential utility in more medically challenging cases.Keywords: microinvasive glaucoma surgery/MIGS, glaucoma, iStent inject, trabecular micro-bypass, IOP, stratification, severity

Mark J Gallardo,1 Steven R Sarkisian Jr,2 Steven D Vold,3 Inder Paul Singh,4 Brian E Flowers,5 Anita Campbell,6 Kavita Dhamdhere,7 Thomas W Samuelson8 On behalf of the GEMINI study group1El Paso Eye Surgeons, PA, El Paso, TX, USA; 2Oklahoma Eye Surgeons, PLLC, Oklahoma City, OK, USA; 3Vold Vision, Fayetteville, AR, USA; 4Eye Centers of Racine & Kenosha, Racine, WI, USA; 5Ophthalmology Associates, Fort Worth, TX, USA; 6Grene Vision Group, Wichita, KS, USA; 7Sight Sciences, Menlo Park, CA, USA; 8Minnesota Eye Consultants, Minneapolis, MN, USACorrespondence: Kavita Dhamdhere Email kdhamdhere@sightsciences.comPurpose: To report interim 6-month safety and efficacy outcomes of 360° canaloplasty and 180° trabeculotomy using the OMNI® Surgical System concomitantly with phacoemulsification in patients with open-angle glaucoma (OAG).Setting: Fifteen multi-subspecialty ophthalmology practices and surgery centers located in 14 states (Alabama, Arizona, Arkansas, Florida, Georgia, Iowa, Kansas, Montana, Nebraska, North Dakota, Oklahoma, Pennsylvania, Texas, and Wisconsin).Design: Prospective, multicenter, IRB approved study of patients treated with canaloplasty (360°) and trabeculotomy (180°). Eligible patients had cataract and mild-moderate OAG with intraocular pressure (IOP) ≤ 33 mmHg on 1 to 4 hypotensive medications.Methods: Medication washout prior to baseline diurnal IOP (Goldmann). Effectiveness outcomes included mean IOP and medications. Safety outcomes included adverse events (AE), best corrected visual acuity (BCVA) and secondary surgical interventions (SSI). Analysis includes descriptive statistics and t-tests evaluating change from baseline.Results: A total of 137 patients were enrolled and treated. Mean diurnal IOP after washout was 23.8 ± 3.1 mmHg at baseline. At month 6, 78% (104/134) were medication free with IOP of 14.2 mmHg, a mean reduction of 9.0 mmHg (38%). 100% (104/104) had a ≥ 20% reduction in IOP and 86% (89/104) had IOP ≥ 6 and ≤ 18 mmHg. The mean number of medications at screening was 1.8 ± 0.9 and 0.6 ± 1.0 at month 6. AE included transient hyphema (4.6%) and IOP elevation ≥ 10 mmHg (2%). There were no AE for loss of BCVA or recurring hyphema. There were no SSI.Conclusion: Canaloplasty followed with trabeculotomy and performed concomitantly with phacoemulsification has favorable intra and perioperative safety, significantly reduces IOP and anti-glaucoma medications through 6 months in eyes with mild-moderate OAG.Keywords: viscodilation, MIGS, open-angle glaucoma, glaucoma surgery, canaloplasty, trabeculotomy, OMNI

JD Sheppard,1 IP Singh21Department of Ophthalmology, Eastern Virginia Medical School, Norfolk, VA, USA; 2Department of Glaucoma, The Eye Centers of Racine & Kenosha, Racine, WI, USAPurpose: With the increasing use of minimally invasive surgical techniques for intraocular pressure (IOP) lowering in glaucoma patients, there is a need to examine best practices regarding the postoperative management of these patients. Corticosteroids, though effective in controlling postoperative ocular pain and inflammation, present distinct challenges in glaucoma surgery patients, as their use can be associated with IOP elevation. Loteprednol etabonate (LE) is an ocular corticosteroid designed to have an improved safety profile relative to other corticosteroids.Methods: We report here a representative selection of cases in which patients were successfully treated with LE ophthalmic gel 0.5% (LE gel) following a variety of minimally invasive glaucoma surgery (MIGS) procedures. Cases included patients undergoing various procedures including a Trabectome combined with cataract surgery; micro-stent surgery (iStent) combined with cataract surgery; supraciliary CyPass Micro-Stent placement combined with cataract surgery; Kahook Dual Blade goniotomy; and ab interno canaloplasty using the iTrack catheter.Observations: In all cases, use of LE gel during the postoperative period appeared effective and safe in reducing inflammation and controlling pain. No adverse events or IOP elevations were noted, even in those patients continuing use of LE gel past the postoperative period for longer than six months with documented follow-up. In two cases, patients with elevated IOP using either prednisolone or difluprednate postoperatively were switched to LE gel, with a subsequent reduction in IOP.Conclusions: This selection of cases involving patients undergoing MIGS suggests that LE gel may be an effective and safe option for treating postoperative inflammation and pain following such procedures with minimal to no effect on IOP or other negative sequalae.Keywords: loteprednol etabonate, minimally invasive glaucoma surgery, intraocular pressure, postoperative pain and inflammation, safety

Syril K Dorairaj,1 Malik Y Kahook,2 Blake K Williamson,3 Leonard K Seibold,4 Mohammed K ElMallah,5 Inder P Singh6 On behalf of the KDB Goniotomy Study Group 1Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, 2School of Medicine, University of Colorado, Denver, CO, 3Williamson Eye Center, Baton Rouge, LA, 4School of Medicine, University of Colorado, Aurora, CO, 5Ocala Eye, Ocala, FL, 6The Eye Center of Racine and Kenosha, Kenosha, WI, USA Purpose: The aim of this study was to compare intraocular pressure (IOP) outcomes in eyes with cataract and glaucoma undergoing phacoemulsification (phaco) in combination with goniotomy using the Kahook Dual Blade (KDB) or implantation of a single iStent trabecular bypass device.Methods: Retrospective analysis of IOP and IOP-lowering medication reduction in eyes undergoing phaco-goniotomy with KDB (n=237) or phaco-iStent (n=198). Preoperative, intraoperative, and postoperative data were collected through 6 months of follow-up. Outcome measures included mean IOP reduction, mean reduction in IOP-lowering medications, and the proportion of eyes achieving ≥20% IOP reduction or ≥1 medication reduction from baseline.Results: Mean IOP in the phaco-goniotomy with KDB group decreased from 17.9±4.4 mmHg at baseline to 13.6±2.7 mmHg at Month 6 (P

ABSTRACT: The incidence, pattern and clinical types of cutaneous tuberculosis, along with responses to treatment, observed amongst our total dermatology outpatients over the past three years are projected in this study.

Ulcerative colitis is a chronic, refractory disease caused by dysregulation of mucosal immune responses to the indigenous bacterial flora as well as genetic and environmental variables. Recently, there has been increasing interest towards the use of herbal medicines for the treatment of ulcerative colitis and the potential benefits could lie in their high patient acceptability, effectiveness, safety, and relatively low cost. It has been reported that Chebulic myrobalan (Terminalia chebula) exhibits anti-oxidant, anti-inflammatory and immunomodulatory properties. The present study was designed to evaluate the protective potential of extract of dried fruit pulp of T. chebula against Dextran sulphate sodium (DSS)-induced ulcerative colitis in male BALB/c mice. Three cycles of DSS (3 % w/v in drinking water), each followed by a seven-day remission phase were used to induce ulcerative colitis in mice. Animals were treated with T. chebula (300 mg/kg and 600 mg/kg) starting from I st remission period to the end of the study. Different biochemical assays, histological evaluation and molecular analysis were performed to evaluate the protective effects of T. chebula extract in DSS induced colitis. T. chebula modulates the expression of nuclear factor kappa B, adenosine monophosphate kinase, tumour necrosis factor-alpha, sirtuin 1 and interleukin-1β. Furthermore, it also accorded coloprotective effects against DNA damage, apoptosis, inflammation and nitrosative stress. Finally, it was found that the high dose of the T. chebula extract (600 mg/kg) was found to be more effective than a low dose (300 mg/kg) in restoring the ulcerative colitis induced colonic damage., Competing Interests: Declaration of Competing Interest Authors of the present investigation declared no competing interests., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Aim: The purpose of this study was to conduct and interpret a pooled 12-month analysis of two prospective, multi-center, randomized, double-masked, controlled trials designed to assess the efficacy and safety of the travoprost intracameral implant (slow-eluting [SE] implant in development as a new therapeutic and fast-eluting [FE] implant included for masking purposes) in subjects with open-angle glaucoma (OAG) or ocular hypertension (OHT)., Methods: Subjects with OAG or OHT, on 0-3 intraocular pressure (IOP)-lowering medications, baseline unmedicated mean diurnal IOP of ≥ 21 mmHg, and IOP ≤ 36 mmHg at each baseline diurnal timepoint, received either a travoprost implant and twice-daily (BID) placebo eye drops or BID timolol 0.5% eye drops and a sham procedure. Subjects were followed through 12 months and assessed for IOP, reduction in topical IOP-lowering medications, and safety parameters including treatment-emergent adverse events (TEAEs). IOP at 8AM was prospectively collected at all study visits through 12 months and diurnal IOP, measured at 8AM, 10AM, and 4PM, was prospectively collected at baseline, day 10, week 6, and months 3 and 12., Results: A total of 1150 subjects were randomized (385 FE implant, 380 SE implant, and 385 sham/timolol) across the two trials. Statistical non-inferiority to timolol and clinically relevant reductions in 8AM IOPs were demonstrated at month 12. In more detail, both implant groups demonstrated statistical non-inferiority to timolol and clinically relevant reductions from baseline in mean diurnal IOP at all visits over the 12-month evaluation period when diurnal IOP was collected. Additionally, both implant groups demonstrated robust treatment effect based on 8AM average IOP from day 10 through the specified visit which ranged from day 10 to month 12 from 6.9 to 8.5 mmHg in the FE implant group; 6.8 to 8.5 mmHg in the SE implant group; and 7.3 to 7.5 mmHg in the sham/timolol group. With regards to reduction in topical pharmacotherapy, at month 12, 77.6% of FE and 81.4% of SE implant eyes were completely free of all topical IOP-lowering medications and a significantly greater proportion of FE and SE implant eyes (89.9% and 93.0%) versus sham/timolol eyes (66.9%) were on the same or fewer topical IOP-lowering medications compared with pre-study (p <  0.0001). Furthermore, of subjects on topical IOP medications at screening, a significantly greater proportion of FE implant (80.2%) and SE implant (85.1%) eyes versus sham/timolol (22.8%) eyes were on fewer topical IOP-lowering medications at month 12 compared with pre-study (p <  0.0001). Lastly, of SE implant eyes on same or fewer topical IOP-lowering medications at month 12, the average through month 12 decreased by 0.9 medications, and of those SE implant eyes on fewer topical IOP-lowering medications compared with pre-study, the average through month 12 decreased by 1.4 medications. The most common TEAEs related to study treatment were hyperemia (conjunctival or ocular), iritis, and IOP increased., Conclusion: The travoprost intracameral implant demonstrated robust IOP-lowering efficacy that was sustained and statistically non-inferior to timolol over the entire 12 months, resulting in a significant reduction in topical IOP-lowering medication use, with the majority of SE implant eyes remaining completely free of all topical IOP-lowering medications. In addition, the implant demonstrated a favorable safety and tolerability profile based on this pooled 12-month analysis of two pivotal trials., Trial Registration: ClinicalTrials.gov identifiers NCT03519386 (registered May 09, 2018) and NCT03868124 (registered March 08, 2019)., (© 2024. The Author(s).)

Introduction: Cancer is a prominent cause of death globally, triggered by both non-genetic and genetic alterations in genes influenced by various environmental factors. The tetrahydroisoquinoline (THIQ), specifically 1,2,3,4-tetrahydroisoquinoline serves as fundamental element in various alkaloids, prevalent in proximity to quinoline and indole alkaloids., Area Covered: In this review, the therapeutic applications of THIQ derivatives as an anticancer agent from 2016 to 2024 have been examined. The patents were gathered through comprehensive searches of the Espacenet, Google patent, WIPO, and Sci Finder databases. The therapeutic areas encompassed in the patents include numerous targets of cancer., Expert Opinion: THIQ analogues play a crucial role in medicinal chemistry, with many being integral to pharmacological processes and clinical trials. Numerous THIQ compounds have been synthesized for therapeutic purposes, notably in cancer treatment. They show great promise for developing anticancer drugs, demonstrating strong affinity and efficacy against various cancer targets. The creation of multi-target ligands is a compelling avenue for THIQ-based anticancer drug discovery.

Rheumatoid arthritis is an autoimmune disease mainly affecting the joints categorized by inflammation, swelling of the synovium and decrease in the joint movement. Bakuchiol, a meroterpene class of natural product present in Psoralea corylifolia known to possess anti-inflammatory effects by a variety of mechanisms. However, its effects in rheumatoid arthritis still remain unclear. In the present investigation, we studied the anti-arthritic effects of bakuchiol via in silico and in vivo experiments. It also showed antioxidant effects measured using DPPH assay where it showed free radical scavenging activity with IC 50 value 468.26 μg/ml. Molecular Docking studies carried out on COX-1 (PDB ID: 3 N8Z), COX-2 (PDB ID: 4PH9) and TNF-α (PDB ID: 7JRA), proteins involved in inflammation in arthritis. Bakuchiol showed the maximum binding affinity for TNF-α with binding affinity score is -7.29 kcal/moland less affinity was observed for COX-1 and 2. In vivo antiarthritic effects were studied in arthritic female wistar rats model prepared by intradermal injection of freund's complete adjuvant. Bakuchiol was administered orally at dose of 10,20 and 40 mg/kg for 21 days. Our treatment showed that bakuchiol at 20 and 40 mg/kg exhibited significant anti-inflammatory effects (p<0.001) showed by significant decrease in paw volume, paw diameter, spleen and thymus weight and increase in pain threshold and body weight in arthritic rat model. A significant decrease in hematological parameters such as total leukocyte count (TLC), platelet count, CRP and rheumatoid arthritis factor (RF) and increase in red blood cells count, ESR and hemoglobin further demonstrated that bakuchiol treatment suppresses the progression of adjuvant induced arthritis (AIA) in arthritic rat model. Histological analysis further revealed that bakuchiol ameliorates the pathological manifestations of AIA and reverse the abnormality induced by AIA in rats shown by protection against bone necrosis involved with low influx of inflammatory cells. Therefore, in silico and in vivo results revealed that bakuchiol has the potential to be developed as potent antiarthritic agent., (© 2024 Wiley-VHCA AG, Zurich, Switzerland.)

Murraya koenigii leaves are widely used as a spice and also have several biological activities. The major active constituents are carbazole alkaloids. Quantitation by HPLC or HPTLC requires pure marker compounds, whereas nuclear magnetic resonance spectroscopy can be used as a quantitative technique without the requirement of a pure marker compound. An alkaloid-rich fraction was prepared from the leaves and a validated qNMR method was developed for the quantitation of nine carbazole alkaloids, namely mahanimbine, girinimbine, koenimbine, koenine, kurrayam, mukonicine, isomahanimbine, euchristine B and bismahanine. One of the major compounds, koenimbine, was isolated and quantified by HPTLC to compare the results. The results obtained by qNMR were compared with the reported yields of these compounds.

Purpose: To evaluate the performance and safety of minimally invasive glaucoma surgery with a supraciliary drainage device (MINIject; iSTAR Medical, Wavre, Belgium) in primary open-angle glaucoma (POAG) as a stand-alone procedure., Design: Meta-analysis., Methods: At 11 sites in Colombia, France, Germany, India, Panama, and Spain, 82 patients were treated in 3 prospective, multicenter, interventional, nonrandomized trials (STAR-I, II, III). Data were pooled in a meta-analysis of up to 2 years of follow-up postimplantation. The main outcome measures were mean relative and absolute reduction in diurnal intraocular pressure (IOP) compared to baseline. Secondary outcomes included patients with IOP ≤18 mmHg, patients with IOP reduction ≥20%, number of IOP-lowering medications, adverse events, and endothelial cell density loss., Results: At the 2-year follow-up (n = 66), mean IOP was reduced from 23.8 ± 3.3 mmHg at baseline to 14.4 ± 4.5 mmHg (-39.3%; P < 0.0001). An IOP reduction of ≥20% was achieved in 89.4% of patients, with 84.8% having an IOP ≤18 mmHg. IOP-lowering medications were reduced from a mean of 2.4 ± 1.1 to 1.4 ± 1.4 (P < 0.0001), with 37.9% of patients being medication-free at 2 years. Mean endothelial cell density loss at 2 years was 6.2 ± 9.1% compared to baseline and no patient had a loss >30%., Conclusions: This meta-analysis demonstrates the favorable safety and efficacy profile of a supraciliary device implanted in a stand-alone, ab-interno procedure in patients with mild-to-moderate POAG. The data demonstrate that MINIject is a safe and effective, bleb-free treatment option for patients requiring low target IOP up to 2 years., (Copyright © 2023 The Authors. Published by Elsevier Inc. All rights reserved.)

A new HPLC-PDA method was developed and validated for simultaneous determination of five phenolic compounds ( trans- and cis - isomers of tiliroside, quercetin-3- O -β-D-glucoside, ellagic acid, kaempferol-3- O -β-D-glucoside and isorhamnetin-3- O -glucoside) in the leaves of Hippophae salicifolia D. Don. Of the five compounds, three (tiliroside, quercetin-3- O -β-D-glucoside and ellagic acid) were isolated and characterised by spectroscopy techniques. The developed HPLC method provided a selective, sensitive and rapid analysis with good linearity ( r 2 > 0.999), accuracy and precision. Also, the leaves of H. salicifolia were extracted by three different extraction techniques viz. reflux, microwave and ultrasound. Methanolic extracts prepared by reflux method showed the highest content of all the five compounds.

Objective: The objective of this study was to evaluate the efficacy and safety of topical nanoemulsion (NE)-loaded cream and gel formulations of Hippophae rhamnoides L. (sea buckthorn [SBT]) fruit oil for wound healing., Materials and Methods: The NE-loaded cream and gel formulations of H. rhamnoides L. (SBT) fruit oil (IPHRFH) were prepared and evaluated for their wound-healing activity on female Sprague-Dawley (SD) rats. They were further divided into groups (seven) and the wound-healing activity was determined by measuring the area of the wound on the wounding day and on the 0th, 4th, 8th, and 10th days. The acute dermal toxicity of the formulations was assessed by observing the erythema, edema, and body weight (BW) of the rats., Results: The topical NE cream and gel formulations of H. rhamnoides L. (SBT) fruit oil showed significant wound-healing activity in female SD rats. The cream formulation of IPHRFH showed 78.96%, the gel showed 72.59% wound contraction on the 8th day, whereas the positive control soframycin (1% w/w framycetin) had 62.29% wound contraction on the 8th day. The formulations also showed a good acute dermal toxicity profile with no changes significantly affecting BW and dermal alterations., Conclusions: The results of this study indicate that topical NE-loaded cream and gel formulation of H. rhamnoides L. (SBT) fruit oil are safe and effective for wound healing. The formulations showed no signs of acute dermal toxicity in female SD rats., (Copyright © 2024 Copyright: © 2024 Indian Journal of Pharmacology.)