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Retinitis pigmentosa (RP), a heterogenous group of inherited retinal disorder, causes slow progressive vision loss with no effective treatments available. Mutations in the rhodopsin gene (RHO) account for ~25% cases of autosomal dominant RP (adRP). In this study, we describe the disease characteristics of the first-ever reported mono-allelic copy number variation (CNV) in RHO as a novel cause of adRP. We (a) show advanced retinal degeneration in a male patient (68 years of age) harboring four transcriptionally active intact copies of rhodopsin, (b) recapitulated the clinical phenotypes using retinal organoids, and (c) assessed the utilization of a small molecule, Photoregulin3 (PR3), as a clinically viable strategy to target and modify disease progression in RP patients associated with RHO-CNV. Patient retinal organoids showed photoreceptors dysgenesis, with rod photoreceptors displaying stunted outer segments with occasional elongated cilia-like projections (microscopy); increased RHO mRNA expression (quantitative real-time PCR [qRT-PCR] and bulk RNA sequencing); and elevated levels and mislocalization of rhodopsin protein (RHO) within the cell body of rod photoreceptors (western blotting and immunohistochemistry) over the extended (300 days) culture time period when compared against control organoids. Lastly, we utilized PR3 to target NR2E3, an upstream regulator of RHO, to alter RHO expression and observed a partial rescue of RHO protein localization from the cell body to the inner/outer segments of rod photoreceptors in patient organoids. These results provide a proof-of-principle for personalized medicine and suggest that RHO expression requires precise control. Taken together, this study supports the clinical data indicating that RHO-CNV associated adRPdevelops as a result of protein overexpression, thereby overloading the photoreceptor post-translational modification machinery.

Purpose: Rhino-orbital-cerebral mucormycosis (ROCM) is the most common presentation of mucormycosis. Sinonasal–orbital debridement with exenteration is a life-saving procedure in ROCM patients in view of severe involvement of sinuses and the eyeball. Following the second wave of coronavirus disease 2019 (COVID-19), there was a massive surge in mucormycosis cases in India in post-COVID-19 patients. Of over 300 cases of mucormycosis admitted in our hospital, many underwent exenteration and these specimens were evaluated histopathologically, where fat necrosis was found to be a prominent finding. The spectrum of fat necrosis in ROCM in orbital fat has not been described in literature. Hence, we sought to evaluate the significance and spectrum of orbital fat necrosis in ROCM. Methods: This 3-month retrospective study included 15 cases of ROCM which underwent exenteration. Clinical data, radiologic details, and histopathologic findings were tabulated. Sections were also subjected to Periodic acid Schiff (PAS) and Gomori’s methenamine silver (GMS) stains for confirming the fungus. Results: All 15 cases showed fat stranding on computed tomography (CT) scan. On histopathologic examination, various tissue reaction patterns observed included acute/chronic inflammatory infiltrate, suppurative granulomas with giant cells, coagulative and fat necrosis, broad aseptate fungal hyphae with or without angioinvasion, and neural invasion. Fungal hyphae were confirmed with PAS and GMS stains. The spectrum of fat necrosis observed in all the cases included 1) acute necrotizing fat necrosis, 2) ghost adipocytes with or without saponification, and 3) crystalline/gouty fat necrosis. Conclusion: Fat necrosis is a significant finding in ROCM, both on CT scan and histopathology. All three patterns of fat necrosis may be observed simultaneously in a case of ROCM.

Purpose: Non-obstructive azoospermia (NOA) represents the persistent absence of sperm in ejaculate without obstruction, stemming from diverse disease processes. This survey explores global practices in NOA diagnosis, comparing them with guidelines and offering expert recommendations. Materials and Methods:Materials and Methods: A 56-item questionnaire survey on NOA diagnosis and management was conducted globally from July to September 2022. This paper focuses on part 1, evaluating NOA diagnosis. Data from 367 participants across 49 coun-tries were analyzed descriptively, with a Delphi process used for expert recommendations. Results:Results: Of 336 eligible responses, most participants were experienced attending physicians (70.93%). To diagnose azoosper-mia definitively, 81.7% requested two semen samples. Commonly ordered hormone tests included serum follicle-stimulating hormone (FSH) (97.0%), total testosterone (92.9%), and luteinizing hormone (86.9%). Genetic testing was requested by 66.6%, with karyotype analysis (86.2%) and Y chromosome microdeletions (88.3%) prevalent. Diagnostic testicular biopsy, distinguishing obstructive azoospermia (OA) from NOA, was not performed by 45.1%, while 34.6% did it selectively. Differ-entiation relied on physical examination (76.1%), serum hormone profiles (69.6%), and semen tests (68.1%). Expectations of finding sperm surgically were higher in men with normal FSH, larger testes, and a history of sperm in ejaculate. Conclusions:Conclusions: This expert survey, encompassing 367 participants from 49 countries, unveils congruence with recommended guidelines in NOA diagnosis. However, noteworthy disparities in practices suggest a need for evidence-based, international consensus guidelines to standardize NOA evaluation, addressing existing gaps in professional recommendations.

Background and Aims: Precise airway management is vital in thoracic surgeries to ensure patient safety and optimal outcomes. Choosing the correct double-lumen tube (DLT) size is challenging, as it typically relies on height, gender and subjective experience. This study investigates using ultrasonography (USG) and computed tomography (CT) to measure cricoid cartilage diameter for objective DLT sizing. Methods: In a randomised study, 120 adult patients undergoing elective thoracic surgery were randomised to three groups: Group A (DLT size determined by USG), Group B (DLT size determined by CT) and Group C (DLT size determined by conventional methods based on height and gender). The primary outcome variable was the appropriateness of DLT size. Secondary outcome variables were the degree of lung collapse and sore throat. Student’s t-test and ꭓ2 test were used to analyse continuous and dichotomous variables, respectively. Results: DLT sizing based on cricoid cartilage diameter improved the accuracy, with inappropriate sizes found in 25% in the conventional group, 5% in the USG group and 2.5% in the CT group (P < 0.05). Lung collapse was better in the USG (excellent in 92.5%) and CT (95%) groups compared to the conventional group (70%) (P < 0.05). Moderate sore throat was higher in the conventional group (37.5%) compared to the USG (5%) and CT groups (7.5%). Conclusion: The study demonstrates that USG- and CT-guided measurements of cricoid cartilage diameter are reliable and effective methods for determining DLT size in thoracic surgery compared to conventional methods.

Abstract What nutrient supply options can ensure maximum productivity and optimize the nutrient uptake of rice–wheat system (R-W system)? an experiment started in the year 1998 (19-year-old) to examine the impact of optimal nutrient supply (NS) strategies to maximize crop productivity and nutritional security in R-W system. To determine the best nutrient management strategies (BNMS), seven different NS methods were tested. These included (organic and mineral fertilizers), as well as combinations such as integrated plant nutrition system (IPNS), IPNS + B (berseem), and IPNS + C (cowpea), with the aim of enhancing the productivity and nutrient absorption of R-W system. Results showed that rice grain yield notably wide-ranging from 1.61 to 5.81 t ha−1 under different NS options and highest rice grain yield (mean of 19 years) was observed at IPNS + C (5.81 t ha−1), which was at par with IPNS (5.79 t ha−1), STCR (soil test crop response) (5.76 t ha−1) and IPNS + B (5.67 t ha−1) followed by 100% recommended dose fertilizer NPK (4.41 t ha−1), which equality with OF (organic farming) (4.04 t ha−1) and lowest was recorded in control plot (1.61 t ha−1). Wheat grain yield varied significantly from 1.43 to 5.86 t ha−1 under different NS options. The highest yield (mean of 19 years) was observed in treatments IPNS + B (5.86 t ha−1), IPNS (5.77 t ha−1), IPNS + C (5.48 t ha−1), and STCR (5.45 t ha−1), followed by OF at 4.49 t ha−1, NPK at 3.76 t ha−1, with the lowest in the control plot at 1.43 t ha−1. Additionally, total phosphorus and sulfur accumulation in rice (grain: 8.41 to 39.09 kg ha−1; straw: 6.02 to 23.54 kg ha−1) varied significantly across nutrient supply treatments. Overall, adoption of IPNS integration with legumes (IPNS + B and IPNS + C), can significantly improve productivity and nutrient accumulation in R-W systems. Incorporating legumes into farming practices is advised for sustained productivity and nutritional benefits.

Background: Schizophrenia is a severe psychiatric condition that affects approximately 24 million people worldwide. The complex pathophysiology of schizophrenia presents various challenges for researchers and doctors. Therefore, it is crucial to curate robust pharmacotherapy for patients with schizophrenia to ease their symptoms. Establishing proper standards for patient care requires an ammunition of research studies done on the disease and its therapy, upon which health-care practitioners can rely for future patient care. Unfortunately, there is a void of adequate research studies done on understanding the prescription patterns of schizophrenia in India, especially in rural areas. To improve patient outcomes, there is a need for increased research on this particular subject. Aim: The aim of this study was to assess the prescription pattern of antipsychotics in patients with schizophrenia at a tertiary care hospital in rural Karnataka. Setting and Design: This is an observational study carried out in MVJ Medical College and Research Hospital, Bengaluru, India. Materials and Methods: The study included a total of 139 inpatients, regardless of their age and sex, who had been diagnosed with schizophrenia. The study was conducted for a period of 6 months, from February 2022 to July 2022. Data collection involved a case record form (CRF) designed for assessing treatment patterns. An investigator was assigned to the Department of Psychiatry, where patients with schizophrenia were discovered and after reviewing their medication chart, necessary data were filled into the CRF. The obtained data were then compiled and assessed. Results: Paranoid schizophrenia was the major subclass (90.0%). The prescription pattern showed that second-generation antipsychotics (SGAs) were prescribed more than first-generation antipsychotics (FGAs), 112 (81.29%) and 41 (29.5%) prescriptions, respectively. In SGAs, tablet olanzapine received the most prescriptions which was 42 (30.22%). Tablet haloperidol was the major FGA to be prescribed receiving 18 prescriptions (12.95%). This study also included the assessment of combination drugs which showed that tablet risperidone + tablet trihexyphenidyl was the most prescribed combination drug 118 (78.43%). Conclusion: Our study showed that our findings aligned with several similar studies and also differed from a few, underscoring the need for further research and individualized treatment approaches to manage this complex psychiatric disorder.