Structural basis of broad SARS-CoV-2 cross-neutralization by affinity-matured public antibodies

Descendants of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant now account for almost all SARS-CoV-2 infections. The Omicron variant and its sublineages have spike glycoproteins that are highly diverged from the pandemic founder and first-generation vaccine strain, resulting in significant evasion from monoclonal antibody therapeutics and vaccines. Understanding how commonly elicited antibodies can broaden to cross-neutralize escape variants is crucial. We isolate IGHV3-53, using "public" monoclonal antibodies (mAbs) from an individual 7 months post infection with the ancestral virus and identify antibodies that exhibit potent and broad cross-neutralization, extending to the BA.1, BA.2, and BA.4/BA.5 sublineages of Omicron. Deep mutational scanning reveals these mAbs' high resistance to viral escape. Structural analysis via cryoelectron microscopy of a representative broadly neutralizing antibody, CAB-A17, in complex with the Omicron BA.1 spike highlights the structural underpinnings of this broad neutralization. By reintroducing somatic hypermutations into a germline-reverted CAB-A17, we delineate the role of affinity maturation in the development of cross-neutralization by a public class of antibodies.

A review on the surface modification of materials for 3D-printed diagnostic devices

Three-dimensional (3D) printing in tissue engineering and biosensing of analytes by using biocompatible materials or modifying surface structures is an upcoming area of study. This review discusses three common surface modification techniques, viz. alkaline hydrolysis, UV light photografting, and plasma treatment. Alkaline hydrolysis involves the reaction of an alkaline solution with the surface of a material, causing the surface to develop carboxyl and hydroxyl groups. This technique can enhance the biocompatibility, surface wettability, adhesion, printability, and dyeability of materials, such as acrylonitrile butadiene styrene (ABS), polycarbonate, and polylactic acid (PLA). This review also mentions details about some of the surface-modified 3D-printed diagnostic devices. Although most of the devices are modified using chemical processes, there are always multiple techniques involved while designing a diagnostic device. We have, therefore, mentioned some of the devices based on the materials used instead of categorising them as per modification techniques. 3D printing helps in the design of sophisticated shapes and structures using multiple materials. They can, therefore be used even in the design of microfluidic devices that are very useful for biosensing. We have also mentioned a few materials for printing microfluidic devices.

Enhanced specific loss power of hematite-chitosan nanohybrid synthesized by hydrothermal method

We used a hydrothermal technique to develop nano-scale α-Fe2O3 particles and functionalized them with chitosan. An X-ray diffraction study revealed α-Fe2O3 nanoparticles were of single-phase, lattice constants were a = 5.07 Å and c = 13.68 Å, and the grain size was 27 nm. The presence of lattice fringes in the HRTEM image confirmed the crystalline nature of the α-Fe2O3. The Mössbauer spectra reveal a mixed relaxation state, which supports the PPMS studies. Zero-field cooled studies revealed the existence of a Morin transition and blocking temperature. The z-average value of the coated particles by DLS was between 218 and 235 nm, PDI ranged from 0.048 to 0.119, and zeta potential was +46.8 mV. We incubated the Vero and HeLa cell lines for 24 h to study the viability of the nanohybrids at different concentrations. Hyperthermia studies revealed the maximum temperature and specific loss power attained by the hematite-chitosan nanohybrid solution of a concentration between 0.25-4 mg ml-1. The Tmax at the lowest and highest concentrations of 0.25 and 4 mg ml-1 were 42.9 and 48.3°C, while the SLP were 501.6 and 35.5 W g-1, which are remarkably high when the maximum magnetization of α-Fe2O3 nanoparticles was as small as 1.98 emu g-1 at 300 K.

Volumetric Analysis of Renal Masses as Predictors of Partial Nephrectomy Outcomes

Objective: To examine the role of endophytic tumor volume (TV) assessment (endophycity) on perioperative partial nephrectomy (PN) outcomes. Patients and Methods: Retrospective review of 212 consecutive laparoscopic and open partial nephrectomies from single institution using preoperative imaging and 1-year follow-up. Demographics, comorbidities, RENAL nephrometry scores, and all peri- and postoperative outcomes were recorded. Volumetric analysis performed using imaging software, independently assessed by two blinded radiologists. Univariate and multivariate statistical analysis were completed to assess predictive value of endophycity for all clinically meaningful outcomes. Results: Among those undergoing minimally invasive surgery (MIS), lower tumor endophycity was associated with higher likelihood of trifecta outcome (negative surgical margin, <10% decline in estimated glomerular filtration rate, the absence of complications) irrespective of max tumor size. For MIS, estimated blood loss increased with greater tumor endophycity regardless of tumor size. Among those who underwent open partial nephrectomy, lower tumor endophycity was associated with trifecta outcomes for tumors >4 cm only. On multivariate analysis with log-scaled odds ratios (OR), tumor endophycity and total kidney volume had the strongest correlation with tumor-related complications (OR = 3.23, 2.66). The analysis identified that tumor endophycity and TV on imaging were inversely correlated with of trifecta outcomes (OR = 0.53 for both covariates). Conclusions: Volumetric assessment of tumor endophycity performed well in identifying PN outcomes. As automated imaging software improves, volumetric analysis may prove to be a useful adjunct in preoperative planning and patient counseling.

Non-coding 7S RNA inhibits transcription via mitochondrial RNA polymerase dimerization

The mitochondrial genome encodes 13 components of the oxidative phosphorylation system, and altered mitochondrial transcription drives various human pathologies. A polyadenylated, non-coding RNA molecule known as 7S RNA is transcribed from a region immediately downstream of the light strand promoter in mammalian cells, and its levels change rapidly in response to physiological conditions. Here, we report that 7S RNA has a regulatory function, as it controls levels of mitochondrial transcription both in vitro and in cultured human cells. Using cryo-EM, we show that POLRMT dimerization is induced by interactions with 7S RNA. The resulting POLRMT dimer interface sequesters domains necessary for promoter recognition and unwinding, thereby preventing transcription initiation. We propose that the non-coding 7S RNA molecule is a component of a negative feedback loop that regulates mitochondrial transcription in mammalian cells.

POS1500-HPR BABS ON A MISSION: AN EXPERIMENTAL STUDY ON THE EFFECTS OF MESSAGE FRAMING AND THE USE OF A PATIENT TESTIMONIAL ON BELIEFS AND INTENTIONS OF OSTEOARTHRITIS PATIENTS

Background

It is important that patients receive appropriate and reliable information that effectively targets beliefs in order for them to adhere to health behaviors. Framing (focusing on either gains or losses; [1]) is one of the most commonly used techniques in health communication to influence beliefs. In addition, the use of a testimonial in educational material might strengthen effects as intentions to adhere to health behaviors seem to rely strongly on testimonies of other patients. However, little is known about the potential of framing and patient testimonies to impact beliefs and change in health behaviors in osteoarthritis (OA).

Objectives

To study the effects of 1) message framing and 2) patient testimonies on beliefs about and intentions to be physically active and use pain medication.

Methods

We conducted an experiment consisting of a 2 (gain-frame vs loss-frame) x 2 (testimonial versus informative message) factorial design. Members of a research panel (n=639) with a self-reported diagnosis of knee OA were invited to participate. Participants were randomized into one of four video messages applying framing and the use of either a testimonial or facts. The messages (mean (SD) words 1073 (129)) were audiotaped by the same female speaker, subtitled, and complemented with images (duration of ~10 minutes). The four different combinations were: informative-loss (“If you are not physically active, this can lead to more pain[…].”), informative-gain (“If you are physically active, this can lead to less pain[…].”), testimonial-loss (“When I wasn’t physically active, I experienced more pain[…].”), testimonial-gain (“When I was physically active, I experienced less pain[…].”). After this video, participants filled out a questionnaire on socio-demographic and disease characteristics, and rated 3 statements concerning beliefs on a 7-point Likert scale (completely disagree – completely agree), and one 7-point Likert scale item on intentions (I do not do this now and am not planning doing this – I am doing this already for more than 6 months) each for both physical activity and pain medication based on the Theory of Planned behavior questionnaire [2]. ANOVA was used to assess the main and interaction effects of framing and the use of a testimonial on mean beliefs and intentions.

Results

A total of 154 respondents completed the questionnaire (Table 1). Framing nor the use of a testimonial impacted beliefs and intentions on physical activity. Loss framing resulted in more positive beliefs about pain medication (mean (SD) 5.5 (1.6)) than gain framing (mean (SD) 4.9 (1.9), p=.04, 95% CI [0.0, 0.1]). Within the loss frame, the patient testimonial scored significantly more positive on pain medication beliefs (mean (SD) 5.0 (1.7)) than the informative message (mean (SD) 6.0 (1.1), p=.02, 95% CI [0.1, 1.6]) (Figure 1).

Table 1.

Characteristics of participants (n=154)

Female, n (%)110 (71)Age (in years), mean (SD)62.3 (7.9)BMI, mean [kg/m2], (SD)27.3 (4.4)Daily functioning (KOOSa; 0-100), mean (SD)64.5 (18.0)Pain VAS (0-10), mean (SD)4.6 (2.2)Symptoms for more than five years, n (%)96 (62.3)Presence of OA in other joints, n (%)85 (55.2)Knee replacement, n (%)32 (20.8)Presence of comorbidities, n (%)111 (72.0)Figure 1.

Interaction of framing and the use of a patient testimonial on beliefs about pain medication

Conclusion

This study showed that stating the disadvantages of nonadherence to pain medication resulted in more positive beliefs about pain medication than stating the advantages of adherence. The use of a patient testimonial within this loss frame strengthened the effect. Our findings indicate that health care providers should be aware of the potential effects of emphasising either gains or losses in educational messages to their patients.

References

[1]Rothman, A.J. and P. Salovey, Shaping perceptions to motivate healthy behavior: the role of message framing. Psychol Bull, 1997. 121(1): p. 3-19.

[2]Ajzen, I., Constructing a Theory of Planned Behavior Questionnaire. 2006. 1-12.

Disclosure of Interests

None declared

A bispecific monomeric nanobody induces spike trimer dimers and neutralizes SARS-CoV-2 in vivo

Antibodies binding to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike have therapeutic promise, but emerging variants show the potential for virus escape. This emphasizes the need for therapeutic molecules with distinct and novel neutralization mechanisms. Here we describe the isolation of a nanobody that interacts simultaneously with two RBDs from different spike trimers of SARS-CoV-2, rapidly inducing the formation of spike trimer-dimers leading to the loss of their ability to attach to the host cell receptor, ACE2. We show that this nanobody potently neutralizes SARS-CoV-2, including the beta and delta variants, and cross-neutralizes SARS-CoV. Furthermore, we demonstrate the therapeutic potential of the nanobody against SARS-CoV-2 and the beta variant in a human ACE2 transgenic mouse model. This naturally elicited bispecific monomeric nanobody establishes an uncommon strategy for potent inactivation of viral antigens and represents a promising antiviral against emerging SARS-CoV-2 variants.

A bispecific monomeric nanobody induces spike trimer dimers and neutralizes SARS-CoV-2 in vivo

Antibodies binding to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike have therapeutic promise, but emerging variants show the potential for virus escape. This emphasizes the need for therapeutic molecules with distinct and novel neutralization mechanisms. Here we describe the isolation of a nanobody that interacts simultaneously with two RBDs from different spike trimers of SARS-CoV-2, rapidly inducing the formation of spike trimer-dimers leading to the loss of their ability to attach to the host cell receptor, ACE2. We show that this nanobody potently neutralizes SARS-CoV-2, including the beta and delta variants, and cross-neutralizes SARS-CoV. Furthermore, we demonstrate the therapeutic potential of the nanobody against SARS-CoV-2 and the beta variant in a human ACE2 transgenic mouse model. This naturally elicited bispecific monomeric nanobody establishes an uncommon strategy for potent inactivation of viral antigens and represents a promising antiviral against emerging SARS-CoV-2 variants.

Comparison of Pterygium Recurrence Rates Between Attending Physicians and Supervised Trainee Residents

PURPOSE

To compare the recurrence rates after pterygium surgery performed by supervised trainee residents and attending physicians.

METHODS

This retrospective study included pterygium surgeries performed by trainee residents and attending physicians in an academic institution in South Texas in the years 2008 to 2019. All residents performed surgeries under direct supervision of an attending physician. Only primary pterygium cases with a minimum postoperative follow-up of 6 months were included. Patients' demographics, primary surgeon, use of conjunctival autograft (CAU) or amniotic membrane graft (AMG), recurrence of pterygium, follow-up length, and complications were recorded.

RESULTS

This study included 240 eyes of 229 patients with a mean age of 55.6 ± 12.3 years (range, 28-91 years). Of these eyes, 100 surgeries were performed by attending physicians (including 87 with CAU and 13 with AMG) and 140 surgeries by trainee residents (including 119 with CAU and 21 with AMG). There were no significant differences between the 2 groups of patients regarding age, sex, and surgical technique (CAU vs. AMG). Patients were followed up for an average of 19.8 ± 15.2 months. No statistically significant differences were found in comparing the rate of pterygium recurrence between attending physicians and residents when using CAU (6.8% vs. 10.0%, respectively; P = 0.42) and AMG (69.2% vs. 47.6%, respectively; P = 0.22). Moreover, there were no significant differences in other postoperative complications between the groups.

CONCLUSIONS

Pterygium recurrence rates were similar between attending physicians and supervised trainee residents. Thus, acceptable outcomes can be expected when pterygium surgery is performed by a supervised ophthalmology resident.

Structure-guided multivalent nanobodies block SARS-CoV-2 infection and suppress mutational escape

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread, with devastating consequences. For passive immunization efforts, nanobodies have size and cost advantages over conventional antibodies. In this study, we generated four neutralizing nanobodies that target the receptor binding domain of the SARS-CoV-2 spike protein. We used x-ray crystallography and cryo-electron microscopy to define two distinct binding epitopes. On the basis of these structures, we engineered multivalent nanobodies with more than 100 times the neutralizing activity of monovalent nanobodies. Biparatopic nanobody fusions suppressed the emergence of escape mutants. Several nanobody constructs neutralized through receptor binding competition, whereas other monovalent and biparatopic nanobodies triggered aberrant activation of the spike fusion machinery. These premature conformational changes in the spike protein forestalled productive fusion and rendered the virions noninfectious.

Interfacial reaction during friction stir assisted scribe welding of immiscible Fe and Mg alloy system

We report on interfacial characteristics and chemistry of bonded Mg-Fe interfaces welded using friction stir assisted scribe technique (FaST). Two pairs of dissimilar joints: (AZ31-DP590) and (Pure Mg-DP590) were studied to shed light on joining mechanisms responsible for bonding of “immiscible” pairs of Mg and Fe. We present first direct experimental evidence of presence of oxide layer, Al segregation by atom probe tomography and nano steel grains close to interface by transmission electron microscopy study.

Selection, biophysical and structural analysis of synthetic nanobodies that effectively neutralize SARS-CoV-2

The coronavirus SARS-CoV-2 is the cause of the ongoing COVID-19 pandemic. Therapeutic neutralizing antibodies constitute a key short-to-medium term approach to tackle COVID-19. However, traditional antibody production is hampered by long development times and costly production. Here, we report the rapid isolation and characterization of nanobodies from a synthetic library, known as sybodies (Sb), that target the receptor-binding domain (RBD) of the SARS-CoV-2 spike protein. Several binders with low nanomolar affinities and efficient neutralization activity were identified of which Sb23 displayed high affinity and neutralized pseudovirus with an IC50 of 0.6 µg/ml. A cryo-EM structure of the spike bound to Sb23 showed that Sb23 binds competitively in the ACE2 binding site. Furthermore, the cryo-EM reconstruction revealed an unusual conformation of the spike where two RBDs are in the 'up' ACE2-binding conformation. The combined approach represents an alternative, fast workflow to select binders with neutralizing activity against newly emerging viruses.

An alpaca nanobody neutralizes SARS-CoV-2 by blocking receptor interaction

SARS-CoV-2 enters host cells through an interaction between the spike glycoprotein and the angiotensin converting enzyme 2 (ACE2) receptor. Directly preventing this interaction presents an attractive possibility for suppressing SARS-CoV-2 replication. Here, we report the isolation and characterization of an alpaca-derived single domain antibody fragment, Ty1, that specifically targets the receptor binding domain (RBD) of the SARS-CoV-2 spike, directly preventing ACE2 engagement. Ty1 binds the RBD with high affinity, occluding ACE2. A cryo-electron microscopy structure of the bound complex at 2.9 Å resolution reveals that Ty1 binds to an epitope on the RBD accessible in both the 'up' and 'down' conformations, sterically hindering RBD-ACE2 binding. While fusion to an Fc domain renders Ty1 extremely potent, Ty1 neutralizes SARS-CoV-2 spike pseudovirus as a 12.8 kDa nanobody, which can be expressed in high quantities in bacteria, presenting opportunities for manufacturing at scale. Ty1 is therefore an excellent candidate as an intervention against COVID-19.

An alpaca nanobody neutralizes SARS-CoV-2 by blocking receptor interaction

SARS-CoV-2 enters host cells through an interaction between the spike glycoprotein and the angiotensin converting enzyme 2 (ACE2) receptor. Directly preventing this interaction presents an attractive possibility for suppressing SARS-CoV-2 replication. Here, we report the isolation and characterization of an alpaca-derived single domain antibody fragment, Ty1, that specifically targets the receptor binding domain (RBD) of the SARS-CoV-2 spike, directly preventing ACE2 engagement. Ty1 binds the RBD with high affinity, occluding ACE2. A cryo-electron microscopy structure of the bound complex at 2.9 Å resolution reveals that Ty1 binds to an epitope on the RBD accessible in both the 'up' and 'down' conformations, sterically hindering RBD-ACE2 binding. While fusion to an Fc domain renders Ty1 extremely potent, Ty1 neutralizes SARS-CoV-2 spike pseudovirus as a 12.8 kDa nanobody, which can be expressed in high quantities in bacteria, presenting opportunities for manufacturing at scale. Ty1 is therefore an excellent candidate as an intervention against COVID-19.

Reducing chromium uptake through application of calcium and sodium in spinach

In peri-urban areas, the use of wastewater for crop production is a common practice due to water scarcity. Moreover, in the recent years, large quantity of wastewater generation and discharge as industrial effluent in water resources is another issue for reduction of water quality. The leather industries are significantly contributing chromium (Cr) in effluent, whereas, other industries may have salt and cationic load in their discharges are mixed up. Therefore, it is mandatory to study the interactive effect of different effluent constituents on crop plants. In this connection, a pot culture experiment was conducted at the ICAR-Indian Institute of Soil Science, Bhopal to compute the effect of application of calcium (Ca) and sodium (Na) ions on Cr uptake by spinach crop in Vertisol of central India. Three levels of Cr (0, 50, 100 mg kg^-1), calcium (0, 2, 4 mM), and sodium (0, 40, 80 mM) were applied in combinations. The spinach variety All Green was used as a test crop and harvested at full maturity. Results showed that application of Ca and Na reduced the Cr uptake in spinach crop. The reduction of Cr uptake was more in the root than shoot. Applied calcium acted as an essential plant nutrient and enhanced the crop biomass. Sole applications of Na adversely affected the crop biomass and Cr uptake in both root and shoot of spinach. In conclusion, application of Ca fertilizers reduced the Cr toxicity in spinach and could be used as a strategy for the safe utilization of tannery industrial effluents for crop production.

Abnormal bone mineral content and density in people with tetrasomy 18p

Tetrasomy 18p is a rare chromosomal abnormality, resulting from an additional iso-chromosome composed of two copies of the short arm. It is characterized by craniofacial abnormalities, neuromuscular dysfunction, and developmental delay. The Chromosome 18 Clinical Research Center has established the largest cohort of individuals with this rare genetic condition. Here, we describe a case series of 21 individuals with tetrasomy 18p who have a previously unreported clinical finding: low bone mineral density. Most individuals met criteria for low bone density despite being relatively young (mean age of 21 years). Clinicians providing care to individuals affected by Tetrasomy 18p should be aware of their increased risk for decreased bone density and pathological fractures.

Acute Life-Threatening Hemorrhage in Neonates With Severe Hemophilia A: A Report of 3 Cases

Hemorrhagic shock is a rare, emergent condition that is often fatal in newborns. In this article, we report cases of 3 neonates presenting with acute, life-threatening hemorrhage who were subsequently diagnosed with severe hemophilia (<1% factor VIII). The first infant was tachycardic, pale, and had a precipitous drop in his hemoglobin secondary to a subgaleal hemorrhage. The second patient sustained a splenic rupture, a sequela that has been reported in only 4 other neonatal cases. The last infant presented with tonic-clonic seizures and respiratory distress. Head imaging demonstrated extracranial and intracranial hemorrhage, complications that can result in 20% mortality. All 3 patients were successfully treated with clotting factor concentrate and blood products. After normalization of factor VIII levels, the newborns did not develop any new hemorrhages and were discharged home within 3 weeks of birth. Pediatric providers should be aware that these signs and symptoms may be potentially lethal complications in neonates with severe factor VIII deficiency.

Reconstitution of the Recombinant RanBP2 SUMO E3 Ligase Complex

One of the few proteins that have SUMO E3 ligase activity is the 358 kDa nucleoporin RanBP2 (Nup358). While small fragments of RanBP2 can stimulate SUMOylation in vitro, the physiologically relevant E3 ligase is a stable multi-subunit complex comprised of RanBP2, SUMOylated RanGAP1, and Ubc9. Here, we provide a detailed protocol to in vitro reconstitute the RanBP2 SUMO E3 ligase complex. With the exception of RanBP2, reconstitution involves untagged full-length proteins. We describe the bacterial expression and purification of all complex components, namely an 86 kDa His-tagged RanBP2 fragment, the SUMO E2-conjugating enzyme Ubc9, RanGAP1, and SUMO1, and we provide a protocol for quantitative SUMOylation of RanGAP1. Finally, we present details for the assembly and final purification of the catalytically active RanBP2/RanGAP1*SUMO1/Ubc9 complex.

The RanBP2/RanGAP1*SUMO1/Ubc9 SUMO E3 ligase is a disassembly machine for Crm1-dependent nuclear export complexes

Continuous cycles of nucleocytoplasmic transport require disassembly of transport receptor/Ran-GTP complexes in the cytoplasm. A basic disassembly mechanism in all eukaryotes depends on soluble RanGAP and RanBP1. In vertebrates, a significant fraction of RanGAP1 stably interacts with the nucleoporin RanBP2 at a binding site that is flanked by FG-repeats and Ran-binding domains, and overlaps with RanBP2's SUMO E3 ligase region. Here, we show that the RanBP2/RanGAP1*SUMO1/Ubc9 complex functions as an autonomous disassembly machine with a preference for the export receptor Crm1. We describe three in vitro reconstituted disassembly intermediates, which show binding of a Crm1 export complex via two FG-repeat patches, cargo-release by RanBP2's Ran-binding domains and retention of free Crm1 at RanBP2 after Ran-GTP hydrolysis. Intriguingly, all intermediates are compatible with SUMO E3 ligase activity, suggesting that the RanBP2/RanGAP1*SUMO1/Ubc9 complex may link Crm1- and SUMO-dependent functions.

Effect of a myosin regulatory light chain mutation K104E on actin-myosin interactions

Familial hypertrophic cardiomyopathy (FHC) is the most common cause of sudden cardiac death in young individuals. Molecular mechanisms underlying this disorder are largely unknown; this study aims at revealing how disruptions in actin-myosin interactions can play a role in this disorder. Cross-bridge (XB) kinetics and the degree of order were examined in contracting myofibrils from the ex vivo left ventricles of transgenic (Tg) mice expressing FHC regulatory light chain (RLC) mutation K104E. Because the degree of order and the kinetics are best studied when an individual XB makes a significant contribution to the overall signal, the number of observed XBs in an ex vivo ventricle was minimized to ∼20. Autofluorescence and photobleaching were minimized by labeling the myosin lever arm with a relatively long-lived red-emitting dye containing a chromophore system encapsulated in a cyclic macromolecule. Mutated XBs were significantly better ordered during steady-state contraction and during rigor, but the mutation had no effect on the degree of order in relaxed myofibrils. The K104E mutation increased the rate of XB binding to thin filaments and the rate of execution of the power stroke. The stopped-flow experiments revealed a significantly faster observed dissociation rate in Tg-K104E vs. Tg-wild-type (WT) myosin and a smaller second-order ATP-binding rate for the K104E compared with WT myosin. Collectively, our data indicate that the mutation-induced changes in the interaction of myosin with actin during the contraction-relaxation cycle may contribute to altered contractility and the development of FHC.

Assessment of chromium efficacy on germination, root elongation, and coleoptile growth of wheat (Triticum aestivum L.) at different growth periods

The tannery effluents contain a high concentration of chromium (Cr). It drastically reduces the crop yield when used for irrigation purpose. A huge volume of tannery effluents is available as irrigation for crop production. It is negatively affecting germination as well as yield of the crop. The wheat seeds were exposed to five different concentrations of Cr (0, 20, 40, 80, and 100 ppm). In Petri plates, 100 seeds were placed and the germination percent was recorded after 72 hour (h). Root elongation and coleoptile growth were measured at 72, 120, 168, and 240 h. Results showed that the germination percent of the test crop decreased with increasing Cr levels. It decreased by 6, 14, 30, and 37 % under the Cr concentration of 20, 40, 80, and 100 ppm, respectively. The root elongation was more sensitive than the coleoptile growth. The negative correlation was found between Cr levels and root elongation as well as coleoptile growth. These growth parameters were significantly affected up to 80 ppm of Cr level. The wheat growers using tannery effluent as irrigation should be well treated prior to application.

Moisture sorption studies on vacuum dried coconut presscake

Moisture sorption isotherms of vacuum dried coconut presscake were determined at 25 °C, 30 °C, and 38 °C using a gravimetric technique. Sorption isotherms exhibited Type II behaviour. The effect of temperature on equilibrium moisture content was not significant (p > 0.05). Three models available in the literature viz., GAB, BET, and Halsey models were fitted to the sorption data. Out of the three tested models, Halsey model best fitted the experimental data with a relative deviation percent below 10%. The net isosteric heat of sorption was determined from the equilibrium adsorption data using the Clausius-Clapeyron equation. Isosteric heats of sorption were found to decrease exponentially with increasing moisture content.

Abstract P2-11-07: Endothelial progenitor cells as novel markers of anthracycline induced cardiac injury

Background: Anthracyclines including doxorubicin (DOX) cause myocardial damage that manifests as either subclinical decrements of left ventricular ejection function (LVEF) or overt cardiomyopathy. LVEF changes and cardiac risk factors are insufficient predictors of future DOX cardiotoxicity. Bone marrow derived endothelial progenitor cells (EPCs) are mobilized and are homed to sites of myocardial injury to help with repair of damaged myocardium. We hypothesized that EPC levels would be indicative of early DOX cardiotoxicity. Hence, we prospectively collected serial blood samples to evaluate functional EPCs, Troponin I (Ti) and B-natriuretic peptide (BNP), in patients (pts) receiving DOX-based chemotherapy.

Methods: Eligible pts were initiating adjuvant DOX for early stage breast cancer. Pts underwent cardiac magnetic resonance (CMR), Ti, BNP, and EPC at baseline, after 1 cycle of DOX, and after completion of DOX. CD133+ progenitor cells were isolated from the peripheral blood mononuclear cells (PBMC) using AutoMACS (automated magnetic cell sorting, Miltenyi Biotech). In vitro colony forming unit (CFU) assay was performed for isolated CD133+ progenitor cells on MethoCult (Stemcell Technology). After 8 days of culture, EPC colonies were counted using a two-step image analysis algorithm. Repeated measures analysis of variance modeled changes in cardiac markers over time. Logistic regression was used to correlate variables with abnormal Ti.

Results: Forty two women were enrolled. The average age was 52 years (range 33–68) and stage distribution was I (14%), II (58%) and III (28%). All but one patient received peg-fligrastim after DOX. Thirty six pts had EPC/cardiac biomarkers and twenty nine pts had CMRs at all three time points. LVEF decreased 1.6% following completion of DOX (95% CI: −3.8 to 0.6, p = 0.16). There was a non-linear trend in EPCs over time (p = 0.05), with an initial increase followed by a decrease, with average values of 59 (95% CI: 50–70), 65 (95% CI: 55–75), and 50 (95% CI: 40–60), respectively, across the three time points. By the end of treatment, 54% (95% CI: 0.37–0.71) of women had abnormal troponins (median: 0.03, range: 0.02 to 0.17). Variables associated with abnormal troponins included lower baseline EPCs (p = 0.095), older age (p = 0.075) and initial increase in BNP post cycle 1 (p &lt; 0.03). In a multivariable model, age (p = 0.04) and BNP (p = 0.04) were independent prognostic factors for abnormal troponins, where the odds of abnormal troponins was 65% higher for every 5-year increase in age (OR = 1.65, 95% CI: 1.02–2.66) and 58% higher for every 1.5-fold increase in BNP (OR = 1.58, 95% CI: 1.01–2.46). Baseline EPC did not remain in the final model with p = 0.12.

Conclusions: DOX was well-tolerated with no significant changes in LVEF as measured by serials CMRs. Older age and increased BNP were independent prognostic factors for rise in Ti. We observed an initial increase of EPCs with DOX exposure followed by a decrease after the end of treatment. Although not statistically significant, lower EPCs at baseline, corresponding to lower cardiac reserve, were correlated with abnormal Ti. This is the first study reporting an intriguing association of EPCs with traditional cardiac biomarkers during DOX chemotherapy. Funded by R21 CA143787-02.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P2-11-07.

Kruppel-like factor 2 (KLF2) regulates monocyte differentiation and functions in mBSA and IL-1β-induced arthritis

Kruppel-like factor 2 (KLF2) plays an important role in the regulation of a variety of immune cells, including monocytes. We have previously shown that KLF2 inhibits proinflammatory activation of monocytes. However, the role of KLF2 in arthritis is yet to be investigated. In the current study, we show that recruitment of significantly greater numbers of inflammatory subset of CD11b(+)F4/80(+)Ly6C+ monocytes to the inflammatory sites in KLF2 hemizygous mice compared to the wild type littermate controls. In parallel, inflammatory mediators, MCP-1, Cox-2 and PAI-1 were significantly up-regulated in bone marrow-derived monocytes isolated from KLF2 hemizygous mice, in comparison to wild-type controls. Methylated-BSA and IL-1β-induced arthritis was more severe in KLF2 hemizygous mice as compared to the littermate wild type controls. Consistent with this observation, monocytes isolated from KLF2 hemizygous mice showed an increased number of cells matured and differentiated towards osteoclastic lineage, potentially contributing to the severity of cartilage and bone damage in induced arthritic mice. The severity of arthritis was associated with the higher expression of proteins such as HSP60, HSP90 and MMP13 and attenuated levels of pPTEN, p21, p38 and HSP25/27 molecules in bone marrow cells of arthritic KLF2 hemizygous mice compared to littermate wild type controls. The data provide new insights and evidences of KLF2-mediated transcriptional regulation of arthritis via modulation of monocyte differentiation and function.

Aggregation of sensory data using fuzzy logic for sensory quality evaluation of food

A method of sensory evaluation using fuzzy logic has been proposed in this paper. The method was applied for evaluation of sensory quality of tea liquor made out of dried CTC tea. Linguistic data (e.g., excellent, very good, good, satisfactory, fair, not-satisfactory, etc.) on individual tea liquor's quality attributes and the perception of the evaluators (e.g., extremely important, highly important, important, somewhat important, not-at-all important, etc.) for relative importance of these quality attributes were obtained. Sensory score between 0 and 100 for (i) Judges' preference for different quality attributes of tea liquor in general, (ii) Quality attributes ranking of tea liquor and the (ii) Overall quality of tea liquor were estimated. The last one can be utilized for the ranking of the different tea liquors.

Performance evaluation of a double drum dryer for potato flake production

A double drum dryer working under atmospheric pressure was developed for water evaporation rate of 20 kg/h. Potato slurry of 12% solid concentration was dried to obtain potato flakes. Experiments were carried out at drum speed of 5 to 30 rpm, steam pressure 2 to7 kg/cm(2) gauge (saturation temperature 120-164 °C) and liquid level 5 to 10 cm at the nip of drums. The responses obtained were, moisture content of the potato flakes: 1.18-44.15% (db), dry matter output rate: 1.33-2.87 kg dry solid/h and L value of colour: 30.9-66.4. Steam pressure and drum speed were the most influencing parameters affecting all 3 responses. Optimum combination of operating variables for obtaining potato flakes of 8% (db) moisture content, high dry solid output rate and high L value of colour was: drum speed 19.6 rpm, steam pressure 4.3 kg/cm(2) gauge (saturation temperature 145 °C) and liquid level at the drum nip 6.3 cm. At this combination of independent variables, residence time of the product on drum surface would be 2 s, final moisture content of product 8% (db), product output rate 2.4 kg dry solid/h and L value of colour 53.

Effectiveness of intra-operative and post-operative use of 5-fluorouracil in trabeculectomy--a randomized clinical trial

INTRODUCTION

The success rate of trabeculectomy is limited by postoperative scarring.

OBJECTIVE

To evaluate the effectiveness of intra-operative and post-operative use of 5-Fluorouracil (5-FU) in trabeculectomy.

MATERIALS AND METHODS

Thirty consecutive eyes undergoing trabeculectomy were randomized systematically into 3 groups of ten patients each. Group A served as a control; in Group B intraoperative 5-FU was used, whereas Group C received post-operative sub-conjunctival 5-FU. The variables studied were pre- and post-operative intraocular pressure, post-operative bleb characteristics and complications.

STATISTICS

Data were evaluated using the SPSS ver 10.0 program. ANOVA, paired t test and chi2 tests were performed.

RESULTS

The means of age in years of patients in group A, B and C were 49 +/- 9.23, 56.50 +/- 8.39 and 52.10 +/- 8.96 respectively (p = 0.222). The means of pre-operative IOP in groups A, B and C were 37.80 +/- 10 mmHg, 42.00 +/- 11.22 mmHg and 29.40 +/- 12.82 mmHg respectively. The medians of pre-operative anterior chamber depth (ACD) in groups B and C were 3 and 2 in group A according to van Herrick's grading. The mean values of final IOP were 11.90 +/- 3.50, 11.70 +/- 4.24, 11.00 +/- 2.83 mmHg (p = 0.841). The median post-operative anterior chamber depth in all the groups was similar compared to the pre-operative anterior chamber depth (p = 0.510). The final bleb scores in all the groups were similar (p = 0.873).

CONCLUSION

The intra-operative and post-operative use of 5-FU in trabeculectomy is almost equally effective in terms of IOP control and bleb characteristics.

Orbital rhabdomyosarcoma in an adult

INTRODUCTION

Rhabdomyosarcoma is the most common primary orbital malignant tumor in children. Orbital lesions represent about 10 % of all the cases of rhabdomyosarcoma. Rhabdomyosarcoma is a rare cause of proptosis in adults.

OBJECTIVE

To report a case of primary orbital rhabdomyosarcoma in a 45-year-old female.

DESIGN

Interventional case report. The main outcome measures are a rare cause ofproptosis in an adult, discussion on treatment options and prognosis ofrhabdomyosarcoma.

RESULT

The patient underwent total orbital exenteration and was referred for radiotherapy and chemotherapy.

CONCLUSION

Rhabdomyosarcoma is a rare cause of proptosis in adults. It should be suspected in a case of rapidly-progressive proptosis in adults.

Association between pregnancy-induced hypertensive fundus changes and fetal outcomes

BACKGROUND

Ocular involvement in pregnancy-induced hypertension (PIH) is common.

OBJECTIVE

To study the association between pregnancy-induced hypertensive fundus changes and fetal outcomes.

SUBJECTS AND METHODS

A prospective cohort study was carried out including 153 subjects with the diagnosis of PIH. The subjects were evaluated for hypertensive fundus changes. Fetal outcomes were assessed in terms of gestational age, birth weight, 1 minute Apgar score, stillbirth and neonatal death.

STATISTICS

The chi2 test was used to evaluate the association between the various fundus changes and fetal outcomes using SPSS version 10 software program.

RESULTS

Fundus changes were found in 13.7% of the subjects. The means of systolic and diastolic BP of the subjects with hypertensive fundus changes were 182.86 +/- 33.64 and 125.24 +/- 21.36 respectively, whereas those values without fundus changes were 150.72 +/- 12.86 and 100.07 +/- 9.51.Vitreous hemorrhage, serous retinal detachment and macular star were not found in this study. Fetal outcomes in PIH patients with vascular changes alone were similar to those with no fundus changes. Retinal and optic nerve head changes were found to be associated (p = 0.016) with low birth weight (< 2.5 kg). Choroidal changes and optic nerve head changes were associated with low Apgar score.

CONCLUSION

Retinal and optic nerve head changes are associated with low birth weight. Choroidal changes and optic nerve head changes are associated with low Apgar score. Fundus evaluation in patients with PIH is an important procedure to predict adverse fetal outcomes.

The patterns of refractive errors among the school children of rural and urban settings in Nepal

Introduction: The uncorrected refractive error is an important cause of childhood blindness and visual impairment. Objective: To study the patterns of refractive errors among the urban and rural school going children of Nepal. Subjects and methods: A total of 440 school children of urban and rural schools within the age range of 7-15 years were selected for this study using multi-stage randomization technique. Results: The overall prevalance of refractive error in school children was 19.8 %. The commonest refractive error among the students was myopia (59.8 %), followed by hypermetropia (31.0 %). The children of age group 12-15 years had the higher prevalence of myopia as compared to the younger counterparts (42.5 % vs 17.2 %). The prevalence of myopia was 15.5 % among the urban students as compared to 8.2 % among the rural ones (RR = 1.89, 95 % CI = 1.1-3.24). The hypermetropia was more common in urban students than in rural ones (6.4 %) vs 5.9 %, RR = 1.08 (95 % CI: 0.52-2.24). Conclusion: The prevalence of refractive error in the school children of Nepal is 19.8 %. The students from urban settings are more likely to have refractive error than their rural counterparts. DOI: 10.3126/nepjoph.v2i2.3717 Nep J Oph 2010;2(2) 114-120

A randomised clinical trial comparing the outcome of trabeculectomy using triangular versus rectangular scleral flaps

BACKGROUND

trabeculectomy is the standard surgical procedure for management of glaucoma.

OBJECTIVE

to compare the outcome of triangular and rectangular scleral flaps in trabeculectomy.

MATERIALS AND METHODS

this study was carried out in the Department ofOphthalmology, BPKIHS, Dharan, over a period of one year. A total of 22 patients undergoing trabeculectomy were randomized to undergo either trabeculectomy with triangular scleral flap (Group A= 11 eyes) or trabeculectomy with rectangular flap (Group B = 11 eyes).

OUTCOME MEASUREMENT

the parameters studied were intraocular pressure (IOP), anterior chamber depth (ACD), bleb characteristics and surgical complications.

STATISTICS

P value of<0.05 was considered significant. All calculations were executed using SPSS 11.0 software program.

RESULTS

the age ranged between 40 to 76 years with the mean of 56.5 +/- 9.25 years. The most common preoperative diagnosis was angle closure glaucoma. The postoperative percentage of IOP reduction (Group A=68.9%; Group B=66.51%) was statically significant in both the groups (p=0.001). Trabeculectomy was almost equally effective with complete surgical success of 91% in group A, and 82% in group B (p=0.534). Final bleb scores were almost similar in both the groups with 3.27 +/- 1.5 in group A and 3.36 +/- 1.21 in group B (p=0.877). Hypotony with the IOP less than 6 mmHg was found in the first post-operative day in 2 patients in Group A and in 1 in Group B. All of them improved spontaneously within a week.

CONCLUSION

both triangular and rectangular scleral flaps in trabeculectomy are equally effective in terms of post surgical IOP control, bleb characteristics and complications.

Efficacy of lid everting suture in the management of involutional lower eyelid entropion using 4-0 silk versus 4-0 chromic catgut

BACKGROUND

involutional lower eyelid entropion is a common ophthalmic condition requiring surgical correction.

OBJECTIVE

to compare the efficacy of lid everting sutures in the management ofinvolutional lower lid entropion using 4-0 silk versus 4-0 chromic catgut.

MATERIALS AND METHODS

fifty eyes with involutional lower eyelid entropion were enrolled into the study and divided randomly into two groups, A and B. Group A underwent lid everting suture with 4-0 chromic catgut and group B with 4-0 silk. The parameters assessed were pre- and post-operative lower lid excursion (LLE) and horizontal lid laxity (HLL).

STATISTICAL ANALYSIS

data were plotted in the excel spread sheet and analyzed using SPSS 11.0 software program. The difference between the two groups was compared using Chi square test and unpaired t test.

RESULTS

while comparing the pre-operative and post-operative changes of HLL within the two groups separately, there was 63% reduction of HLL in group A(p=0.001) and 68% reduction (p=0.001) in group B. In groupA, there was 48.2% improvement in LLE and in group B 52% postoperatively (p=0.001). The success rate in each group was 92%. The cost of surgery in group A was higher than that in group B (p=0.003).

CONCLUSION

lid everting suture by 4-0 silk is as effective as 4-0 chromic catgut. The cost of lid everting suture by 4-0 catgut is higher than that of 4-0 silk. The silk suture can be recommended for correction of lower lid involutional entropion in a country with low socioeconomic status.

Pattern and determinants of ocular complications in leprosy patients in eastern Nepal

BACKGROUND

odular complications of leprosy can lead to blindness.

OBJECTIVE

to report the pattern and determinants of ocular complications in patients with leprosy from eastern Nepal.

METHODS

a cross-sectional study was carried out analyzing one hundred and eighty six patients of leprosy presenting between Jan 2002-Nov 2004. All the patients were categorized using WHO and Ridley and Jopling classification. After determining bacillary indices in all of them, a detailed ocular examination was carried out. Independent risk factors were determined for ocular involvement.

RESULTS

ocular complications were found in 30.65% of the leprosy patients; lagophthalmos (17.74%) was the most frequent followed by uveitis (8.60%). Most of the patients having visual loss had it due to corneal complications and none of the patients with uveitis had vision <6/18. The patients released from treatment (83.33%) and those currently on treatment (31.63%) had higher occurrence of complications. Risk factors for ocular involvement were higher bacillary index, longer disease duration (p-=0.031, RR=1.109, 95% CI=1.009-01.218) and decreased corneal sensation(p=0.001, RR=3.564; 95 % C I=2.014-6.306). Higher Schirmer values (p=0.012, RR=0.935, 95% CI=0.888-0.985) were found to be protective for ocular complications. STASTICS: SPSS ver 10.0 was used for data analysis. The P value of <0.05 was considered as significant.

CONCLUSIONS

the prevalence of complications is high in patients released from treatment for leprosy. Cornea-related complications are the most important cause of visual disability and blindness. Risk factors for ocular complications are higher bacillary index, longer disease duration and decreased corneal sensation.

Safety of primary intraocular lens insertion in unilateral childhood traumatic cataract

This study analyzes the results of cataract surgery with primary intraocular lens implantation in unilateral childhood traumatic cataract following penetrating trauma and its long term follow up. It is a hospital based study of 114 children (age 3-10 years) with unilateral traumatic cataract who underwent extracapsular cataract extraction/ lens aspiration with implantation of posterior chamber intraocular lens (IOL). Primary posterior capsulotomy (PPC) was performed in 57 eyes and the rest 57 were without PPC (NPPC). The patients were followed up at regular intervals for a period of 3 years. Postoperative inflammation and pupillary capture were two frequent complications seen during postoperative period. Development of posterior capsular opacification (PCO) was 1/57, 4/57 at 8th week and 7/30 and 14/39 at 6 months, in PPC and NPPC group, respectively. Best corrected visual acuity (BCVA)>or=6/18 was achieved in 50% of eyes at 8th week post operatively and the same at 3 years with/without membranectomy/capsulotomy was evident in 73.3% of eyes. Meticulous case selection with insertion of "in the bag IOL" and subjecting the traumatized cataractous eyes to primary posterior capsulotomy are factors responsible for optimal outcome in unilateral traumatic cataract in children.

Safety of Primary Intraocular Lens Insertion in Unilateral Childhood Traumatic Cataract

This study analyzes the results of cataract surgery with primary intraocular lens implantation inunilateral childhood traumatic cataract following penetrating trauma and its long term follow up.It is a hospital based study of 114 children (age 3-10 years) with unilateral traumatic cataract whounderwent extracapsular cataract extraction/ lens aspiration with implantation of posterior chamberintraocular lens (IOL). Primary posterior capsulotomy (PPC) was performed in 57 eyes and the rest57 were without PPC (NPPC). The patients were followed up at regular intervals for a period of 3years.Postoperative inflammation and pupillary capture were two frequent complications seen duringpostoperative period. Development of posterior capsular opacification (PCO) was 1/57, 4/57 at 8thweek and 7/30 and 14/39 at 6 months, in PPC and NPPC group, respectively. Best corrected visualacuity (BCVA) ≥ 6/18 was achieved in 50% of eyes at 8th week post operatively and the same at 3years with/without membranectomy/capsulotomy was evident in 73.3% of eyes.Meticulous case selection with insersion of “in the bag IOL” and subjecting the traumatizedcataractous eyes to primary posterior capsulotomy are factors responsible for optimal outcome inunilateral traumatic cataract in children.Key words: childhood, intraocular lens, Nepal, traumatic cataract

Effect of topical mitomycin C on corneal endothelium

PURPOSE

To evaluate patients with ocular surface squamous neoplasia (OSSN) on treatment with topical mitomycin C (MMC) with regard to changes in corneal thickness and endothelial count.

DESIGN

Prospective, nonrandomized, interventional series.

METHODS

In this prospective evaluation, 25 patients with OSSN with different clock hours of involvement (range, one to eight), age varying from 19 to 76 years, were treated with topical MMC 0.04% in a cyclic manner. Preoperative corneal thickness measurement and endothelial cell density were obtained, and the tests were repeated after one, three, and six months of complete resolution. The fellow eyes of the same patients served as controls.

RESULTS

Mean +/- standard deviation (SD) pachymetry and endothelial cell counts before and after instillation were 504.48 +/- 5.45 microm and 2325.76 +/- 192.52 cells/mm2 and 503.52 +/- 5.75 microm and 2297.60 +/- 192.08 cells/mm2, respectively, suggesting no significant difference in the above two parameters. Similarly, in the fellow control eyes, mean +/- SD pachymetry and endothelial cell counts before and after instillation were 502.80 +/- 4.34 microm and 2326.72 +/- 191.93 cells/mm2 and 504.64 +/- 5.19 microm and 2313.60 +/- 192.03 cells/mm2, respectively.

CONCLUSIONS

Topical 0.04% MMC drops do not significantly affect the corneal endothelium. However, its judicious use and long-term follow-up are mandatory.

Prevalence of glaucoma in Sunsari district of eastern Nepal

AIMS

To determine prevalence of glaucoma and glaucoma suspect in subjects 40 years and above in Sunsari district of eastern Nepal.

METHODS

A community based cross sectional study examining 1600 selected subjects was carried out. In all subjects best corrected visual acuity was determined. Oblique torch light test was used for anterior chamber depth evaluation. Intraocular pressure (IOP) measurements with Perkins tonometer and fundus examination were carried out in the community. Subjects diagnosed as glaucoma suspect were further evaluated in the hospital using slit lamp examination, gonioscopy and Goldmann perimetry. Glaucoma was defined by characteristic disc and visual field changes irrespective of the level of IOP.

RESULTS

Of 1600 subjects examined, the prevalence of glaucoma was found to be 0.938%. The prevalences of primary open angle glaucoma, primary angle closure glaucoma, secondary glaucoma and ocular hypertension were 0.562%, 0.125%, 0.250% and 0.500% respectively. Lens induced glaucoma accounted for all the cases of secondary glaucoma.

CONCLUSION

The prevalence of glaucoma in the Sunsari District of Nepal is 0.938%, which is lower than that reported in the neighboring regions. Lens induced glaucoma is highly prevalent as a cause of secondary glaucoma.

Striving for the perfect surgery in traumatic cataract following penetrating trauma in a tertiary care hospital at eastern Nepal

This study analyzes the result of traumatic cataract surgery in a tertiary care hospital at eastern Nepal. It is a hospital-based study of 112 patients (age 15-62), who underwent cataract extraction for unilateral traumatic cataracts. The study was carried out to evaluate the surgical outcome of tramatic cataract. Thirty-eight eyes had associated posterior capsular defect. No serious postoperative complications were encountered. Posterior capsular opacification at the end of sixth week was evident only in two eyes. Best corrected visual acuity nof 6/18 or more at the eighth week was achieved in 61 (54%) eyes. Astigmatism of less than 3D was achieved in 82 (73%) eyes. Rational surgical approach in traumatic cataract provides encouraging results. To comment on actual outcome long term follow up is mandatory.

Plasma and aqueous humur ascorbic acid levels in people with cataract from diverse geographical regions of Nepal

Ascorbic acid in aqueous humor of the eye has a role as an antioxidant in delaying cataract formation. In a cross-sectional comparative study, ascorbic acid levels from aqueous humor and venous blood obtained from patients with cataracts in mountainous regions (1,300-2,000 meters) and subtropical lowlands (<100 meters) of Nepal were measured spectrophotometrically with the objective of comparing the levels of aqueous humor ascorbic acid in patients with cataracts from these two diverse geographical regions. Of 131 patients included in the study, 59 were from the mountainous region of Nepal (Group A) and 72 were from the subtropical lowlands (Group B). The mean (+/- SD) plasma ascorbic acid level (mg%) of the subjects in Group A was 0.65 (+/- 0.20) and Group B was 0.85 (+/- 0.31). The aqueous ascorbic acid levels ranged from 12-28 mg % (mean +/-SD = 17.5+/-4.52) and 14-50 mg % (mean +/-SD =23.47+/-8.66) in Groups A and B, respectively. The difference of the plasma and aqueous humor ascorbic acid levels between the two groups was statistically significant (p<0.01). The plasma and aqueous humor ascorbic acid levels in the people with cataracts from the mountainous region of Nepal were significantly lower than those from subtropical lowlands. This may be because of the effect of high altitude and ultraviolet rays on ascorbic acid metabolism.

Indirect traumatic optic neuropathy--retrospective interventional case series from a tertiary care center in eastern Nepal

To report the demography, nature of insult and ocular characteristics in patients presenting with indirect traumatic optic neuropathy and to evaluate the visual outcome with mega dose methylprednisolone therapy. Retrospective hospital data analysis of all patients admitted with indirect traumatic optic neuropathy and treated with mega dose methylprednisolone therapy in the last three years was conducted. Nine patients (M:F= 8:1) were identified with unilateral optic nerve injury. Road traffic injury was the most common cause of injury. Lid ecchymosis and swelling on the same side was the most frequent ocular abnormality noted, followed by loss of consciousness. Time of presentation varied from 3 hours to 11 days. All patients except two had visual acuity of no light perception at presentation. Following therapy there was improvement in visual acuity in two patients who presented within two days of injury. Patients present late with traumatic optic neuropathy in this hospital. Most of the patients are with no light perception. High dose steroids was found to be beneficial only in patients presenting early (<two days).