OBJECTIVES: QoL studies in patients with HAE have not been carried out in the Indian subcontinent. Hence, we carried out this study to assess the QoL and to identify factors associated with impaired QoL in patients with HAE.
METHODS: This was a cross-sectional observational study carried out in confirmed cases of HAE, aged >18 years, using angioedema QoL score and angioedema control test.
RESULTS: We enrolled 135 patients with HAE (aged 18-80 years) with a mean age of 40.93 years. We observed that the QoL directly correlates with angioedema control and is also affected by other factors such as gender, duration of follow-up, and the frequency of episodes. Genitalia swelling, positive family history, and presence of mortality due to HAE in the family also significantly impact the QoL of patients with HAE. In addition, patients with type 1 HAE reported a poorer QoL as compared to patients with type 2 HAE.
CONCLUSION: We report the QoL of patients with HAE from settings where none of the first-line medications are available. Results of the study suggest that disease control is the most important factor that influences the QoL.
METHOD: Case report and literature review.
RESULT: A 53-year-old gentleman with underlying Stage III B renal cell carcinoma with lung metastasis and gout presented in June 2021 with bilateral red eyes following Coronavirus disease (COVID-19) vaccination. He had undergone a nephrectomy for renal cell carcinoma and was on Pembrolizumab therapy for 5 years. Examination showed right eye injected conjunctiva with diffuse punctate epithelial erosions over the cornea, which was treated with topical steroids. The left eye is suspected to have infective keratitis, which is treated with topical antibiotics and subsequently steroids for the ocular surface inflammation. However, he developed a left eye paracentral sterile corneal melt which rapidly progressed to perforation measuring 1 mm in size. The perforation was temporarily sealed with tissue glue, but he eventually required a full thickness corneal patch graft. Patient has been doing well post-operatively for the last 3 years.
CONCLUSION: The diagnosis and management of irAEs are challenging and necessitate continuously updated diagnostic and monitoring tools. As checkpoint inhibitors become more promising in the management of malignancies, it is crucial for both the oncologist and ophthalmologist to be aware of the potential ocular adverse effects of these drugs.
AIMS: This study aimed at developing and characterizing the ethanolic vesicular hydrogel system of Nigella sativa (NS) oil (NS EV hydrogel) for the enhancement of anti-psoriatic activity.
OBJECTIVE: The objective of this study was to develop NS EV hydrogel and evaluate its anti-psoriatic activity.
METHODS: The identification and quantification of TQ content in different NS seed extracts and marketed oil were measured by an HPTLC method using n-hexane and ethyl acetate as solvent systems. Preparation of ethanolic vesicles (EVs) was performed by solvent injection method, while its antipsoriatic activity was evaluated employing an Imiquad (IMQ)-induced plaque psoriasis animal model.
RESULTS: A compact HPTLC band was obtained for TQ at an Rf value of 0.651. The calibration plot was linear in the range of 1-10 μg/spot, and the correlation coefficient of 0.990 was indicative of good linear dependence of peak area on concentration. From the different NS sources, the high TQ content was obtained in the marketed cold press oil, i.e., 1.45±0.08 mg/ml. Out of various NS oilloaded EVs, the F6 formulation revealed the smallest particle size (278.1 nm), with log-normal size distribution (0.459) and adequate entrapment efficiency. A non-uniform shape was observed in the transmission electron microscopy. The viscosity of F6 formulation hydrogel was 32.34 (Pa·s), which exhibited plastic behavior. In vivo, efficacy studies demonstrated decreased inflammation of the epidermis and dermis and a marked decrease in the levels of IL-17 by NS EV hydrogel compared to plain NS oil and standard drugs (Betamethasone and Dr. JRK Psorolin Oil).
CONCLUSION: It may be concluded from the findings that NS-loaded EV gel was as good as betamethasone cream but more efficacious than the other treatments.
MATERIAL AND METHOD: 25 healthy electronic cigarette smokers and 25 age- and gender-matched healthy non-smokers were included in the study. RNFL, GCL, IPL and choroidal thickness were measured by SD-OCT using an automated programme. After normality tests, an independent sample t-test was used to analyse the differences in RNFL, GCL, IPL, and choroidal thickness values between the groups.
RESULTS: The mean age of electronic cigarette smokers and non-smokers was 33.68 and 33.64 years, respectively. The mean smoking history was 6.6 years (range 5-8 years). Most of the participants smoked 2-5 ml of e-liquid per day (52%), while 36% smoked more than 5 ml and 12% smoked less than 2 ml per day. The mean intraocular pressure in the electronic cigarette smoker group was 15.0 mmHg, while the non-smoker group was 15.32 mmHg. The mean axial length in the electronic cigarette smoker group and non-smoker group was 23.36 and 23.63 mm, respectively. No significant difference was observed regarding RNFL, GCL, IPL or choroidal thickness between both groups.
CONCLUSION: The thickness of the RNFL, GCL, IPL, and choroid was found to be similar in both the healthy electronic cigarette smokers and non-smokers groups.
METHODS: Participants were randomized to BNT162b2 (Comirnaty, 30 µg) or messenger RNA (mRNA)-1273 (Spikevax, 100 µg). The primary end point was the rate of two-fold antibody titer increase 14 days after vaccination, targeting the receptor binding domain (RBD) region of wild-type SARS-CoV-2. The secondary end points included changes in neutralizing activity against wild-type and 25 variants. Safety was assessed by monitoring solicited adverse events (AEs) for 7 days.
RESULTS: A total of 269 participants (mean age 81 years, mRNA-1273 n = 135/BNT162b2 n = 134) were included. Two-fold anti-RBD immunoglobulin (Ig) G titer increase was achieved by 101 of 129 (78%) and 116 of 133 (87%) subjects in the BNT162b2 and the mRNA-1273 group, respectively (P = 0.054). A second booster of mRNA-1273 provided higher anti-RBD IgG geometric mean titer: 21.326 IU/mL (95% confidence interval: 18.235-24.940) vs BNT162b2: 15.181 IU/mL (95% confidence interval: 13.172-17.497). A higher neutralizing activity was noted for the mRNA-1273 group. The most frequent AE was pain at the injection site (51% in mRNA-1273 and 48% in BNT162b2). Participants in the mRNA-1273 group had less vaccine-related AEs (30% vs 39%).
CONCLUSIONS: A second booster of either BNT162b2 or mRNA-1273 provided substantial IgG increase. Full-dose mRNA-1273 provided higher IgG levels and neutralizing capacity against SARS-CoV-2, with similar safety profile for subjects of advanced age.
METHODS: This retrospective study comprised 284 right eyes. Patients aged 18 years or older with myopia up to -12.00 D and/or astigmatism up to -6.00 DC and who underwent femtosecond LASIK were recruited. Patients were divided into three subgroups: low myopia (-0.50 to -3.00 D), moderate myopia (>-3.00 to ≤-6.00 D), and high myopia (>-6.00 D), according to their pre-LASIK spherical equivalent (SE). The variables included for analysis were PCC (central 0-3.0 mm, pericentral 3.0-6.0 mm, and peripheral region 6.0-9.0 mm), PCE, PCA, internal anterior chamber depth, intraocular pressure, and central cornea thickness at the pre- and post-LASIK stages.
RESULTS: The central PCC remained unchanged across all three myopia subgroups at 1 month when compared to the pre-LASIK stage and remained stable at 6 months. The pericentral regions became flatter across all myopia subgroups at 1 month postsurgery (P < 0.001) and remained unchanged at 6 months. This trend was not seen in the peripheral cornea regions, which remained unchanged at 1 and 6 months post-LASIK when compared to pre-LASIK mean readings. There were minimal changes in post-LASIK posterior cornea astigmatism throughout follow-up. There was no incidence of post-LASIK surgery ectasia in this study population.
CONCLUSION: Post-LASIK, the different cornea subregions behaved differently. Overall, the posterior cornea surface remained stable post-LASIK across all myopia subgroups throughout follow-up.
AREAS COVERED: We intend to discuss the pathogenesis, diagnosis, and treatment modalities directed toward EBV-associated LPD in patients with distinct IEIs.
EXPERT OPINION: EBV-driven lymphoproliferation in IEIs presents a diagnostic and therapeutic problem that necessitates a comprehensive understanding of host-pathogen interactions, immune dysregulation, and personalized treatment approaches. A multidisciplinary approach involving immunologists, hematologists, infectious disease specialists, and geneticists is paramount to addressing the diagnostic and therapeutic challenges posed by this intriguing yet formidable clinical entity.