The discovery of the human immunodeficiency virus (HIV) as the causative organism of acquired immunodeficiency syndrome (AIDS) and the inability of modern medicine to find a cure for it has placed HIV as one of the most dreaded pathogens of the 21st century. With millions of people infected with HIV, it was once thought to result in “medical apocalypse”. However, with the advent of antiretroviral therapy (ART), it is now possible to control HIV. Adherence to ART helps to keep the viral load under control and prolong the time of progression to AIDS, resulting in near normal life expectancy. Even with the introduction of ART, a substantial number of patients fail to adhere due to a variety of reasons, including adverse side effects, drug abuse, mental disorders, socioeconomic status, literacy, and social stigma. With the availability of so many options for HIV treatment at each stage of the disease progression, physicians can switch between the treatment regimens to avoid and/or minimize the adverse effects of drugs. Close monitoring, major social reforms, and adequate counselling should also be implemented to circumvent other challenges.

Diabetic macular ischemia (DMI) is a troublesome complication of diabetes mellitus. The pathogenesis, progression, consequences, and treatment options for this disease are still poorly understood. However, it is believed that this complication is associated with several risk factors like poor glycemic control and high blood pressure. Two factors have been identified in the pathogenesis of the disease that play pivotal roles in disease development and progression. One of these factors includes extensive damage to the microvasculature of the retina. This includes narrowing of the vascular lumen and extensive damage to the endothelial cells, pericytes and the extracellular matrix. The second factor includes extensive damage to the neurosensory layer of the retina. DMI is always associated with other complications of diabetic retinopathy like retinal edema, so it is very difficult to find an isolated case of DMI. Moreover, the condition is also very rare making it very difficult to study and diagnose. However, a number of diagnostic tests like optical coherence tomography (OCT), fluorescence angiography (FA), and perimetry can be used as tools for the early detection of DMI. Since this disease damages the retina, loss of vision is an inevitable consequence that can progressively worsen over time. Also, DMI has been implicated as a risk factor for retinal edema and progressive diabetic retinopathy. Until now, no defined treatment protocol has been devised. The only available treatments focus on the management of risk factors (hyperglycemia and hypertension). Still, many aspects of DMI remain poorly studied and understood. This review paper aims to add to our current understanding of diabetic macular ischemia (DMI).

OBJECTIVE -Our objectives were to determine the prevalence of previously undiagnosed abnormal glucose tolerance, i.e., diabetes and impaired glucose tolerance (IGT) in patients with acute coronary syndrome and to assess the utility of admission and fasting glucose in identifying diabetes in these patients.RESEARCH DESIGN AND METHODS -Glycemic status was characterized on the basis of admission plasma glucose (APG), fasting plasma glucose (FPG), and an oral glucose tolerance test (OGTT) in 140 patients admitted to the hospital with acute coronary syndrome, who were not known to have diabetes (mean Ϯ SD age 67.3 Ϯ 13.4 years; 79% men). OGTTs were performed on days 5-7 after admission.RESULTS -The prevalences of diabetes and IGT were 27 and 39%, respectively, according to OGTT criteria. Receiver operating characteristic curves showed that the area under the curve for diagnosing diabetes was 0.83 (P Ͻ 0.001) for FPG, 0.79 (P Ͻ 0.001) for APG, and 0.84 (P Ͻ 0.001) for FPG and APG applied in combination. A FPG cutoff Ն5.6 mmol/l (100 mg/dl) and/or APG Ն7.8 mmol/l (140 mg/dl) yielded a sensitivity of 89.5% and a positive predictive value of 43.6% for detecting diabetes.CONCLUSIONS -A high prevalence of abnormal glucose tolerance was seen in patients with acute coronary syndrome. The combination of FPG Ն5.6 mmol/l (100 mg/dl) and/or APG Ն7.8 mmol/l (140 mg/dl) was highly sensitive for identifying diabetes. Although weakly specific, this simple algorithm could offer a practical initial screening tool at the acute setting in the high-risk population with acute coronary syndrome.

The present work was designed to study the impact of dielectric barrier discharge (DBD) plasma, ultrasound (US), and thermal treatment on the functional, rheological, and microbial analysis of sugarcane juice. The results showed that plasma and US treatment did not significantly affect the pH and color of the juice. Total soluble solids (°Brix) value increased from 16.30 ± 0.10 for untreated to 20.50 ± 0.15 during plasma treatment at 45 V for 2 min and 16.65 ± 0.27 during US treatment (40 kHz, power 240 W, and time 40 min). The maximum increase of 25% in total phenolic contents (TPC) and 21% in total flavonoid contents (TFC) was observed in a plasma‐treated sample at 40 and 45 V (for 2 min) respectively, whereas 18% in TPC and 16% TFC was observed in the US‐treated sample (40 kHz, power 240 W, and time 30 min) as compared to control sample. Plasma treatment increased the antioxidant activities (Ferric reducing antioxidant power (FRAP) assay and 2,2‐Diphenyl‐1‐picrylhydrazyl (DPPH) activity) toward maximum at 40 V and only 6% of vitamin C was degraded than others. Similarly, plasma treatment significantly reduced particle size, which further led to decreased significantly (P < 0.05) the apparent viscosity of sugarcane juice with a rise in shear rate and drove to a speedy breakdown on initial shearing. A significant reduction was observed in the microbial load among all treatments as compared to the control. Significant reductions of 3.6 and 0.50 log CFU/mL were observed in the total aerobic mesophilic and yeast and mold counts after DBD plasma treatment at 45 V for 2 min, respectively. Thus, we can conclude that novel technology like plasma treatment can be effectively used at an industrial scale for the preservation and processing of sugarcane juice. Practical Application Nowadays, novel processing techniques are employed to improve the nutritional quality and stability of juices. The consequences of the present research showed that DBD plasma treatment could improve the TPC, TFC, antioxidant activities, vitamin C, and rheological properties while reducing the activity of the microbial load better than the US and thermal treatment. The verdicts described that novel processing methods can enhance the quality of sugarcane juice at an industrial scale.