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Current developments in cellular resolution in-vivo retinal imaging systems at the UC Davis will be presented. Instrumentation developments include the combination of adaptive optics with optical coherence tomography and scanning laser ophthalmoscopy. © 2011 Optical Society of America.

PurposeThe purpose of this study is to evaluate the macular morphological changes associated with idiopathic epiretinal membrane (iERM) using high-resolution Fourier-domain optical coherence tomography (FD-OCT), as they correlate with visual acuity and microperimetry (MP-1).MethodsIn all, 24 eyes (19 subjects) with iERM were imaged prospectively using FD-OCT with axial resolution of 4.5 μm and transverse resolution of 10 to 15 μm. MP-1 and Stratus OCT were carried out in a subset of eyes.ResultsThe mean log of the minimum angle of resolution best-corrected visual acuity (BCVA) was 0.18±0.16 (range: -0.08 to 0.48, Snellen equivalent 20/15(-1) to 20/60). ERM was visualized in all 24 eyes with FD-OCT and in 17 eyes (85%) of 20 eyes imaged with Stratus OCT. Although BCVA correlated with macular thickening in the central 1 mm sub-field of the Stratus ETDRS (P=0.0005) and macular volume (central 3 mm area) on FD-OCT (P

We describe results of retinal imaging with a novel instrument that combines adaptive optics - Fourier-domain optical coherence tomography (AO-OCT) with an adaptive optics scanning laser ophthalmoscope (AO-SLO). One of the benefits of combining Fd-OCT with SLO includes automatic co-registration between the two imaging modalities and the potential for correcting lateral and transversal eye motion resulting in motion artifact-free volumetric retinal imaging. Additionally this allows for direct comparison between retinal structures that can be imaged with both modalities (e.g., photoreceptor mosaics or microvasculature maps). This dual imaging modality could provide insight into some retinal properties that could not be accessed by a single imaging system. Additionally, extension of OCT and SLO beyond structural imaging may open new avenues for diagnostics and testing in ophthalmology. In particular, non-invasive vasculature mapping with these modalities holds promise of replacing fluorescein angiography in vascular identification. Several new improvements of our system are described, including results of testing a novel 97-actuator deformable mirror and AO-SLO light intensity modulation. © 2010 SPIE.

The increasing need for clean water can be attributed to a number of reasons, such as population growth, industrial development, and climate change. As a result of modern industrial and agricultural methods, the amount of trash generated daily is also on the rise. Waste management and increasing demand for freshwater are two of the most pressing problems facing the human race today and in the future. This study makes an attempt to strike a balance between these two concerns by repurposing a common biowaste, the banana stem, to collect solar energy for a desalination application. Banana stems work well for interfacial solar desalination because of their capillarity and the fact that they float. Camphor-soothed banana stems were placed in a solar still to collect solar thermal energy and to transfer it to the water surrounding them, speeding up the evaporation process and resulting in more freshwater. Over the course of three days, measurements were taken with the water level held constant and the stem thickness of the bananas varied between 0.5 and 1.5 cm. Enviro-economic studies and water quality analysis were used to calculate greenhouse gas emissions, carbon dioxide mitigation, and the carbon credits obtained. Compared to a standard still, a maximum yield of 934 mL was achieved at an efficiency of 36.35 percent. The CPLs (costs per liter) for the MSS (modified solar still) and the CSS (conventional solar still) were USD 0.0503 and USD 0.0665. In comparison to its CSS counterpart, the MSS had a CPL that was 32.21 percent lower. The treated water retained a 95.77% reduction in TDS compared to salt water. The MSS is predicted to release 219.62 kg of carbon dioxide, 1.67 kg of sulfur dioxide, and 0.69 kg of nitrous oxide over its lifetime. In addition, the MSS saved USD 20.94 in carbon credits after avoiding the emission of 2.09 tonnes of CO2.

Presents a letter to the editor reporting on a case of intravitreal triamcinolone acetonide in Eales' disease, a condition manifesting as retinal periphlebitis.

The treatment of wastewater is highly challenging due to large fluctuations in flowrates, pollutants, and variable influent water compositions. A sequencing batch reactor (SBR) and modified SBR cycle-step-feed process (SSBR) configuration are studied in this work to effectively treat municipal wastewater while simultaneously removing nitrogen and phosphorus. To control the amount of dissolved oxygen in an SBR, three axiomatic control strategies (proportional integral (PI), fractional proportional integral (FPI), and fuzzy logic controllers) are presented. Relevant control algorithms have been designed using plant data with the models of SBR and SSBR based on ASM2d framework. On comparison, FPI showed a significant reduction in nutrient levels and added an improvement in effluent quality. The overall effluent quality is improved by 0.86% in FPI in comparison with PI controller. The SSBR, which was improved by precisely optimizing nutrient supply and aeration, establishes a delicate equilibrium. This refined method reduces oxygen requirements while reliably sustaining important biological functions. Focusing solely on the FPI controller's performance in terms of total air volume consumption, the step-feed SBR mechanism achieves an excellent 11.04% reduction in consumption., Competing Interests: The authors declare there is no conflict., (© 2024 The Authors This is an Open Access article distributed under the terms of the Creative Commons Attribution Licence (CC BY 4.0), which permits copying, adaptation and redistribution, provided the original work is properly cited (http://creativecommons.org/licenses/by/4.0/).)

This study performed bench scale studies on anaerobic co-digestion of cheese whey and septage mixed with biochar (BC) as additive at various dosages (0.5 g, 1 g, 2 g and 4 g) and total solids (TS) concentrations (5%, 7.5%, 10%,12.5% and 15%). The experimental results revealed 29.58% increase in methane yield (486 ± 11.32 mL/gVS) with 27% reduction in lag phase time at 10% TS concentration and 50 g/L of BC loading. The mechanistic investigations revealed that BC improved process stability by virtue of its robust buffering capacity and mitigated ammonia inhibition. Statistical analysis indicates BC dosage had a more pronounced effect (P < 0.0001) compared to the impact of TS concentrations. Additionally, the results were modelled using Gompertz model (GM) and artificial neural network (ANN) algorithm, which revealed the outperformance of ANN over GM with MSE 17.96, R 2 value 0.9942 and error 0.27%. These findings validated the practicality of utilizing a high dosage of BC in semi-solid anaerobic digestion conditions., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Lactose in cheese whey is increasingly challenging to metabolise under normal conditions. The hydrolysis of whey lactose into glucose and galactose using enzymatic methods has been acclaimed to confer benefits like enhanced substrate availability for better degradation in anaerobic digestion. In the present study, whey lactose was subjected to hydrolysis using the enzyme β-galactosidase derived from Aspergillus oryzae fungus to reduce the difficulty of lipid and fat transformation in anaerobic digestion. The individual and combined effects of hydrolysis parameters, pH, enzyme load, reaction time and temperature were studied using Response Surface Methodology by Central Composite Design. The optimum conditions were determined based on variance analyses and surface plots; pH 4.63, temperature 40.47°C, reaction time 25.96 min and enzyme load 0.49%. Results showed a maximum lactose hydrolysis value of 86.21%, while the predicted value was 87.44%. Indeed, enzyme hydrolysis induced a change of soluble chemical oxygen demand around 24.6% and 75.8% reduction in volatile fatty acid concentration. Upon anaerobic digestion, the pre-hydrolysed whey revealed a 3.6-fold higher bio-methane production than that of raw hey, and a visible decrease in volatile fatty acid concentrations. The resultant data agreed with the Gompertz model, and lag phase times were significantly reduced for hydrolysed whey.

Background: Radial probe endobronchial ultrasound (R-EBUS) is often utilized in guided bronchoscopy for the diagnosis of peripheral pulmonary lesions. R-EBUS probe positioning has been shown to correlate with diagnostic yield, but overall diagnostic yield with this technology has been inconsistent across the published literature. Currently there is no standardization for R-EBUS image interpretation, which may result in variability in grading concentricity of lesions and subsequently procedure performance. This was a survey-based study evaluating variability among practicing pulmonologists in R-EBUS image interpretation., Methods: R-EBUS images from peripheral bronchoscopy cases were sent to 10 practicing Interventional Pulmonologists at two different time points (baseline and 3 months). Participants were asked to grade the images as concentric, eccentric, or no image. Cohen's Kappa-coefficient was calculated for inter- and intra-observer variability., Results: A total of 100 R-EBUS images were included in the survey. There was 100% participation with complete survey responses from all 10 participants. Overall kappa-statistic for inter-observer variability for Survey 1 and 2 was 0.496 and 0.477 respectively. Overall kappa-statistic for intra-observer variability between the two surveys was 0.803., Conclusions: There is significant variability between pulmonologists when characterizing R-EBUS images. However, there is strong intra-rater agreement from each participant between surveys. A standardized approach and grading system for radial EBUS patterns may improve inter-observer variability in order to optimize our clinical use and research efforts in the field., Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jtd.amegroups.com/article/view/10.21037/jtd-23-998/coif). A.C.C. has received research and consulting funding from Olympus, Boston Scientific, Johnson and Johnson and Intuitive Surgical. A.S. is a consultant for Olympus, which manufactures the radial EBUS device. S.P. is a consultant for Ambu Inc. The other authors have no conflicts of interest to declare., (2024 Journal of Thoracic Disease. All rights reserved.)

In recent years, anaerobic digestion (AD) has gained popularity as a practical method for generating clean energy and efficiently managing organic waste. However, the effectiveness of the reactor is compromised by the accumulation of ammonia, acids, and nutrients, leading to inhibition and instability. Because of its adaptability, biochar (BC) has sparked a substantial interest in biogas production and can be created by charring biomass and waste materials. Adding BC to the AD process could yield the following benefits: mitigating toxic inhibition, reducing the duration of the methanogenic lag phase, immobilising functional bacteria, and enhancing the rate of electron transfer between methanogenic and acetogenic microorganisms. Nonetheless, there remains to be more comprehensive knowledge regarding the multifaceted function of BC and its intricate mechanisms in the generation of biogas in AD. The research summarises scattered information from the literature on BC production from various feedstocks and factors affecting its characteristics. Additionally, a comprehensive analysis of the utilisation of BC as an additive within AD is presented here, emphasising how BC characteristics impact AD processes and how they effectively engage key challenges., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Lactose in cheese whey wastewater (CWW) makes it difficult to degrade under normal conditions. The effect of ultra-sonication (US), ozonation and enzymatic hydrolysis on increasing the bioavailability of organic matter in CWW and biogas production were evaluated. The pre-treatment conditions were: specific energy input varied from 2130 to 8773KJ/KgTS for a sonication time of 4.5-18.5 min, Ozone (O 3 ) dosages ranging from 0.03 to 0.045gO 3 /gTS were applied for 4-16 min, pH (3.8-7.1), temperature (35°C-55°C), enzyme dosage (0.18-0.52%), was operated from 7.75 to 53 min for enzymatic hydrolysis by β-galactosidase. The results of the US reported a maximum sCOD solubilisation of 77.15% after 18.5 min of operation, while the corresponding values for ozonation and enzymatic methods were 64.8% at 16 min and 54.79%, respectively. The organic matter degradation rates evaluated in terms of protein and lactose hydrolysis were 68.78%,46.03%; 47.83%,16.15% and 54.22%,86.2%respectively, for US, ozonation and enzymatic methods. The cumulative methane yield for sonicated, ozonised and enzymatically hydrolysed samples were 412.4 ml/g VS, 361.2 ml/g VS and 432.3mlCH 4 /gVS, respectively. Regardless of the lower COD solubilisation rates attained, enzymatic pre-treatment showed maximum methane generation compared to US and ozonation. This could be attributable to the increased activity of β-galactosidase in hydrolysing whey lactose. The energy calculations revealed that the pre-conditioning of organic-rich CWW with enzymatic hydrolysis is more effective and efficient, yielding a net energy gain (gross output energy-input energy) of 9166.7 KJ and an energy factor (ratio of output to input energy) of 6.67. The modified Gompertz model well simulated all experimental values., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Purpose: To report a new photographic macular feature identified on multimodal imaging in eyes with silicone oil in situ., Methods: Retrospective, observational case series of three eyes of three patients., Results: Two eyes had undergone initial vitrectomy for vitreous hemorrhage with fibrovascular membranes causing tractional retinal detachments secondary to retinovascular occlusion. One eye had further vitrectomy for rhegmatogenous retinal detachment complicated with proliferative vitreoretinopathy. All three eyes had multiple, discrete, coarse, hyperreflective deposits at the silicone oil-retina interface on optical coherence tomography macular scans, with increased reflectivity from the inner retinal layers. On multicolor and infrared images, these preretinal deposits produced hyporeflective darker spots giving a quasi-pitting appearance of the retinal surface against glossy bright reflection from silicone oil, thus simulating an appearance of ‟a strawberry." These deposits are causing inverse pitting of the oil bubble. On blue autoflourescence imaging, the preretinal deposits caused hypoautoflourescence. Partial silicone oil emulsification was seen superiorly in two of these patients with a different clinical and optical coherence tomography appearance from these hyperreflective macular deposits., Conclusion: We describe a new distinctive ‟Strawberry Retina" appearance identified on multicolor and infrared macular images associated with hyperreflective, coarse deposits at the silicone oil-retina interface.

Per- and polyfluoroalkyl substances (PFAS) cause potential threats to biota and are persistent and never-ending substances in the environment. Regulations and ban on legacy PFAS by various global organizations and national level regulatory agencies had shifted the fluorochemical production to emerging PFAS and fluorinated alternatives. Emerging PFAS are mobile and more persistent in aquatic systems, posing potential greater threats to human and environmental health. Emerging PFAS have been found in aquatic animals, rivers, food products, aqueous film-forming foams, sediments, and a variety of other ecological media. This review summarizes the physicochemical properties, sources, occurrence in biota and the environment, and toxicity of the emerging PFAS. Fluorinated and non-fluorinated alternatives for several industrial applications and consumer goods as the replacement of historical PFAS are also discussed in the review. Fluorochemical production plants and wastewater treatment plants are the main sources of emerging PFAS to various environmental matrices. Information and research are scarcely available on the sources, existence, transport, fate, and toxic effects of emerging PFAS to date., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Background: To report a novel technique for explantation of cloudy Oculentis intraocular lens (IOL)., Methods: A retrospective review of patient's electronic records was performed. The technique includes pars plana vitrectomy, deflooring (large posterior capsulectomy) of the capsular bag, IOL explantation with preserving the anterior capsule, and a secondary IOL placement., Results: Twenty eyes of 19 symptomatic patients were studied. Preoperative Snellen visual acuity ranged from 6/60 to 6/6; 15 eyes (75%) had visual acuity of 6/12 or better. Postoperative visual acuity ranged from 6/60 to 6/6; 18 eyes (90%) had visual acuity of 6/12 or better, and 2 eyes (10%) had visual acuity worse than 6/12. Among these eyes, 13 eyes (65%) had sulcus-fixated IOL, 5 eyes (25%) had sutureless scleral-fixated IOL, and 2 eyes (10%) had retropupillary iris clip IOL. Perioperative surgical complications included localized choroidal detachment in one eye and retinal detachment in another eye. In addition, most patients reported significant improvement in their postoperative vision satisfaction., Conclusion: Our new technique for explantation of cloudy Oculentis IOL provides a standard surgery allowing a safe predictable and repeatable removal of these lenses comparing with the anterior segment approach. This technique could also be used for removal of other IOLs.

PFAs (poly and perfluoroalkyl compounds) are hazardous and bioaccumulative chemicals that do not readily biodegrade or neutralize under normal environmental conditions. They have various industrial, commercial, domestic and defence applications. According to the Organization for Economic Co-operation and Development, there are around 4700 PFAs registered to date. They are present in every stream of life, and they are often emerging and are even difficult to be detected by the standard chemical methods. This review aims to focus on the sources of various PFAs and the toxicities they impose on the environment and especially on humankind. Drinking water, food packaging, industrial areas and commercial household products are the primary PFAs sources. Some of the well-known treatment methods for remediation of PFAs presented in the literature are activated carbon, filtration, reverse osmosis, nano filtration, oxidation processes etc. The crucial stage of handling the PFAs occurs in determining and analysing the type of PFA and its remedy. This paper provides a state-of-the-art review of determination & tools, and techniques for remediation of PFAs in the environment. Improving new treatment methodologies that are economical and sustainable are essential for excluding the PFAs from the environment., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Background: The Northern Sydney Local Health District was one of the first health regions to be affected by COVID-19 in Australia., Aims: To describe the clinical characteristics, risk factors and outcomes in our low-prevalence Australian population., Methods: This is a retrospective analysis of 517 laboratory-confirmed COVID-19 cases between January and June 2020. Patient information was collected as part of routine care within the COVID-19 Virtual Hospital system. Outcomes examined were death, recovery at 30 days and intensive care unit (ICU) admission., Results: The case fatality rate was 1.8%. Multivariate analysis showed factors independently associated with death, composite outcome of death/ICU admission or incomplete recovery at 30 days were age >80 years and presence of two or more comorbidities. Most cases acquired COVID-19 through international (50.9%) or cruise ship travel (9.1%). Healthcare workers comprised 12.8% of the cohort and represented a disproportionately high percentage of the 'unknown' source group (27.6%). The median incubation period was 5 days (interquartile range 3-8); one patient had an incubation period of 15 days. Hospitalisation was required in 11.8%, ICU admission in 2.1% and ventilation in 1.4%. A Radiographic Assessment of Lung Oedema score on chest X-ray of >10 was independently associated with death., Conclusions: In this low prevalence, well resourced Australian setting, we report an overall low mortality. Factors associated with adverse patient outcomes on multivariate analysis were age greater than 80 and the presence of two or more comorbidities. These data can assist in early risk stratification of COVID-19 patients, and in surge capacity planning for hospitals., (© 2021 Royal Australasian College of Physicians.)

Two cases of acute postoperative Granulicatella adiacens endophthalmitis following uneventful phacoemulsification surgery are reported. The cases had intracameral cefuroxime as antibiotic prophylaxis, visual acuity (VA) was perception of light and hand movements, respectively, and there was severe anterior chamber inflammation and dense vitritis with no fundal view. Vitreous biopsy identified G adiacens using genome sequencing. Intraoperative findings included extensive retinal hemorrhages, abscesses, occluded retinal vessels, and retinal necrosis. Because of the ischemic retinal appearance, pan-retinal photocoagulation endolaser was performed. Postoperatively both cases developed rhegmatogenous retinal detachment (RRD) anterior to the laser marks and were successfully treated. VA improved to 6/18 and 6/60, respectively. Hyperreflective dots and Henle fiber layer hemorrhage are reported for the first time, to the authors' knowledge, in association with endophthalmitis. The successful outcome suggested that intraoperative pan-retinal photocoagulation could be considered in such ischemic cases to prevent rubeosis and to reduce the risk for postoperative RRD or limit its extent if it recurs.

Oral squamous cell carcinoma (OSCC) is highly predominant in India due to excessive use of tobacco. Here we investigated Long INterpersed Element 1 (LINE or L1) retrotransposon activity in OSCC samples in the same population. There are almost 500,000 copies of L1 occupied around 30%  of the human genome. Although most of them are inactive, around 150-200 copies are actively jumping in a human genome. L1 encodes two proteins designated as ORF1p and ORF2p and expression of both proteins are critical for the process of retrotransposition. Here we have analyzed L1 ORF1p expression in a small cohort (n = 15) of paired cancer-normal tissues obtained from operated oral cancer patients. Immunohistochemistry (IHC) with the human ORF1 antibody showed the presence of ORF1p in almost 60%  cancer samples, and few of them also showed aberrant p53 expression.  Investigating L1 promoter methylation status, showed certain trends towards hypomethylation of the L1 promoter in cancer tissues compared to its normal counterpart. Our data raise the possibility that L1ORF1p expression might have some role in the onset and progression of this particular type of cancer., Competing Interests: Declaration of Competing Interest The authors declare that they have no competing interests., (Copyright © 2020. Published by Elsevier Inc.)

Background/aims: Classical M1 macrophage activation exhibits an inflammatory phenotype while alternative M2 macrophage activation exhibits an anti-inflammatory phenotype. We aimed to determine whether there are discriminant patterns of macrophage polarization in Crohn's disease (CD) and intestinal tuberculosis (iTB)., Methods: Colonic mucosal biopsies from 29 patients with iTB, 50 with CD, and 19 controls were examined. Dual colored immunohistochemistry was performed for iNOS/CD68 (an M1 φ marker) and CD163/CD68 (an M2 φ marker), and the ratio of M1 φ to M2 φ was assessed. To establish the innate nature of macrophage polarization, we analyzed the extent of mitochondrial depolarization, a key marker of inflammatory responses, in monocyte-derived macrophages obtained from CD and iTB patients, following interferon-γ treatment., Results: M1 φ polarization was more prominent in CD biopsies ( P =0.002) than in iTB ( P =0.2) and control biopsies. In granuloma-positive biopsies, including those in CD, M1 φ predominance was significant ( P =0.001). In iTB, the densities of M1 φ did not differ between granuloma-positive and granuloma-negative biopsies ( P =0.1). Interestingly, higher M1 φ polarization in CD biopsies correlated with high inflammatory response exhibited by peripheral blood-derived monocytes from these patients., Conclusions: Proinflammatory M1 φ polarization was more common in colonic mucosa of CD patients, especially in the presence of mucosal granulomas. Further characterization of the innate immune system could help in clarifying the pathology of iTB and CD., Competing Interests: CONFLICT OF INTEREST: No potential conflict of interest relevant to this article was reported.

Background and Study Aims:  Invagination, which can occur in any part of the intestine, usually affects children and is the second most common cause of intestinal obstruction after pyloric stenosis. The cause of these intussusceptions in children is usually unknown and they typically occur within the ileocolic region. Management of pediatric patients with the condition often consists of surgical intervention. However, this retrospective study from the University Hospital of the University of São Paulo, Brazil, reports a series of cases of intussusception in children in whom a colonoscopy was used to reverse the intussusception., Patients and Methods:  From April 2010 to January 2015, 30 pediatric patients underwent a colonoscopy as an noninvasive method for treatment of children's intestinal intussusception., Results:  Overall, treatment with colonoscopy was successful in reversing invagination in 66.7 % of the patients. However, 33.3 % of patients required surgery to resolve the intussusception., Conclusion:  Noninvasive colonoscopy is a potential treatment for intussusception in children.

Background/aims: Patients with inflammatory bowel disease (IBD) often require immunosuppressive therapy and blood transfusions and therefore are at a high risk of contracting infections due to hepatitis B (HBV) and hepatitis C (HCV) and human immunodeficiency virus (HIV). In the present study, we assessed the prevalence of these infections in patients with IBD., Methods: This retrospective study included 908 consecutive patients with IBD (ulcerative colitis [UC], n=581; Crohn's disease [CD], n=327) who were receiving care at a tertiary care center. Ninety-five patients with intestinal tuberculosis (ITB) were recruited as disease controls. Prospectively maintained patient databases were reviewed for the prevalence of HBV surface antigen, anti-HCV antibodies, and HIV (enzyme-linked immunosorbent assay method). HCV RNA was examined in patients who tested positive for anti-HCV antibodies. Prevalence data of the study were compared with that of the general Indian population (HBV, 3.7%; HCV, 1%; HIV, 0.3%)., Results: The prevalence of HBV, HCV, and HIV was 2.4%, 1.4%, and 0.1%, respectively, in the 908 patients with IBD. Among the 581 patients with UC, 2.2% (12/541) had HBV, 1.7% (9/517) had HCV, and 0.2% (1/499) had HIV. Among the 327 patients with CD, 2.8% (8/288) had HBV, 0.7% (2/273) had HCV, and 0% (0/277) had HIV. One patient with CD had HBV and HCV coinfection. The prevalence of HBV, HCV, and HIV in patients with ITB was 5.9% (4/67), 1.8% (1/57), and 1.2% (1/84), respectively., Conclusions: The prevalence of HBV, HCV, and HIV in north Indian patients with IBD is similar to the prevalence of these viruses in the general community. Nonetheless, the high risk of flare after immunosuppressive therapy mandates routine screening of patients with IBD for viral markers., Competing Interests: Conflict of interest: None.