bluuebunny/crossref_metadata_2025 huggingface dataset:
The Influence of the Corona-Virus on the Tunisian Supply Chain and Transshipment Problem
Authors: Fadoi Elleuch , Boudabbous Semi
Published: August 2023

This article aims to provide results of the impact of the Corona-Virus pandemic on the functioning of Tunisian companies. Based on a sample of these companies, the results showed a strong disruption of the various links in the supply chain following the generalized confinement of the population and the closure of borders.Overall, this study contributes both to the study of the effect of Corona-Virus on Supply Chain management and to the implications of the literature in this field and has important practical implications.We therefore sought to find out which links in the supply chain were the most impacted by applying ARENA modeling.The findings suggest that the analysis of the results makes it possible to detect the manifest existence of specific operating models.The Lateral-Transshipment and Commodity Allocation problem in the context of the COVID-19 outbreak has many novel features. For this, we propose a new multi-objective optimization model for Lateral-Transshipment of emergent products in two steps. The objectives envisaged are the optimization of the quality of the transhipped product, the satisfaction of customer demand and the minimization of the overall cost including the shortage penalty.
ANTIMICROBIAL ACTIVITY TEST OF 96% ETHANOL EXTRACT OF FLOWERS, LEAVES, AND STEM BARK OF TIGARUN (Crateva magna DC.) AGAINST Staphylococcus aureus and Malassezia furfur
Authors: Hasani Najwi , Rika Hartati  , Elin Julianti
Published: August 2023

Staphylococcus aureus and Malassezia furfur One of the microbes that can cause folliculitis is the inflammation of the skin in the hair follicles. The use of natural ingredients as antimicrobials must be developed as an alternative to overcome the resistance and side effects of chemical drugs. Tigarun (Crataeva magna DC.) is a typical plant in South Kalimantan that can be developed as a natural antimicrobial agent for the treatment of skin infections. Previous studies have reported that tigarun has antimicrobial activity, but no studies have reported its potential antimicrobial activity against folliculitis-causing microbes. Therefore, this study aimed to determine the antimicrobial activity of 96% ethanol extracts of the flowers, leaves, and stem bark of tigarun (Crataeva magna DC.) against microbes that cause folliculitis, including Staphylococcus aureus and Malassezia furfur. Extraction was performed by the maceration method using 96% ethanol. The antimicrobial activities of the extracts were tested using the agar diffusion method. Based on the results of the antimicrobial activity test using the agar diffusion method, the tigarun flower extract showed better antimicrobial activity than the leaf and tigarun bark extracts. Flower extract activity at 200 mg/mL concentrations against Staphylococcus aureus (10.65 ± 0.25) and the fungus Malassezia furfur (7.40 ± 0.40) with moderate inhibition zone ketogenic
 Keywords: Folliculitis, tigarun, antimicrobial, agar diffusion
Elements of integrated business management as a mechanism for profitability in the inns of the La Troncal sector
Authors: Hinojosa Caballero Ana Gabriela , Boza Aguirre Joffre Edgar , Guzmán Chávez Jonnathan Fernando , Morales Calle Lucia Carolina
Published: August 2023

The canton of La Troncal in the province of Cañar is identified as a natural tourist center, which is why identifying the elements of integrated business management as a mechanism of profitability in the inns is of vital importance to demonstrate the economic revival of the area, a literature review of the elements of business management was conducted, A survey was applied to representatives of inns in the tourism sector and after an analysis of the results of these surveys, the lack of application of different elements of integrated business management was evidenced, and it was recommended to the interested parties to review the organization of their company to apply these elements more efficiently, which will bring them an increase in profitability in the future.
Determination of the Weighted Average Cost of Capital (WACC) applied to a COOPAC of Lima Cercado
Authors: Sánchez Rodríguez Leopoldo Zacarías
Published: August 2023

In a context characterized by continuous changes, in which political instability is coupled with the damage caused by cyclone Yaku and the consequences of heavy rainfall that affected large areas of the northern coast of our country during the first three months of 2023. In addition, the actions taken by the Superintendence of Banking, Insurance and AFP against certain Savings and Credit Cooperatives, due to the negative balances in their equity accounts, have caused a high level of uncertainty and distrust towards the management carried out by the Peruvian cooperative system. This is due to the fragility of their financial structures, both for those involved internally and externally. Therefore, the main objective of this study was to determine the Weighted Average Cost of Capital in the financial decision making of a savings and credit cooperative in Lima Cercado. To achieve this, a descriptive study was carried out that addressed the fundamental concepts and appropriate techniques, based on a theoretical review of the evolution of corporate finance, considered a novelty in today's business.
Quality impact, with the use of more than three sigmas in the statistical control of processes by variables
Authors: Hidalgo Torres José Luis
Published: August 2023

The main objective of this study is to show how the use of more than ± 3? in the formulas to determine the limits of the variables in the statistical process control charts affects the quality of the manufactured products and, consequently, the final consumer. In the research process, the induction and description methods were used to determine the required values of the parameters, constants and others used, which allow showing the proposed objective. The results in this study indicate that the use of more than ± 3? in the statistical process control formulas by variables can have a negative impact on the quality of the final product. This is because the use of wider limits may allow more variability in the process to go undetected, which may result in more defective or out-of-specification products. Consequently, this can negatively affect customer satisfaction and company reputation. Therefore, it is important to take these findings into account when setting control limits on statistical process control charts.
Industrial Safety and Occupational Health Strategies: The Case of a Water Treatment Plant in Ecuador
Authors: López López Jessica Cecibel , Alcívar Espín Roberto Andrés
Published: August 2023

This research aims to establish strategies in Industrial Safety and Occupational Health (SISO) using the case study of a water treatment plant in Ecuador; preventive activities in this area are poorly developed, being relegated to the background for not being considered important for production processes, this reality is worrying because despite the efforts made to implement a series of public policies; the figures of accidents and incidents indicate that it is still required to improve the SISO systems, to ensure the life, health and integrity of workers. The methodology used is descriptive and correlational, applying the inductive, deductive and analytical method, in addition to the integration of elements and sub-elements of an Occupational Safety and Health Management System proposed by the Andean Instruction Regulations, Resolution 957: 2008, and the ISO 45001:2018 standard; the population of interest was considered to be the 59 people working at the Water Treatment Plant in Santa Elena-Ecuador, of which 24 were selected to collect data through a survey. As a result, the proposed strategies are on par with the ISO 45001:2018 standard, which includes all the necessary requirements that an organization must have to ensure the safe provision of its services, minimizing risks or accidents, and providing a safe working environment for people.
Burnout in the teaching profession: a study at the Universidad Politécnica Salesiana Sede Guayaquil, Ecuador
Authors: Calle Carrión Iskra Casandra , Bastidas Jiménez Marcelo Javier
Published: August 2023

The most productive organizations invest in their human capital and implement strategies to reduce levels of stress and fatigue at work.  Burnout affects many countries in Europe and Latin America, especially those in the medical and teaching professions. Ecuador is no exception. The objective of this research is to know how Burnout Syndrome affects the teaching staff of an Ecuadorian university, using a descriptive methodology with a quantitative approach. The method used was the survey, using an instrument based on the "Maslach" burnout inventory, a tool that consists of 22 questions divided into three dimensions: emotional exhaustion, depersonalization and personal fulfillment. For the analysis, the following groups were defined: no burnout, mild/moderate burnout and severe burnout. A higher percentage of severe burnout is evidenced in men. The same occurs in the group of people between 35 and 44 years of age. It is concluded that there is an affectation in the quality of life of the teachers of the Salesian Polytechnic University caused by the Burnout Syndrome, it is recommended to improve the working condition of the employees to raise the levels of motivation and productivity of the organization.
Analysis of the Level of Responsiveness of Local Government Public Services through Social Media
Authors: SOANTAHON Sherwin Mikhael
Published: August 2023

Purpose: This study aims to analyze the level of responsiveness of local government public services through social media. This issue was raised due to the increasing trend of social media use by the public and the potential for providing public services to the community through social media. In this study, we will look at the level of responsiveness of local government agencies, especially city governments, in serving people who request public services through social media.Methodology:This research uses a mixed approach (mixed method) with sample selection using random sampling techniques based on area (cluster random sampling). The sample used comes from representatives of the Regional Government from the city level based on the division of the western, central, and eastern parts of Indonesia.Findings:The results of this study indicate that the level of responsiveness of local government public services through social media is still low. The sample analysis results in this study show that only 10.71% of official local government social media accounts respond to complaints/submissions of public services through social media.Implication:From the results of this study, the level of responsiveness of local government public services is still relatively low. It can hurt the quality and image of public services by the Regional Government.
Research Trends in E-tourism: A Bibliometric Analysis using VOSviewer
Authors: AWANG Mesak Yamres
Published: August 2023

Purpose: This study was conducted to determine (1) the growth of the number of scientific publications in the field of E-tourism, (2) the number of publications per field/subject, and (3) the map of publication development based on keywords and publication year.MethodologyThis study used a quantitative descriptive method with bibliometric analysis. Data was collected by searching through the Google Scholar database with the keyword "E-tourism" with the category "keywords for 2012–2022 using Publish or Perish 8 software. In addition, VOSviewer software is used to analyze the publication of development maps.FindingsThe study results show that the growth of scientific publications in land e-tourism shows fluctuations and an increasing trend. The highest increase will occur in 2022, with 41 documents (13.67%). Most subjects and subjects are in the fields of services, development, technology, and systems. While the keywords that appear the least are effort and challenge. The interrelationships between topics are grouped into eight clusters, seen through network visualization.ImplicationThis research is expected to assist researchers in determining themes to be researched and can also be a reference for tourism research.
Association Situation and Educational Situation in Elementary School
Authors: WIDIANSYAH Apriyanti
Published: August 2023

Purpose The research aims to find out how the situation of the association in shaping education both in social situations and education in elementary schools.MethodologyThe research methodology used is Descriptive Qualitative Research, intending to obtain an overview of the correlative dimensions of the synergism of social situations and educational situations in elementary schools, with the hope of developing substantive thinking as a whole (not dichotomous and partial). The data collection techniques used include: First, Observation, ; Second, interviews; Third, literature; Fourth, Documentation.FindingsWhen it comes to social situations and educational situations, educators, including teachers as educators at school, need to keep in mind carefully so that they can place themselves in the correct position in every situation that may be encountered in carrying out their duties as a teacher/educator. A teacher must know when he is just hanging out with his students and when he is educating or being an educator. In order not to act wrongly because, for ordinary people, the two situations are the same, and call them by the same name.ImplicationNo two children are identical in this world. In social situations, children get the opportunity to express what they live. Children can freely and spontaneously express their thoughts, feelings, and desires. Children can develop their personality with the opportunity to act and behave as he wants. On the one hand, children do feel dependent on adults, but on the other hand, children want to gain freedom or independence. This desire can be obtained by children in the association.
Organ-sparing resection techniques in the treatment of liver echinococcosis
Authors: Krasnov A. O. , Anishchenko V. V. , Pachgin I. V. , Krasnov K. A. , Pelts V. A. , Krasnov O. A. , Pavlenko V. V.
Published: August 2023

This study aims to present and evaluate the results of treating surgery patients using organsparing resection interventions for liver echinococcosis.

Material and methods. The study presents the results of treating 103 patients (51/49.6 % males, 52/50.6 % females) who have undergone total radical pericystectomy/atypical liver resection for liver echinococcosis. Patients were divided into two groups: Group 1, with interventions performed through laparotomic access (n = 84), and Group 2, with interventions using laparoscopic techniques (n = 19).

Results. In the abdominal intervention group, there was no statistically significant advantage in the rate of parenchyma dissection between different methods (p > 0.05). The average time of haemostasis without the Tachocomb haemostatic substance applied showed a lower value (p = 0.17). The average blood loss during the Pringle manoeuvre was significantly lower (p = 0.043).

There was no statistically significant advantage in the laparoscopic intervention group as regards the rate of parenchyma dissection (p = 0.74). The average haemostasis time was significantly shorter in patients using the Floseal haemostatic matrix than those treated otherwise (p = 0.001). In patients with the improved laparoscopic Pringle manoeuvre, blood loss was significantly less than in those who had not undergone the technique (p = 0.00008).

No statistically significant differences were observed (p = 0.76) when comparing the percentages of nonspecific complications in the two groups. The average value of postoperative bed-day was significantly lower in the laparoscopic surgical treatment group (p = 0.00001).

Conclusion. Using the Pringle maneuver when performing abdominal and laparoscopic interventions statistically proved its effectiveness. The use of the Floseal haemostatic matrix during laparoscopic operations allowed a statistically significant reduction in the time of haemostasis and intraoperative bleeding. The duration of the operation and the time of dissection of the parenchyma in the laparoscopic surgery were significantly higher (p < 0.05). The immediate results of the laparoscopic and abdominal interventions proved comparable.
Results of preoperative application of micronised purified flavonoid fraction as part of a multimodal analgesic regimen in anorectal surgery: a prospective, randomised, placebo-controlled, double-blind study
Authors: Garmanova T. N. , Markaryan D. R. , Kazachenko E. A. , Ishchenko R. V. , Lukyanov A. M. , Krivonosova D. A. , Agapov M. A.
Published: August 2023

This study aims to assess the efficiency of micronised purified flavonoid fraction (MPFF) administration prior to open haemorrhoidectomy on postoperative pain severity reduction.

Methods. The prospective clinical study involved patients with haemorrhoidal disease. Participants were randomly divided into two groups: the first one received 1000 mg of MPFF (Detralex®) 15 days before surgery, seven days after surgery, according to the acute haemorrhoid treatment scheme, and 1000 mg per day until 30 days after surgery; the second one received a placebo. The primary endpoint was the frequency of opioid intake.

Results. The study included 182 participants (102 and 82 in the experimental and control group, respectively). Postoperative pain at rest and during defecation was significantly lower in the experimental group on days 6—9 postoperatively (p < 0.05). The use of opioids and other NSAIDs after surgery did not differ between groups. There was no significant difference between groups in side effects frequency and time to return to the usual lifestyle. As for the quality of life, the control group had significantly higher levels of self-care difficulty, anxiety and lingering pain/discomfort, being more likely to suffer from other persistent complaints.

Conclusion. The preoperative administration of MPFF as analgesia has demonstrated safety and efficacy, effectively reducing postoperative pain in anorectal surgery while avoiding an increase in side effects. Hence, it is recommended for routine implementation in patient care as an essential component of multimodal analgesia during anorectal surgery.
Reliability of self-assessment of quality of life in patients with hiatal hernia associated with gastroesophageal reflux disease after videolaparoscopic anti-reflux surgery
Authors: Oskretkov V. I. , Tseymach E. A. , Andreasyan A. R. , Grigoryan M. A. , Maslikova S. A.
Published: August 2023

This article aims to investigate the reliability of self-assessment of the quality of life in patients with hiatal hernia after undergoing videolaparoscopic anti-reflux intervention. To achieve this, the responses to a questionnaire were compared with the results of a study on the failure of the cardia anti-reflux mechanism.

Materials and methods. A total of 213 patients who underwent videolaparoscopic oesophagus fundoplication were included in this study. The participants completed three questionnaires: GORD-HRQL, GIQLI, and SF-36. The responses obtained from the questionnaires were then compared with the results of a cardia anti-reflux mechanism study, which involved X-ray endoscopy of the oesophagus and stomach, daily oesophageal pH-metry, and oesophagogastric junction manometry. Based on the responses to the three questionnaires, the quality of life index was calculated for all patients. Additionally, a composite index of cardia anti-reflux mechanism failure was computed to assess the severity of pathological gastro-oesophageal reflux and describe the effectiveness of the cardia anti-reflux mechanism in preventing it.

Results. The comparison of the components forming the integral quality of life index with the composite index of cardia anti-reflux mechanism failure before and after the operation revealed an inverse relationship: as the values of the integral quality of life index decreased, the values of the composite index of cardia anti-reflux mechanism failure increased.

Conclusion. The self-assessment of the quality of life by patients with GORD-associated hiatal hernia after anti-reflux intervention, as assessed through GORD-HRQL, GIQLI, and SF-36 questionnaires, is accurate and can be effectively utilized for screening and diagnosing disease recurrence.
A prediction model for after postoperative outcome in SARS-CоV-2 patients: a retrospective observation study
Authors: Orbelyan L. K. , Durleshter V. M. , Trembach N. V. , Sinkov S. V. , Rogal M. M. , Vysotskii O. V. , Babenko E. S. , Murashko D. S.
Published: August 2023

Introduction. Coronavirus infection can complicate the perioperative course of any surgical intervention, posing an acute problem in surgical patients with COVID-19. At the same time, the risk factors and their contribution to the adverse outcome remain obscure.

Objectives. This study aims to identify risk factors for postoperative death in patients diagnosed with SARS-CoV-2.

Materials and methods. The study offers a retrospective analysis of data from 1029 patients at the Krasnodar Regional Clinical Hospital № 2, which had been converted into a COVID-19 treatment facility.

Results. A total of 421 (41 %) patients underwent high-risk surgery. Mortality in the study cohort reached 21.2 %. Factors such as the ASA baseline physical status, age, surgery duration and the degree of lung damage seen on CT scans (CT-3 and CT-4) serve as independent predictors of death. Using these parameters makes it possible to predict perioperative mortality with high accuracy (AUROC = 0.814).

Conclusion. The study examined risk factors for poor outcomes in surgery patients with COVID-19 and developed a model to predict death in this group of patients. The frequency of adverse outcomes after surgical treatment of patients with SARS-CоV-2 was relatively high, the predictors of death being advanced age, baseline physical status, surgery severity and duration, as well as the volume of lung damage seen on CT scans. The developed model allows accurate prediction of an unfavourable outcome.
Distal biceps tendon ruptures: clinical features, diagnostic strategy and treatment options
Authors: Egiazaryan K. A. , Ratiev A. P. , Ershov D. S. , Okhanov O. A. , Mikhaylova E. S.
Published: August 2023

Relevance. This paper reviews the latest evidence concerning distal biceps tendon repair, particularly aspects such as tear type, patient demographics, diagnostic clues, surgical indications, the anatomy of distal tendon insertion, radial tuberosity, single- vs double-incision reconstruction, fixation techniques (bone tunnels, distal biceps button, interference screw, button plus screw) and postoperative outcomes.

Material and methods. The MEDLINE, Cochrane, Web of Science, Scopus and Elibrary online databases were searched using the keywords ‘distal biceps tendon’, ‘elbow’, ‘intramedullary’, ‘partial’. ‘complete’, ‘review’ and ‘rupture’. Sixty publications on distal biceps tendon rupture treatment were identified that appeared over 60 years, between 1951 and October 2021.

Results and discussion. The review has demonstrated that complete deltoid ligament (DBT) tears are predominantly diagnosed clinically, while medical imaging has proven to be a valuable adjunct for diagnosing partial tears. Advances in clinical and medical imaging of partial tears have the potential to expedite the diagnostic process and guide treatment strategies. Primary repair is commonly employed for complete tears, utilizing either a single-incision or double-incision approach, resulting in favorable clinical outcomes. However, the double-incision technique carries a higher risk of heterotopic ossification, whereas the single-incision approach presents a greater risk of nerve-related complications. To mitigate the risk of posterior interosseous nerve lesions in single-incision repairs, intramedullary fixation may serve as a viable solution. Additionally, DBT endoscopy holds promise for the treatment of low-grade partial tears and tendinosis.
Arthroscopic repair of the supraspinatus tendon with single-stage decompression of the suprascapular nerve at the superscapular notch
Authors: Giniyatov A. R. , Ivanov A. A. , Egiazaryan K. A. , Tamazyan V. O. , Ratiev A. P.
Published: August 2023

The history of shoulder problems dates back to ancient times, and the shoulder joint plays a significant role in various aspects of human life. Throughout history, doctors have been providing assistance to individuals experiencing shoulder pain. In the 20th century, significant advancements were made in shoulder surgery, driven by an improved understanding of joint biomechanics and the recognition of new diagnostic methods. Arthroscopy, a minimally invasive surgical technique, was first used for diagnosing shoulder conditions only about 30 years ago. Since then, it has replaced many open surgical procedures due to its enhanced visualization capabilities and lower invasiveness, leading to reduced injury rates. Suprascapular nerve decompression at the suprascapular notch is an example of a procedure that has benefited from arthroscopy. Dr. Laurent Lafosse's detailed description of arthroscopic manipulation in 2007 has been crucial in advancing this technique.

This article aims to shed light on the pathogenesis of suprascapular nerve compression at the suprascapular notch following supraspinatus tendon retraction and examine the potential complications of suprascapular neuropathy. The principal author of this article has successfully performed 20 supraspinatus tendon repair operations with simultaneous decompression of the suprascapular nerve at the suprascapular notch, achieving positive outcomes in the postoperative period.
Recent advances in the surgical treatment of malignant liver tumours: a review
Authors: Pelts V. A. , Pavlenko V. V. , Tropin V. E. , Krasnov A. O. , Rudaeva E. V.
Published: August 2023

This article reviews unresolved problems in the surgical treatment of primary and metastatic liver cancer and ways to overcome them. The state of affairs in liver surgery calls for new patient-oriented rational surgical tactics, the use of patient-oriented methods of diagnosis and surgical treatment of malignant liver tumours, as well as multidisciplinary therapeutic and diagnostic approaches.
Warthin cyst of lacrimal sac: A rare presentation of a common tumor!
Authors: Nagtode Apurva H , Jayagayathri Rajagopalan , Thomas Linya , Dayakar Yadalla
Published: August 2023

Warthin tumor is a common and benign salivary gland tumor comprising of 2-15% of all epithelial tumors of the parotid gland. The extra-parotid presentation is seen to be rare at sites like the eyelid, caruncle, and the lacrimal gland. In this study, we have reported an extremely rare case of Warthin cyst of the lacrimal sac in an 82-year-old male patient with swelling over the medial canthal region since the past 2 years.
An incidental finding of a rare anomaly: Intraorbital cyst with coexisting optic disc pit
Authors: Das Nibedita , Das Joyeeta , Baidya Kalyan
Published: August 2023

A 46-year-old gentleman referred for opinion about an orbital mass discovered on imaging for left eye blunt trauma. On examination, an orbital cystic lesion along with an optic nerve pit was found, which has been rarely reported. In this present case, we will describe some investigational findings of such a rarely described anomaly and emphasizing the role of optic nerve imaging in each case of optic disc pit and other malformations of optic nerve.
Acute annular outer retinopathy (AAOR)—First report from India
Authors: Patnaik Gazal , Rajendran Vinata , Sobrin Lucia , Biswas Jyotirmay
Published: August 2023

Acute annular outer retinopathy (AAOR) is a very rare variant of white dot syndrome. Ocular imaging helps in distinguishing it from acute zonal occult outer retinopathy. We report the first case of AAOR, from India, with multimodal imaging, highlighting the role of early immunomodulatory therapy in visual prognosis.
Rare case of accommodative loss after barrage laser in myopic eyes and the novel method of rehabilitation using topical pilocarpine
Authors: Kaur Ramneet , Sethi Neha K , Kataria Prerna , Dihana Ashu
Published: August 2023

Accommodation is mediated by the short posterior ciliary nerves (SPCN) through muscarinic innervation to ciliary muscles. We report a case of an 18-year female who presented with glare and loss of near vision in both eyes after barrage laser to the peripheral retina for multiple lattices with atrophic holes. Before laser, both eyes (OU) best corrected visual acuity (BCVA) with myopic correction was 20/20. After 1 week post-laser, near vision decreased to OU N18, and pupils were dilated and sluggishly reacting. A working diagnosis of bilateral accommodative and pupillary paralysis secondary to laser-induced damage to SPCN was made. We rehabilitated her with topical 1% pilocarpine drops for a month and she recovered. This is one of the few case reports of internal ophthalmoplegia following a barrage laser in a myopic patient. Another uniqueness is the use of 1% pilocarpine drops as a temporary rehabilitation for near vision correction.
Neurofibromatosis type 1 presenting as buphthalmos at birth and developing into dural herniation over a period of seven years
Authors: Bhomaj Pooja , Patel Nidhi , Chandak Piyush
Published: August 2023

Neurofibromatosis type 1 (NF1) is a genetic disorder that is characterized by appearance of benign tumors of the nerves, soft tissues, and the skin. We discuss a case of a newborn who presented with buphthalmos in the left eye and who, over the years, developed all the features of NF1. There was progressive proptosis, plexiform-neurofibroma of the eyelid, café-au-lait spots, and pigmentation along the trigeminal nerve. There was absent left sphenoid bone–associated dural herniation into orbital spaces, as detected on MRI. Keeping neurofibromatosis as an etiological differential in patients presenting with buphthalmos can help treating physicians understand the spectrum of the approaching disease and counsel the parents accordingly.
A unique case of an exophytic solitary fibrous tumor of sclera
Authors: Sujithra H , Shyam Praveena , Kandula Pooja , Pillai Gopal S , Eapen Malini , Jayasankaran Sandhya C
Published: August 2023

A solitary fibrous tumor (SFT) is a rare primary mesenchymal tumor of the orbit with typical clinical manifestations and varied phenotypic morphology. They also have unique immunohistochemical properties, which form the mainstay of the diagnosis of SFT. Orbital SFTs reported in the literature are mostly extraconal or intraconal in origin. Here, we report a unique case of SFT of ocular origin, namely scleral, with a long clinical course of over 18 years.
Anti-MOG antibody optic neuritis in AML – A case report
Authors: Barigali Aditya , Pai Mithun , Ganesh Sri
Published: August 2023

We report a unique presentation of anti-myelin oligodendrocyte (MOG) optic neuritis in a patient with AML in remission. An elderly man presented with diminished vision in the right eye associated with headache and jaw pain. Systemic investigations revealed no leukemic recurrence. The presence of anti-MOG antibodies and optic nerve enhancement suggested of unilateral optic neuritis. Steroid therapy resulted in the resolution of disc edema. We faced a diagnostic dilemma in a patient with unilateral disc edema in the background of multiple systemic diseases. A methodical approach to investigations helped us in accurate diagnosis, institution of prompt therapy, and minimizing visual morbidity. We present this case to highlight the importance of differentiating leukemic optic nerve infiltration from other causes of unilateral disc edema, as their therapeutic approaches are different.
Acute myeloid leukemia relapsing in the vitreous
Authors: Agrawal Kushal U , Bakshi Chetna , Dutta Supriya
Published: August 2023

A 47-year-old female was a known case of acute myeloid leukemia (AML-M5) and presented with a diminution of vision in the right eye (OD) for two weeks. Examination revealed pigmented cells in the anterior vitreous of both eyes with vitritis OD. She was further treated with vitreous biopsy and diagnostic vitrectomy under air OD. The cytology examination of the vitreous biopsy revealed infiltration with myeloblasts confirming the diagnosis of extramedullary relapse of AML inside the vitreous. She was further treated with intrathecal chemotherapy. She did not have any further relapse till two years after her last follow-up. This case highlights a rare location of extramedullary relapse of AML inside the vitreous which has not been reported as per the literature search. Moreover, diagnostic vitrectomy under air helped in getting more undiluted vitreous fluid, which also helped in confirming the relapse with cytology examination.
Apical idiopathic orbital inflammatory disease presenting with disc edema - A case report
Authors: Mohankumar Arthi , Mohan Namitha , Senthilnathan Chittam , Rajan Mohan
Published: August 2023

Idiopathic orbital inflammatory disease (IOID) is an inflammatory pathology of the orbital contents like muscles, lacrimal glands, and periorbital fat. This report presents a case of a 24-year-old female with axial proptosis, defective vision, and lid edema in the left eye. Her best-corrected visual acuity (BCVA) was 6/36 N8 with grade 1 relative afferent pupillary defect (RAPD) and impaired color vision in the left eye. Magnetic resonance imaging (MRI) of the left orbit showed infiltration of the retro-orbital fat with thickening of the optic nerve sheath. She was diagnosed with apical IOID with optic perineuritis and was treated successfully with intravenous and oral steroids.
Goniotomy combined with giant fibrotic encapsulated bleb resection and drainage plate removal for refractory glaucoma: A case report
Authors: Hu Kun , Zhang Yingzhe , Lin Fengbin , Song Yunhe , Zhang Xiulan
Published: August 2023

We report a case of goniotomy (GT) with giant fibrotic bleb resection and drainage plate removal following multiple failed antiglaucoma filtering surgeries. A 36-year-old man underwent trabeculectomy and Ahmed glaucoma valve implantation, revealing a giant fibrotic capsule with medically uncontrolled intraocular pressure (IOP) in the left eye. Removal of the drainage tube, resection of the fibrotic bleb, and a combination with GT were performed successfully, and the IOP was well controlled with a 6-month follow-up after surgery. GT may be successful for refractory glaucoma after filtering for surgical failure caused by fibrosis.
–Inadvertent intravitreal injection of microdroplet of sclerosant during lower lid inclusion cyst management
Authors: Pandey Nidhi , Yadav Hitesh , Saurabh Kumar
Published: August 2023

Globe perforation during oculoplastic procedures is uncommon. Inclusion cysts of the conjunctiva are amenable to complete excision but tend to recur if a part of the cyst wall remains. Sclerosant injections have been tried successfully to collapse inclusion cysts of the conjunctiva. Our case presented with signs of globe perforation two days after the second cyst aspiration and sclerosant injection procedure. The case was managed with a laser barrage of the suspected perforation site, systemic antibiotics, and steroids, resulting in complete visual and functional recovery at the 1-month follow-up. This is the first such case reported in the literature.
Clinical presentation and outcomes of trivial trauma-associated giant macular holes in children with Best vitelliform macular dystrophy
Authors: Ramachandran Sivaranjan , Parameswarappa Deepika C , Takkar Brijesh , Jalali Subhadra , Padhy Srikanta K
Published: August 2023

We present three cases of children with giant macular holes in relation to trivial trauma. These children had brittle retina secondary to Best vitelliform macular dystrophy (BVMD) which made them vulnerable to the irreversible complications. None of the three cases had any signs of trauma in the anterior segment pointing to trivial nature of the trauma. Two cases progressed to retinal detachment. This series highlights the importance of ocular protection and special care needed for children with BVMD.
A curious case of filamentary keratitis following uncomplicated Strabismus surgery!
Authors: Shetty Shashikant B , Aguiar Marushka , Venkatraman Mathangi , Pradhan Priyarthi
Published: August 2023

Filamentary keratitis is an ocular condition in which filaments composed of degenerated epithelial cells and mucus develop on and adhere to the corneal surface causing pain and foreign body sensation, usually seen associated with ocular surface disorders. We report the case of a 33-year-old male who developed filamentary keratitis after undergoing uncomplicated strabismus surgery for exotropia secondary to third-nerve palsy with aberrant regeneration. His symptoms were controlled after D-Panthenol was used. Filamentary keratitis is an extremely rare occurrence following strabismus surgery but should be kept in mind and managed appropriately.
Bull gore injury of the eye: Nightmare of Jallikattu!
Authors: Christy Josephine S , Parab Aditi , Mouttapa Fredrick
Published: August 2023

We describe a unique case of needless blindness where the patient completely lost his vision in a split second while playing Jallikattu, a bull-taming sport in Tamil Nadu. This case report aims to highlight the ocular trauma in animal sports and the importance of creating awareness among medical professionals about its grave consequences. The introduction of protective safety protocols during sports can go a long way in avoiding severe, irreversible blindness, and save precious lives too.
Minimally invasive approach for the management of tube–corneal touch in aniridic glaucoma
Authors: Bansal Sanchi , Singh Tanu , Gupta Gayana , Kumar Suresh , Ichhpujani Parul
Published: August 2023

Aniridic glaucoma, with a prevalence of around 50% in aniridia patients, often requires surgical management with glaucoma drainage device implantation. It is associated with many complications related to the tube or plate. We present a case of tube endothelial touch in aniridic glaucoma where repositioning of the Ahmed glaucoma valve tube was performed using transcameral prolene suture fixation. The advantage of this technique is that it is minimally invasive and maintains the stability of the anterior chamber throughout the surgery.
Vision-threatening reactions of hyaluronidase after local anesthesia: A case series and review of literature
Authors: Singh Arti , Singh Kamaljeet , Rana Jagriti , Singh Upasna , Sharma Anirrud , Kumar Vineet
Published: August 2023

Hyaluronidase is an often used drug in ophthalmology to enhance the effect of local anesthesia. Hypersensitivity reaction to hyaluronidase is a rare complication. Various cases showing varied presentations have been reported in the literature. Here, we report three cases presented with hypersensitivity reaction to hyaluronidase, which were more fulminant, presented with proptosis, blisters, necrosis, and loss of corneal sensation. When such a situation arises, early diagnosis, differentiation from infectious etiology, and timely management with immunosuppressive therapy are crucial for these vision-threatening complications.
Brittle cornea syndrome: Case report and discussion on correct denomination
Authors: Muñoz Salazar Lina M , Martínez Córdoba Claudia J , Ariza Torrado Irina P , Fernández Delgado Ángela M , Ruiz Robles Luis A
Published: August 2023

Brittle cornea syndrome (BCS) is a rare connective tissue disease, with autosomal recessive inheritance, caused by mutation of ZNF469 and PRDM5 genes. Its main characteristic is severe corneal thinning and weakness, with a tendency for corneal rupture, that occurs spontaneously or after minimal ocular trauma. We present the case of a 4-year-old girl, with corneal rupture in both eyes after minor traumas, and with hypoacusis and joint hypermobility as extraocular manifestations, emphasizing the difficulties of treatment, and discussing the correct denomination of the syndrome as BCS, avoiding the frequent confusion with Ehlers Danlos type VI.
A rare case of isolated congenital corneal dermoid: Literature review and histopathologic correlation
Authors: Agrawal Nikhil , Khera Sudeep , Rajpurohit Tapasya , Shakrawal Jyoti , Asodariya Ronak , Tandon Manjari , Bhatnagar Kavita
Published: August 2023

A dermoid cyst is a benign congenital tumor that arises due to the entrapment of ectodermal elements along the line of embryonic closure. Limbal dermoid is the most common dermoid reported in the literature. However, isolated corneal dermoid has rarely been described. Here, we present a case of a 19-year-old man who presented with a giant isolated congenital corneal dermoid, which is distinct from the typical limbal dermoid histopathologically and in terms of management.
Traumatic endophthalmitis following injury by a fish: A rare case report and review of literature
Authors: Kumar Jayant , Ravindran Ram Sudarshan , Singh Kritika , Babu Naresh
Published: August 2023

A 26-year-old male presented with decreased vision in left eye (OS) following an attack by a fish while swimming in a pond. His best corrected visual acuity (BCVA) was hand movements in OS and 20/20 in right eye (OD). Fundus examination and ultrasonography B-scan confirmed the presence of traumatic endophthalmitis in OS. Wound exploration confirmed the presence of a foreign body near limbus, which was removed and found to be a cartilaginous fish tissue measuring 4.5 millimeters in length. Pars plana vitrectomy was performed, and intravitreal antibiotics were administered. The case highlights a rare form of ocular injury and its management.
Bilateral choroidopathy as an initial presentation in systemic lupus erythematosus
Authors: Palsule Aratee , Agarkhedkar Renu , Anupama
Published: August 2023

We present a case of bilateral (B/L) choroidopathy as an initial presentation in systemic lupus erythematosus (SLE). A 25-year-old female presented with complaints of swelling, redness, and diminution of vision (DOV) with myopic shift since 10 days. Oral antihistaminics were prescribed, considering food allergy due to history of ingestion of fish. But she developed further DOV with macular and facial edema after 2 months. On detailed investigations and consultation with a nephrologist and a rheumatologist, she was diagnosed to have SLE and treated with immunosuppressants. This case highlights that ophthalmic examination should be carefully done and monitored as it may be the only sign of presentation and disease progression.
Birdshot chorioretinopathy in a South Asian patient
Authors: Apivatthakakul Atitaya , Goldberg Naomi R , Sobrin Lucia
Published: August 2023

To describe the clinical features of a South Asian patient with HLA-A29-positive birdshot chorioretinopathy (BSCR). A 54-year-old South Asian woman presented with blurred vision and floaters. The ophthalmic examination showed bilateral vitritis and retinal vasculitis. Fluorescein angiography revealed a bilateral disc and retinovascular leakage along the arcades. On indocyanine green angiography, multiple hypo-fluorescent lesions were found. Work-up revealed positive HLA-A29. BSCR is primarily seen in patients of European descent, but it can occur in other ancestries. We present an HLA-A29-positive BSCR South Asian patient to highlight that this disease can be seen in patients of South Asian descent.
Bilateral radiation retinopathy in a patient with Ewing sarcoma of the left sinonasal cavity with orbital extension
Authors: O’Donovan Charles , Wu Angela Ding , Lim Wei Sing , Strauss Sandra J , Saunders Daniel
Published: August 2023

A 25 year old with Ewing sarcoma of the left sinonasal cavity with orbital extension who had undergone chemotherapy and proton beam therapy presented with bilateral painless reduced vision. She was diagnosed with radiation retinopathy and treated with anti-VEGF injections. This is a rare case where the contralateral eye has been affected by radiation treatment. Factors increasing the retinopathic effects of radiation include increased radiation dosage, increased fraction size, concomitant vascular disease, and concurrent use of chemotherapy. It is essential that all patients subjected to head and neck radiotherapy are consented to this adverse side effect, including the contralateral eye being affected.
Bilateral combined anterior and posterior scleritis – A case of organ-limited idiopathic vasculitis
Authors: Chudasama Falguni , Mehta Parin , Desai Anuja , Mistry Rutviz
Published: August 2023

We present a case of a 69-year-old female with complains of bilateral painful red eyes and blurred vision. The patient was treated elsewhere for allergic conjunctivitis and then came here for a second opinion. The patient was diagnosed as a case of bilateral anterior plus posterior scleritis based on clinical findings, optical coherence tomography (OCT), and ultrasound B-scan reports. Thorough systemic evaluation for the possibility of infection and systemic vasculitis was performed based on a rheumatologist opinion. Topical and systemic steroids along with cyclophosphamide were started after admitting the patient for diabetes monitoring. The patient regained the best corrected vision from 6/12 to 6/6 with complete resolution of OCT findings after 15 days. This case highlights the importance of thorough eye check-up including posterior segment evaluation in all cases of scleritis and a multi-disciplinary approach in order to achieve early remission of the episode.
More to it than meets the eye- A case of Takayasu arteritis and antiphospholipid syndrome, associated with ocular ischemic syndrome, neovascularization and secondary angle closure
Authors: Philip Reni , Iqbal Arshad , Prakash V Jaya , Baskaran Mani
Published: August 2023

We describe an atypical case of bilateral ocular ischemic syndrome with neovascularization and secondary angle closure in a 28-year-old lady with features of antiphospholipid syndrome (APS) and Takayasu arteritis; the latter being detected on evaluation of the etiology of the ocular condition. She was treated with pan retinal photocoagulation in one eye and anterior retinal cryotherapy in the other eye (due to poor visualization of the retina initially) followed by cataract surgery. Systemic evaluation was done. Takayasu arteritis was detected and appropriate management was advised under specialist care. Her systemic condition was stable, ocular neovascularization was regressing, and visual acuity improved in the pseudophakic eye; a drop in visual acuity due to the progression of cataract and macular ischemia was noted in the phakic eye at follow-up. Timely detection and appropriate management of ocular and systemic conditions in such cases can preserve vision and limit further systemic morbidity.
Atypical viral keratitis in a graft
Authors: Beniwal Abhijeet , Bafna Rahul K , Rani Deeksha , Asif Mohamed I
Published: August 2023

A 70-year-old male patient, a known case of rheumatoid arthritis, presented with multiple elevated atypical vesicular corneal lesions admixed with an active epithelial defect in the right eye for 2 days. The patient was operated penetrating keratoplasty for mixed keratitis 2 months back. Based on history and clinical findings, a working diagnosis of viral keratitis was made, and the treatment regimen was changed to topical and systemic anti-viral therapy. Subsequently at the end of 2 weeks, the vesicular lesions transformed themselves into umbilicated lesion and healed thereof. Viral keratitis can have a myriad of atypical presentations; therefore, under such circumstances, a strong clinical suspicion with pre-emptive systemic examination will be helpful in achieving optimal outcomes.
Orbital unicentric Castleman’s disease of plasma cell type: A rare case report
Authors: Lin Yunru , Hui Yang , Zhang Lixing , Zhang Jiuming
Published: August 2023

Castleman’s disease (CD) is a rare lymphoproliferative disorder. Recently, we admitted a 68-year-old male with CD presenting as a retro-orbital mass, who had been treated with a surgical procedure. The pathology report was in favor of CD, plasma cell type, which is a rare pathologic type in this clinical entity. Space-occupying lesion of the orbit is an extremely unusual condition of CD. So, we consider that this case was a rare case of CD involving atypical location and atypical pathologic findings.