bluuebunny/crossref_metadata_2025 huggingface dataset:
An Innovative Framework for the Design of Higher Education STEM Induction Programmes
Authors: Rodgers Alisha S. , Agg Chloe , Gironacci Elia , Collingwood Joanna F. , Popham Thomas J.
Published: July 2023

This chapter presents an innovative framework detailing 14 best practice recommendations for the design of higher education STEM induction programmes. The framework has been devised through a student-led initiative as part of a fourth-year engineering undergraduate group project undertaken at the University of Warwick. The framework aims to successfully facilitate student transition by bridging the gap between prior schooling and higher education. The framework can be used as a supporting tool by other educators to assist in the delivery of higher education induction programmes for multiple subjects of study. The design of an induction programme is presented to provide an example of how the framework's recommendations can be implemented in practice. The programme has been specifically designed to facilitate first-year engineering undergraduate transition. It is anticipated that the reader may take inspiration from these designs and implement their own novel induction programme successfully facilitating student transition into higher education in alternative study contexts.
Using Social Identity Mapping to Explore the Experience of Transitioning International Students
Authors: Pownall Ian , Raby Alison , Stork Andrew , Lochtie Dave , Walker Ben W.
Published: July 2023

This chapter explores, through rich interviews with international postgraduate students, their experiences of higher education transition as they enter and move through their studies. The authors use a social identity mapping activity developed for personal tutoring that visually surfaces the social nature of these transitional changes focusing upon how their identity is constructed and developed. Through using semi structured conversations, the activity aimed to surface aspects of their identity which are otherwise difficult to access. Strong evidence was found for the need to support international students in a variety of ways. These included support to manage expected and unexpected changes in who they are becoming, to manage changes in their stressors, and to develop reflective and reflexive awareness.
Recent Developments and Modeling Efforts in Port Logistics
Authors: Oudani Mustapha , Oufaska Kenza , El Raoui Hanane , Haloui Doha
Published: July 2023

The port logistics sector is crucial to the world transportation system, as over 80% of worldwide trade in terms of volume is handled by vessels and ports. This conventional industry is experiencing a significant industrial upgrading from labor-intensive to semi-automated and to fully automated due to the demand for improved operational efficiency and the shortage of competent. These challenges have raised the demand for efficient decision-support tools. The port logistics industry has reached a new stage of development. Although the role of ports and terminals in integrated logistics has been well studied, research on the factors that contribute to port logistics competitiveness is still lacking. The purpose of this chapter is to investigate recent developments and the most prominent efforts on modeling port logistics decision problems and based on it to offer insight into how seaports and terminals can improve their competitiveness. The authors investigate the use of Industry 4.0 in port logistics.
Matrices of Sets as a Mathematical Tool Enabling Efficient Planning of Intermodal Freight Transport
Authors: Charhbili Mohamed , El Yaagoubi Amina , Di Francesco Renaud , Berrah Lamia
Published: July 2023

This research is a component of the FLUSYNCHRO initiative and is focused on constructing a decision support tool for comparing multimodal transport routes from one point to another based on several factors, including distance, time, and environmental considerations. The study employs the innovative theoretical framework of matrices of sets to model container-based intermodal transportation with a particular emphasis on river, rail, and road modalities as well as environmental externalities. The intermodal transport network is presented as a multi-level graph, with each level represented by a matrix of sets comprising terminals, links, and data of the corresponding mode of transport. The determination of multimodal paths is achieved through the multiplication of associated matrices of sets of each mode. The Seine Axis is the region to which this investigation applies, as all three transport modes are accessible. The principal goal is to promote the usage of environmentally sustainable intermodal transportation systems.
Optimal Infrastructure Planning and Placement of Charging Stations for Electric Vehicles
Authors: Preetham Chanati Ganesh , Kandar Shyamalendu
Published: July 2023

Due to environmental pollution and the ever-growing energy demand, there has been a shift from conventional vehicles toward electric vehicles (EVs). Public acceptance of EVs and their large-scale deployment raise the requirement for a fully operational charging infrastructure. Charging station (CS) planning for electric vehicles (EVs) for a region has become an important concern for urban planners to meet the escalating demand for EVs. There are diverse challenges and parameters concerned with finding an optimal placement and infrastructure planning for setting up charging stations for electric vehicles in a smart city. This chapter aims to provide a comprehensive review of some recent state-of-the-art proposals on this emerging research field. The core proposal presented in techniques are elaborated and the advantages and disadvantages of the proposals are unveiled. A comparison of the reviewed techniques is also depicted, and light is flashed on the future direction of research in this field.
Forging Constitutional and Parliamentary Democracy Through Constituency Offices in South Africa
Authors: Tshishonga Ndwakhulu Stephen
Published: July 2023

This chapter deliberates on the role and importance of parliamentary democracy in consolidating democratic governance at community level through the establishment of constituency offices. The democratic government is challenged not only to be inclusive but also to ensure governance measures and that institutional arrangements are in place to consolidate parliamentary democracy based on the precepts enshrined in the Constitution. Thus, constituency offices provide MPs with a forum to share policy related information and further engage constituencies in matters pertaining to policy making and advocacy. The chapter argues that effective constituency offices should not only be the channel of information and communication between MPs and the people, but should also be agents for policy advocacy and implementation. The chapter made use of secondary data in the form of books, journal articles, and governmental policies and documents as well as selected interviews with national members of parliament (MPs) and provincial members of parliaments (PMPs).
Patrimonialism, “Godfatherism,” and Elections in Nigeria's Fourth Republic
Authors: Adegoke Abidemi
Published: July 2023

Theoretically, democracy and political unrest are inversely related. Practically, however, political unrest is becoming a recurring occurrence in some democracies. This contradictory feature of contemporary human society informs the attempt made by this study to explain the nexus between “godfatherism,” patrimonialism, and election on one hand; and the impact these have on enduring unrest in the Nigerian political system. The study, using the elite consensus or group cohesion typology as a framework of analysis and mixed research methods, explained the inevitability of “godfatherism” in the Nigerian political space and the impact their unregulated engagements have, alongside the fragile nature of the Nigerian state on political unrest in the Fourth Republic. Having established the foundations of recurring political unrest, the study calls for a wide range of reform in the political, economic, media, and civil society space and further entrenchment of democratic ethos through purposeful political education of citizens.
Exploring Mixed Reality
Authors: Nasr Rana Salah , El-Deeb Sara
Published: July 2023

Researchers recently became interested in mixed reality (MR) because of the availability of hardware that integrates the advantages of two worlds. As an immersive and innovative technological solution for consumers and brands, research has provided insights into the implementation of MR. This technology is promising to transform business models and consumer behavior. Studies have revealed how MR boosts consumer engagement and purchase intentions. In this chapter, the diverse concepts and techniques of recent technological breakthroughs are reviewed. This includes the differences between augmented reality (AR), virtual reality (VR), and MR. Also, MR will be explored to understand the fusion of reality and virtuality, challenges, and limitations in emerging trends. Thus, providing insights from the perspective of digital marketing that results in better interaction with consumers due to the immersive and interactive experiences it offers.
Quantitative Structure-Activity Relationship (QSAR) Study of Potential Phytochemicals for the Development of Drugs Against Neurological Diseases
Authors: Satpathy Raghunath
Published: July 2023

Neurological diseases have recently evolved into a global concern and are commonly observed in elderly populations. Common examples of these diseases are Alzheimer's disease (AD), Parkinson's disease (PD), Huntington's disease (HD), and amyotrophic lateral sclerosis (ALS). The remarkable application of the computational approach in biological sciences has expedited the drug development process from natural compounds that uncover opportunities to develop new medications. In the computer-aided drug design (CADD) process, the quantitative structure-activity relationship (QSAR) method is crucial in molecule screening and lead optimization. This chapter discusses the potential phytochemicals used to treat these diseases. The process of CADD, along with QSAR methods and the importance of blood-brain barriers (BBB), has been elaborated. The targets of AD and the QSAR analysis of the phytochemicals have been discussed by taking AD as a case study with the challenges of treating these diseases.
Treating Narcolepsy With Traditional Chinese Medicine
Authors: Chin Yap Lay , Seng Kho Boon , Ye How Yng , En Poo Rou , Aslam Muhammad Shahzad , Kim Yun Jin , Linchao Qian , Peryen Teoh , Qi Koh Yong , Jun Lim Ye , Cheah Ooi Yin , Chi Tee Niam
Published: July 2023

Narcolepsy is an uncommon brain condition characterized by falling asleep suddenly without any proper reason or time. In this chapter, the authors include a brief history of narcolepsy, clinical symptoms, pathophysiology, and current treatments for the disease. The review explains narcolepsy according to the theory of TCM. The authors review the curative effect, pharmacological properties, and clinical results of herbs and prescriptions against narcolepsy. The study searched keywords such as ‘narcolepsy,' ‘Traditional Chinese medicine,' ‘sleep disorder,' ‘excessive sleepiness,' and ‘medicinal treatment' using databases such as CNKI, PubMed, and Google Scholar. Based on the analysis of data obtained from 110 articles, the authors have classified the herbs and prescriptions by their curative effects, following the theory of traditional Chinese medicine. Some herbs can be used alone, while others can use in conjunction with other prescriptions.
Comparative Methods for Antioxidant Activity in Extract of Milk
Authors: Tomovska Julijana , Vllasaku Ilmije
Published: July 2023

Milk, known as “medicine and food for a long life,” is characterized by a certain nutritional value. It is an irreplaceable food for children, adults, and developed countries to pay attention to its production. In this chapter, there is an emphasis on antioxidants are compounds, which are not nutrients but have antioxidant capacity in vitro and provide an artificial index of antioxidant power. The material for this examination is milk from three farms and commercial milk. The antioxidant activity is examined by two methods: Phosphomolybdate method, where the results obtained from calibration curve of Gallic acid range of 2,35 - 4.85 μg/mL at 695nm UV area; and % Hydrogen peroxide scavenging used standard ascorbic acid, with results 36.2 - 57.6 μg/mL at 230 nm Visible areas. Results of the two methods compared, there are small deviations in the milk from two farms, which have the opposite tendency of the values, especially in the second method, but in relation to the level of one method, those values are partially the same.
Deep Learning-Based Machine Color Emotion Generation
Authors: Nie Tongyao , Lv Xinguang
Published: July 2023

This paper investigates generating machine color emotion through deep learning. The grayscale image colorization model's training process resembles human memory color. Sixty images were recolored and quality evaluated to explore machine generated color impressions. Six experimental samples were recolored under D65, A, CWF, and TL84 light sources. Changes in lightness, chroma, and hue angle compared the original and colorized images, exploring light source effects on machine color perception. Analyzing differences in coloring results within the CIEL* a* b* color space for pixels with equal grayscale verified machine color emotion generation. Results show the machine learns to form color impressions from samples. Different light source color temperatures impact color prediction accuracy. The machine accurately colors images based on semantic context, demonstrating spontaneous color emotion generation through deep learning. This research positively contributes to the development of intelligent devices with color emotion.
Multi-Feature Video Recommendation Based on Hypergraph Convolution for Mobile Edge Environment
Authors: Wang Haiyan , Hong Jun , You Kaixiang , Luo Jian
Published: July 2023

With the massive growth of edge devices, how to provide users with video recommendation services in a mobile edge environment has become a research hotspot. Most traditional video recommendation methods regard the relationship between user and neighbor to be linear and ignore higher-order connectivity among users, which results in poor recommendation performance. Besides, these methods use a single feature to represent user preferences, which cannot effectively alleviate the data sparsity problem. To improve the performance of video recommendation, this article proposes a multi-feature video recommendation method based on hypergraph convolution (MVRHC). Hypergraph convolution is adopted to compute user neighborhood-level features for modeling high-order correlations among users. Final features are obtained by fusing multi-party features through attention mechanism. And video recommendation is then implemented based on the obtained features. Experimental results on two real-world datasets demonstrate that MVRHC has better performance compared with baseline methods.
The Analysis of Key Success Factors Affecting the Satisfaction of Agricultural Organizational Information Systems
Authors: Wu Yingli , Liu Qingquan , Zhou Shengjin , Zhou Mingming , Li Xin
Published: July 2023

This article takes the WeChat public account of agriculture and rural areas in J Province as the research object to explore the influencing factors of satisfaction of organizational information system (IS) in agricultural sector. Firstly, new media is taken as the background, and the characteristics and communication factors of agricultural informatization are analyzed. Secondly, a user satisfaction questionnaire of the WeChat public account of agriculture and rural areas of J Province is designed based on the satisfaction theory and the success model of IS. Finally, the influencing factors of users' satisfaction with agricultural and rural WeChat public accounts are studied through questionnaire survey. The results show that the correlation coefficients among perceived value (PV), information quality (IQ), perceived usefulness (PU), and platform satisfaction are all positive, and p £ 0.01.
More / All Electric Vertical Take-Off and Landing (VTOL) Vehicle Sensitivities to Propulsion and Power Performance
Authors:   NASA Glenn Research Center, Snyder Christopher
Published: July 2023

Battery power and energy density are important parameters for emerging concepts for more / all-electric vehicles. Electric propulsion and power system performance is also important. To better understand how electric propulsion and power systems component performance influences overall vehicle design, a sensitivity assessment was performed noting changes in vehicle gross weight and energy usage. Updated versions of the Revolutionary Vertical lift Technology (RVLT) Project vertical takeoff and landing (VTOL) urban air mobility (UAM) reference vehicles and missions were used. NASA electric vehicle studies are discussed which were used to help select the range of electric propulsion and power system performance parameters used in this assessment. Thermal management systems (TMS) considerations are also important; new and innovative power management and distribution (PMAD) systems can reduce electric system weight and losses, reducing thermal management constraints often imposed by electric systems modest maximum use temperatures. Vehicles with higher disk loadings require higher power levels per unit weight for VTOL operations, which make them more sensitive to electric system weights and efficiencies. Battery, all-electric vehicles show different sensitivities to component performance than turboelectric or hybrids systems. Battery, all-electric propulsion systems may increase vehicle weight and size, but still results in lower mission energy usage than their hydrocarbon-fueled versions. Significant vehicle weight growth to electric propulsion and power system power-to-weight reductions also occurs at different levels among the various concepts. From these results, one can more readily identify required component performance levels, potential component choices, or research and development paths.
History of international connections of myology in Europe
Authors: Angelini Corrado
Published: July 2023

Over the past centuries, myology as a basic and clinical science has passed through three major stages of development: the classical period, the modern nosographic stage, and the molecular era. The classical period spans the sixteenth century up to the earlier parts of the twentieth century. During this time, several major muscle diseases were clinically and pathologically characterized, including Duchenne muscular dystrophy (DMD), myotonic dystrophy, and facio-scapulo-humeral dystrophy, by master clinicians such as Duchenne, Erb, Becker, Steinert, Landouzy, Dejerine, Meryon, and others. These accomplishments laid solid foundations for the following modern era with nosographic classification and the following molecular era. European clinicians and scientists were major contributors to the modern era in the second half of the twentieth century, which is characterized by three major discoveries. First, it was observed that substantial elevation of the serum activity of creatine kinase indicates muscle damage or destruction. Then, the adaptation of modern histo-and cytochemical techniques to the study of muscle biopsies markedly improved the diagnostic accuracy and made possible the identification of new changes and structures. Thirdly, the advent of modern biochemical techniques permitted the identification of various enzyme defects/storage diseases such as Pompe disease, McArdle's disease, and carnitine deficiency states. The molecular era was made possible by the strikingly fast development of molecular biology and its application to muscle diseases. This permitted the identification of gene defects in many inherited diseases, leading to an accurate and specific diagnosis. The growth of international collaboration in Europe was achieved through the exchange of international scientists and collaborative networks.
Efficacy of Rigid-Angle Bronchial Blockers for Uniportal Video-Assisted Thoracoscopic Tumor Resection
Authors: Li Ying-Tzu , Chiu Hsin-Chan , Hsiao Yueh-Chen , Hsu Hsao-Hsun , Chen Jin-Shing , Cheng Ya-Jung
Published: July 2023

Background:

For uniportal video-assisted thoracoscopic surgery (VATS), which is greatly dependent on satisfactory lung collapse without lung compression from another port, few reports have elucidated the intraoperative efficacy of bronchial blockers (BBs). We hypothesized that operation time would be prolonged if BBs required more intraoperative repositioning during surgical manipulation. We compared the operation times of different surgical procedures performed using BBs with double-lumen tubes (DLTs) in uniportal VATS.

Materials and Methods:

Patients who underwent intubated uniportal VATS were enrolled retrospectively from March to May 2019. Data on the patient, anesthetic, and surgical factors were collected. Regression analyses were performed to determine the effect of various factors on operation time.

Results:

317 patients who underwent uniportal VATS were included. Wedge resection constituted 70.7%, and anatomic resection constituted 29.3% of procedures. BBs were applied for left- and right-side wedge resection (85.6% and 78.7%, respectively) and left- and right-side anatomic resection (74.1% and 56.4%, respectively). The surgical factors significantly affecting operation time were operation procedures (P < .01), number of lymph nodes sampled (P < .001), and size of tumors (P < .01).

Conclusions:

The efficacy of BBs was comparable to that of DLTs for uniportal VATS wedge resection. With significantly less preference for right-side anatomic resection, the efficacy of DLTs was comparable with that of BBs, which were applied in more than half of right-side uniportal anatomic VATS. We conclude that even in uniportal VATSs, rigid-angled BBs demonstrate comparable efficacy with feasible alternatives.
The ProtekDuo in Percutaneous Peripheral Venopulmonary-Arterial ECMO and PROpella Configuration for Cardiogenic Shock with Biventricular Failure
Authors: Maybauer Marc O. , Swol Justyna , Sharif Ammar , Benson Clayne , Brewer Joseph M.
Published: July 2023

This article describes a case study where a patient with ProtekDuo + oxygenator and Impella CP (PROpella) in biventricular failure and cardiogenic shock was reconfigured to venopulmonary-arterial (VP-A) extracorporeal membrane oxygenation (ECMO), secondary to leg ischemia. The ProtekDuo was subsequently used as double-lumen drainage cannula, returning blood into a newly percutaneously placed femoral arterial cannula, mimicking venoarterial (V-A) ECMO in VP-A configuration. The following day, an Impella 5.5 could be placed and the ProtekDuo was reconfigured back to its default venopulmonary (V-P) ECMO configuration, now again as PROpella with minimally invasive biventricular groin-free full mechanical circulatory support. However, while in VP-A, good drainage blood flows of up to 4.5 LPM could be achieved similar to the ProtekDuo forward flow. None of the lumens collapsed secondary to negative pressure in the system. Drainage through the ProtekDuo for VP-A ECMO is feasible and without complications for a 24-hour period. This new method extends the ProtekDuo’s spectrum of use.
Use of Intraoperative Transesophageal Echocardiography and Epiaortic Ultrasound to Diagnose False Lumen Enlargement of Chronic Aortic Dissection
Authors: Honda Jun , Hakozaki Takahiro , Hasegawa Takayuki , Obara Shinju , Inoue Satoki
Published: July 2023

In communicating aortic dissection, if only the entry or reentry is closed, residual blood flow may cause enlargement of the false lumen. In this case, surgeons were unable to occlude the entry with a stent graft due to the strong flexion of the bilateral common iliac arteries, so they closed only the reentry in the hope that blood flow from the reentry would be high. Unfortunately, due to the high blood flow from the entry, the false lumen was enlarged. But the use of transesophageal echocardiography and epiaortic ultrasound contributed to its diagnosis.
Effect of Albumin Usage during Cardiopulmonary Bypass on Postoperative Acute Kidney Injury in Cardiac Surgery Patients: A Historical Cohort Study
Authors: Khademi Saeed , Heirany Friba , Jouybar Reza , Dehghanpisheh Laleh , Ghazinoor Mohmmad , Mehr Leila Shojaei
Published: July 2023

Introduction:

Acute kidney injury (AKI) after cardiac surgery is a common and serious postoperative complication and is associated with an increased risk of mortality, morbidity, length of hospital stay, and costs. We evaluated the effect of albumin usage on postoperative AKI in patients who underwent on-pump Coronary Artery Bypass Graft Surgery (CABG).

Methods:

This non-randomized cohort study was conducted on data from adult patients who underwent elective CABG, from March of 2015 to March of 2019. We assessed two groups of patients including the albumin (who received 50cc albumin 20% in priming solution) and the non-albumin groups. We recorded demographic data, medical history, and preoperative laboratory data. We compared postoperative changes in serum creatinine (Cr), blood urea nitrogen (BUN), and Glomerular Filtration Rate (GFR) up to 72 hours after surgery with preoperative ones. Also, the stage of kidney dysfunction was assessed according to the AKIN classification. The statistical analysis of the data was processed by SPSS 24 program.

Results:

Overall, we reviewed 506 patients chart [260 (51.4%) in albumin and 246 (48.6%) in non-albumin group]. In both groups, serum Cr, BUN, and GFR increased in 72 hours postoperatively compared with preoperative levels. This increase was greater in the non-albumin group than in the albumin group. However, the difference was not statistically significant between the two groups (p > 0.05). None of the patients developed renal failure or required dialysis.

Conclusion:

We concluded that the use of albumin in prime solution did not have a statistically significant effect on postoperative renal dysfunction after CABG.
Complete Heart Block Caused by Sinus of Valsalva Pseudoaneurysm—A Rare Case
Authors: Ahmad Tanveer , Abohamar Samah Esmaeel , Hado Hussain , Tasca Giordano , Aljerayed Nasser
Published: July 2023

Acquired pseudoaneurysms of the aortic root involving the sinus of Valsalva (SOV) are rare and serious complications arising from trauma, infection, or following cardiac surgery or intervention. Complete heart block (CHB) is an atypical presentation of SOV pseudoaneurysm due to either direct compression effects or involvement of the main conducting system by blood and inflammatory cell infiltration. Herein, we describe a rare case of a patient who presented with CHB caused by an SOV pseudoaneurysm following polytrauma and was treated with surgical closure of pseudoaneurysm followed by implantation of a permanent pacemaker to treat the persistent CHB.
Central nervous system involvement in multiple myeloma: Experience from a tertiary cancer center and review of literature
Authors: Jain Kavita , Bommannan Karthik , Ganesan Prasanth , Arumugam Jhansi Rani , Sagar Tenali Gnana , Sundersingh Shirley
Published: July 2023

Background:

Multiple myeloma (MM) results from clonal expansion of immunoglobulin secreting, heavy chain class-switched, terminally differentiated B-lymphocytes (plasma cells), resulting in radiologic or biochemical evidence of end-organ damage. Though neurological manifestations (peripheral neuropathies, spinal radiculopathies, cranial nerve palsies, and metabolic encephalopathies) can occur during the disease course, direct central nervous system (CNS) infiltration by malignant plasma cells (CNS-MM) is very rare (~1%) and has a dismal prognosis (survival of <6 months).

Methodology:

Clinico-laboratory profile and outcome of CNS-MM patients diagnosed and treated at a tertiary cancer care hospital were retrospectively analyzed.

Results:

On scrutinizing 500 consecutive myeloma case records, 4 patients with CNS-MM were identified. All these patients were diagnosed during myeloma relapse, and all had deceased within 1 week and 12 months of developing CNS infiltration. Our experience with CNS-MM patients is similar to the experiences documented across major world literature.

Conclusion:

Our manuscript reinforces that CNS-MM should be considered in any myeloma patient presenting with unexplainable CNS manifestations. As there are no prospective studies to recommend optimal treatment strategies, CNS-MM still remains a dismal complication of myeloma.
Fractured blood stained steroid implant
Authors: Takkar Brijesh , Godbole Anushri Prakash
Published: July 2023

The usual biodegradation of the sustained release steroid implant does not involve fractures. The case presented in this report was noted to have vitreous haemorrhage staining a steroid implant injected for management of diabetic retinopathy. The implant gradually thinned in the areas adjacent to the haemorrhage, to eventually fracture into 2 pieces. Fracture of the implant is an uncommon event and may be a cause of concern as it can potentially alter the pharmacokinetics/dynamics of the drug.
Contralateral autologous corneal transplantation in an human immunodeficiency virus-positive patient with multiple failed grafts
Authors: Potti Sudhakar , Nayak Aparna N
Published: July 2023

A 61-year-old human immunodeficiency virus (HIV)-positive female patient, planned for a repeat penetrating keratoplasty in the left eye after two failed grafts, also had an absolute right eye and a clear cornea with healthy endothelium (CD4-2445 cells/mm2) with no perception of light. Due to an unexpected damage to the only optical grade tissue that occurred during surgery, consent was taken from the patient to perform an autokeratoplasty from the contralateral blind eye and was successfully performed on the left eye with visual potential. The blind eye received a therapeutic grade donor tissue.
Post-deep anterior lamellar keratoplasty ectasia in a case of macular corneal dystrophy
Authors: Singhal Deepali , Raj Nimmy , Maharana Prafulla K
Published: July 2023

A 30-year-old female presented with diminution of vision in the right eye for 2 months. She was a known case of macular corneal dystrophy and had undergone OD deep anterior lamellar keratoplasty 2 years back. The best corrected visual acuity (BCVA) was 6/18 at 6 months. At presentation, the BCVA was 4/60 and 6/60 in OD and OS, respectively. The graft was clear with no interface haze. An area of graft ectasia with thinning at the inferotemporal (7–9'o clock) graft–host junction was noted clinically and on tomography. Rigid gas permeable contact lenses showed a BCVA of 6/9 and were advised.
Senile scleral plaque – Clinical and anterior segment optical coherence tomography correlation
Authors: Rajagopal Rama , Priyanka Maria T , Balaji Janarthanam J
Published: July 2023

Senile scleral plaques are common age-related degenerative changes quite often diagnosed on routine examination. We report a case of an elderly female, incidentally noted to have clinical findings suggestive of a senile scleral plaque. Anterior segment optical coherence tomography (AS-OCT) concurred with clinical findings. They are in general non-progressive or slowly progressive. Although the risk of progression is rare, considering the rare possibility of perforation, we recommend periodic review both clinically and with AS-OCT. Imaging may also be valuable in patients with senile scleral plaques undergoing scleral procedures and repeated intravitreal injections to understand the possible risks of perforation.
A new association of olfactory hypoplasia and limited elevation
Authors: Yang Hee Kyung , Kim Jae Hyoung , Hwang Jeong-Min
Published: July 2023

Congenital cranial dysinnervation disorders (CCDDs) as a group of neurodevelopmental diseases could present with various combinations of the affected cranial nerves. Olfactory aplasia or hypoplasia has been reported with other cranial nerves affected. Herein, we present an unreported association of olfactory aplasia and limited elevation in two patients who did not have other ocular motor nerve aplasia or hypoplasia on magnetic resonance (MR) imaging. We present two patients—an 11-month-old boy and a 9-year-old boy who showed limited elevation and were found to have olfactory aplasia. In conclusion, aplasia of the olfactory bulb may be associated with strabismus with some degree of ophthalmoplegia, thus should be carefully examined with various clinical manifestations.
Stellate nonhereditary idiopathic foveomacular retinoschisis treated as cystoid macular edema
Authors: Takkar Brijesh , Dube Mihika , Goyal Prakhar , Singh Ashwini , Sabarwal Sunita
Published: July 2023

Stellate nonhereditary idiopathic foveomacular retinoschisis (SNIFR) is a rare eye disease, hitherto unreported in Indians. We report a case of SNIFR in an Indian female wrongly treated as cystoid macular edema (CME). Differentiation between chronic CME and foveoschisis is paramount while dealing with rare diseases like SNIFR.
Imbalanced symmetry of anterior segment dysgenesis – A novel case report and review of literature
Authors: Angmo Dewang , Lakra Subodh , Gupta Barkha , Bari Aafreen
Published: July 2023

Anterior segment dysgenesis (ASD) is a spectrum of disorders affecting the anterior chamber structures and is frequently associated with glaucoma and corneal opacity. It usually has bilateral presentation. We report a case of a 22-year-old male with unilateral Peters anomaly. However, on detailed examination, trabeculodysgenesis was noted in the fellow eye. This highlights the importance of a complete bilateral ocular examination with gonioscopy even in unilateral congenital ASD, which can aid in early diagnosis and management.
A rare case of Haberland syndrome
Authors: Asif Mohamed I , Goel Siddhi , Yadav Mrinalini A , Singh Vipul , Maharana Prafulla K
Published: July 2023

A 10-month-old male child presented with a mass lesion in the left eye which was present since birth as noted by the parents. It was non-progressive. He also had left eye upper eyelid coloboma and a single nodular lesion on the left zygomaticotemporal region along with multiple nodular lesions on the scalp with non-scarring alopecia. A pediatric consultation was sought for systemic associations and a diagnosis of Haberland syndrome was made. Surgical debulking of the ocular lesion was done along with optical correction and amblyopia therapy for visual rehabilitation.
A rare case of bilateral Phthiriasis palpebrarum with crab louse
Authors: Dureja Rohit , Madduri Bhagyasree
Published: July 2023

Phthiriasis palpebrarum is a rare cause of blepharitis in which Pthirus pubis infests the eyelashes. We report a case of bilateral Phthiriasis palpebrarum with crab louse. A 48-year-old woman presented with severe itching in both eyes for 4 days. Careful slit-lamp examination revealed multiple motile lice and nits in the eyelashes of both eyes with mild conjunctival hyperemia. Treatment was started by manually removing all the adult lice and eyelashes where nits were seen adhering and by the application of petrolatum jelly. After 2 weeks, she was symptomatically better with no louse or nit on her eyelashes on ocular examination.
Herpes simplex viral keratitis - A mixed bag of challenging case scenarios
Authors: Singh Aastha , Acharya Manisha
Published: July 2023

Herpes simplex virus (HSV) keratitis is a potentially blinding condition of the eyes. HSV can afflict any of the anatomical layers of the cornea, sometimes more than one layer at one time, and presents with a spectrum of clinical manifestations. Recalcitrant course, recurrences, and variable response to therapy can make managing these patients a true challenge, particularly in the pediatric age group and recipients of corneal transplants. Here, we report a series of five cases of HSV keratitis from our practice that presented with diagnostic and management dilemmas and were successfully managed with a combination of medical and surgical treatment.
Pigmentary glaucoma associated with anterior megalophthalmos
Authors: Popiela Magdalena , Mathews Divya
Published: July 2023

We present a case of anterior megalophthalmos associated with secondary pigmentary glaucoma in the right eye, with other factors contributing to his raised intraocular pressure (IOP). The mechanism of glaucoma was multifactorial – pigment dispersion syndrome, abnormal angle architecture, IOP rises post pars plana vitrectomy with gas, postcataract extraction, element of steroid response. He underwent successful viscocanalostomy to control his IOP. To the best of our knowledge, there is no previous literature publication on viscocanalostomy as a surgical management of glaucoma in an eye with anterior megalophthalmos.
Keratoconus in association with Mullerian dysgenesis – A case report
Authors: Anitha Venugopal , Madkaikar Aditee , Ghorpade Aditya , Ravindran Meenakshi
Published: July 2023

Keratoconus (KC) is a multifactorial disease with numerous associated systemic disorders. Hormonal dysfunction is commonly identified as a risk factor in the progression of KC. However, KC is very rarely known to be associated with congenital uterine anomalies. We present a case report of a 34-year-old female diagnosed with bilateral KC with hypoplastic uterus and septate vagina, albeit with normal sex hormonal parameters. Recognizing the existence of this rare association will encourage the diagnosis of such cases in futurity. Also, it is mandatory to do karyotyping in these cases to rule out the risk of developing gonadoblastoma.
Variable response of sub-retinal hyper-reflective membranes to anti-vascular endothelial growth factor treatment in bilateral neo-vascular age-related macular degeneration
Authors: Chakraborty Debdulal , Mondal Soumen , Boral Subhendu , Saha Asmita
Published: July 2023

Sub-retinal hyper-reflective material (SHRM) is an important spectral-domain optical coherence tomography biomarker in neo-vascular age-related macular degeneration (nAMD). The exact nature of SHRM is not known, but it may contain fluid, fibrin, blood, neo-vascular tissue, and so on. Although nAMD with avascular SHRM usually resolves with anti-vascular endothelial growth factor and is known to have better visual prognosis, those with vascular SHRM have significantly poor final vision. We present a unique case of nAMD with an avascular SHRM in the right eye and a vascular SHRM in the left eye and how the two eyes behaved with treatment over a period of 12 months.
Transition to single-step transepithelial photorefractive keratectomy in the same session following intraoperative flap complication
Authors: Ozturkmen Cem , Karslioglu Melisa , Sahin Afsun
Published: July 2023

Recently, a new variation of transepithelial PRK, called TransPRK, was introduced, in which both the epithelium and stroma are removed in a single step, in one ablation profile. In this report, we present a case of a 31-year-old male patient who was prepared for laser-assisted in-situ keratomileusis (LASIK) surgery but switched to TransPRK combined with mitomycin C (MMC) application following intraoperative flap complication in one eye. As a result of the timely and on-site intervention, no haze was seen. TransPRK may be considered as an alternative with the advantages of reduced risk of postoperative pain and haze formation in intraoperative incomplete flap formation.
Retinitis pigmentosa with acute central serous chorioretinopathy with pachychoroid phenotype
Authors: Goel Nikita , Sen Ahana , Chattree Surabhi , Kumar Saurabh , Roy Rupak
Published: July 2023

We report a case of retinitis pigmentosa (RP) coexisting with acute central serous chorioretinopathy (CSCR) with pachychoroid phenotype. A 37-year-old male showed clinical features of RP in both eyes with acute CSCR in the right eye. Fundus fluorescein angiography showed ink blot hyperfluorescence with focal leakage, which was successfully treated with focal laser. Both eyes showed features of pachychoroid. RP and CSCR occurring simultaneously is very rare and there are only a few reports published in literature, but none with pachychoroid features. We report the first case of RP with acute CSR with pachychoroid phenotype and comment on its treatment outcome.
Rare presentation of bilateral congenital toxoplasmosis in newborns
Authors: Bhandari Mahak , Goyal Anubhav , Lekha T , Mampilly Tony , Stephan Sindhu T , Giridhar Anantharaman
Published: July 2023

Congenital toxoplasmosis is asymptomatic in 85% of the cases and can flee detection due to a lack of a standard screening protocol. Management of foveal-threateningToxoplasmaretinochoroiditis is critical and involves pyrimethamine and sulfadiazine as the first-line treatment, but safer drugs like clindamycin and azithromycin are also available. We report two cases of bilateral congenitalToxoplasmaretinochoroiditis in infants who were screened in the newborn intensive care unit (NICU), to highlight the importance of timely treatment with a combination of steroids and antibiotics in order to prevent vision-threatening sequelae.
Saga of primary myxoid liposarcoma of the orbit
Authors: Ramakantha Chatura K , Bhattacharya Aditi , Kusagur Shivayogi
Published: July 2023

A 24-year-old female presented with proptosis and limitation of eye movements and was investigated radiologically with a tentative diagnosis of lymphangioma. Initial biopsy was considered to be in favor of optic glioma on histopathology, but immunohistochemistry was negative for Glial fibrillary acidic protein (GFAP). A year later, the patient reported back with worsening proptosis. She underwent exenteration of left eye for a posterior mass encasing the optic nerve. The final diagnosis of myxoid liposarcoma was rendered on excision biopsy. The difficulties experienced in establishing diagnosis are shared in this case report.
Acetazolamide-induced bilateral choroidal effusion with shallow anterior chamber following uncomplicated cataract surgery
Authors: Singh Swati , Bhardwaj Kanika , Ramachandran Obuli
Published: July 2023

Choroidal effusion is a collection of fluid in the suprachoroidal space, which may be rarely seen after few surgical procedures or in unoperated eyes, especially in the settings of hypotony, inflammation, or both. Certain systemic medications such as sulfonamides have been identified to induce sudden myopic shift and acute angle closure glaucoma with ciliochoroidal effusion. We report a case of a 78-year-old man who developed bilateral choroidal effusion on the first postoperative day after an uncomplicated cataract surgery in one eye. The most probable cause was identified to be the consumption of carbonic anhydrase inhibitor in both pre- and postoperative periods, and there was a complete resolution of choroidal detachment after discontinuation of the drug.
Ocular manifestations of DiGeorge syndrome
Authors: Jayasri P , Stephen Mary , Kasturi Nirupama , Kaur Anureet
Published: July 2023

A 20-year-old woman with facial features of DiGeorge syndrome came for a regular ophthalmic examination. She had hypoparathyroidism with hypocalcemic tetany and severe anemia but no cardiac anomalies. On ophthalmic examination, the visual acuity was 6/6 OU. She had bilateral eyelid hooding, ptosis, esophoria, posterior embryotoxon, and dilated, tortuous vessels with disc edema in the fundus. Bilateral vascular tortuosity and disc edema could mimic established papilledema or plus disease, which has significant treatment implications. Hence knowledge of ocular and systemic features is essential in providing recommendations for DiGeorge syndrome.
Rare case of inferotemporal orbital fat prolapse – Clinical, histopathologic, and anterior segment optical coherence tomography correlation
Authors: Rajagopal Rama , Chauhan Gaurav , Balaji Janarthanam J
Published: July 2023

Orbital fat prolapse (OFP) is the herniation of intraconal fat into the subconjunctival space, which occurs mostly in the superotemporal quadrant and is more common bilaterally. We report a rare case of unilateral inferotemporal OFP and its anterior segment optical coherence tomography (ASOCT) features. On ASOCT, the lesion appeared uniformly smooth with no definite capsule. Fat lobules appeared hyporeflective, while the interlobular septae appeared hyperreflective. A hyporeflective space was noted, separating the fat and the overlying conjunctival stroma. This space was, however, obliterated in the areas corresponding to the maximum convexity of the lobules. These ASOCT findings correlate with the described histopathologic features of the OFP described in literature. Inferotemporal OFP and corresponding ASOCT features, to the best of our knowledge, have not been reported previously. We also propose its role in documenting progression that can aid in surgical decision-making.
Widespread retinal hemorrhages in a patient with atypical optic neuritis
Authors: Kaushik Madhurima , Mani Karthik Kumar , Varadharajan Shriram , Shah Virna M
Published: July 2023

Retinal hemorrhages are rare in optic neuritis. We report a case of atypical optic neuritis with widespread retinal hemorrhages. A 30-year-old Indian woman presented with sudden painful and severe visual loss in the left eye for 3 days. Fundus examination showed minimal optic disk edema associated with intraretinal hemorrhages extending to the periphery in the left eye. On neuroimaging, long segment thickening of the intraorbital segment of the left optic nerve was appreciated with T2 hyperintensity. Serum myelin oligodendrocyte (MOG) antibodies and neuromyelitis optica (NMO) antibodies were negative. Visual acuity improved rapidly after the administration of intravenous high-dose steroids, and fundus abnormalities resolved rapidly. Retinal hemorrhages can also be present in atypical optic neuritis in the absence of severe optic disk edema. Clinicians should be mindful of the variable presentations of optic neuritis to initiate proper and timely treatment.
An unusual case of Heimann–Bielschowsky phenomenon associated with mature cataract
Authors: Dogra Shray , Kaur Navneet , Prasher Pawan
Published: July 2023

Heimann–Bielschowsky phenomenon (HBP) is an unusual condition with a low-frequency, coarse, vertical nystagmoid movement that develops after long-standing profound vision loss in an eye. We report a case of HBP in an eye with a mature senile cataract that resolved spontaneously after cataract surgery. A 50-year-old male presented with a mature senile cataract in his right eye, without any previous history of abnormal movements of either eye. The affected eye was only perceiving hand motions at 2 ft due to the mature cataract, along with an intermittent, slow, vertical nystagmoid movement. The evaluation was consistent with the diagnosis of HBP, and it was decided to proceed with cataract surgery and reassess postoperatively. The patient underwent uneventful cataract surgery with good visual outcome as well as spontaneous resolution of the HBP. To the best of our knowledge, this is the first case of HBP associated with senile cataract, which resolved after cataract surgery was performed.
Optic disk pallor—Catch the masqueraders. Role of carotid angiography
Authors: Gounder Srinivasan , Ahuja Pragya , Akhtar Naheed , Waris Abdul , Narang Mohak
Published: July 2023

NA-AION is the most common ischemic optic neuropathy, with an incidence rate of 2.5–11.8 per 1,00,000 in the population older than 50 years. Patients at high risk of complications due to carotid atherosclerosis may only present with ophthalmic symptoms initially. We report here a case of a 52-year-old male with disk pallor, provisionally diagnosed as NAAION. On examination, his BP was raised, and had raised ESR and hypercholesterolemia on his blood work. CT Carotid angiogram revealed attenuated internal carotids on the side of involvement with a small eccentric hypodense plaque in the common carotid. This case report of frequently diagnosed NA-AION has been shared to lay emphasis on the importance of a thorough systemic workup in these patients, as their association with systemic illnesses like stroke and obstructive sleep apnea is well known. It will help in not only saving the other eye but also their lives from such life-altering diseases.