bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effect of Bentonite Using Edible Oil as a Dispersed Medium on the Rheological, Thermal and Water Absorption Properties of PBS/Bentonite Composites
Authors: Wiriya-Amornchai Atiwat , Ausab Rudeerat , Jemkuntod Neungruthai , Phattarateera Supanut
Published: April 2022

Polybutylene succinate (PBS) with bentonite was investigated for its rheological, thermal and water absorption properties. The bentonite (BTN) was modified with soybean oil (SBO) and lard oil (LO) (2:98 clay: oil % by weight) by mechanical stirring and ultrasonication. The composites were prepared using an internal mixer and processed by compression molding. Under the bentonite modification conditions, XRD showed that the bentonite layers were penetrated with edible oils into the small layers and the enhancement of d-spacing between the BTN-layers in the composites. A small platelet-like structure of the modified bentonite composites was observed by SEM micrographs. The increase in MFI of untreated bentonite displayed the viscosity of PBS involving the moisture and water molecules decreased the frictional force. In addition, the viscosity of composites between PBS and treated bentonite with LO represented in an increase of the MFI value. Regarding the thermal properties, the presence of bentonite could act as a nucleating agent for PBS at low content (1-2%). Moreover, the treated with edible oils of bentonite could increase the percentage crystallinity of PBS at higher bentonite content. The presence of bentonite tends to increase the water absorption behavior of PBS/bentonite composites.
Study on the Highe-Temperature Mechanical of Al2O3f/SiO2 and SiO2f/SiO2 Ceramic Matrix Composites
Authors: Ci Ji Liang , Cui Feng Dan , Zhang Li Li , Zhang Jian , Lv Yi , Zhao Ying Min , Zhang Hao
Published: April 2022

Al2O3f/SiO2 and SiO2f/SiO2 ceramic matrix composites were manufactured by silica sol-infiltration-sintering method. The mechanical properties of composites under room temperature to 1200 °C were tested on-line with universal testing machine. It is found that Al2O3f/SiO2 composites present a higher strength than SiO2f/SiO2 at room temperature and 1000 °C. The strength of two composites dramatic decrease with temperature increased to 1200 °C. Also, SEM and XRD methods were adopted to investigate the micro-structure of cross-fraction and crystal phase of composites, indicating a strong interaction between fibers and matrix under high temperature. Finally, the dielectric properties of two composites under room temperature to 1200 °C were discussed.
Size-Controlled C/N-Doped TiO2 Nanoparticles for Visible-Light-Driven Photocatalysis of Formaldehyde from Plywood
Authors: Yan Xiao Ying , Zhang Guo Bao , Yuan Rong Hui , Ye Xiang Yu , Chen Xi Xi , He Hui Hui
Published: April 2022

We reported a facile solvothermal approach to synthesize C/N-doped TiO2 (C/N-T) using a template-free method. The morphology and composition of the C/N-T were evaluated by transmission electron microscopy, X-ray diffraction, wavelength dispersive spectroscopy and X-ray photoelectron spectroscopy. The photodegradation of formaldehyde was studied in environmental chambers under specific conditions combined with UV-Vis determinations. The catalytic oxidations of C/N-T nanoparticles were characterized by degrading formaldehyde of plywood, which was induced via visible-light illumination. A maximum 95.7% of degradation efficiency within 55 min showed enhanced photocatalytic activity.
Numerical Analysis of Nucleation and Growth of Stray Grain Formation during Laser Welding Nickel-Based Single-Crystal Superalloy Part III: Kinetic and Thermodynamic Obviation of Solidification Cracking
Authors: Gao Zhi Guo
Published: April 2022

To pertinently balance growth kinetics, solidification thermodynamics and dendrite expitaxy of multicomponent nickel-based single-crystal supralloy during laser processing, effect of thermometallurgy determinant factors, including laser power, welding speed and welding configuration, on solidification behavior, such as nonequilibrium solidification temperature range, and dendrite growth, such as dendrite trunk spacing, are progressively advanced to forestall solidification cracking phenomena. Symmetric developments of dendrite trunk spacing and solidification temperature range alongside solid/liquid interface are crystallographically driven by useful (001)/[100] welding configuration to auspiciously bring about crack-insusceptible and well-oriented dendrite growth. Dissimilarly, unsymmetrical developments of dendrite trunk spacing and solidification temperature range alongside solid/liquid interface are crystallographically driven by (001)/[110] welding configuration to insidiously favor crack-unresistant and disoriented dendrite growth. Higher heat input thermodynamically and kinetically boosts wide solidification temperature range, appalling stray grain growth with excess of solute ahead of dendrite tip and large size of crack-unresistant region to thermometallurgically disintegrate epitaxial growth for untoward solidification cracking, and therefore should be strictly withstood. Although geometry of symmetrical weld pool both sides is the same in infelicitous (001)/[110] welding configuration, [100] region of dendrite growth is more liable to ruinous stray grain growth and extensive solidification temperature range than [010] region of dendrite growth to complicate dendrite growth and exacerbate weld integrity. The determinant mechanism of crystallography-aided amelioration of solidification cracking resistance as result of kinetics-and thermodynamics-driven dendrite growth is propitiously proposed. Furthermore, the credible and understandable theoretical predictions are in conformity with the experiment results.
Preparation of Non-Enzymatic Glucose Sensing Nanocomposite Based on NiCo2O4 Nanosheets@ Reduced Graphene Oxide and Design of Glucose Detection System
Authors: Dong Min , Hu Hong Li , Duan Yu Lie
Published: April 2022

A non-enzymatic glucose sensing nanomaterial which consists of the NiCo2O4 nanosheets grown on reduced graphene oxide (NiCo2O4@rGO) is synthesized by a simple co-precipitation procedure. Firstly, the morphology and composition of the NiCo2O4@rGO are analyzed. Subsequently, the glucose sensing characteristics of the NiCo2O4@rGO are researched by Cyclic Voltammetry and Amperometry. The test results show that the prepared NiCo2O4@rGO has excellent glucose sensing properties. In the two linear detection range of 0.01mM-5.50mM and 5.50mM-15.50mM, the sensitivity reaches 4372.9μA·mM-1cm-2 and 1686.1μA·mM-1cm-2, respectively. In addition, in order to reduce the cost of electrochemical testing and improve the convenience and practicability of detection, a portable potentiostatic glucose detection system based on three electrodes is designed. Through testing, it is found that the non-enzymatic glucose detection system based on NiCo2O4@rGO has good practical application potential in the field of glucose detection.
From nature to man: Environmental anthropology in the Anthropocene
Authors: Bajrami Ani
Published: April 2022

The dramatic changes brought by the relationship between humans and their natural environments by different human activities such as the exploitation of natural resources and use of fossil fuels threatens humanity at large. Beside considerable disagreements on when Anthropocene began, it is considered an epochal transformation linked to deterioration of global ecologies, loss of biodiversity and environmental degradation. Environmental anthropologists are contributing both theoretically and by important ethnographic insights in analyzing and understanding the consequences of climate changes in socio-ecological systems worldwide. In this article we provide an overview of main theoretical contributions during the development of environmental anthropology as a discipline. In addition, we highlight the possible Cultural Evolution theory (CE) contribution in climate changes consequences to a socio-ecological system.
A simple LC-MS/MS method for pharmacokinetic study of carvedilol and 4/-hydroxyphenyl carvedilol at a low dose
Authors: Eiamart Wanna , Prompila Nantaporn , Jumroen Yaowatree , Sayankuldilok Nonlanee , Chariyavilaskul Pajaree , Wittayalertpanya Supeecha
Published: April 2022

Background and purpose:

The study was aimed at validating a simple, rapid, and low-cost LC-MS/MS method for carvedilol and 4/-hydroxyphenyl carvedilol assay in human plasma. The validated method was applied to investigate the pharmacokinetics after a low dose of 6.25 mg. carvedilol.

Experimental approach:

In this study, the plasma was extracted by liquid-liquid extraction and evaporated the organic layer to dryness, then both analytes in the residue were reconstituted and detected by LC- MS/MS. The method was validated following the guideline on bioanalytical method validation. Thirty-one healthy volunteers participated in the pharmacokinetic study. After 10 h of fasting, each volunteer received one tablet of 6.25 mg carvedilol orally. Blood samples were collected at 16 prescheduled time points. The plasma samples were analyzed for pharmacokinetics.

Findings/Results:

The method was linear over a range of 0.050-50.049 ng/mL for carvedilol and 0.050- 10.017 ng/mL for 4/-hydroxyphenyl carvedilol. Crucial validated results reached the requirements of selectivity, accuracy, precision, and stability. Pharmacokinetics of carvedilol and 4/-hydroxyphenyl carvedilol were evaluated which showed Cmax at 21.26 ± 9.23 and 2.42 ± 2.07 ng/mL; AUC0-t 66.95 ± 29.45 and 5.93 ± 3.51 ng.h/mL; AUC0-inf 68.54 ± 30.11 and 6.78 ± 3.49 ng.h/mL; and T1/2 6.30 ± 1.95 and 6.31 ± 6.45 h, respectively.

Conclusion and implications:

The validated method was able to detect and quantify both analytes in plasma samples and can be applied to the pharmacokinetic study of carvedilol and 4/-hydroxyphenyl carvedilol after receiving carvedilol at 6.25 mg orally.
Hydroethanolic extract of Lavandula angustifolia ameliorates vincristine-induced peripheral neuropathy in rats
Authors: Sahranavard Shamim , Khoramjouy Mona , Khakpash Mahsima , Askari Seyyed Ahmad , Faizi Mehrdad , Mosaddegh Mahmoud
Published: April 2022

Background and purpose:

Peripheral neuropathy is one of the most common adverse effects of cancer chemotherapy. Vincristine is prescribed to treat a variety of carcinomas, including lymphoma and leukemia, and may cause progressive peripheral neuropathy due to the damage of microtubules and mitochondria of neurons and affects inflammatory processes. This study was designed to evaluate the effects of Lavandula angustifolia hydroalcoholic extract (LHE) of aerial part on vincristine-induced peripheral neuropathy in a rat model.

Experimental approach:

Neuropathy was induced in rats by daily intraperitoneal administration of vincristine (0.1 mg/kg for 2 weeks). Following the induction of neuropathy, animals were treated with the LHE (100, 200, and 400 mg/kg, p.o.) or pregabalin (20 mg/kg, IP) for 2 weeks, and their responses to vincristine-induced hyperalgesia and locomotor impairment were measured.

Findings/Results:

LHE, at the dose of 400 mg/kg, showed analgesic effects in response to thermal hyperalgesia, tactile allodynia, and gait impairment. Also, pregabalin (20 mg/kg, IP) improved the symptoms of vincristine-induced peripheral neuropathy.

Conclusions and implications:

According to the results, we can conclude that LHE alleviates neuropathic symptoms of vincristine and the effect is probably related to the presence of phenols and flavonoids in the extract.
Policies and measures implemented to reduce the impact of international sanctions on Iran's pharmaceutical sector
Authors: Emami Farideh , Cheraghali Abdol Majid
Published: April 2022

Background and purpose:

Continuous evaluation of the policies and interventions could explore their efficacies in improving the accessibility and availability of medicines in the local market. This study explained the health system policies of the Islamic Republic of Iran concerning the impact of the economic sanctions on the local pharmaceutical market and addressed the issue of whether these policies were able to improve patients’ access to medicines.

Experimental approach:

In this study, qualitative and quantitative research methods were used. In the qualitative part, semi-structured interviews with pharmaceutical system experts were used. In the next step, the structural analysis method was used. In the quantitative part, numerical sales data of the selected medicines were extracted and analyzed.

Findings/Results:

Reported statistics regarding the presence of the medicines in the market indicates the obvious fluctuations in the numerical sales of medicines in the studied years. This may indicate that the policies implemented are not able to fully compensate for the negative effects of sanctions and improve access to medicine. In addition, according to some experts, policy, and management weaknesses are mainly rooted in unresolved domestic hurdles which have exacerbated the effects of international sanctions on the country’s pharmaceutical market.

Conclusions and implications:

Effective policy-making in response to economic sanctions can reduce the negative effect of international sanctions and result in drug shortages. Results of this study showed despite efforts made by the Iran health sector to subside the impact of sanctions on the pharmaceutical sector, there is an obvious disruption of the medicine supply chain in the market.
Further evidence to support acute and chronic anti-inflammatory effects of Nasturtium officinale
Authors: Mostafazadeh Mostafa , Sadeghi Heibatollah , Sadeghi Hossein , Zarezade Vahid , Hadinia Abolghasem , Panahi Kokhdan Esmaeel
Published: April 2022

Background and purpose:

Previously, we reported the anti-inflammatory properties of Nasturtium officinale (watercress) in several models of acute inflammation. This study was designed to explore the effects of topical and systemic administrations of N. officinale in the two chronic inflammatory models and to evaluate the role of TNF-α and IL-1β in these effects.

Experimental approach:

Folin-Ciocalteu and aluminum chloride methods were used to estimate the extract’s total phenol and flavonoid content, respectively. Carrageenan-induced paw edema was carried out and TNF-α and IL-1β concentrations in the carrageenan-treated paw tissue were determined. Formalin injection into rat hind paws (7 days) and the application of 12-O-tetradecanoyl phorbol-13-acetate (TPA) on mouse ears (9 days) were used to simulate chronic inflammation. Furthermore, a histological assessment of the inflamed tissues was carried out.

Findings/Results:

The extract’s flavonoid and phenolic contents were 90.26 ± 4.81 mg rutin equivalents/g and 68 ± 8.16 gallic acid equivalents/g gallic acid, respectively. N. officinale pretreatment in all doses administered considerably decreased carrageenan-induced edema. The extract also reduced IL-1β levels in carrageenan- treated paws while did not affect TNF-α levels. Oral and topical administrations of N. officinale considerably reserved the paw and ear edema. The extract also ameliorated the tissue injuries due to formalin and TPA challenges.

Conclusion and implications:

The data confirmed the topical and systemic anti-inflammatory effects of watercress against two chronic models of inflammation. They suggested that these properties are not related to TNF-α but could be attributed to inhibition of IL-1β and inhibition of leukocyte infiltration.
Comparison of follicular T helper cells, monocytes, and T cells priming between newly diagnosed and rituximab-treated MS patients and healthy controls
Authors: Yahyazadeh Sheida , Esmaeil Nafiseh , Shaygannejad Vahid , Mirmosayyeb Omid
Published: April 2022

Background and purpose:

The use of anti-CD20 monoclonal antibodies like rituximab (RTX) to deplete B cells has practical therapeutic implications in multiple sclerosis (MS) patients. However, the therapy’s impact on other immune cells is also important. Therefore, in this study, we assessed the effects of RTX therapy on Tfh cells, T cells, T cells priming, and monocytes in MS patients compared to newly-diagnosed MS patients and healthy subjects.

Experimental approach:

Thirty newly-diagnosed and RTX-treated MS patients and healthy control were included. Peripheral blood mononuclear cells were isolated from whole blood for assessment of Tfh cells, CD4+, CD8+, CD4+CD45RA+, CD3+HLA-DR+, and CD3+CD4+CD25+ T cells by flow cytometry. Whole blood was lysed by lysis solution to assess CD45+CD14+ monocytes by flow cytometry. Also, the serum level of interleukin 21 was measured by the ELISA method.

Findings / Results:

We showed that RTX treatment led to a decrease in Tfh cells and their predominant cytokine, interleukin 21. Also, we found a statistically significant reduction in CD3+HLA-DR+ and CD3+CD4+CD25+ T cells in RTX-treated patients compared to new cases and healthy control. Moreover, we found a decrease in the CD45+ CD14+ monocyte population in the RTX-treated group compared to the healthy control.

Conclusion and implications:

Our data suggest that following treatment with RTX, Tfh cells, monocytes, and T cells priming declined happened, and fewer T cells were activated. Also, due to the interaction between B cells and Tfh cells, Tfh targeting could be assessed as a therapeutic strategy in MS.
Electrocardiographic Evolution of Heart Block in Lyme Carditis
Authors: Ilieva Lubka B. , Saad Essam , Iskandar Marc , Brady Peter A.
Published: April 2022

A 23-year-old male presented with dizziness and weakness and reported travel to a tick-prevalent region 1 month prior. Initial electrocardiogram showed a high-grade atrioventricular block with narrow-complex escape rhythm, which progressed to a complete heart block with a wide-complex escape the next day. Resolution of the heart block was documented at follow-up after treatment with appropriate antibiotic therapy. Heart block in Lyme carditis is more commonly reported to be supra-Hisian, manifesting as a narrow-complex escape rhythm. Infra-Hisian block is rare, which manifests as a wide-complex escape rhythm, and may occasionally require permanent pacemaker implantation.
Study of the Client Experience and Continuation Rate of Postpartum Intrauterine Copper-T Device in Semi-Urban Population in India
Authors: Agrawal Swati , Induja R , Chopra Kanika , Singh Anuradha , Sood Shilpa , Puri Manju
Published: April 2022

Background:

Postpartum intrauterine copper device (PPIUCD) is a reliable and efficient method of contraception for women. In spite of its ease of administration, its acceptance is very low owing to a number of factors. The current study was undertaken to analyze the continuation rates and problems among women accepting PPIUCD as contraceptive method.

Methods:

The present study was undertaken in the family planning department of a teaching hospital in New Delhi. It was an ambispective, observational study in which 880 beneficiaries of PPIUCD were telephonically contacted and interviewed. A pro forma containing demographic profile, obstetric history of the women, date and timing of insertion of PPIUCD, source of information about PPIUCD, side effects encountered, willingness to continue, and reasons of discontinuation, if applicable, was filled and the data, collected thus, were analyzed.

Results:

Most of the women enrolled in the study had a mean age of 26.5 (±4.1) years; the average parity was two. The timing of insertion of PPIUCD was postplacental in majority of women (91.7%). Most of the women received information about PPIUCD from health-care workers (90.1%). It was found that 86.7% of women were using PPIUCD at the time of interview and 73.3% were satisfied with it and willing to continue further. The predominant side effect observed was pain abdomen (15%), followed by menstrual irregularity.

Conclusion:

The present study revealed a high continuation rate of PPIUCD. Health-care professionals were the foremost source of information for PPIUCD. It is a highly effective method which needs to be popularized among the masses by the active participation of media and other agencies as it has the potential to bridge the gaps in existing family planning services.
Refractory perifoveal exudative vascular anomalous complex like lesion responding to intravitreal dexamethasone implant
Authors: Nataraj Ashok , Sheth Jay , Soman Manoj , Nair Unnikrishnan
Published: April 2022

A 66-year-old male patient presented with the right eye (OD) decreased vision for 1 month duration. His best-corrected visual acuity (BCVA) was 6/36 in OD and 6/6 in the left-eye (OS). He had bilateral non-proliferative diabetic retinopathy (NPDR) changes with the presence of a large perifoveal aneurysmal lesion, which was diagnosed as perifoveal exudative vascular anomalous complex (PEVAC)-like lesion based on clinical evaluation, spectral domain optical coherence tomography (SD-OCT), and fundus fluorescein angiography (FFA). The patient underwent three intravitreal ranibizumab injections with minimal response. However, he showed excellent improvement in BCVA to 6/6 with complete resolution of fluid on SD-OCT after switching to intravitreal Ozurdex implant. This case highlights that an intravitreal dexamethasone implant can be considered as a viable option for the optimal management of PEVAC-like lesions, with good visual acuity outcomes and morphologic response on SD-OCT. Further studies are warranted to gain better insight into the pathogenesis of PEVAC-like lesions and the potential role and mechanism of action of intravitreal dexamethasone implant in its management.
Spontaneous resolution of hypotony after Aurolab aqueous drainage implant due to fibrous ingrowth
Authors: Rajamani Muralidhar , Chaya Craig J , Ramamurthy Chitra
Published: April 2022

Peritubular leak after glaucoma drainage device implantation causing hypotony can occur with the use of needles with a bore larger than 25 G for creating an entry track for the tube. We report a patient who developed persistent hypotony probably due to peritubular leak after Aurolab Aqueous Drainage Implant implantation using a 22-G needle. The hypotony spontaneously resolved 7 months after surgery due to fibrous ingrowth. High intraocular pressures due to tube blockage were treated with Nd: YAG laser to clear the fibrous ingrowth. Surgeons should be aware of fibrous ingrowth as a complication of using a large-bore needle track for tube insertion.
A rare case of post-laser-assisted in situ keratomileusis Scedosporium prolificans keratitis
Authors: Parab Aditi , Christy Josephine S , Narayana Shivananda , Gubert Joseph
Published: April 2022

A 21-year-old female presented with a stick injury in her right eye 6 months after an uneventful laser in situ keratomileusis (LASIK). Diffuse lamellar keratitis which responded well to the initial treatment with topical steroids, progressed rapidly within the next 3 weeks to develop corneal perforation. A microbiological examination revealed a rare fungus Scedosporium prolificans. The patient was successfully managed with topical voriconazole 1% and cyanoacrylate glue for corneal perforation. At the end of 7 weeks, keratitis healed with a best-corrected visual acuity of hand movements. Hence, a strong suspicion of infectious interface keratitis is warranted while treating post-LASIK keratitis.
Endocrine mucin-producing sweat gland carcinoma mimicking meibomian gland carcinoma
Authors: Lahane Sumeet T , Sawant Rohan A , Agarwal Pragati , Doshi Varun K , Parekh Ragini H , Lahane Tatyarao P
Published: April 2022

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare adnexal tumor of the skin with immunoexpression and neuroendocrine differentiation. It can be easily misdiagnosed as a meibomian gland tumor due to its prevalence in the Indian subcontinent over EMPSGC. It has a predilection for the skin of the eyelid and elderly females. It is histologically and immunohistochemically analogous to solid papillary carcinoma of the breast/endocrine ductal carcinoma in situ with a nodular, solid, papillary, and/or cribriform architecture, neuroendocrine differentiation, and mucin production. We describe a case of EMPSGC clinically mimicking meibomian gland carcinoma which was confirmed on immunohistochemistry and histopathological diagnosis.
Reduced fluence photodynamic therapy for subretinal fluid in choroidal nevus
Authors: Narde Harpreet K , Goswami Ananya , Vashistha Vimal , Kumar Atul
Published: April 2022

Choroidal nevus is a benign melanocytic lesion of the posterior uvea. Visual symptoms in choroidal nevus are most commonly secondary to serous neurosensory detachment in upto 50% cases. Here, we describe a case of symptomatic perifoveal Choroidal Nevus with sub-retinal fluid, which was treated with Reduced Fluence Photodynamic Therapy.
Resolution of malignant glaucoma following laser capsulo-hyaloidotomy through the optic hole of intraocular lens
Authors: Krishnamurthy Rashmi , Dikshit Siddharth , Burugupally Keerthi , Singla Shaveta
Published: April 2022

We report a case of pseudophakic malignant glaucoma who was managed with laser capsulo-hyaloidotomy through the dialing hole of the optic of the nonfoldable intraocular lens (IOL). Our case presented with sudden, painful decreased vision in the left eye since 15 days, 3 years after cataract surgery. There was a uniformly shallow anterior chamber with a high intraocular pressure (IOP) of 52 mm Hg and glaucomatous disc damage. After performing laser capsulo-hyaloidotomy through the optic hole of the IOL, we noticed deepening of the anterior chamber, improvement in vision, and good IOP control on antiglaucoma medication, thus showing complete resolution of aqueous misdirection and obviating the need for surgical management.
A rare ocular presentation of melioidosis
Authors: Parvathy GS , Paul Anujeet , Nagarajan Swathi
Published: April 2022

Melioidosis, a multi-system infectious disease caused by Burkholderia pseudomallei, has varied clinical presentations. The ocular manifestations though rare are often either infectious or inflammatory sequelae. We present a case of a 49-year-old fisherman, an alcoholic and diabetic, who presented with fever, breathlessness, and altered sensorium. The pus and blood culture showed Burkholderia pseudomallei. Clinically, the patient deteriorated over a few days and succumbed to septicemia. The fundus evaluation at presentation showed multiple cotton wool spots concentric to the disk bilaterally. Subsequently, the patient developed a solitary Roth spot in the right eye coinciding with his clinical deterioration. The association of melioidosis with this fundus picture is presented for its rarity.
Bilateral hemorrhagic grade 5 disc edema in small vestibular schwannoma with communicating hydrocephalus
Authors: Penumetcha Manasa , Sinha Nidhi , Sahoo Siddhartha S , Rao Gundra N
Published: April 2022

Bilateral optic disc edema is usually a late manifestation of vestibular schwannoma. Raised intracranial pressure due to obstructive hydrocephalus or a large mass lesion are the known causes. We report a case of a 55-year-old female with decreased vision and bilateral hemorrhagic grade 5 papilledema. MRI revealed a small vestibular schwannoma (<2.5 cm) with mild communicating hydrocephalus. Intraoperative CSF pressure was high most likely due to raised protein level in CSF (1 g/L). Bilateral hemorrhagic grade 5 papilledema causing diminution of vision in a case of small vestibular schwannoma with communicating hydrocephalus prompted us to report this case.
Possible IgG4-related disease in a case of necrotizing scleritis
Authors: Giridhar Divya , Pauly Marian , Pillai Vinay S , Anantharaman Giridhar , Subramanian Krishnakumar , Shenoy Padmanabha , Vijayan Anuroopa
Published: April 2022

Necrotizing scleritis can be a diagnostic and therapeutic challenge. We present a case of a 51-year-old female, who had necrotizing scleritis treated for 9 years with intermittent corticosteroid therapy. In view of its recalcitrant nature, she underwent scleral biopsy, which revealed histopathological features suggestive of IgG4- related disease. This case report highlights the importance of including IgG4-related disease as a differential diagnosis of scleritis and the role of scleral biopsy as a diagnostic tool in unresponsive cases.
Squint surgery in a case of osteogenesis imperfecta
Authors: Raghu Nitya , Murthy Sowmya Raveendra
Published: April 2022

Osteogenesis imperfecta (OI) is well known to be associated with blue sclera due to thinning along with skeletal deformities. Not all cases of OI have blue sclera despite having a thinner sclera than in normal individuals. We are presenting a case report of a 28-year-old girl with intermittent exotropia and OI with no evidence of blue sclera. On AS-OCT, scleral thinning was noted at the level of medial rectus muscle insertion. The patient underwent successful recession-resection surgery for the same. The thin sclera and OI need not deter the decision to operate on squint, and a successful squint surgery is possible in eyes with some amount of scleral thinning with careful suturing.
Torpedo maculopathy with bilateral familial fleck retina
Authors: Kumar Mahesh , Singh Kanchan , Ravichandra Gottipati , Patel Akash , Kapoor Monika , Bhargava Rahul
Published: April 2022

This report describes a patient with redness in the left eye and normal vision. Routine fundus examination revealed bilateral macular sparing multiple yellow white retinal flecks situated beneath the retinal vessels. In the right eye, a torpedo-shaped hypopigmented lesion with a hyperpigmented temporal edge was observed temporal to the macula. There was mild thickening of retinal pigment epithelium on spectral-domain optical coherence tomography and retinal thinning and atrophy. Fundus autofluorescence showed multiple hyperfluorescent lesions around the posterior pole with a normal signal and a torpedo lesion of variegated autofluorescence in the right eye. The unusual coexistence of unilateral torpedo maculopathy with bilateral retinal flecks is being reported here.
Malignant hypertension in a child - What lies beneath?
Authors: Aguiar Marushka , Kumar S Mahesh , Shetty Shashikant , Rajan Renu P
Published: April 2022

We report a case of a 7-year-old girl presenting to the Neuro-Ophthalmology OPD with only complaints of chronic headache who was found to have malignant (grade 4) hypertensive retinopathy. Visual acuity was 20/400 in the right eye and 20/80 in the left eye. Blood pressure was 220/120 mm Hg. The patient was not a known hypertensive. Fundoscopy revealed bilateral optic disc swelling, macular stars, and serous retinal detachment in both eyes. The patient was urgently referred to pediatrician for detailed evaluation and systemic control of hypertension. This emphasizes the need for checking blood pressure in children presenting with chronic headache.
An integrated early intervention approach for children with cerebral visual impairment - A case report
Authors: Philip Jannet , Sethuraman Saranya Rajagopal , Hussaindeen Jameel R , Swaminathan Meenakshi
Published: April 2022

A 2-year-old child with cerebral visual impairment (CVI) was brought by the mother to the pediatric ophthalmology clinic. She underwent a detailed functional vision and developmental assessment that revealed impairments in visual developmental skills, sensory, motor, and social skills. She was admitted into an integrated, parent-centered, structured early intervention program specifically designed for her for 3-months after which there were improvements noticed in visual developmental skills such as visual fixation, attention, and tracking; sensory skills such as tactile, olfactory, and gustatory; motor skills, including neck control and fine motor grasping; and age-appropriate social and communication skills. Through this case report, we aim to bring out the benefits of an evidence-based systematic early intervention approach in a child with CVI.
Possible abnormal origin of inferior oblique from a congenital dermoid cyst
Authors: Sardar Uzma , Taimur Fariha , Manzoor Amna , Akbar Maheen , Ahmad Saadullah , Afghani Tayyab
Published: April 2022

A 4-year-old female child presented with a cystic swelling medially along the floor of the orbit with mild ipsilateral medial canthus dystopia on the left side. This swelling was present since birth with no significant orbital dystopia or any extraocular movement defects. During surgery, a trilobed yellowish cyst was found near the inferomedial wall of the orbit. Incidentally, the inferior oblique muscle was found to be originating from the medial lobe of the cyst. The cyst was removed completely, and the inferior oblique was reinserted to the inferomedial orbital margin. Histopathology was consistent with dermoid cyst. To the best of the authors' knowledge, the case of abnormal origin of inferior oblique muscle from an orbital dermoid cyst has not been reported before.
Effects of early intervention in a child with cerebral palsy and cerebral/cortical visual impairment
Authors: Bhushan Karthik , Christy Beula , Manohar Vivian
Published: April 2022

Cerebral (CVI)/cortical visual impairment is a decrease in the visual response due to damage or malfunction of the visual processing centers in the brain. While on the other hand, cerebral palsy (CP) is a permanent, nonprogressive disorder of movement and posture due to lesion of the infant's brain. This article presents a case study of a child with CP and CVI, and the strategies adopted in the Early Intervention program to that would work on the neuroplasticity. This in turn has demonstrated the improvement in the functional mobility, and the overall independence of the child.
Serial swept-source optical coherence tomography angiography changes within deeper choroid in tubercular serpiginous-like choroiditis
Authors: Patel Rushik , Delhiwala Kushal , Khamar Bakulesh
Published: April 2022

A 31-year-old female was diagnosed with active placoid tubercular serpiginous-like choroiditis (TB-SLC) in the right eye. Serial swept-source optical coherence tomography angiography (SS-OCTA) of deeper choroid revealed unique dilated, tortuous, and disorganized tangled network of medium-sized choroidal vessels (MCV) at presentation (mimicking bag-of-worms) with increased compactness on paradoxical worsening and significant reorganization on resolution. SS-OCTA of choriocapillaris (CC) revealed extensive flow void at presentation, which increased on paradoxical worsening and its reversal with minimal CC atrophy on resolution. Visual acuity improved from 20/200 to 20/30. Serial changes from presentation till resolution provide hypothesis about unique appearance within choroid in TB-SLC lesion.
A rare finding of lamellar macular hole with lamellar hole-associated epiretinal proliferation in retinal vein occlusion
Authors: Kumar Kshitiz , Sinha Tushar K , Bhattacharya Debashish
Published: April 2022

A 69-year-old female presented with right eye vision of 20/120 Snellens. Ultrawide-field fundus imaging showed old vitreous hemorrhage with superotemporal sclerosed vessels post venous occlusion. Spectral-domain optical coherence tomography revealed degenerative lamellar macular home (LMH) with lamellar hole-associated epiretinal proliferation (LHEP). The patient underwent surgery using vitrectomy with the embedding technique. Post surgery, good recovery of the foveal contour was achieved with vision improving to 20/40. LMH with LHEP can be a sequela of chronic macular edema in RVO.
Acute eclipse retinopathy
Authors: Kalita Iva R , Singh Harsh V
Published: April 2022

Eclipse retinopathy is a rare clinical entity occurring as a result of unprotected gazing at the solar eclipse. OCT features of eclipse retinopathy vary with time of presentation and degree of damage. The presence of hyperreflective foci (HRF) in acute solar retinopathy has never been described in past. We are reporting a case of eclipse retinopathy presenting very early with asymmetrical involvement of the right eye (RE) more than the left eye (LE). We demonstrated the presence of HRF on early OCT corresponding to the degree of damage and correlating with final visual recovery (LE complete recovery while RE incomplete visual recovery).
An unusual case of hide and seek with a broken piece of a preloaded trifocal intraocular lens following an uneventful phacoemulsification
Authors: Natung Tanie , Singh Thangjam A , Pandey Ishita , Devi Oinam S
Published: April 2022

Breakage of an intraocular lens (IOL) haptic during implantation is a rare complication of cataract surgery. We report here a case of a broken fragment of a trifocal IOL playing hide and seek and causing corneal edema repeatedly after an uneventful phacoemulsification and preloaded trifocal IOL (AT LISA tri 839MP) implantation. It was ultimately removed successfully and the patient achieved good vision. It is postulated that the broken piece of IOL migrated to and fro, from sulcus to anterior chamber. The breakage of IOL should also be kept in mind in the case of postoperative corneal edema when other causes have been ruled out.
Hyper-reflective track as an imaging biomarker for clinical improvement in photic retinopathy
Authors: Sindal Manavi D , Ratna Bholesh , Jose Kurian
Published: April 2022

Photic damage occurs due to varied etiologies. In two cases presenting with acute onset symptoms, fundus exam in Case 1 (Welder's arc) showed foveal yellow spot in the left eye. In Case 2 (Solar eclipse), foveal yellow spot was noted bilaterally. Spectral domain Optical coherence tomography revealed disruption of ellipsoid zone and a hyperreflective track extending from outer to inner retina. This hyperreflective track resolved on follow-up and correlated with symptomatic improvement. The hyperreflective track possibly indicates acute photic damage to retina and can serve as a prognostic marker for clinical improvement.
Hyperacute stromal and endothelial rejection in therapeutic penetrating keratoplasty with residual intra-stromal crystalline deposits
Authors: Agarwal Manokamna , Srinivasan Bhaskar , Iyer Geetha , Agarwal Shweta , Sudharshan Sridharan , Janarthanam Jothi B , Rajagopal Rama
Published: April 2022

Stromal rejection is rare and uncommonly seen in its pure form. We report a case of hyperacute stromal rejection followed by endothelial rejection post-therapeutic penetrating keratoplasty (PK) done for fungal keratitis. The rejection episode responded to steroids with a clearing of the graft. Residual mid to deep intra-stromal crystalline deposits remained at the area of stromal rejection, which remained stationary for a follow-up period of 1 year. The patient underwent Anterior segment optical coherence tomography (AS-OCT) to demonstrate the condition objectively.
Highly motile intravitreal worm in epiretinal plane
Authors: Yadav Divya , Sonawane Nikita , Singh Harsh V
Published: April 2022

A 37-year-old-man presented with the perception of wriggling movements in the left eye. The fundus revealed a highly motile nematode epiretinally. The location and plane of the movements were confirmed with optical coherence tomography (OCT), which also showed its intraretinal attachment. Multiple attempts of laser photocoagulation failed due to its incessant rapid movements in the antero-posterior axis. Immediate vitrectomy was deferred due to the risk of breakage. With combination therapies of peribulbar lignocaine and oral anti-helminthics for 2 days, a marked reduction in the motility, thickening, and swelling was noticed and it could finally be killed with laser. To the best of our knowledge, this is the first case report of a live intravitreal worm treated non-invasively.
Bilateral isolated superior ophthalmic vein thrombosis
Authors: Agrawal Sahil , Neupane Swechya , Modaboyina Sujeeth , Bajaj Mandeep S , Das Deepsekhar
Published: April 2022

Bilateral superior ophthalmic vein thrombosis (SOVT) being extremely rare requires diligent evaluation for a definitive diagnosis. A 19-year-old male presented with pain and swelling around both eyes for 5 days. He had bilateral proptosis with gross limitation of movements (extraocular movement) and visual acuity of 6/9 in both eyes. On palpation, no mass was found. Contrast-enhanced magnetic resonance imaging orbit demonstrated bilateral superior ophthalmic vein dilation. Keeping a clinical suspicion of bilateral SOVT, systemic evaluation revealed raised anticardiolipin antibody levels at two occasions 12-weeks apart. A diagnosis of antiphospholipid syndrome was made and anticoagulant therapy was commenced. At 2-week follow-up, there was marked improvement in clinical features.
Use of intravitreal dexamethasone implant to control paradoxical worsening in a case of syphilitic acute placoid posterior chorioretinitis
Authors: Brar Manpreet , Grewal Dilraj Singh , Singh Grewal Satinder Pal , Sharma Mansi , Brar Rahatdeep Singh , Dogra Mangat
Published: April 2022

Paradoxical worsening of ocular syphilis after initiation of antimicrobial therapy is rare, however it is important for the clinicians to be aware of this occurrence, as prompt recognition and timely intervention with corticosteroids can lead to restoration of vision. Alteration/discontinuation of antimicrobial therapy may not be indicated. Our case highlighted the role of dexamethasone implant to control such paradoxical worsening in a young patient with ocular syphilis.
Uveitis-Glaucoma-Hyphema syndrome following sutureless scleral fixated intraocular lens
Authors: Sindal Manavi D , Chhabra Kanika , Sinha Ayushi
Published: April 2022

Uveitis-glaucoma-hyphema (UGH) syndrome is a rare complication usually seen with anterior chamber intraocular lens. We report the occurrence of sudden-onset blurred vision and pain 1 year after an uneventful sutureless scleral fixated intraocular lens (SFIOL) implantation. Despite initial conservative management, the symptoms persisted. A recurrence of VH, uncontrolled IOP, and an irritable painful eye led to the diagnosis of UGH syndrome, and the SFIOL was explanted. We postulate a floppy iris secondary to previous trauma with resultant iris chaffing as the cause for the occurrence of UGH syndrome.
Seroprevalence of Bartonella quintana Infection
Authors: Mai Ba-Hoang-Anh
Published: April 2022

Introduction:

Bartonella quintana is an anaerobic bacillus whose main target is the erythrocyte. This bacterium transmitted by the body louse notably infected the soldiers of the First World War from where the name of this disease: fever of the trenches. The 90s marked the return of this bacterial infection. B. quintana infection in the homeless was reported in the literature with a high incidence in these populations worldwide. This upsurge of cases justified this study for a better understanding of B. quintana infections.

Methods:

We conducted a systematic review to evaluate the seroprevalence of B. quintana infection by using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines to collect scientific papers from PubMed and Google Scholar based on combining keywords.

Results:

The review included 45 articles published from April 1996 to March 2020 with 84 subpopulations of 21 countries from 4 continents; among them, 61 subpopulations had a positive rate from 0.2% to 65%. These subpopulations were divided into four main groups: homeless people, healthy people, blood donors, and symptoms/diseases. Homeless people were the main target of this infection, and three factors related to susceptibility were homeless period, age, and alcoholism. 6/11, 12/20, and 32/41 subpopulations of healthy people, blood donors, symptoms/diseases, respectively, had a positive percentage. However, factors of exposure in these three groups were not mentioned. Other reservoirs, vectors, and transmitted routes were identified to partially explain the worldwide spread of the infection, and it is important to have more further investigations to identify potential risk factors. This will help to limit contamination and prevent effectively.

Conclusions:

This serological overview indicated the importance of B. quintana infection that has emerged in multiple regions, touched worldwide populations.
Vascular Loop of Anterior Inferior Cerebellar Artery Causing Disabling Tinnitus, Vertigo, and Hearing Loss - A Review
Authors: Swain Santosh Kumar
Published: April 2022

The vascular anatomy of the anterior inferior cerebellar artery (AICA) is highly variable. In respect to the neurovascular relationship in the internal auditory canal (IAC), the AICA is intimately related with vestibulocochlear and facial nerve. Vascular loop of AICA, especially located in the IAC, is rare. This vascular loop of the IAC may result in the compression over the vestibulocochlear nerve. Microvascular compression of the eighth cranial nerve is an important cause for disabling tinnitus, vertigo, and hearing loss. Disabling tinnitus and vertigo due to intrameatal vascular loop of AICA compression, the vestibulocochlear nerve can be treated with help of drilling the internal acoustic meatus and separate the vascular loop from the vestibulocochlear nerve. The intrameatal AICA and vestibulocochlear nerve conflict produce specific pathological features and their surgical treatment is also invariably challenging. Decompression of the vestibulocochlear nerve by the opening of the IAC and transposition of the AICA is thought to be an effective treatment modality for radiologically confirmed cases with clinical presentations of unilateral sensorineural hearing loss and pulsatile tinnitus. The aim of this review article is to describe the details of vascular anatomy, etiopathology, clinical presentations, diagnosis, neurophysiology, and current treatment of the vascular loop of AICA in IAC which often pose challenge to the clinicians.
Assessment of Risk Factors and Management of Ischemic Stroke at Ibrahim Malik Teaching Hospital in Khartoum, 2018
Authors: Mohammed Ayat A. , Arbab Ahmed H. , TAbdalla T. Mohammed T.
Published: April 2022

Context:

Ischemic stroke is an acute medical condition with life-threatening complications; therefore, understanding its common risk factors, early management, prevention from recurrent attack, and in our population is necessary.

Aim:

The aim of this study is to assess common risk factors and management of ischemic stroke at Ibrahim Malik Teaching Hospital (Khartoum, Sudan).

Methodology:

A retrospective, hospital-based study was conducted at Ibrahim Malik Teaching Hospital Khartoum State. The study included all medical records of patients hospitalized with Ischemic stroke from January 2017 to January 2018. The data were collected using a well-designed data collection form and analyzed with SPSS.

Results:

Out of 116 participants, ischemic stroke was more frequent in males (59.5%), adults over 65 years (57.8%). Forty-four percent of participants had a history of hypertension. Smoking and family history with ischemic stroke were observed only in 10.3% and 5.2% of participants, respectively. Aspirin (100–300) mg plus atorvastatin 40 mg were the most prescribed regimen of 44.8%. The highest type of drug-drug interaction reported was monitor closely (41.4%) and serious (33.6) type drug-drug interactions. While 74.1% of participants were discharged, the rate of death was significantly higher in females and participants over 65 years' age.

Conclusions:

Past medical history of hypertension and elderly age were the major risk factors with ischemic stroke. Aspirin plus statin therapy is the most frequently used regimen with nonadherence to the guidelines regarding the use of thrombolytic therapy and anticoagulants. Serious type drug-drug interactions were detected among prescribed medications.