bluuebunny/crossref_metadata_2025 huggingface dataset:
Babao Dan Inhibits Gastric Cancer Progression in vivo through Multiple Signaling Pathways
Authors: Shang Hai-Xia , Fang Yi , Guan Bin , Guan Jian-Hua , Peng Jun , Zhao Jin-Yan , Lin Jiu-Mao
Published: January 2024

Objective:

The aim of this study was to explore the effects of Babao dan (BBD), a traditional Chinese medicine, on gastric cancer (GC) progressionin vivo.

Materials and Methods:

A subcutaneous xenograft mouse model of GC was established using MGC80-3 cells. The terminal deoxynucleotidyl transferase-mediated dUTP: 2’-deoxyuridine 5’-triphosphate -biotin nick-end labeling method was adopted to detect cell apoptosisin vivo. The expression levels of proteins associated with proliferation, apoptosis, and angiogenesis were measured by immunohistochemical staining or western blotting (WB). The activation and protein levels of p-c-Jun N-terminal kinase (JNK), p-p38, p-extracellular-regulated kinase 1/2, p-nuclear factor-κB (NF-κB), and p-STAT3 were examined by Bio-plex and WB.

Results:

BBD significantly inhibited tumor growth in GC mouse models with no adverse effect on body weight or organ function. It was also found that BBD significantly suppressed the proliferation of GC tumor cells, induced the apoptosis of tumor cells, and inhibited angiogenesis through inactivating with mitogen-activated protein kinase, NF-κB, and STAT3 pathways.

Conclusions:

BBD exerts suppressive effects on GC tumor growth by regulating multiple pathwaysin vivo, which may provide a novel treatment option for GC therapy.
Comparison of Dental Implant Placement Accuracy Using a Static Surgical Guide, a Virtual Guide and a Manual Placement Method - An In-Vitro Study
Authors: Lysenko Anna V. , Yaremenko Andrey I. , Ivanov Vladimir M. , Lyubimov Aleksandr I. , Leletkina Natalia A. , Prokofeva Alina A.
Published: January 2024

Introduction:

The use of a surgical guide during pre-operative planning significantly increases the efficiency and safety of dental implantation. However, the current widespread use of static navigation has led to a decrease in accuracy. Dynamic navigation, on the other hand, can be an alternative. This study compared the accuracy of dental implant placement on jaw models using static navigation, a virtual guide and the manual placement method.

Materials and Methods:

Nine patients with favourable conditions were selected, and three-dimensional full-body jaw models were set up. Group I had 21 implants placed using static navigation, Group II had 21 implants placed using dynamic navigation and Group III had 21 implants placed using the ‘free hand’ method. Placement accuracy was calculated by the deviation between the planned implant position and the actual position obtained from post-operative cone-beam computed tomography and model scanning.

Results:

The deviation from the planned implant position was 0.4° in Group I and 0.5° in Group II. The ‘free hand’ method yielded the worst result, with a statistically significant difference between Groups I and II. However, implantation using dynamic navigation showed a lower variance of deviation, with the majority of implants having a deviation ≤0.5 mm (86% compared to 67% in the static navigation group).

Discussion:

The accuracy of implant positioning using a virtual guide with dynamic imaging was comparable to static navigation and surpassed the accuracy obtained using the ‘free hand’ technique. This study highlights the potential of dynamic navigation control in dental implantology and warrants further clinical research to improve this system.
Patient-Specific Implants in Maxillofacial Reconstruction - A Case Report
Authors: Joshi Samir , Salema Hamza Javed , Pawar Sudhir , Nair Vivek Sunil , Koranne Vaishali , Sane Vikrant Dilip
Published: January 2024

Rationale:

The successful utilisation of three dimensional (3D) techniques in engineering a titanium patient specific implant (PSI) for a patient who underwent hemimaxillectomy following post COVID mucormycosis infection.

Patient Concerns:

Issues related to problems associated with resection following mucormycosis, such as occlusal function, aesthetics and facial asymmetry.

Diagnosis:

The patient affected by mucormycosis was left with Aramany class 1 and Cordeiro type II sub total maxillectomy defect.

Treatment:

The patient was operated for mucormycosis followed by reconstruction with patient specific implant.

Outcome:

Positive clinical outcomes, including improved facial symmetry, function and psychological well being with immediate replacement of the teeth, the benefits of which far outweigh the traditional approach.

Take away Lessons:

The advances in the use of PSI by integration of 3D printing and computer aided design computer aided manufacturing (CAD-CAM) technology for extensive and challenging defects in the maxillofacial region have been highlighted in this case report.
Incidence and Management of Tooth Root Fracture in Mandibular Fracture Line - A Retrospective Study
Authors: Sahoo Nanda Kishore , Dubey Prajesh , Vaswani Himani , Pandey Swati
Published: January 2024

Introduction:

In cases of trauma, the most common fractures of the facial region are the nasal bone fractures followed by mandibular fractures. About 60% of mandible fractures are associated with teeth in the fracture line; however conversely, the dentulous mandible has a higher susceptibility of fracture in any impact. Whenever a tooth is involved in the fracture line, it is not unlikely that the tooth root fracture will be associated with it. The prognosis and treatment of such a tooth persistent in a fracture line depends upon the level of tooth root fracture.

Materials and Methods:

This retrospective study was conducted in the Department of Oral and Maxillofacial Surgery in a Meerut hospital. The eligibility criteria were based on the cases involving fracture line passing through the teeth bearing area of mandible. Total of 56 cases of mandibular fracture treated from January 2021 till December 2022 by open reduction and fixation were included in the study.

Results:

A total of 56 patients (66 fracture lines) with mandibular fractures were selected, out of which 18 (32%) patients had fracture of the root of the tooth in the fracture line. Third molar root fracture were present in 12 cases (66.6%), first premolars in 4 cases (22.2%), and first molars in 2 cases (11.1%). There were 14 multi rooted teeth (77.7%) and 4 single rooted teeth (22.2%) involvement. All the multi rooted teeth fracture were treated by extraction during open reduction and fracture fixation. The single rooted teeth were successfully treated by endodontic treatment postoperatively.

Discussion:

The fracture line passing through the dentate segment may fracture the tooth crown and/or root or propagate through the socket without any injury to the root. Root fracture at cervical and middle third is constantly exposed to oral fluids. The affected tooth may be mobile and lose vitality. Teeth in the line of fracture must be removed when they preclude the correct reduction of the segments or if they represent a risk for infection. If the tooth or root does not cause any hindrance during reduction or it is not infected, the tooth can be salvaged by endodontic therapy. The incidence of root fracture was seen in 32% of cases. Fracture of the third molar roots was the single largest group (66.6%). No root fracture was observed in the anterior segment.
Maxillofacial Soft-tissue Healing Efficacy between Nano-chitosan and Collagen–Chitosan Membrane – A Comparative Study
Authors: Kumar N Harish , Samuel Soumi , Mathew Suseela , Jacob M. Rosemol , Amruth P.
Published: January 2024

Introduction:

Routine wound management in maxillofacial trauma with soft-tissue injury needs to be addressed in a systematic way to prevent untoward complications. In this study, we examined the effects of a novel surgical dressing material on pain, wound healing and scar and its feasibility to common people. Our aim is to compare the efficacy and potency of the nano-chitosan membrane and collagen–chitosan membrane as surgical dressing materials for soft-tissue wounds in the maxillofacial region.

Materials and Methods:

Thirty participants who sustained soft-tissue injury in the maxillofacial region were included in the study. Post-suturing, Group A participants were treated with nano-chitosan membrane impregnated with chlorhexidine, Group B participants were treated with collagen–chitosan membrane impregnated with chlorhexidine and Group C participants had received chlorhexidine powder as conventional wound care management and recalled and evaluated for wound healing, pain and scar at seventh day, one month and three months postoperatively.

Results:

The wound healing efficacy of both Group A and B participants was nearly comparable and Group A had better wound healing (P = 0.043) when compared to conventional chlorhexidine dressing material. In relation to pain intensity, Group A was reported with a low intensity of pain and also with better results in scar assessment at the third-month follow-up.

Discussion:

This study had proven that even though the wound healing efficacy of both nano-chitosan and collagen–chitosan membranes is nearly comparable, nano-chitosan shows better results on the evaluation of parameters such as wound healing, pain and scar. Nano-chitosan membrane has better wound healing when compared to conventional chlorhexidine dressing material.
Developing mathematical models to compare and analyse the pharmacokinetics of morphine and fentanyl
Authors: Shenoy Prathvi , Rao Mahadev , Chokkadi Shreesha , Bhatnagar Sushma , Salins Naveen
Published: January 2024

Background and Aims:

The two-compartment model is generally used in pharmacokinetics to illustrate the distribution and excretion of drugs. In this study, we evaluated the distribution patterns of morphine and fentanyl by using a two-compartment model.

Methods:

Using numeric analysis techniques, non-linear ordinary differential equations were used to mathematically analyse drug distribution, transition, and concentration in the body compartments. Math Works, Inc., MATLAB, version 2023a, a programming tool, was used to characterise the impact of initial concentration and rate constants on the kinetics of the drug. For a definite therapeutic concentration of morphine and fentanyl in blood, pharmacokinetic characteristics were plotted.

Results:

The study results showed the time taken by morphine and fentanyl to reach a target concentration in the blood that is sufficient to generate the preferred therapeutic effects. The mathematical models comparing morphine and fentanyl pharmacokinetics showed that fentanyl reached the target therapeutic concentration 125 minutes earlier than morphine and was metabolised and removed from the body more rapidly (44 minutes earlier than morphine).

Conclusion:

These comparative mathematical models on morphine and fentanyl enable the determination of drug dosages and understanding of drug efficacy that facilitates optimising dosing regimens. The right choice between them can be made based on the time to reach the target therapeutic concentration in the blood, elimination time, severity of pain, and patient characteristics.
Perioperative crisis resource management simulation training in anaesthesia
Authors: Pai Dinker R. , Kumar VR Hemanth , Sobana R
Published: January 2024

Simulation-based education is now recognised to be a valuable tool to impart both technical and non-technical skills to healthcare professionals of all levels. Simulation is an well accepted educational tool for cultivating teamwork skills among residents globally. Simulation-based education encompasses diverse modalities, ranging from task trainers and simulated patients to sophisticated high-fidelity patient simulators. Notably, anaesthesiologists globally were early advocates of integrating simulation into education, particularly to instruct anaesthesia residents about the intricacies of perioperative crisis resource management and collaborative interdisciplinary teamwork. Given the inherent high-risk nature of anaesthesia, where effective teamwork is pivotal to averting adverse patient outcomes, and also to improve overall outcome of the patient, simulation training becomes imperative. This narrative review delves into the contemporary landscape of simulation training in perioperative anaesthesia management, examining the pedagogical approaches, simulators, techniques and technologies employed to facilitate this training.
Role of artificial intelligence in perioperative monitoring in anaesthesia
Authors: Garg Shaloo , Kapoor Mukul Chandra
Published: January 2024

Artificial intelligence (AI) is making giant strides in the medical domain, and the field of anaesthesia is not untouched. Enhancement in technology, especially AI, in many fields, including medicine, has proven to be far superior, safer and less erratic than human decision-making. The intersection of anaesthesia and AI holds the potential for augmenting constructive advances in anaesthesia care. AI can improve anaesthesiologists’ efficiency, reduce costs and improve patient outcomes. Anaesthesiologists are well placed to harness the advantages of AI in various areas like perioperative monitoring, anaesthesia care, drug delivery, post-anaesthesia care unit, pain management and intensive care unit. Perioperative monitoring of the depth of anaesthesia, clinical decision support systems and closed-loop anaesthesia delivery aid in efficient and safer anaesthesia delivery. The effect of various AI interventions in clinical practice will need further research and validation, as well as the ethical implications of privacy and data handling. This paper aims to provide an overview of AI in perioperative monitoring in anaesthesia.
Enhancing healthcare communication education: Standardised patient programmes
Authors: Nawathe Pooja A. , Herrington Alaina
Published: January 2024

This article delves into standardised patients’ (SP) roles in healthcare education, using role-play and in-person methodology for realistic scenario simulation and learner technical and non-technical skill enhancement. Key to the success of the SP programme are phases like recruitment, onboarding, training and continuous quality improvement, cultivating a qualified pool of engaged SPs. Sustained SP engagement involves strategies such as tailored training sessions, quizzes, just-in-time videos and anaesthesia-specific self-assessment tools. The benefits of sessions led by SPs lie in their flexibility, providing anaesthesia learners with a controlled, experiential learning environment, where they can safely learn from mistakes. Addressing challenges in launching SP programmes for training, the article underscores clear objectives, strategic resource allocation, curriculum integration and specialised SP training. Implementing technology, quality assurance and ongoing evaluations are vital for dynamic SP programmes. The article advocates holistic SP programme implementation and optimisation, with continuous improvement for acquiring skills by anaesthesia professionals.
Scope of artificial intelligence in airway management
Authors: Naik Naveen B. , Mathew Preethy J. , Kundra Pankaj
Published: January 2024

The evolution of artificial intelligence (AI) systems in the field of anaesthesiology owes to notable advancements in data processing, databases, algorithmic programs, and computation power. Over the past decades, its accelerated progression has enhanced safety in anaesthesia by improving the efficiency of equipment, perioperative risk assessments, monitoring, and drug administration systems. AI in the field of anaesthesia aims to improve patient safety, optimise resources, and improve the quality of anaesthesia management in all phases of perioperative care. The use of AI is likely to impact difficult airway management and patient safety considerably. AI has been explored to predict difficult intubation to outperform conventional airway examinations by integrating subjective factors, such as facial appearance, speech features, habitus, and other poorly known features. This narrative review delves into the status of AI in airway management, the most recent developments in this field, and its future clinical applications.
Role of simulation-based training in thoracic anaesthesia
Authors: Parab Swapnil Y. , Ranganathan Priya , Shetmahajan Madhavi , Malde Anila
Published: January 2024

Simulation-based training (SBT) aims to acquire technical and non-technical skills in a simulated fashion without harming the patient. Simulation helps the anaesthesiologist acquire procedural competence and non-technical abilities. In thoracic anaesthesia, various simulators are available with varying degrees of fidelity and costs. Apart from improving bronchoscopy-related skills, other potential applications of SBT include the practice of lung isolation in normal and difficult airway scenarios, troubleshooting complications during surgeries, and certification of the proficiency of anaesthesiologists. A pragmatic approach is required for choosing the simulator based on its availability, cost, and benefits. Although the literature supports SBT to improve procedural skills, retention of the skills and their translation into improving clinical outcomes remain largely unproven. Randomised, controlled studies targeting the effect of SBT on the improvement of clinical outcomes of patients are needed to prove their worth.
Faculty development programmes in simulation-based teaching: An exploration of current practices
Authors: Soni Lipika , Ramachandran Rashmi , Rewari Vimi
Published: January 2024

Background and Aims:

Simulation-based teaching (SBT) has become integral to healthcare education, offering a dynamic and immersive learning experience for bridging theoretical knowledge with real-world clinical practice. Faculty members play a crucial role in shaping the effectiveness of simulation-based education, necessitating the implementation of comprehensive faculty development programmes. This scoping review explores existing literature on training programmes for simulation-based teaching, focusing on strategies employed and the overall impact on educators and the quality of simulation-based education.

Methods:

The scoping review comprised five sequential steps: identifying the research question; identifying relevant studies; study selection; charting the data; and collating, summarising, and reporting the results. The research questions focused on existing practices and approaches in faculty development for simulation-based teaching, challenges or barriers reported, and the effectiveness of utilised methods and strategies.

Results:

A systematic search of databases yielded 13 studies meeting inclusion criteria out of 1570 initially screened papers. These studies provided insights into various aspects of faculty development programmes, including their nature, duration, and participant profiles. Despite the diversity in approaches, detailed, specialty-specific programmes were scarce, especially in anaesthesiology. Challenges, while implicit, lacked explicit exploration. Most studies reported positive outcomes, emphasising achievement of learning objectives, appreciable course content, and relevance to teaching practices.

Conclusion:

This scoping review describes the existing literature regarding the faculty training or development programmes related to SBT. The programmes target various health professionals and have a wide range of durations. The need for such a programme targeting anaesthesiologists is emphasised.
Management of refractory glaucoma in Cogan–Reese variant of ICE syndrome with secondary tube implantation
Authors: Senthilkumar Vijayalakshmi A , Ramesh Sujitha , Puthuran George V
Published: January 2024

Glaucoma secondary to iridocorneal endothelial syndrome is refractory to medical treatment, and its management is always challenging. We report the clinical course and management of refractory glaucoma in a 47-year-old male diagnosed with Cogan–Reese syndrome with an 11-year follow-up result. He initially underwent trabeculectomy, which eventually failed after 7 years; hence, an Aurolab aqueous drainage implant (AADI) was placed superotemporally. On subsequent follow-up, as the AADI tube got retracted, secondary AADI implantation was placed in the superonasal quadrant. Later, his vision dropped due to cataract and underwent phacoemulsification with intraocular lens implantation along with tube trimming.
Hidden orbital inert foreign body: A tale of two cases
Authors: Kumar Sonali Vinay , Kumar Vinay , Sati Alok , Mishra Sanjay Kumar
Published: January 2024

Most of the inorganic foreign bodies are inert and are not removed as they do not elicit an inflammation. However, migration of foreign body and constant rubbing of it against structures in the vicinity sometimes can result in complications like abscess, granuloma, chronic draining sinus, and orbital cellulitis. We report here two unique cases of hidden orbital inert bodies, in which the foreign body led to delayed complications after remaining dormant for many years. This case report illustrates that potential devastating effects can occur even with inert foreign bodies. Hence, patients harboring inert bodies should be advised frequent follow-up to detect adverse events at the earliest.
Effects of modified continuous blanket sutures on fixing auto-conjunctival transplantation in double-head pterygium surgery
Authors: Zhu Chenlei , Shen Jiahui , Ma Huixiang , Zhang Zongduan
Published: January 2024

In this case series, large nasal and temporal pterygia from 112 patients (totaling 122 eyes) were concurrently excised. The temporal wound was covered using two pedicled transposition auto-conjunctival grafts applied using the double shoelace-type modified continuous blanket sutures (MCBS) technique. The nasal wound was covered by a free conjunctival graft from the same eye by using the MCBS technique. During the follow-up period (averaging 50.49 ± 20.53 months), all patients exhibited smooth ocular surfaces with minimal inflammatory reactions. By the end of the follow-up, there were no instances of graft loss or retraction. In addition, no major complications such as symblepharon in the superior fornices, corneoscleral ulcers, or conjunctivitis granulomas were reported. Transient graft edema was noted in three eyes (2.5%) within the first 2 postoperative weeks. Recurrence was only observed in 0.82% of cases (1 out of 122 eyes). This modified surgical technique offered mild inflammation and stable contraposition sutures, resulting in effective ocular surface reconstruction and a notably low recurrence rate for double-headed pterygium.
Retained intraocular bee stings: A case series of four patients
Authors: Venugopal Anitha , Madkaikar Aditee , Ravindran Meenakshi
Published: January 2024

Ocular injuries due to bees and wasps are rare ophthalmic emergencies needing urgent treatment requiring removal of the inciting foreign body and/or immediate medical therapy. Traditional treatment dictates immediate surgical removal along with topical steroids. We present a series of four patients with bee sting injuries and retained intraocular stingers. All cases had retained stinger embedded in the cornea at presentation and received prompt medical treatment. The inflammatory effects of the toxin were successfully neutralized with medical therapy, and the inert exoskeletal chitinous stinger embedded in the cornea caused no direct harm in the long run.
Acetazolamide –friend to foe
Authors: Khanam Zeba , Krishnamoorthy Sripriya , Baskaran Veena , Mashruwala Abha
Published: January 2024

Bilateral acute angle closure attacks are rare and usually secondary to drugs or concurrent microspherophakia. Acetazolamide, a sulphonamide medication used in controlling intraocular pressure, is known to cause uveal effusion precipitating secondary acute angle closure attack. Here we report a well-documented case of concurrent bilateral angle closure with shallowing of the anterior chamber, supra-ciliary effusion, and serous and hemorrhagic choroidal detachment after administration of oral acetazolamide that resolved on withdrawing the insulting agent.
Streptococcus equinus keratitis after small-incision lenticule extraction: A case report and literature review
Authors: Zheng Jingjing , Wang Yue , Fang Xuejun
Published: January 2024

A 20-year-old male patient underwent small-incision lenticule extraction (SMILE) due to compound myopic astigmatism in both eyes. On the first day after SMILE, the patient was diagnosed with infectious keratitis (IK) caused by Streptococcus equinus. Emergency surgery was performed, and 2.5% vancomycin solution was used to wash the corneal interlamine of both eyes. After surgery, intensive antibiotic treatment and glucocorticoids were administered to reduce haze in the corneal epithelium and prevent corneal scar hyperplasia. IK was controlled in both eyes, and the uncorrected distance visual acuity in both eyes was 20/20.
Conjunctival pyogenic granuloma: A series of three case reports
Authors: Das Sujit
Published: January 2024

Conjunctival pyogenic granuloma (PG) is an acquired, benign lobulated capillary hemangioma. The etiology of PG is not known properly. It is most commonly seen at a traumatic wound site or near a suture line after surgery and other insults. Herein, we report three cases of conjunctival PG and found a relationship with post-dental treatment in two of our cases.
Association of acute macular neuroretinopathy with acute optic neuritis following COVID-19 infection
Authors: Li Tong , Hou Lihua
Published: January 2024

Acute optic neuritis is characterized by thinning of the inner retinal layers on optical coherence tomography. Acute macular neuroretinopathy is an outer retinal disorder that leads to thinning of the outer nuclear layer. A 34-year-old woman experienced decreased bilateral visual acuity 1 day following the coronavirus disease 2019 infection. Brain magnetic resonance imaging and demyelination testing revealed mild-to-moderate uneven enhancement of bilateral optic nerve segments, with anti-mog antibody reactivity. Hormone therapy was initiated, which led to outer nuclear layer thinning, completion of the ellipsoid zone, and an absent chimeric zone. The patient’s vision had been fully restored at her 1-year follow-up.
Escitalopram-related bilateral cystoid macular edema
Authors: Civelekler Mustafa , Güven Yusuf Ziya , Akay Fahrettin
Published: January 2024

We want to describe a case of bilateral macular edema caused by escitalopram (a commonly prescribed selective serotonin reuptake inhibitor). A patient who reported bilaterally decreased vision 1 month in duration was referred to our retinal clinic. Optical coherence tomography revealed bilateral cystoid macular edema. He was taking escitalopram (single-isomer S-citalopram), which has not been reported to cause CME. Escitalopram is a widely used drug. More cases of CME should be examined to determine a possible drug association. Physicians prescribing escitalopram should consider possible effects on eye health.
Cocaine induced PRES – A 25-year-old woman with reversible vision loss
Authors: Brar Sumair , Kapila Aastha T , Chhabra Shiba T , Singla Monika
Published: January 2024

Drug abuse is a frequent cause of stroke in the young adults. The more commonly associated drugs with stroke are cocaine, heroin, and psychotomimetic drugs as cannabis, etc., Cocaine is reported more commonly to be associated with ischemic as well as hemorrhagic stroke, though association with posterior reversible encephalopathy syndrome (PRES) like presentation is very uncommon as seen in our patient. She was a young lady who presented to us with headache, seizure, and vision loss after consuming cocaine.
Vaccine needle prick-related retinal injury
Authors: Kalita Iva R , Singh Harsh V
Published: January 2024

A 7-year-old male presented with left eye subconjunctival hemorrhage following injury with a 23-G vaccine needle (COVID-19 vaccine) while playing. Examination revealed a best-corrected visual acuity of 20/30 in the left eye with the presence of localized subconjunctival hemorrhage and trace vitreous hemorrhage with normal intraocular pressure. Peripheral fundus examination revealed the presence of a peripheral retinal tear with an adjacent retinal cyst. A laser barrage was done to the retinal tear, and the patient was kept under close follow-up. On follow-up at 3 months, vision improved to 20/20 with the resolution of vitreous hemorrhage and attached retina. Thus, we report a rare case of retinal tear due to an inefficiently disposed vaccine needle, stating the importance of following occupational safety by the vaccinators as well as other health administrators.
Bilateral optic neuropathy as the initial presentation in a patient with systemic lupus erythematosus
Authors: Panigrahi Pradeep Kumar , Pattnaik Lolly , Patro Manaswini
Published: January 2024

Optic neuropathy is a very rare sight-threatening complication associated with systemic lupus erythematosus (SLE). A 35-year-old female presented with sudden-onset bilateral loss of vision of 6 weeks’ duration. She had a positive history of skin rash, arthralgia, and fever. Funduscopy revealed bilateral pale optic discs. Laboratory and radiological investigations led to a diagnosis of SLE-associated optic neuropathy. The patient was treated with pulse steroids and hydroxychloroquine. No improvement in vision was noted in the initial follow-up after the initiation of treatment.
A case of syphilitic chorioretinitis masquerading as acute posterior multifocal placoid pigment epitheliopathy
Authors: Yalcinsoy Kubra O , Doguizi Sibel , Ozdal Pinar C
Published: January 2024

Ocular involvement can be the first and only manifestation of syphilis, and it may mimic any sign of posterior segment involvement. We report a 22-year-old man with syphilitic multifocal chorioretinitis who had clinical and imaging findings with acute posterior multifocal placoid pigment epitheliopathy (APMPPE) features in both eyes without any systemic and neurological symptoms. Systemic antibiotic and corticosteroid treatment led to regression in multifocal chorioretinitis lesions and improvement in visual acuity. Syphilis may present as APMPPE. Syphilis tests should be kept in mind and carefully evaluated in the differential diagnosis of patients presenting with intraocular inflammation of unknown origin.
Bilateral acute angle closure attack in Weill–Marchesani syndrome: A case report
Authors: Jamal Shagufa , Soundaria Sakthivel , Kavitha Srinivasan
Published: January 2024

Bilateral acute primary angle closure attack, though possible, is a rare condition. Secondary causes such as psychotropic drugs (topiramate), snake bite, and general anesthesia have been implicated in various case reports. We hereby describe a rare case of bilateral simultaneous acute angle closure attack secondary to microspherophakia and lens subluxation in a young lady with Weill–Marchesani syndrome, which was initially misdiagnosed as acute primary angle closure glaucoma. This case highlights the importance of eliciting proper history and paying attention to general examination findings to rule out secondary causes in a young patient with bilateral acute angle closure glaucoma.
The family of crooked arteries
Authors: Agarwal Sagar , Nayak Madhurima A , Sawal Rashi Taori
Published: January 2024

Familial retinal arterial tortuosity syndrome (fRATs) is an autosomal dominant condition characterized by Tortuosity of second‐ and third‐order retinal arterioles but no retinal hemorrhages. We present a case series of a family of three affected members with fRATS. The 47-year-old father presented with diminution of vision, and we found preretinal and intraretinal hemorrhages in the macula. Retinal arterioles of the second‐ and third‐order were tortuous. We examined his children and found similar retinal findings. Clinical exome sequencing revealed a heterozygous c.1501G>A (p.Gly501Ser) mutation involving the COL4A1 gene. To our knowledge, this is the first case report of fRATS from India.
Documentation of capsular block syndrome with swept-source anterior segment optical coherence tomography
Authors: Jain Neha , Aggarwal Karishma , Mittal Vikas
Published: January 2024

A turbid white fluid was noticed in the retrolental space in the right eye of a 57-year-old male who had undergone cataract surgery 4 years ago. With clinical suspicion of capsular block syndrome (CBS), a swept-source anterior segment optical coherence tomography (SS-ASOCT) was conducted. Hyperreflective echo was detected between the posterior surface of the intraocular lens and the posterior capsule. Prompt relief from CBS was achieved through Nd: YAG laser treatment. The advent of SS-ASOCT allows rapid and detailed assessment of the eye’s anterior segment owing to its deeper ocular tissue penetration and better axial resolution within a few seconds.
A rare case of very late recurrence of CSCR-induced CNVM following intra-articular injection of depot steroid
Authors: Das Sudipta , Ghosh Bhaskar , Chakraborty Debdulal
Published: January 2024

Choroidal neovascular membrane (CNVM) is a major cause of long-term vision loss in patients with chronic central serous chorioretinopathy (CSCR). External steroid medications, both oral and injectable, have long been proven as one of the major contributors to CSCR pathogenesis. Here, we report an old case of CSCR with CNVM, who presented with reactivation of CSCR and CNVM, 6 weeks following intra-articular steroid injection for chondromalacia patellae after an unusual gap of 8 years. Exposure to high doses of steroids can be a significant risk factor for reactivation of CSCR CNVM in susceptible individuals, even after a long disease-free interval. The disease process responded well to intravitreal anti-vascular endothelial growth factor (anti-VEGF; ranibizumab) treatment with good visual and anatomical outcomes.
Chronic central serous chorioretinopathy with vitreomacular traction: Surgical management
Authors: Shukla Dhananjay
Published: January 2024

An elderly man with poor vision in both eyes presented with a clinical picture suggestive of bilateral chronic central serous chorioretinopathy, which was confirmed by autofluorescence imaging. Optical coherence tomography revealed a cystoid maculopathy with coexistent vitreomacular traction in the right eye and foveal atrophy in the left eye. The patient subsequently followed up only after a year, when the vitreous traction had worsened into a full-thickness macular hole in the right eye. Vitrectomy with internal limiting membrane flap inversion helped to recover the macular anatomy and function in the only treatable eye of the patient despite the chronic background degenerative disease.
Acute posterior multifocal placoid pigment epitheliopathy following inactivated SARS-CoV-2 vaccination: A case report
Authors: Kaymak Nilufer Zorlutuna
Published: January 2024

A 25-year-old woman presented with redness and pain in both eyes after the first dose of the inactivated vaccine Corona Vac (Sinovac Biotech Ltd., Beijing, China). She had non granulomatous anterior segment inflammation and multiple creamy placoid lesions within the posterior pole and midperipheral retina bilaterally. Fluorescein angiography (FA) revealed early hypofluorescent and late hyperfluorescent lesions, while indocyanine green angiography (ICGA) demonstrated hypofluorescent lesions throughout all phases. A diagnosis of acute posterior multifocal placoid pigment epitheliopathy (APMPPE) was made, and the patient was started on a course of oral prednisolone that was tapered and the inflammation was completely resolved.
Cone dystrophy with supernormal rod response – A rare case report
Authors: Mathew Elizabeth , Maitray Aditya , Mahalingam Maanasi , Rajendran Anand
Published: January 2024

Cone dystrophy with supernormal rod response (CDSRR), also known as potassium channel subfamily V, member 2 (KCNV2) retinopathy, is a rare autosomal recessive cone rod dystrophy, which derives its name from its characteristic full-field electroretinography (ERG) features and the causative gene mutation (KCNV2 gene). It is one of the rare eye retinal dystrophies where ERG is pathognomonic and directly carries the genetic imprint of the condition. Here, we discuss the case of a 9-year-old Indian child with history of diminution of vision in both eyes. Full-field ERG showed a characteristic response of supranormal scotopic b-wave amplitude at high luminance intensities along with broadened trough of the a-wave with late negative component with reduced and delayed photopic response suggestive of CDSRR.
Retinal detachment and microvasculopathy in HIV patients with cytomegalovirus retinitis: A case series
Authors: Sivaranjani S , Nath Anamika , Chaitanya Vivek
Published: January 2024

We report two cases of bilateral rhegmatogenous retinal detachment (RRD) associated with cytomegalovirus retinitis (CMVR) in human immunodeficiency virus (HIV) patients, treated with 23G pars plana vitrectomy (PPV), endolaser (EL), and silicon oil injection (SOI). Both patients had retinal microvasculopathy changes and were managed for postoperative cystoid macular edema (CME). Our cases highlight the challenges in treating RRD associated with CMVR in HIV patients and the importance of close follow-up for these patients.
Intraoperative corneal staining during cataract surgery
Authors: Singh Kamaljeet , Bhatt Kriti , Rana Jagriti , Gupta Shekhar
Published: January 2024

Intraoperative corneal staining with trypan blue dye is an uncommon complication of cataract surgery that occurs at the time of staining of the anterior capsule. Inadvertent corneal staining with Descemet’s membrane detachment (DMD) occurred in a 70-year-old male, while stromal edema following corneal staining occurred in an 80-year-old female while attempting to stain the anterior capsule. DMD was managed with air tamponade, and stromal edema was conservatively managed. One must thus be aware of corneal staining with trypan blue during cataract surgery. This complication can be avoided by using sharp-tipped instruments, proper wound construction, and proper depth perception, which can be done by adjusting the microscope.
Diamond ophthalmic burr-assisted deep anterior lamellar keratoplasty – Case series
Authors: Majumdar Ashis , Dutta Jayanta , Ghosh Rudra Prosad
Published: January 2024

This case series presents a simple technique using the diamond ophthalmic burr (DOB) to perform successful deep anterior lamellar keratoplasty (DALK) in cases where the big-bubble technique is unsuitable or intraoperative Descemet membrane perforation occurs. Five patients underwent DOB-assisted DALK, and postoperative outcomes were evaluated, including best-corrected visual acuity, corneal astigmatism, residual host tissue thickness, and postoperative endothelial cell count. Manual corneal lamellar dissection was performed, followed by DOB-assisted pre-Descemet layer polishing and donor graft attachment using 16 (10-0) Monofilament Nylon sutures. The postoperative visual acuity significantly improved. DOB-assisted DALK is a viable alternative.
Bilateral cataract in Fahr’s syndrome: A rare case presentation
Authors: Eqbal Shadma , Kusumesh Rakhi , Kumari Pinki
Published: January 2024

Fahr’s syndrome refers to a rare syndrome characterized by symmetrical and bilateral intracranial calcification. A 17-year-old female presented with bilateral diminution of vision. The patient had a history of dystonia with distal limbs involvement. An ocular examination revealed a bilateral cataractous lens. CT scan of the brain and orbit revealed bilateral, large area of bilateral calcification over the thalamus, basal ganglia, subcortical white matter, dentate, and cerebellar hemisphere. The secondary causes of bilateral calcification were excluded to make the clinical diagnosis of idiopathic bilateral striopallidodentate calcinosis, which is known as Fahr’s syndrome. Our aim in this case is to highlight the ophthalmic manifestation of a rare neurological syndrome.
Philadelphia chromosome-positive acute lymphoblastic leukemia presenting with bilateral serous retinal detachment: A case report and review of the literature
Authors: Yalçın Cumali , Özkalemkaş Fahir , Özkocaman Vildan , Ersal Tuba , Yaşar Mete , Kırıştıoğlu Mehmet Ömer , Yalçınbayır Özgür
Published: January 2024

We report a case who presented with bilateral serous retinal detachment (SRD) as the initial sign of Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL). A 49-year-old female presented with blurred vision. A colored fundus image of the patient revealed SRD around the posterior pole’s optic disc. Bone marrow aspiration showed infiltration with lymphoblasts. The patient was diagnosed with Ph+ ALL. SRD regressed in the color fundus image of the patient after induction chemotherapy and intrathecal methotrexate. The patient’s visual symptoms completely regressed. In conclusion, acute leukemia should be considered in the differential diagnosis of cases presenting with SRD.
Vogt–Koyanagi–Harada-like presentation: A short case series
Authors: Kumar Dhivya Ashok , Vijayan Jiji P , Agarwal Amar
Published: January 2024

We report a short case series of Vogt–Koyanagi–Harada (VKH)-like presentation in the eyes of Indian patients following vaccination. Patients with symptoms and signs of VKH that developed after coronavirus disease 2019 (COVID-19) vaccination, who presented with the first episode of the disease were included. There were five patients with four probable VKH and one incomplete VKH, with the mean time of onset being 5.4 ± 3.7 weeks. All patients had bilateral presentation. Steroid treatment was effective with no recurrence. Any vaccination can act as a trigger for the first episode of VKH presentation, and patient education on the same is needed.
Bilateral choroidal neovascular membrane in multifocal serpiginoid choroiditis in young children - Case report of two patients with swept-source optical coherence tomography angiography correlation
Authors: Shakeel Areeba , Bhatt Darshan , Biswas Jyotirmay
Published: January 2024

We present two cases of bilateral multifocal serpiginoid choroiditis (MSC) in young children with latent tuberculosis infection. Vitritis was seen in both cases. Multiple recurrences were noticed over regular follow-up visits. Anti-tubercular treatment was advised along with oral corticosteroids and immunomodulatory drugs for better remission. Swept-source optical coherence tomography angiography (SS-OCTA), used for monitoring disease activity, showed the development of bilateral choroidal neovascular membrane in both cases due to long-standing choroidal inflammation. Intravitreal anti-VEGF was administered for the regression of the neovascular membrane. MSC in the younger age group is a rare occurrence. This case highlights the importance of SS-OCTA and regular follow-up.
Multimodal imaging in fundus flavimaculatus with macular vitelliform lesion
Authors: Ramanadhane Raghulnadhan , Majumdar Bristi , Gupta Shamayita , Sen Ahana , Bhattacharyya Sampurna , Chattree Surabhi , Sinha Sourav , Saurabh Kumar , Roy Rupak
Published: January 2024

We report a case of fundus flavimaculatus (FFM) with macular vitelliform lesion. The study was done in a center in eastern India. A 38-year-old male presented with painless diminution of vision. His best corrected visual acuity (BCVA) was 20/60 and 20/25 in the right and left eye, respectively. There were polymorphous, yellowish, mid-peripheral retinal flecks and foveal vitelliform lesions. Investigations were suggestive of FFM. We have described the various multimodal imaging modalities to differentiate FFM and vitelliform dystrophy. It is crucial to differentiate these diseases due to the difference in visual prognosis. We report a case of FFM with a foveal vitelliform lesion.
Acute unilateral childhood proptosis as a presenting symptom of sickle cell disease
Authors: Sharma Ria , Moharana Bruttendu , Yakang Dani , Sharma Bhavana
Published: January 2024

Although rare, orbital bone marrow infarction is a serious complication in patients with sickle cell disease (SCD). Ophthalmologists should have a high index of suspicion for this disease in cases of acute childhood proptosis. Appropriate early management will prevent optic nerve dysfunction and permanent vision loss. Here, we present a case where the patient presented to the ophthalmologist with complaints of pain and proptosis, which led to the diagnosis of SCD.
Reopening the severely contracted lens capsular bag post phaco-vitrectomy by mini anterior peripheral capsulorhexis and visco-dissection
Authors: Jiang Feng , Zhang Ye , Chen Fei-Fei , Liu Ya-Jun , Xie Zheng-Gao
Published: January 2024

To introduce a novel technique for reopening the capsular bag with severe fibrosis for aphakic patients after primary phaco-vitrectomy. Ocular viscosurgical device (OVD) was injected into the anterior chamber. An area of the anterior capsule was identified where the fibrosis was less severe and therefore left a wider healthy peripheral capsule. A cystitome was used to perforate the anterior capsule near the anterior capsular margin, and care was taken not to injure the posterior capsule below. The mini anterior capsulorhexis was then performed with capsular forceps, approximately 2 mm in diameter. A blunt cannula was used to slightly separate the anterior and posterior capsule right at the mini capsulorhexis. OVD was then injected slowly and continuously through the mini-opening to separate the two layers until the capsular bag was completely reopened. A foldable IOL was implanted into the capsular bag. Four consecutive cases (4 eyes) were enrolled in this study. All the fibrotic capsular bags in four eyes were reopened by mini anterior peripheral capsulorhexis combined with visco-dissection. Secondary in-the-bag IOL implantation was carried out smoothly.

Conclusion:

This novel surgical technique is safe and effective in reopening the capsular bag with severe fibrosis after primary phaco-vitrectomy.
Delayed noninfectious intraocular inflammation and retinal vasculitis after single intravitreal Brolucizumab® injection for polypoidal choroidal vasculopathy
Authors: Venkatesh Ramesh , Mishra Sai B , Mangla Rubble , Acharya Isha , Chitturi Sai P , Krishna Shruthi M , Chhablani Jay , Prabhu Vishma
Published: January 2024

A 52-year-old woman with extrafoveal polypoidal choroidal vasculopathy (PCV) in her right eye was treated with a single intravitreal injection of 6 mg/0.05 ml brolucizumab (BZB) and focal thermal laser therapy. The patient complained of redness and blurred vision in her right eye for the previous week at the 4-week follow-up visit. PCV-related clinical findings revealed complete regression. There was circumcorneal congestion, diffuse nongranulomatous keratic precipitates, grade 2+ anterior chamber flare and cells, grade 1+ vitreous haze, posterior vitreous cells, hyperemic disc with perivascular sheathing, and retinal vasculitis. Following treatment with topical and systemic steroids, the intraocular inflammation (IOI) worsened, and vision was reduced to 6/60 after a week of steroid therapy at a subsequent follow-up visit. A pars plana vitrectomy was performed, and vitreous cytology revealed small lymphocytes with no evidence of intraocular infection. At the 6-month follow-up visit, the patient’s vision had improved to 6/6 and the signs of IOI had resolved. This case demonstrates that even after a single intravitreal injection of BZB, an eye that had previously received no antivascular endothelial growth factor injection can develop IOI.
A Case Report on Hendren’s Technique for Managing Symptomatic Isolated Urogenital Sinus in an Infant
Authors: Thanneeru Suresh Kumar , Gupta Amit , Ahmad Reyaz
Published: January 2024

ABSTRACT

Isolated urogenital sinus is a rare anomaly. These cases may have high confluence which adds complexity to surgical correction. There are controversies regarding timing and techniques of management. We present a case report on managing such a case in an infant with bladder outlet obstruction and pyocolpos.
Granular Cell Tumor (Abrikossoff’s Tumor) of the Vulva in Childhood
Authors: Boscarelli Alessandro , Ahmed Yusuf , Schleef Jürgen , Guida Edoardo
Published: January 2024

ABSTRACT

Granular cell tumors (GCTs) (Abrikossoff’s tumors) are rare neoplasms derived from Schwann cells. Immunohistochemistry remains the most useful instrument for diagnosing GCTs. Complete surgical excision has been demonstrated to be curative for benign lesions. However, long-term follow-up in these patients is strongly recommended.