bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of construction cost of residential buildings in Sri Lanka: offsite vs onsite
Authors: Gunarathne J. A. T. W. , Ramachandra T. , Madushika U. G. D
Published: July 2023

Offsite construction (OSC) entails the planning, designing, manufacturing, transportation, and assembly of prefabricated building components at the construction site. As recommended in previous studies, the offsite construction technique can be considered a high-quality and cost-effective construction method that consumes less time and labour while delivering higher productivity. Consequently, it is recognized as a sustainable solution compared to existing onsite structures in countries like Sri Lanka, given the restriction on the availability of resources and high constructional cost. However, this technique is underutilized in the Sri Lankan construction industry, creating a significant void that must be addressed with sufficient cost data and broader access to knowledge regarding the positive impacts of the technique. This research seeks to evaluate current OSC practices together with a comparison of the cost of two similar-natured onsite and offsite residential projects to determine the economic feasibility of OSC in Sri Lanka. The required cost data were extracted through semi-structured interviews with the professionals who engaged in building projects and document reviews. The comparative analysis indicated that beams, columns, masonry walls, and wall finishes (plastering) are contributing to 100% cost-saving in offsite projects compared to onsite projects due to the offsite concrete wall. Further, concrete walls, stairs and ramps, roofs, and floor slab shows 25%, 16%, 12%, and 8% cost saving for the off-site project compared to an onsite project, respectively. Hence, the adoption of off-site elements would enable construction clients and investors to achieve substantial savings in the construction cost of buildings.
Effect of risk perception and vulnerability on adaptive architecture in flood resilience: a case from Ratnapura, Sri Lanka
Authors: Weerasuriya W. A. A. , Rajapaksha U.
Published: July 2023

In the last few decades, the frequency and severity of floods in South Asia have vastly increased due to the increase in global surface temperature and change in rainfall patterns. The lack of risk perception, high vulnerability and lack of proper architectural adaptations have added to the negative consequences of disasters. This study discusses the effect of risk perception and vulnerability on flood resilient architecture. The research was conducted with 35 participants selected from the Mudduwa area in Rathnapura, Sri Lanka where the annual flood frequency and damage is very high. The collected data was analyzed using statistical software to calculate a composite mean score to each theoretical factor risk perception, vulnerability, and architectural adaptation. With assumptions, a non-parametric correlation test was carried out to identify the relationship between the three theoretical factors and their subsequent variables. The research findings concluded that risk perception has a positive correlation with architectural adaptation, but vulnerability demonstrates a negative correlation. According to the study, vulnerability acts as a resistance to the correlation between risk perception and architectural adaptation. In conclusion this study elaborates on the importance of a proper system of adaptation for vulnerable people living in flood prone areas.
Efficiency boost of inverted polymer solar cells using electrodeposited n-type Cu2O electrons selective transport layers (ESTLs)
Authors: Wanninayake W.T.M.A.P.K. , Namawardana D.G.K.K. , Wanigasekara R.M.G. , Jayathilaka K.M.D.C. , Wijesundera R.P. , Siripala W.P. , Malik M.I.
Published: July 2023

Polymer solar cells (PSCs) have attracted tremendous interest as suitable candidates for harnessing solar energy in the recent years. The inherent optoelectronic properties of the inorganic transition metal oxide, negative type cuprous oxide (n-Cu2O), makes it an attractive candidate to improve the performance of PSCs when incorporated as the electron selective transport layers (ESTLs) in the device. In this study, inverted PSCs were fabricated on stainless steel (SS) substrates with n-Cu2O as the ESTL. The n-Cu2O films were prepared by electrodeposition method, followed by annealing under ambient conditions. The active layer material was prepared as bulk heterojunction blend using regioregular poly(3-hexylthiophene) (P3HT) and phenyl-C61-butyric acid methyl ester (PCBM). Poly-(4,3-ethylene dioxythiophene):poly(styrenesulphonate) (PEDOT:PSS) was used as the hole transport layer (HTL) and the final device structure was SS/n-Cu2O/P3HT:PCBM/PEDOT:PSS/Au. Annealing of the n-Cu2O ESTL in air was optimized observing the photoactive performance of the device. Optoelectronic performance of the devices was characterized using spectral response and dark and light current-voltage (I-V) measurements. n-Cu2O ESTL- incorporated devices have absorbed more photons in the short wavelength region of 450‒600 nm with the annealing of n-Cu2O ESTL due to the reduction of electron-hole recombination. The performance of the devices was significantly increased after incorporating pre-annealed n-Cu2O ESTL at 175 °C for 30 min in air. The maximum power conversion efficiency (PCE) was 0.35%.
Impact of Covid-19 on Stock Market Indices: Evidence from Colombo Stock Exchange
Authors: Adikari A. A. V. S. , Buddhika H. J. R.
Published: July 2023

Purpose: The study intends to address the question, “What is the impact of the Covid-19 pandemic on stock market indices in the Colombo Stock Exchange”. This would support potential and existing investors to understand the behaviour of the stock market during the pandemic to make effective long-term decisions since there are only a few studies currently available in Sri Lankan context.Design/Methodology/Approach: A log-linear multiple regression model was executed whereby the dependent variables, All Share Price Index and S&P SL 20 index, were regressed against independent variables, daily new cases and deaths reported, fiscal and monetary policy measures implemented, and island-wide travel restrictions imposed during the period to analyze the impact of Covid-19 on the financial market over 270 days, from 27th January 2020 to 30th April 2021, covering two waves of the pandemic.Findings: The regression analysis revealed a positive relationship between the stock indices and the number of daily cases and deaths and a negative relationship with the travel restrictions imposed during the period. The policy measures implemented by the Government of Sri Lanka were insignificant in the index movements. Based on the results of this study, a positive impact on the stock indices was discovered during the pandemic; hence investors should refrain from panic withdrawals from the market.Originality: This is among the few studies to analyze the stock market performance during the Covid-19 pandemic adapted to the Sri Lankan context. The variables taken in the study can cover various aspects of the pandemic situation.
Agricultural machinery photoelectric automatic navigation control system based on back propagation neural network
Authors: Sun Yerong , Yi Kechuan
Published: July 2023

So as to study the influence of speed factors on the stability of tractor automatic navigation system, combined with neural network control theory, the author proposed a dual-objective joint sliding mode control method based on lateral position deviation and heading angle deviation, using back propagation neural network to establish two-wheel tractor-path dynamics model and straight-line path tracking deviation model, the overall system simulation was carried out by using Matlab/Simulink, and the reliability of the control method was verified. The experimental results showed: when the tractor was tracked with the automatic control of linear path under the condition of the variable speed, the maximum deviation of the lateral position deviation was 12.7cm, and the average absolute deviation was kept within 4.88cm; the maximum deviation of the heading angle deviation was 5°, and the average absolute deviation was kept within 2°; the maximum value of the actual rotation angle was 3.13°, and the standard deviation of the fluctuation was within 0.84°. Under the condition of constant speed and variable speed, using the joint sliding mode control method designed by the author, the dual-objective joint control of lateral position deviation and heading angle deviation could be realized, the controlled overshoot was small, the controlled deviation was small after reaching a stable state, and the adaptability to speed factors was strong, which basically could meet the accuracy requirements of farmland operations.
Diabetes Self-Management in Vulnerable Populations
Authors: Jang Soo Mi
Published: July 2023

For medically, socially, or economically vulnerable populations, diabetes self-management in daily life may be difficult due to trouble accessing healthcare and social, economic, and cultural barriers associated with poverty. Doctors, nurses, nutritionists, and social workers meet various patients from vulnerable populations (e.g., low-income single-person households) in clinical settings. However, there has been a lack of discussion on the characteristics and needs of vulnerable patients with diabetes and relevant interventions. The purpose of this study is, first, to examine the characteristics and psychosocial difficulties of low-income single-person households, and second, to discuss ways to support diabetes selfmanagement.
The Importance of Early Diagnosis for Gestational Diabetes Mellitus
Authors: Lee Min Jin
Published: July 2023

Recently, there has been an increase in the number of young individuals with obesity, as well as an increase in the number of older pregnant women, resulting in a higher incidence not only of gestational diabetes, but also of diabetes during the first trimester. In addition, there has been an increase in the number of pregnant women with higher-than-normal glucose tolerance that do not meet the diagnostic criteria for diabetes at their first prenatal examination. In such cases, it is important to consider whether it is appropriate to wait until gestational age of 24 weeks to diagnose gestational diabetes via the oral glucose tolerance test or whether early diagnosis and management should be pursued. There is a lack of high-quality research on the appropriate timing and methods for early diagnosis of gestational diabetes. The upcoming results of the ongoing the Treatment of Booking Gestational Diabetes Mellitus (TOBOGM) study will provide an opportunity to evaluate the appropriate timing for gestational diabetes diagnosis.
Assessment of Insulin Secretion and Insulin Resistance
Authors: Park So Young
Published: July 2023

Impaired insulin secretion and increased insulin resistance are major contributors to the pathogenesis of diabetes mellitus (DM). Because pancreatic β-cell function and insulin resistance play an important role in the prevention, diagnosis, treatment, and prognosis of DM, several methods for measuring them have been developed based on dynamic and static tests. Because dynamic tests are time consuming and labor intensive, they are not suitable for use in practice. Static tests are simple and less invasive but do not reflect the complex processes of glucose and insulin metabolism. To easily measure insulin secretion capacity, insulinogenic index calculated from oral glucose tolerance test or mixed meal tolerance test and HOMA-β (homeostasis model assessment for β-cell function) can be used. To assess insulin resistance, HOMA-IR (homeostasis model assessment for insulin resistance) can be used. To measure insulin secretion and insulin resistance more accurately, efficiently, and easily, standardized insulin assay should be establishment and new tests should be continuously developed.
Impact of Ketamine versus Propofol for Anesthetic Induction on Cognitive Dysfunction, Delirium, and Acute Kidney Injury Following Cardiac Surgery in Elderly, High-Risk Patients
Authors: Wittwer Erica D. , Cerhan Jane H. , Schroeder Darrell R. , Schaff Hartzell V. , Mauermann William J.
Published: July 2023

Objective:

Evaluate the effects of ketamine versus propofol when used for induction of anesthesia in elderly, high-risk cardiac surgical patients on postoperative complications including cognitive dysfunction, delirium, and acute kidney injury.

Methods:

Prospective, randomized study performed at a tertiary medical center. A total of 52 patients aged ≥70 and older presenting for complex cardiac surgery were randomized to receive either ketamine or propofol for induction of anesthesia. Patients underwent a battery of cognitive testing preoperatively and postoperatively and the incidence of delirium and acute kidney injury were measured. Norepinephrine (NEE) equivalents following induction were assessed for each group.

Results:

A total of 49 patients were included, 25 in the ketamine group and 24 in the propofol group with 3 patients excluded from the analysis. No difference was found between groups in either postoperative cognitive dysfunction or delirium incidence. Acute kidney injury occurred in 6 (24%) patients in the ketamine group in 12 (50%) patients in the propofol group, but the difference did not meet statistical significance (P = 0.08; Relative Risk = 2.1, 95% CI 0.9–4.7). NEE equivalents were lower in the ketamine group, 9.6 ± 22.2 versus 32.7 ± 46.0, P < 0.03.

Conclusions:

The use of ketamine versus propofol for induction of anesthesia did not impact the incidence of postoperative cognitive dysfunction or delirium. Twice as many patients in the propofol group developed acute kidney injury, although not reaching statistical significance and warranting further investigation. In elderly, high-risk patients, ketamine was associated with a significantly reduced need for vasopressor support following induction.
High Thoracic Epidural Anesthesia and Dexmedetomidine for Awake Off-Pump Coronary Artery Bypass Grafting: A Feasible Option for Patients with Severe Pulmonary Disease
Authors: Barnwal Neeraj K. , Bhaskar Vinil S. , Jain Kamlesh L.
Published: July 2023

High thoracic epidural anesthesia in cardiac surgery as the sole anesthetic technique is used in a select groups of patients having severe pulmonary co morbidities. We describe a case series of three patients at high risk for post operative pulmonary complications where this technique was used along with dexmedetomidine infusion for conscious sedation in off pump coronary artery bypass grafting. Proper selection of patients, proper placement of the epidural catheter at the appropriate level and timing of catheter insertion and removal are of paramount importance.
Three-Dimensional Transesophageal Echocardiographic Detection of Left Ventricular Outflow Tract Obstruction by Residual Native Mitral Leaflet following Mitral Valve Replacement in a Hypertrophic Obstructive Cardiomyopathy Patient
Authors: Palaniswamy Nithiyanandhan , Munaf Mamatha , Babu Saravana , Gadhinglajkar Shrinivas V.
Published: July 2023

Hypertrophic obstructive cardiomyopathy (HOCM), although a worldwide prevalent cardiac disease, it imposes a greater task in the patient management. The association of coronary artery disease with HOCM poses an immense perioperative challenge and it demands an expert transesophageal echocardiography (TEE) examination for guiding the surgery and detailed assessment after surgical correction. We report a case of HOCM with coronary artery disease where the post-cardiopulmonary bypass three-dimensional TEE played a crucial role in exact identification of the mechanism of fixed left ventricular outflow tract obstruction, when the two-dimensional TEE failed to provide adequate information.
Restrictive strabismus in-patient with congenital third nerve palsy
Authors: Joshi Rajesh Subhash , Jain Divya Harshawardhan , Hiremath Vidya P
Published: July 2023

In this study, we describe a case of restrictive exotropia in a 10-year-old female with amblyopia. The diagnosis of the accessory muscle was established through the magnetic resonance imaging (MRI) of the brain and orbit. A patient with restriction of all ocular movements in conjunction with enophthalmos of one eye or both eyes or the retraction of the eyeball should be suspected for an accessory ocular muscle and should be investigated accordingly.
Photorefractive keratectomy with collagen cross-linking in grade 2 progressive keratoconus
Authors: Subudhi Praveen , Patro Sweta , Pattanayak Sabyasachi , Rao Subudhi B Nageswar , Sitaram Silla
Published: July 2023

A 24-year-old male with slowly progressing vision loss over six months came to our hospital. On clinical evaluation, his unaided visual acuity was 3/60, which improved to 6/60 with spherocylindrical correction. His lenticular status and posterior segment were within normal limits. On Pentacam evaluation, there was gross evidence of keratoconus. Over the next two months, his Pentacam scan showed a progressive increase in keratoconic parameters. Hence, he was scheduled for topography-guided photorefractive keratectomy (PRK) with full-threshold collagen cross-linking (CXL). After PRK with CXL, the inferior cone was obliterated, providing a stable corneal surface. His unaided visual acuity at three and six months was 6/12 and 6/9p, respectively. His visual acuity remained at 6/9p at the end of 2 years.
Femtosecond laser-assisted intrastromal MyoRing implantation for correction of irregular astigmatism after penetrating keratoplasty and high myopia
Authors: Aleksandrovna Pozdeyeva Nadezhda , Vladimirovich Sinitsyn Maksim
Published: July 2023

MyoRing was implanted using a femtosecond laser to correct a high irregular corneal astigmatism after penetrating keratoplasty and high myopia. Femtosecond laser-assisted intrastromal MyoRing implantation allows to increase its sphericity, regularity and at the same time to correct high myopia. The creation of an additional “framework” in the corneal transplant by the MyoRing increased its biomechanical properties and prevented regression of the obtained refractive result. Femtosecond laser-assisted intrastromal MyoRing implantation allows to correct irregular astigmatism after penetrating keratoplasty and high myopia.
The chronicles of missing metallic intraorbital foreign body
Authors: Sharma Vandana , Narula Ankita , Chugh Joginder P , Yadav Neeru , Jain Gautam
Published: July 2023

Intraorbital foreign bodies should be thoroughly looked for and removed judiciously and timely in order to avoid sight-threatening complications. In this series of cases, three patients presented with various types of intraorbital foreign bodies secondary to trauma or iatrogenic causes. After confirmation of diagnosis using appropriate radiological investigations, the foreign bodies were retrieved with the help of suitable surgical techniques. Timely intervention prevented infection and other inflammatory processes such as siderosis and other serious complications like airway obstruction and chemical injury. Meticulous examination supported by radiological investigations is the mainstay of management in cases of orbital trauma.
Severe ocular involvement in ecthyma gangrenosum
Authors: Jain Shikha , Kekan Mitali , Mammel Anwara , Pathak Ashok
Published: July 2023

Ecthyma Gangrenosum (EG) is a cutaneous infection occurring mainly in immunocompromised patients with very rare ocular involvement. We report a rare case of an immunocompetent, 16 year old female with bilateral pseudomembranous conjunctivitis preceded by dermatological lesions. Timely intervention and appropriate treatment helped salvage globe in both eyes with improvement of vision in right eye. Only 2 cases have been reported till date of Ecthyma Gangrenosum with ocular involvement. In both the case reports, the globe could not be salvaged.
Managing visual symptoms in cone-rod dystrophy with prosthetic soft contact lens
Authors: Balakrishnan Manju , Iqbal Asif
Published: July 2023

This case demonstrates the utilization of a prosthetic type C contact lens to manage visual symptoms such as photophobia and glare in patients with cone-rod dystrophy. A 20-year-old female patient reported to our clinic with complaints of photophobia, glare, and impaired vision and was evaluated with different contact lens trials to improve her ability to use her remaining vision effectively. The patient was fitted with ACUVUE OASYS transitions, X-chrome red-tinted contact lenses, and tinted type C contact lenses. All the trials manifest optimal fitting and better comfort but only the tinted type C contact lens resulted in pronounced improvement in photophobia, glare, and vision both indoors and outdoors. Finally, a tinted type C contact lens is effective in relieving photophobia and glare and making a remarkable changeover in the quality of life. Thus, all contact lens practitioners should use these lenses to treat victims with glare and photophobia caused by cone-rod dystrophy.
Latent Mycobacterial fortuitum infection presenting as ocular sarcoidosis
Authors: Babu Kalpana , Hegde Preethi , Kumar Suma P
Published: July 2023

A 62-year-old lady presented with bilateral granulomatous uveitis and cystoid macular edema. A diagnosis of ocular sarcoidosis was made (revised International Workshop on Ocular Sarcoidosis [IWOS] criteria) on the basis of lymphopenia, negative Mantoux, and QuantiFERON TB gold tests. Enlarged mediastinal lymph nodes, subpleural nodules, and nodular interstitial thickening were seen on high-resolution computed tomography (HRCT) thorax. Non-necrotizing granulomato us inflammation, negative for mycobacteria on staining and GeneXpert, was noted on endobronchial ultrasound-guided transbronchial lymph node aspiration (EBUS-TBNA). However, culture grew Mycobacterium fortuitum after 3 weeks. This case highlights a rare presentation of latent M. fortuitum infection presenting as ocular sarcoidosis, speculating the coexistence of two diseases in an individual, one possibly triggering the other.
Unusual case of corneo-scleral melt treated with scleral patch graft in a patient of Porphyria Cutanea Tarda
Authors: Tiple Sweety G , Mathur Umang , Das Sima , Gandhi Arpan
Published: July 2023

Porphyria cutanea tarda (PCT) is the most common form of Porphyria, which is a group of metabolic disorders of haem biosynthesis characterized by the involvement of the skin, eyes, and neuro-visceral tissue. Although scleral thinning in the interpalpebral area is a well-documented feature, severe corneal involvement is rarely described. We, herein report a young male who presented with bilateral scleral thinning in the interpalpebral area and an anterior staphyloma in the right eye. Systemic examination was suggestive of PCT. We report the first case of PCT in literature successfully treated with autologous scleral patch graft.
Optical coherence tomography angiography of epiretinal neovascularization in a case of macular telangiectasia type 2 and coexistent proliferative diabetic retinopathy
Authors: Estawro Rania G , Hassouna Abdallah K
Published: July 2023

Epiretinal neovascularization (ERN) is a novel optical coherence tomography angiography (OCTA) finding, which has been recently described in association with macular telangiectasia type 2 (MacTel 2). To our knowledge, this is the first documentation of ERN and coexistent proliferative diabetic retinopathy (PDR), which could be clinically confused with diabetic foveal neovascularization. OCTA is a useful tool to evaluate ERN and differentiate it from diabetic foveal neovascularization.
Anomalous head posture
Authors: Mohan Akshay , Singh Shweta , Sharma Priyanka , Agrawal Siddharth
Published: July 2023

Intermittent exotropia (IXT) usually presents with occasional outward deviation of the eye, asthenopia, headache, diplopia, or photophobia. We report here an unusual presentation of IXT in a 21-year-old man, with an anomalous head posture (AHP) of face rotation towards left as the primary symptom. On examination, there was lateral gaze incomitance, and improved fusion range in dextroversion explained his AHP.
Rhino-orbito-cerebral mucormycosis in a pregnant woman
Authors: Viswamithra Penumala , Muralikrishna Valluru , Sultana Syed S , Sindusha Kommineni , Rani Bokam S
Published: July 2023

Mucormycosis is an uncommon, rapidly progressive, angioinvasive fungal infection characterized by large areas of tissue necrosis. We report a case of a 25-year-old primigravida of gestational age 25 weeks with clinically and radiologically proven COVID-19-related rhino-orbito-cerebral mucormycosis (ROCM) stage 3c with gestational diabetes. She was treated with injection liposomal amphotericin B, but her condition rapidly progressed with impending intracranial extension. She was subjected to total exenteration of the left eye with extensive endoscopic sinus surgery and continued on systemic antifungals along with supportive therapy for four weeks after surgery.
Peli prism fitting for homonymous hemianopia
Authors: Saha Ranindita , Reshamwala Vivek , Satgunam Prem Nandhini
Published: July 2023

Peli prisms are Fresnel prisms for visual field expansion in homonymous hemianopia. They can be dispensed as temporary (press-on) or permanent prisms. In this case series, we discuss the general fitting techniques and report fitting Peli prisms in four unusual scenarios. We show that children and one-eyed patients can be fit with Peli prism. Peli prism can be fit over safety goggles, but fitting in progressive addition lenses can be challenging. Careful counseling, setting realistic goals, giving a proper Peli prism trial, orienting for spatial mislocalization, and demonstrating the visual field expansion are all key ingredients to achieve success.
A rare combination
Authors: Barwar Gulshan , Parchand Swapnil M , Gangwe Anil B , Agrawal Deepshikha
Published: July 2023

A 19-year-old male presented with night blindness and gradual diminution of vision since 5 years. Clinical examination and investigations revealed bilateral atypical retinitis pigmentosa (punctata albescens) with foveal atrophy and optic disc drusen. On general examination, patient had central obesity, post-axial polydactyly and brachydactyly in upper and lower limbs, hypogonadism, cognitive deficit, and speech impairment, which were suggestive of Bardet–Biedl syndrome. This is a rare case of Bardet–Biedl syndrome with atypical retinitis pigmentosa (punctata albescens) and bilateral optic disc drusen.
Posterior ethmoidal mucocele with orbital apex syndrome in a young male
Authors: Saudhamini S , Ramasamy Vidhyadevi , Padmanaban S , Sundar D , Ravisankar V , Vignesh N
Published: July 2023

A 39-year-old male presented with painless diminution of vision in the right eye for 10 days, which was associated with drooping of the upper lid for 4 days. Vision was perception of light with 4 mm ptosis and mild proptosis and 3.5 mm pupil with grade 1 relative afferent pupillary defect (RAPD). Extraocular movements showed abduction and elevation limitation of -2, adduction and depression limitation of -1 in the right eye. Magnetic resonance imaging (MRI) showed right posterior ethmoidal mucocele causing optic nerve compression. Marsupialization of mucocele and optic nerve decompression were done. Post-surgery, vision, ptosis, and extraocular movements improved and pupil remained the same owing to the mechanical effect of the mucocele. Early identification and intervention of posterior ethmoidal mucocele is crucial in preventing visual compromise.
The role of a conjunctival biopsy in the diagnosis of eosinophilic granulomatosis with polyangiitis with ocular involvement
Authors: Prasad Sonali , Mehta Anuj , Gaur Aman
Published: July 2023

A 33-year-old Asian man presented with redness, swelling, and blurring of vision in both eyes for 1 month associated with headache and pain. The patient had a history of allergic rhinitis with a progressive hearing loss for 3 months, followed by bell's palsy. Given his elevated serum cytoplasmic anti-neutrophil cytoplasmic antibody (C-ANCA) and erythrocyte sedimentation rate (ESR) levels as well as computed tomography head, orbit, and peripheral nervous system that showed marked bilateral mastoiditis with opacification of the right middle ear canal and enlargement of the bilateral lacrimal gland, the suspicion of small vessel vasculitis with ocular and ear involvement was high. Because there was no significant lung or kidney involvement, a conjunctival biopsy was attempted, which revealed small capillaries surrounded by eosinophils and plasma cells. Because there are no validated diagnostic tests for eosinophilic granulomatosis with polyangiitis (EGPA), a conjunctival biopsy can be valuable and minimally invasive in the early diagnosis and treatment of small vessel vasculitis.
Persistent fetal vasculature with vascularized cataract and lens cyst
Authors: Bari Aafreen , Lata Suman , Gwal Rajat S.
Published: July 2023

Persistent fetal vasculature may present as anterior, posterior, or mixed type. Its typical features include microphthalmia, retrolental fibrovascular membrane, stretched ciliary processes, Mittendorf dot, total cataract, and Bergmeister papilla. Atypical features described in literature are axial myopia, platyphakia, lentiglobus, and a normal sized cornea. Platy-phakia (Flat-Lens) is a term commonly used for antero-posteriorly flattened crystalline lens. It is a described but extremely rare finding in Persistent Fetal Vasculature and may represent absorption of the lens with fusion of vestigial lens remnants with retrolental fibrovascular membrane.[1] The spectrum of unusual features may also include unregressed vascular vesicular cataractous lens. The visual prognosis in PFV is generally guarded owing to the developmental anomaly and associated amblyopia, strabismus, glaucoma, and retinal pathologies.
Plaque brachytherapy in unresectable medulloepithelioma with anterior chamber seeding and review of literature
Authors: Shah Payal Naresh , Palanivelu Mahesh Shanmugam
Published: July 2023

Medulloepithelioma is a rare nonhereditary tumor seen most often in children, usually in the first decade. In this paper, we present a case of extensive unresectable medulloepithelioma with neovascular glaucoma and anterior chamber seeding, which was confirmed histopathologically by performing biopsy and successfully managed using plaque brachytherapy along with a review of literature on brachytherapy in medulloepithelioma. The unique features in our case are extensive tumor, with anterior chamber seeding and neovascular glaucoma which have been successfully managed with brachytherapy. Also, the placement of brachytherapy plaque over the corneal surface has not been described previously for managing extensive medulloepithelioma. So far, brachytherapy has been tried in only three cases with concomitant neovascular glaucoma, of which two cases required subsequent enucleation.
Efficacy of intravitreal dexamethasone implant in chronic central serous chorioretinopathy
Authors: Behera Umesh C , Shah Miloni , Kelgaonkar Anup , Sahoo Jyotiranjan , Narayanan Raja , Sadda Srinivas R
Published: July 2023

In a prospective proof-of-concept study probing the role of para-inflammation in central serous chorioretinopathy (CSC) pathogenesis, eligible subjects with chronic CSC non-responsive to conventional treatment received a single dexamethasone (DEX) implant monotherapy. Six middle-aged males (mean age = 46.5 ± 10.8 years) with a mean disease duration of 4.5 ± 2.5 years, at the primary efficacy endpoint of six weeks, showed complete resolution of subretinal fluid (SRF) in four out of six eyes, significant reduction of SRF height (174 ± 86 μm to 22 ± 34 μm; P = 0.028) and central subfield thickness (347 ± 139 μm to 180 ± 47 μm; P = 0.003), indicating DEX as a promising treatment option for chronic CSC.
A rare case of corneal perforation with glass perchlet fish
Authors: Shubhescha Shubhescha S , Ugam PS , Ravina Nachnolkar
Published: July 2023

Penetrating ocular injuries following direct impact of fish are rare. A 26-year-old man presented to the emergency department with history of pain and blurring of vision following injury to the left eye due to the impact of glass perchlet fish. Ocular examination revealed best corrected visual acuity of log of minimum angle of resolution (logMAR) 0.18, eyelid edema, blepharospasm, and circumcorneal congestion. A full-thickness corneal laceration measuring 3 mm, confirmed by positive Seidel's test, and a partial-thickness corneal laceration measuring 1.5 mm were noted. Patient was managed by application of cyanoacrylate glue and bandage contact lens. We report the first case of corneal perforation by glass perchlet fish.
Traumatic macular hole repair through topical dorzolamide
Authors: Huang Hsin-Ai , Chen Kuan-Jen , Lai Chi-Chun , Chou Hung-Da
Published: July 2023

Traumatic macular holes (MHs) still have a guarded prognosis. Whether spontaneous closure or early surgical intervention leads to a more favorable outcome is unclear. Topical therapy with carbonic anhydrase inhibitors was reported to be a non-invasive but effective treatment for traumatic MHs. A 17-year-old boy, whose face was injured by a firework explosion, presented to our emergency department with decreased vision in his left eye (20/125). A bio-microscopic examination revealed a vitreous hemorrhage that partially obscured the fundus. Optical coherence tomography (OCT) revealed an MH in the fovea with mild intra-retinal edema and juxtafoveal outer retinal layer alterations. Dorzolamide (2%) was administered four times per day. Two weeks later, OCT revealed a closed MH, and the patient's visual acuity had improved to 20/30 at 2 months following the incident. Topical aqueous suppression therapy may potentiate the closure of traumatic MHs by reducing the amount of intra-retinal fluid. It can serve as a non-invasive therapy for small traumatic MHs, especially those with the intra-retinal fluid, or as a temporary therapy before a scheduled operation.
Surgical management of partial third nerve palsy in a single setting
Authors: Chandran Vidhya , Nishant N
Published: July 2023

We report a case of a middle-aged woman who presented to us 8 months after a road traffic accident with the complaint of binocular diplopia. She had limitation of elevation and depression of OD with ptosis, which improved on OD adduction. She underwent (OD) lateral rectus (LR) transposition to superior rectus with Foster augmentation, (OS) LR recession under adjustable suturing technique – 9 mm (5 + 4), and medial rectus (MR) plication 6 mm under local anesthesia. LR was re-recessed by 1 mm the next day. Postoperatively, at 3 months, prism bar cover test showed orthophoria for distance and near in primary gaze with − 3 limitation of elevation in OD.
Exposing ophthalmia nodosa – The double eversion way
Authors: Sankar Janani , Pradhan Priyarthi , Shetty Shashikant B
Published: July 2023

Ophthalmia nodosa is an inflammatory response of ocular tissue to caterpillar hair or any other insect hair that comes in contact with the eye. A young child with a painful red eye was found to have a dead caterpillar embedded in the upper tarsal conjunctiva. We describe the management and the need for creating awareness among doctors for timely suspicion of a foreign body.
Surgical management of epithelial ingrowth following traumatic lamellar laceration of the cornea
Authors: Katsimpris Andreas , Voulgari Nafsika , Dimitropoulou Anna Nina , Katsimpras Marios , Kymionis George
Published: July 2023

We report a case of epithelial ingrowth (EI) after traumatic corneal lamellar laceration in a 57-year-old woman with a history of corneal trauma on her left eye (LE) 1 month before. On examination, best-corrected visual acuity (BCVA) was counting fingers at 1 m. Slit-lamp biomicroscopy showed a partial thickness corneal laceration with an undisplaced flap with EI within the flap–stroma interface. Since the EI affected the visual axis, we performed mechanical debridement. BCVA of the LE improved to 0.6 at 1 year postoperatively without recurrence of EI and with good flap apposition. We conclude that timely surgical debridement of posttraumatic EI can result in a favorable visual outcome.
Conjunctival rhinosporidiosis
Authors: Bhatia Agrima , Kumar Santosh , Varghese Jeenu , Singh Roohie
Published: July 2023

Rhinosporidiosis is a rare ocular infection and a chronic granulomatous disease caused by Rhinosporidium seeberi. The disease is endemic in India and Sri Lanka but has been known to occur even in colder regions of North America and Eastern Europe. It is most commonly seen as a soft polypoidal pedunculated mass affecting mucus membranes of the nose, pharynx, and conjunctiva. We present a case of a 23 years male who presented with a flat, pedunculated, highly congested mass with a bumpy surface attached at the inferior border of the tarsal conjunctiva. It was initially suspected to be an epithelialized impacted foreign body but when completely excised and sent for histopathological examination revealed rhinosporidiosis. Diagnosis is based solely on microscopic features. Even though a rare clinical entity, it should be borne as a differential in case of any pedunculated conjunctival mass.
Extraosseous sinonasal tract metastasis of Ewing's sarcoma presenting with sixth cranial nerve palsy
Authors: Banerjee Mousumi , Azad Shorya Vardhan , Pahuja Akshra , Kairo Arvind
Published: July 2023

Ewing's sarcoma (ES) is a rare, aggressive, and fatal malignancy of bones and soft tissues that affect children and adolescents. It has a high potential of hematogenous metastasis, with lungs, bones, and bone marrow being the most common sites. Extraskeletal metastasis of Ewing's sarcoma in the sinonasal cavity is rare and usually presents with nasal complaints and periorbital swelling. Diplopia as the presenting complaint of sinonasal tract metastasis of Ewing sarcoma has not been reported in the literature. A high suspicion for metastasis should be kept in mind in patients presenting with atypical ophthalmic findings of Ewing sarcoma and appropriate radio imaging should be procured for early intervention.
Response of a single-dose intravitreal brolucizumab in type 3 macular neovascularization
Authors: Chakraborty Somnath , Sheth Jay Umed
Published: July 2023

The authors describe a case of an 82-year-old female with type 3 macular neovascularization (MNV) who underwent a single-dose of intravitreal injection (IVI) of brolucizumab at baseline. The patient demonstrated significant visual improvement from 20/400 at baseline to 20/32 at 3 months without any significant adverse events. Notably, there was complete resolution of the subretinal fluid (SRF), intraretinal fluid (IRF), and subretinal hyperreflective material (SHRM) at 1 month postinjection, which was maintained for up to 3 months. Further prospective studies with a larger sample size are warranted to better understand the morphological and visual responses of type 3 MNV to brolucizumab therapy.
Implantable phakic contact lens exchange after seven years
Authors: Kapoor Rajesh R , Gade Snehal P , Kapoor Suruchi R
Published: July 2023

Implantable phakic contact lens (IPCL) exchange or removal is commonly done in case of wrong size implantation leading to either pupillary block glaucoma or cataract, residual refractive error, recurrent uveitis, and endothelial cell loss. Usual time for phakic lens exchange is within 3–6 months after the primary procedure. In this case report, we have shown that IPCL exchange can be considered as an option even after a long period of 7 years in young, high myopic patients, where clear lens extraction and corneal refractive procedure are not recommended.
An unusual case of herpes simplex keratitis presenting as persistent epithelial defect after pterygium surgery
Authors: Mahajan Gaurav , Prasher Pawan
Published: July 2023

Pterygium is a common conjunctival degeneration and surgical excision is the mainstay of treatment. HSV keratitis after ocular surgery has been attributed to various factors including reactivation of latent infection secondary to surgical trauma to the corneal subepithelial nerve plexus and the modulation of the ocular immune response in the postoperative period caused by steroids. In the current case, the patient had persistent epithelial defect which was non responsive to routine topical lubricant therapy and showed a classical dendritic ulcer pattern upon staining with fluorescein dye. Upon initiation of conventional anti-viral therapy, the patient improved and the epithelial defect was gradually healed. HSV keratitis can rarely present as a non-healing epithelial defect after pterygium surgery and a close follow-up in the post-operative period, timely diagnosis and prompt antiviral therapy plays an important role in achieving a favourable clinical outcome in such cases.
Posterior reversible encephalopathy syndrome
Authors: Prasad Nishi , Dubey Aditi , Kumar Kavita
Published: July 2023

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome or reversible posterior cerebral edema syndrome, is a reversible neurological condition characterized by headache, altered mental status, visual disturbances, seizures, and unconsciousness. It is a clinic-radiological entity with characteristic features on neuroimaging. We present a case of a young antenatal term patient with pre-eclampsia who had no previous history of hypertension. She underwent a cesarean section and in the post-natal period developed sudden bilateral severe vision loss without seizure because of PRES. The visual loss was reversible and improved on systemic and supportive anti-hypertensive patient.
Nevus of Ota with palatal involvement and Helicobacter pylori gastritis
Authors: Das Dipankar , Sarma Prafulla , Chetri Kamal , Bhattacharjee Harsha , Deshmukh Saurabh , Kumari Nitu , Shinde Kunal
Published: July 2023

Congenital oculodermal melanocytosis is also known as Nevus of Ota, condition where blue nevus of skin and orbit are seen with ipsilateral nevus in conjunctiva and iris. They are often associated with glaucoma which can occur at any age. They can have melanocytosis and develop choroidal melanoma. We report a case of a middle-aged female with facial pigmentation and bilateral scleral, conjunctival, and iris nevus with an advanced glaucomatous change in both eyes and pigmentation of the palatal mucosa. Trabeculectomy with mitomycin-C application was done in the left eye. Gastrointestinal endoscopy by gastroenterologist showed gastritis and Helicobacter pylori infection.
Short-term Effectiveness of Metabolic Surgery in Nonobese Diabetic Patients
Authors: Salgado Wilson , Bastos Eduardo Lemos de Souza , Dantas Anna Carolina Batista , Onzi Tiago Rafael , Silva Lyz Bezerra , Albano Alvaro , Cortez Márcio Valle , Tristão Luca Schiliró , dos Santos Clara Lucato , Bernardo Wanderley Lucato
Published: July 2023

Aim:

The aim of this study was to assess the safety and short-term effectiveness of metabolic surgery (MS) in nonobese diabetic patients.

Methods:

Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used in this systematic review. The search for evidence was performed in the Medline (PubMed), Embase, Cochrane (CENTRAL), LILACS, and ClinicalTrials.gov databases from the inception to February 2023. The main eligibility criteria were nonobese adults (body mass index [BMI] <30 kg/m2) with type 2 diabetes mellitus (T2DM) undergoing MS. T2DM remission rate, glycemic parameters, and weight loss were measured before and after surgery. Complication rate was also described. Outcomes were aggregated and the quality of evidence was sorted. Heterogeneity was assumed when I
2 >50%. The random-effects model was used to perform a proportional meta-analysis.

Results:

Twenty-one studies were included (n = 835). The overall rate of diabetes remission was 50.1% (95% confidence interval [CI] = 43.8%–56.1%; P = 0.993; I
2 = 92%). The mean reduction of glycated hemoglobin and fasting glucose was 2.42% (95% CI = 1.91%–2.93%; P < 0.00001; I
2 = 89%) and 70.60 mg/dL, respectively. A drop of 3.34 points (95% CI = 1.59–5.09; P < 0.0002; I
2 = 95%) was observed in the HOMA-IR, and the mean postprandial glycemia was 123.27 mg/dL. No marked weight loss was observed (−3.80 kg/m2 in BMI; 95% CI = 2.70–4.91; P < 0.00001; I
2 = 95%). There was no postoperative mortality, and the overall postoperative complication rate was about 12%. The certainty of evidence was low or very low.

Conclusion:

MS could be effective in the surgical approach of nonobese diabetic patients, but further long-term, more robust studies are needed to strengthen the evidence.
To Compare the Efficacy of Platelet-Rich Plasma with Low-Level Laser Therapy and Low-Level Laser Therapy Alone in the Treatment of Chronic Plantar Fasciitis
Authors: Saini Sushil Kumar , Saroj Atul Kumar , Verma Ashutosh
Published: July 2023

Background:

Increased body weight, repeated micro trauma and work on hard surfaces are the risk factors for plantar fasciitis. Platelet rich plasma (PRP) can be injected to various tissues where it releases high amounts of platelet derived growth factors that increases growth and healing process. Low level laser therapy (LLLT) is an alternative treatment that uses low power lasers. Potential benefits in reducing the pain and spasm.

Methodology:

Patients between 18 to 60 years were included in this prospective randomized controlled trial. Diagnosis made mainly on clinical grounds. We divided our patients in two groups randomly using simple number random method. GROUP-A patients treated with PRP along with laser therapy. GROUP-B treated with laser therapy only. We used visual analogue scale (VAS) and foot and ankle disability (FAD) index for assessment of pain relief during follow up.

Results:

88 patients were included in this study. The VAS score was significantly (P<0.05) become lower in Group A patients as compared with Group B and significant increase in FAD index (P<0.01) among the Group A patients as compare to Group B from prior to infiltration and at follow up.

Conclusion:

In these patients local infiltration with platelet rich plasma has yielded good results. Low level light therapy also can be used for treating planter fasciitis, but better result found when it given together.
Decisiones de diseño y construcción que influyen en la durabilidad del bambú en edificaciones
Authors: Jaramillo-Benavides Andrea , Librelotto Lisiane , Do Valle Ângela
Published: July 2023

El bambú es un material de construcción orgánico cuya durabilidad depende de las interacciones con el ambiente y del empleo de la técnica constructiva adecuada. Esta investigación exploratoria y predominantemente cualitativa buscó identificar las decisiones de diseño que afectan la durabilidad de los elementos de bambú, por medio del análisis de manifestaciones patológicas y los procesos de degradación en edificaciones de la región Sur de Brasil. El levantamiento de información se realizó por medio de entrevistas e inspección visual. Se analizaron las características de las edificaciones, el proceso de preparación del bambú, su aplicación y mantenimiento, los mecanismos de surgimiento de las manifestaciones patológicas, sus causas y origen probables. Se identificó que la mayoría de las anomalías fue ocasionada por la deficiencia de especificaciones de diseño, agravada por la falta de mano de obra especializada. Al finalizar, se apuntan sugerencias para la toma de decisiones de diseño y ejecución de edificaciones de bambú, con énfasis en la durabilidad.