RATHKE'S CLEFT CYST PRESENTING AS BILATERAL OPTIC ATROPHY

PURPOSE: Reporting a case of Rathke's cleft cyst presenting as bilateral Optic atrophy. Optic atrophy could have been prevented with appropriate surgery if the patient would have consulted ophthalmologist earlier. Case report: A 23 year-old male presented with bifrontal headache and diminution of vision over 6 months period. On fundus examination right eye showed partial optic atrophy and left eye total optic atrophy. MRI Brain showed well defined lobulated cystic lesion in the sella with suprasellar extension, peripheral rim calcification causing widening of sella and displacing anterior cerebral artery and optic chiasma superiorly. Histopathology of the biopsied material was suggestive of Rathke's cleft cyst. Endoscopic endonasal transsphenoidal sinus surgery was done and biopsy was sent which suggested Rathke's cyst. Following surgery there was improvement in the field of vision in right eye. Conclusion: Early diagnosis and removal of a Rathke's cleft cyst has a good prognosis in visual acuity and visual field. Patient ended with optic atrophy because of delayed consultation for headache. KEYWORDS: Rathke's cleft cyst; Optic atrophy; Headache

RATHKE\u27S CLEFT CYST PRESENTING AS BILATERAL OPTIC ATROPHY

PURPOSE: Reporting a case of Rathke\u27s cleft cyst presenting as bilateral Optic atrophy. Optic atrophy could have been prevented with appropriate surgery if the patient would have consulted ophthalmologist earlier. Case report: A 23 year-old male presented with bifrontal headache and diminution of vision over 6 months period. On fundus examination right eye showed partial optic atrophy and left eye total optic atrophy. MRI Brain showed well defined lobulated cystic lesion in the sella with suprasellar extension, peripheral rim calcification causing widening of sella and displacing anterior cerebral artery and optic chiasma superiorly. Histopathology of the biopsied material was suggestive of Rathke\u27s cleft cyst. Endoscopic endonasal transsphenoidal sinus surgery was done and biopsy was sent which suggested Rathke\u27s cyst. Following surgery there was improvement in the field of vision in right eye. Conclusion: Early diagnosis and removal of a Rathke\u27s cleft cyst has a good prognosis in visual acuity and visual field. Patient ended with optic atrophy because of delayed consultation for headache. KEYWORDS: Rathke\u27s cleft cyst; Optic atrophy; Headache

Post-operative complications and visual outcome in eye camp patients undergoing sutureless cataract surgery at a Base Hospital in Vijayapura District, South India

Background: Cataract is the principal cause of blindness in India, accounting for 62.6%. This problem can be tackled, and the backlog of cataract blind can be reduced by performing cataract operations on a large scale. Base hospital approach with screening camps has shown good visual outcome with lesser complications.Aim and Objectives: To study the profile of postoperative complications and visual outcome in eye camp patients undergoing cataract surgery at the base hospital.Materials and Methods: In this cross‑sectional study, 413 patients were included following screening at community screening camps. Patients underwent sutureless small‑incision cataract extraction with intraocular lens implantation under local anesthesia at the base hospital. Postoperative complications and visual outcome were recorded.Results: Immediate postoperative complications were corneal edema (9.44%), striate keratitis (6.77%), expected uveitis (5.56%), secondary glaucoma (2.66%), residual lens matter (2.66%), iris prolapsed (0.48%) and shallow anterior chamber (0.24%), hyphema (0.24%) and iris incarceration (0.24%). Endophthalmitis was reported in 0.48% (one grew citrobacter, rarely reported). Late complications included posterior capsular opacification (3.87%) noted and retinal detachment (0.48%) later. Majority 83.39% of the patients had postoperative best corrected visual acuity (BCVA) between 6/6 and 6/18, 13.42% had BCVA between 6/18 and 6/60, 3.19% had BCVA < 6/60 as at 6 months follow‑up visit (overall percentage is 100%).Conclusions: The overall vision‑threatening complications after cataract extraction in the base hospital are low. Our study reflects the efficacy of the base hospital approach, in terms of visual and surgical outcome, as an important aspect from the public health point of view, which can help in clearing the cataract backlog in developing countries like India.Keywords: Cataract surgery, postoperative complication, postoperative visual outcom

When the specter of the past haunts current groups: Psychological antecedents of historical blame.

Groups have committed historical wrongs (e.g., genocide, slavery). We investigated why people blame current groups who were not involved in the original historical wrong for the actions of their predecessors who committed these wrongs and are no longer alive. Current models of individual and group blame overlook the dimension of time and therefore have difficulty explaining this phenomenon using their existing criteria like causality, intentionality, or preventability. We hypothesized that factors that help psychologically bridge the past and present, like perceiving higher (a) connectedness between past and present perpetrator groups, (b) continued privilege of perpetrator groups, (c) continued harm of victim groups, and (d) unfulfilled forward obligations of perpetrator groups would facilitate higher blame judgments against current groups for the past. In two repeated-measures surveys using real events (N1 = 518, N2 = 495) and two conjoint experiments using hypothetical events (N3 = 598, N4 = 605), we find correlational and causal evidence for our hypotheses. These factors link present groups to their past and cause more historical blame and support for compensation policies. This work brings the dimension of time into theories of blame, uncovers overlooked criteria for blame judgments, and questions the assumptions of existing blame models. Additionally, it helps us understand the psychological processes undergirding intergroup relations and historical narratives mired in historical conflict. Our work provides psychological insight into the debates on intergenerational justice by suggesting methods people can use to ameliorate the psychological legacies of historical wrongs and atrocities

COMPARITIVE STUDY OF DELAYED PRIMARY CLOSURE VERSUS PRIMARY CLOSURE OF SKIN IN CONTAMINATED AND DIRTY ABDOMINAL WOUNDS/ INCISION

Background: It is still a matter of debate whether delayed primary  closure (DPC) of contaminated abdominal incision reduces surgical site infection compared with primary closure (PC ). The rate of wound infection for dirty abdominal wound is approximately 40%, but the optimal method of wound closure remains controversial. Aims and objectives: To determine whether delayed primary skin closure of contaminated and dirty abdominal wounds reduces the rate of surgical site infection (SSI) compared with primary skin closure. Method: Patient diagnosed as acute peritonitis and posted for exploratory laparotomy during the period of October 1 2013 to September 1 2015 were included. The study was conducted at Shri B M Patil Medical College and Hospital, Bijapur. In this series a total of 100 patients were included and were divided in two groups. Each group had 50 patients. For primary closure group, wounds were closed with monofilament interrupted suture. For Delayed primary closure, skin and subcutaneous tissue are left open and packed with 10 % (betadine) povidone iodine soaked gauge, which was changed daily to prevent excessive collection of exudates. The outcome of wound was assessed on post - operative days. Result: In this entire series, wound infection developed after incision closure was 33% .The primary group had a higher rate of wound infection 54% and  delayed primary closure was  12% (P<0.001) and longer length of hospital stay 19.4 days in primary closure group  and 16.5 days in delayed primary closure group (P<0.002). Conclusion: Laparotomy wound complications are multifactorial, it depends on many factors. A strategy of DPC of dirty abdominal wound, clinically appears to decrease the rate of wound infection, when compared with PC without increasing the length hospital of stay

Empyema Thoracis- the role of open thoracotomy with decortication in the era of video-assisted thoracoscopic surgery

Background: Empyema Thoracis, a condition in which purulent fluid accumulates within the pleural cavity, is commonly caused by bacterial infection (both Gram- positive and Gram-negative), such as Mycobacterium tuberculosis, and rarely by fungal infection. Timely intervention significantly reduces morbidity and mortality. Surgical intervention is needed in advanced disease. This study aimed evaluate decortications performed through video-assisted thoracoscopic surgery (VATS) and open thoracotomy. Methods: This retrospective study included 47 patients who underwent decortications by either VATS or open thoracotomy for empyema Thoracis at the Department of Surgery of, BLDE DU Shri B M Patil Medical College from May 2015 to August 2020. Results: Tuberculosis was the most common etiological factor for empyema Thoracis. In 19 patients who underwent VATS decortications, VATS was converted to open thoracotomy in 11 patients. Only 8 patients achieved successful decortication with VATS. Thirty- nine patients (including 11 whose VATS was converted to open thoracotomy) underwent successful open thoracotomy decortications. Thirty-two patients had postoperative bronchopleural fistula, and all cases were successfully managed conservatively. The timing of the surgical intervention is critical in reducing morbidity and mortality. The more advanced the disease, the higher the failure rate of VATS in attaining complete decortications. Conclusion: Open thoracotomy decortication remains the gold standard in attaining complete decortications in advanced empyema Thoracis

CHOICE OF FILTER ORDER IN LPC ANALYSIS OF VOWELS

ABSTRACT In studies of vowel perception and production, the formants of the signal are usually estimated using Linear Predictive Coding (LPC) analysis. The order of the LPC filter is typically estimated by starting with a heuristic value (e.g. the sampling frequency in kHz) and adjusting it in a trialand-error manner. This method is adequate when analyzing a few sounds, but it is cumbersome for studies involving large vowel corpora (and error-prone, since under-and over-estimation of the filter order can both lead to inaccurate formant estimates

Perceptuomotor bias in the imitation of steady-state vowels

Previous studies suggest that speakers are systematically inaccurate, or biased, when imitating self-produced vowels. The direction of these biases in formant space and their variation may offer clues about the organization of the vowel perceptual space. To examine these patterns, three male speakers were asked to imitate 45 self-produced vowels that were systematically distributed in F1/F2 space. All three speakers showed imitation bias, and the bias magnitudes were significantly larger than those predicted by a model of articulatory noise. Each speaker showed a different pattern of bias directions, but the pattern was unrelated to the locations of prototypical vowels produced by that speaker. However, there were substantial quantitative regularities: ͑1͒ The distribution of imitation variability and bias magnitudes were similar for all speakers, ͑2͒ the imitation variability was independent of the bias magnitudes, and ͑3͒ the imitation variability ͑a production measure͒ was commensurate with the formant discrimination limen ͑a perceptual measure͒. These results indicate that there is additive Gaussian noise in the imitation process that independently affects each formant and that there are speaker-dependent and potentially nonlinguistic biases in vowel perception and production

Vapour phase hydrogenation of aqueous levulinic acid to γ-valerolactone over CuZnAlO hydrotalcite

Vapour phase hydrogenation of levulinic acid to γ-valerolactone has been accomplished in aqueous phase over copper-zinc-aluminum hydrotalcite, prepared by co-precipitation method using nitrate salts as their precursors. The hydrotalcite system exhibits superior activity in the hydrogenation and cyclization of 10% aqueous solution of levulinic acid with >99% selectivity for γ-valerolactone at 275 oC under atmospheric pressure of hydrogen (flow rate of H2-30 mL/min)

Study of magnitude and risk factors for refractive errors in tertiary hospital of north Karnataka

Background and Objectives: Refractive errors are leading cause of avoidable blindness in world. Prevention of refractive error by identifying avoidable, modifiable and reversible biological or environmental risk factors could have great impact. Most of the earlier research is oriented towards school children, whereas in current times, onset of refractive error in 3rd and 4th decade is being noticed frequently Changing lifestyle leading to onset of refractive error in adults is new shift of prevalence, etiology of which needs to be researched. This study is designed to incorporate this lacuna to study risk factors for myopia and hyperopia in patients of less than 40 years. Materials and methods: Our prospective cross-sectional study included 400 cases attending routine Ophthalmology consultation. Age, gender, occupation and family history of refractive errors, visual acuity was noted along with automated refraction and cycloplegic refraction in children. Cumulative error calculated as “Spherical equivalent refraction [SER]”. Responses to a questionnaire regarding time spent in different near activities were recorded. It was converted to a composite variable “Dioptre hours” considering different levels of accommodative effort for each activity. Results: The study sample of 400 cases included 16.5% Emmetropia, 79.25% Myopia and 4.25% Hyperopia. 59% females comprised the majority. 27- 40 years age group had maximum number of myopics and 100% Hyperopics. 58.75% of myopics were students, while 82.35% of Hyperopes had a desk job. Risk of having refractive error had an odd of 0.75 if one parent wore glasses (95% confidence interval= 0.39 to 1.42, p=0.43) and an odd of 1.16 if both parents wore glasses. Myopics showed a statistically significant positive correlation between SER and duration of reading (p<0.05). Compared to emmetropes, myopes spent significantly increased duration of time in mobile phones (p<0.05). In Hyperopics, duration spent in studying was significantly lesser compared to emmetropes (p<0.05). Duration of outdoor activities and reading distance did not show any significant correlation with SER in both myopics and hyperopics. Conclusion: Prevalence of refractive errors is highest in 26-40years age group in current times with female predominance. Excessive near work especially reading and using mobile phones leads to myopia onset and progression. Incorporating outdoor activities in curriculum, reducing online teaching programmes may reduce magnitude of refractive errors