scholarly journals Incomitant Exotropia After Nasal Polyp Surgery

2019 ◽  
Vol 7 (11) ◽  
pp. 1825-1827
Author(s):  
Ni Made Ayu Surasmiati ◽  
Ni Made Wasiastiti Budi ◽  
Ni Made Ari Suryathi ◽  
AAA Sukartini Djelantik ◽  
Ni Made Laksmi Utari ◽  
...  
Keyword(s):  
Nasal Polyp ◽  
Double Vision ◽  
Head Turn ◽  
Muscle Transposition ◽  
Main Complaint ◽  
History Of ◽  
Ishihara Test ◽  
Intranasal Surgery ◽  
The Right ◽  
Generation Test

BACKGROUND: Incomitant exotropia is one of ocular complication that has been reported after intranasal surgery. This case report aims to describe the causes of exotropia in a patient with a history of nasal polyp surgery.CASE PRESENTATION: A 50-years-old male, came with the main complaint of double vision 1 month after nasal polyp surgery. He also complained his right eye turned outward. The visual acuity on the right eye was 6/7.5 with his head turn to the left. On the examination, the Hirschberg test was XT 45°, and the Krimsky test > 95 ∆BI. Duction and version test on the right eye were -4 adduction. There was no shifting on the cover-uncover test. Ishihara test was within normal limit, and there was suppression on the right eye in WFDT. On force generation test, we found limited adduction on the right eye and no restriction in force duction test. Head MRI showed atrophy of medial recti on the right eye, 2.2 mm in size. The patient underwent vertical muscle transposition procedure surgery, and it was found atrophy of medial recti without any rupture. Two months after surgery, the double vision was decreased, the result of the Hirschberg test was XT 30° and Krimsky test 65°∆BI. DISCUSSION: Nasal polyp surgery-related incomitant exotropia mostly caused by extraocular muscles rupture. In this case, we found no rupture. Therefore, we suspected the abnormalities of muscles vascularisation, supported by the atrophy of medial recti.

scholarly journals PROPORTIONS AND CHARACTERISTICS OF PATIENTS WITH BRAIN ABSCESS AT SANGLAH GENERAL HOSPITAL IN DENPASAR, BALI, INDONESIA IN 2019-2020

2021 ◽  
Vol 20 (2) ◽  
pp. 176-182
Author(s):  
Putu Satyakumara Upadhana ◽  
◽  
Ni Putu Kostarika Melia Daradila ◽  
Anak Agung Bagus Putra Indrakusuma ◽  
I Gede Krisna Arim Sadeva ◽  
...  
Keyword(s):  
General Hospital ◽  
Brain Abscess ◽  
Univariate Analysis ◽  
Brain Parenchyma ◽  
Cross Sectional ◽  
Main Complaint ◽  
History Of ◽  
Brain Abscesses ◽  
The Right ◽  
High Level

Introduction. A brain abscess is a collection of pus, immune cells, and other materials that are generally caused by bacterial or fungal infection in the brain parenchyma. This disease has a high level of morbidity and mortality, nonetheless, until now there has been no in-depth research on this disease, especially in Bali. Objective. This study aimed to determine the proportion and characteristics of patients with brain abscess at the Sanglah General Hospital, Denpasar, Bali, Indonesia in 2019-2020. Material and methods. This study is an observational study with a cross sectional method. A total of 41 patients with brain abscesses recorded in hospital medical records in 2019-2020 were included in this study. Univariate analysis was performed to obtain the characteristics of patients with brain abscesses. Results. Most of the patients were male (63.4%), aged 20-39 years. The main complaint most often found in patients was decreased consciousness (56.1%), with neurological symptoms in the form of hemiparesis (32.3%). Most of the abscesses were found on the right frontal, right parietal and left parietal with a percentage of 14.06% each. The CT scan results showed a rim contrast enhancement (63.4%), cerebral edema (75.6%), and normal sulcus gyri (51.2%). Up to 50% of patients with a history of surgical procedures underwent a craniotomy. Other disease histories most often found in patients were sinusitis (29.5%), diabetes mellitus (15.3%), and toxoplasmosis (12.5%). Conclusion. There are varying results of the clinical characteristics of patients with brain abscesses, and indicate the natural course of this disease.

scholarly journals Heavy Eye Syndrome Mimicking Abducens Nerve Palsies

2020 ◽  
Vol 47 (5) ◽  
pp. 683-684
Author(s):  
Caberry W. Yu ◽  
Jonathan A. Micieli
Keyword(s):  
Medical History ◽  
Abducens Nerve ◽  
Double Vision ◽  
Spherical Equivalent ◽  
Past Medical History ◽  
Pathological Myopia ◽  
Bilateral Cataract ◽  
Retinal Tears ◽  
History Of ◽  
The Right

A 70-year-old woman was seen in neuro-ophthalmology consultation for a progressive right esotropia. She had a past medical history of asthma and osteoporosis, and her ocular history was significant for pathological myopia (spherical equivalent of −23.00 D OD and −21.00 D OS), bilateral cataract surgeries, and laser retinopexy for retinal tears. Twenty-five years prior to presentation, she developed binocular horizontal diplopia and was found to have a limitation of abduction to 60% and 80% of normal in the right and left eyes, respectively, by a previous neuro-ophthalmologist. She developed a progressive maculopathy in the right eye secondary to myopia, resulting in the resolution of double vision. The resolution occurred because the double vision was binocular in nature and the loss of vision in her right eye functioned similar to monocular occlusion. However, she noticed that her right eye continued to turn in toward her nose.

scholarly journals Bilateral sixth nerve palsies from carotid cavernous fistulas with transient worsening following transvenous embolisation

2019 ◽  
Vol 12 (11) ◽  
pp. e232191
Author(s):  
Sivaruben Kalaichandran ◽  
Jonathan A Micieli
Keyword(s):  
Good Prognosis ◽  
Double Vision ◽  
Similar Treatment ◽  
Bilateral Carotid ◽  
History Of ◽  
The Right ◽  
Carotid Cavernous Fistulas ◽  
Onyx Embolisation ◽  
Sixth Nerve

A 59-year-old man presented with a 2-week history of binocular horizontal diplopia worse when looking to the left. He was diagnosed with a left sixth nerve palsy (6 NP) and had new bilateral findings at a 2-week follow-up with new dilated episcleral blood vessels. Bilateral carotid-cavernous fistulas (CCFs) were suspected and confirmed with CT angiography and catheter angiography. He underwent successful coil and Onyx embolisation of the left cavernous sinus and immediately noticed worsening of the double vision when looking left due to a worse left 6 NP. Three weeks later, he underwent similar treatment of the right CCF and immediately noticed worsening of the double vision when looking to the right and was found to have a worse right 6 NP. His double vision resolved 6 months later. CCFs are rare causes of bilateral 6 NPs and although there is a good prognosis, symptoms may worsen after treatment.

scholarly journals Stargardt's Disease : Case Report

2018 ◽  
Vol 1 (1) ◽  
pp. 27-33
Author(s):  
Dian Ariani ◽  
AK Ansyori ◽  
Ramzi Amin
Keyword(s):  
Low Vision ◽  
Supportive Therapy ◽  
Macular Dystrophy ◽  
Stargardt Disease ◽  
Daily Lives ◽  
Abc Protein ◽  
Main Complaint ◽  
Disease Case ◽  
History Of ◽  
The Right

Introduction. The Stargardt disease is a frequent macular dystrophy and the most common cause of decreased central visus in adults below 50 years. This condition is caused by the presence of mutations in the ABCA4 gene, located in the chromosome chain 1 short sleeve, which encode the ATP-binding cassette (ABC) protein transporter expressed by the outer trunk cell segment. Case Presentation. A man, 59 years old, civil servants, was living in the city, came to the eye Polyclinic RSMH on February 4, 2016. From anamnesis, main complaint of the right eye was view blurred since 2 years ago. The history of the illness since ± 2 years ago, the sufferer complained the right eye view blurred slowly, the longer the more blurred.  Often glare (+), the sufferer also complains to see black spots, such as enclosed curtains (-). Conclusion. A case of Stargardt disease has been reported in a 58-year-old male. Patients come with complaints of blurry vision slowly in both eyes. On posterior segment examination, a picture of atrophy in the macula that typically leads to Stargardt disease. Additional examination of OCT also showed a stretch of RPE depletion. Supportive therapy such as correction with low vision aids or the provision of sun protective glasses can help in the daily lives of patients.

scholarly journals Neuro-ophthalmological presentation of giant intracavernous carotid artery aneurysm in a child

2018 ◽  
Vol 11 (1) ◽  
pp. e225842 ◽  
Author(s):  
Bonifacio Oliquino Buño ◽  
Franz Marie Cruz
Keyword(s):  
Carotid Artery ◽  
Artery Aneurysm ◽  
Abducens Nerve ◽  
Facial Trauma ◽  
Head Turn ◽  
Carotid Artery Aneurysm ◽  
History Of ◽  
Upper Lid ◽  
Large Aneurysm ◽  
The Right

An otherwise healthy, 11-year-old boy presented with a long-standing history of right eye esotropia associated with a right head turn. Following a mild blunt facial trauma, he was brought to an ophthalmologist for binocular horizontal diplopia. Cranial CT scan revealed a large, enhancing lesion in the right cavernous sinus. Neuro-ophthalmological evaluation showed abduction deficit of the right eye, right corneal anaesthesia, right upper lid ptosis and a smaller right pupil suggesting involvement of the intracavernous segments of the right abducens nerve, ophthalmic nerve and oculosympathetic fibres. Cerebral angiography confirmed a large aneurysm involving the petrous, lacerum and cavernous segments of the right internal carotid artery. The child underwent successful clipping of the aneurysm by the neurosurgery service.

Z-line degradation and phagocytosis of sarcomeric fragments in myonecrosis

1983 ◽  
Vol 41 ◽  
pp. 790-791
Author(s):  
Melinda L. Estes ◽  
Samuel M. Chou
Keyword(s):  
Vastus Lateralis ◽  
Inflammatory Myopathy ◽  
Muscle Disease ◽  
White Female ◽  
Inflammatory Cell Infiltrate ◽  
Limb Weakness ◽  
Muscle Diseases ◽  
History Of ◽  
The Right ◽  
Mononuclear Inflammatory Cell

Many muscle diseases show common pathological features although their etiology is different. In primary muscle diseases a characteristic finding is myofiber necrosis. The mechanism of myonecrosis is unknown. Polymyositis is a primary muscle disease characterized by acute and subacute degeneration as well as regeneration of muscle fibers coupled with an inflammatory infiltrate. We present a case of polymyositis with unusual ultrastructural features indicative of the basic pathogenetic process involved in myonecrosis.The patient is a 63-year-old white female with a one history of proximal limb weakness, weight loss and fatigue. Examination revealed mild proximal weakness and diminished deep tendon reflexes. Her creatine kinase was 1800 mU/ml (normal < 140 mU/ml) and electromyography was consistent with an inflammatory myopathy which was verified by light microscopy on biopsy muscle. Ultrastructural study of necrotizing myofiber, from the right vastus lateralis, showed: (1) degradation of the Z-lines with preservation of the adjacent Abands including M-lines and H-bands, (Fig. 1), (2) fracture of the sarcomeres at the I-bands with disappearance of the Z-lines, (Fig. 2), (3) fragmented sarcomeres without I-bands, engulfed by invading phagocytes, (Fig. 3, a & b ), and (4) mononuclear inflammatory cell infiltrate in the endomysium.

Popliteal artery thrombosis secondary to a tibial osteochondroma

VASA ◽  
2011 ◽  
Vol 40 (3) ◽  
pp. 251-255 ◽  
Author(s):  
Gruber-Szydlo ◽  
Poreba ◽  
Belowska-Bien ◽  
Derkacz ◽  
Badowski ◽  
...  
Keyword(s):  
Case Report ◽  
Magnetic Resonance Angiography ◽  
Popliteal Artery ◽  
Doppler Ultrasonography ◽  
Histopathological Examination ◽  
Previous History ◽  
Plain Radiography ◽  
Artery Thrombosis ◽  
History Of ◽  
The Right

Popliteal artery thrombosis may present as a complication of an osteochondroma located in the vicinity of the knee joint. This is a case report of a 26-year-old man with symptoms of the right lower extremity ischaemia without a previous history of vascular disease or trauma. Plain radiography, magnetic resonance angiography and Doppler ultrasonography documented the presence of an osteochondrous structure of the proximal tibial metaphysis, which displaced and compressed the popliteal artery, causing its occlusion due to intraluminal thrombosis..The patient was operated and histopathological examination confirmed the diagnosis of osteochondroma.

Spontaneous Haemophilia in a Female

1960 ◽  
Vol 04 (03) ◽  
pp. 369-375 ◽  
Author(s):  
E. H Braun ◽  
David B. Stollar
Keyword(s):  
Family History ◽  
Bleeding Time ◽  
Dental Extraction ◽  
White Girl ◽  
Complete Family ◽  
Normal Limits ◽  
Sex Chromatin ◽  
History Of ◽  
Generation Test

SummaryA case of haemophilia in a young white girl is described. There was a history of bleeding from birth. The thromboplastin generation test was grossly abnormal and A. H. G. levels were below 1%. Bleeding time and capillary morphology was within normal limits. Dental extraction after transfusion caused almost uncontrollable haemorrhage.A complete family history was obtained for four generations. There was no case of a “bleeder” amongst these.The girl’s apparent sex was confirmed by sex chromatin studies.

COMMONWEALTH Forum: The Politics of Science or the Science of Politics

Commonwealth ◽  
2017 ◽  
Vol 19 (1) ◽  
Author(s):  
John Arway
Keyword(s):  
Public Policy ◽  
Natural Resource ◽  
Factual Information ◽  
The Past ◽  
Difference Of Opinion ◽  
History Of ◽  
The Right ◽  
Scientific Facts ◽  
Environmental Agency ◽  
Laws And Regulations

The challenges of including factual information in public policy and political discussions are many. The difficulties of including scientific facts in these debates can often be frustrating for scientists, politicians and policymakers alike. At times it seems that discussions involve different languages or dialects such that it becomes a challenge to even understand one another’s position. Oftentimes difference of opinion leads to laws and regulations that are tilted to the left or the right. The collaborative balancing to insure public and natural resource interests are protected ends up being accomplished through extensive litigation in the courts. In this article, the author discusses the history of environmental balancing during the past three decades from the perspective of a field biologist who has used the strength of our policies, laws and regulations to fight for the protection of our Commonwealth’s aquatic resources. For the past 7 years, the author has taken over the reins of “the most powerful environmental agency in Pennsylvania” and charted a course using science to properly represent natural resource interests in public policy and political deliberations.

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