Results Of Test Research Articles

The Development of English Differentiated Teaching Modules at 7 Grade Junior High School 3 Tebo

This study aimed to develop the differentiated learning Modul as one of English teaching instruments. As it is required to fulfill one of Merdeka Curriculum characteristics, especially the differentiated learning. This differentiated learning module was designed and developed based on students’ learning styles (auditory, visual and kinesthetic) and students’ talents and interests. This study was conducted using Research and Development method with ADDIE development model. The module development was focused on the series of differentiated learning modules for English in 7 graders. After conducting the analysis, design, and development. The differentiated learning module was validated in term of material and media. The average result in the material validation test was 87,5 % in the very valid category, while the media validation test was 89,5% in the very valid category. Furthermore, the product practicality was found through the questionnaires and product trial observation. The questionnaires were used to find out the perspective of teacher and students toward this developed module. It was found that the module was feasible to be used with the percentage 95,82% for teacher’s questionnaire and 99,15% for students’ questionnaire. Moreover, observation sheet result showed that this differentiated learning module was feasible with the percentage 90,85%.

A rapid immersion measurement for the diffusion constant of chloride ions in the geopolymer concrete

Accurate measurement of chloride ion diffusion coefficient, without external interference, is essential for obtaining data that closely reflects practical conditions. The diffusion constants of chloride ions within fly ash-based geopolymer concrete (FGPC) with a one-dimension immersion method employed to record the time taken for diffusion to occur over a specific distance were investigated in this work. The results showed a clear relationship between the diffusion constant and the strength of FGPC. Within the same strength of FGPC, the diffusion distance (thickness) is proportional to the square root of diffusion time. The minimum diffusion constant is approximately 8.90 × 10−11 m2/s which is close to the result in an immersion test. The method employed in this study is demonstrated to be both feasible and applicable for assessing the diffusion constant of chloride ions in FGPC quickly. It promotes a rapid evaluation method to predict the diffusion process under practical conditions.

Effectiveness analysis of deceleration capacity and traditional heart rate variability in diagnosing vasovagal syncope.

Vasovagal syncope (VVS) is a prevalent medical condition with a lack of efficient methods for its detection. This study aimed to explore an objective clinical indicator in diagnosing VVS. The retrospective analysis involved clinical data of 243 syncope patients from 1 June 2020 to 31 July 2023. Among them, 108 patients had a negative result in the tilt test (TTT), while the remaining 135 patients had a positive result in the TTT. Relevant statistical methods were utilized to examine the correlation between VVS and different indicators of heart rate variability. After screening, 354 patients being considered for VVS were evaluated, resulting in a final sample size of 243. Sex, age, deceleration capacity (DC), and standard deviation of all normal-to-normal intervals (SDNNs) were the variables that showed statistical significance between the TTT(-) group and the TTT(+) group. Independent risk factors identified by multivariate logistic regression were DC [odds ratio (OR) 1.710, 95% confidence interval (CI) 1.388-2.106, P < 0.001] and SDNN (OR 1.033, 95% CI 1.018-1.049, P < 0.001). Comparing the groups, receiver operating characteristic analysis revealed a notable distinction in both DC and SDNN [the respective areas under the curve were 0.789 (95% CI 0.730-0.848) and 0.702 (95% CI 0.637-0.767); the cutoff values were 7.15 and 131.42; P < 0.001, respectively]. In summary, DC can function as an impartial and easily accessible clinical marker for differentiating VVS. A value exceeding 7.15 ms might suggest a higher likelihood of syncope.

Bacillus altitudinis 1.4 genome analysis-functional annotation of probiotic properties and immunomodulatory activity.

Probiotics are live microorganisms that, when administered in adequate quantities, provide health benefits to the host. In this study, phenotypic and genotypic methods were used to evaluate the probiotic properties of Bacillus altitudinis 1.4. The isolate was sensitive to all antimicrobials tested and presented a positive result in the hemolysis test. B. altitudinis 1.4 spores were more resistant than vegetative cells, when evaluated in simulation of cell viability in the gastrointestinal tract, as well as adhesion to the intestinal mucosa. The isolate was capable of self-aggregation and coaggregation with pathogens such as Escherichia coli ATCC 25922 and Salmonella Enteritidis ATCC 13076. Genomic analysis revealed the presence of genes with probiotic characteristics. From this study it was possible to evaluate the gene expression of pro-inflammatory and anti-inflammatory cytokines for different treatments. Viable vegetative cells of B. altitudinis 1.4 increased the transcription of pro-inflammatory factors, in addition to also increasing the transcription of IL-10, indicating a tendency to stimulate a pro-inflammatory profile. Given the results presented, B. altitudinis 1.4 showed potential to be applied in the incorporation of this microorganism into animal feed, since the spores could tolerate the feed handling and pelletization processes.

Misleading Results of Typhi Dot Test in COVID-19 Pandemic

Misleading Results of Typhi Dot Test in COVID-19 Pandemic

Aerobic fitness predicted by demographics, anthropometrics, health behaviour, physical activity and muscle fitness in male and female recruits entering military service

IntroductionThe physical and mental training load can be high during military service. Therefore, tailored preconditioning programmes based on assessment of physical fitness could increase readiness for military service, especially among...

Statistical Analysis of Cataract Disease: A Case Study of 15,221 Patients at the Niger Delta University Teaching Hospital, Okolobiri

Introduction: This research is on the statistical analysis of cataract disease between male and female patients. The objectives were to estimate the distribution of cataract disease over the years with respect to gender and measures the rate of patients with cataract disease (i.e., calculate the annual patients with cataract per 1000 patients) during the same year and test for significant difference between the rate of cataract patients in term of male and female that visited to the hospital.Material and Methods: A retrospective study design was adopted and a total number of 15,221 patients records from Niger Delta University Teaching Hospital eye clinic were collected. Out of which 7,362(48%) were male and 7859(52%) were female. The methods adopted for data analysis were Trend analysis, Vital statistics, Paired Samples t-Test, Chi-Square, Probability tree diagram and Conditional probability.Results: Results showed that male patients’ rate with cataract diseases was slightly higher than female per thousand visitations. Testing for significant difference between the rate of male and female cataract patients using paired t-test, showed no significant difference between them at 5% level. However, there was a moderate correlation between them with r= (0.552), p= 0.199. The result for test for association showed that there is no evidence of an association between gender and disease status. Results showed that probability of a male having the disease was slightly higher than female.Conclusion: This research is on the statistical analysis of cataract disease, its occurrence and determinants between male and female patients.

Clostridium perfringens in central Colombia: frequency, toxin genes, and risk factors

Clostridium perfringens is an opportunistic bacterium that causes intestinal diseases in both humans and animals. This study aimed to assess the frequency of C. perfringens and the presence of toxin-encoding genes in fecal samples from individuals with or without gastrointestinal symptoms in the Department of Boyacá, Colombia. Additionally, risk factors associated with carriage and disease development were analyzed. A total of 114 stool samples were analyzed using a molecular test based on specific polymerase chain reaction (PCR) targeting 16S-rRNA and alpha toxin (cpa) genes. For individuals with a positive result for the PCR test, stool samples were cultured on Tryptose Sulfite Cycloserine (TSC) agar. Two to five colonies forming units were selected based on phenotypic characteristics, resulting in 56 bacterial isolates. These isolates were then analyzed for toxin-coding genes associated with gastrointestinal diseases. In addition, sociodemographic and clinical data from 77 individuals were also analyzed. The overall frequency of C. perfringens was 19.3% (n = 22/114). The detection frequency in 77 individuals with clinical data was 16.6% (n = 5/30) among symptomatic individuals and 21.2% (n = 10/47) among asymptomatic individuals. All 56 isolates obtained carried the cpa gene, while cpb2 was present in 10.7% (n = 6/56); cpe and cpb genes were not detected. Notably, diabetes and autoimmune diseases are significantly associated with an increased risk of C. perfringens detection (adjusted OR 8.41: 95% CI 1.32–35.89). This study highlights an elevated frequency of C. perfringens and the presence of the cpb2 gene in asymptomatic individuals compared with their symptomatic counterparts. These findings offer insights into the distribution and virulence factors of C. perfringens at a micro-geographical level. This information supports the need for developing tailored prevention strategies based on local characteristics to promote active surveillance programs based on molecular epidemiology.

Focal shock waves increase efficacy and prolong the effect of botulinum toxin on spasticity in patients with brain injury from stroke and multiple sclerosis.

Assess the effects on spasticity reduction of the association between focal extracorporeal shock wave therapy and botulinum toxin type A, versus the toxin only in brain injury patients. Eighteen patients were included. The study had two phases: the first phase was observational, and botulinum toxin type A was used. The second was a prospective, deliberate intervention phase in which the toxin was injected and focal extracorporeal shock wave treatment was added (1 sessions/week, for three weeks). The patients were followed up in the 1st, 4th and 6th month, the Ashworth Scale criterion was applied and, for those with lower limb involvement and changes in walking the 10-metre walk test was used. Patients treated with toxin only showed a statistically significant improvement in spasticity, with 1 point on the Ashworth Scale from week 5, which disappeared at week 17. However, the combined therapy reduced spasticity by 2 points from week 1 to week 25 (p < 0.001), with a faster result in the 10-meter gait test (p = 0.004). Combined and simultaneous treatment with botulinum toxin and focal extracorporeal shock wave reduced spasticity in a more effective and prolonged way than treatment with botulinum toxin only.

The effects of thoracic mobility versus lumbopelvic stabilization exercises on lower extremity flexibility, dynamic balance and proprioception in patients with chronic ankle instability

BACKGROUND: Chronic ankle instability (CAI) presents neuromuscular control and functional performance difficulties. Although ankle-focused rehabilitation is widely practised, the relative effects of exercises targeting thoracic mobility and lumbopelvic stabilization in addressing CAI have not been thoroughly investigated. OBJECTIVE: The study aims to compare the effects of thoracic mobility and lumbopelvic stabilization exercises in patients with CAI. METHODS: The study was designed as a prospective randomized controlled clinical trial. A total of 30 participants (mean age = 31.93 ± 7.31; 21F/9M) who scored 27 points or on the Cumberland ankle instability tool voluntarily were enrolled in the study. The participants were randomly divided into two groups. In addition to the rehabilitation protocols, each participant was given a home exercise program, including ankle-strengthening exercises (3 times a week). The first group trained with thoracic mobility (TM), while the second group did lumbopelvic stabilization (LS) exercises under supervision twice a week for eight weeks. Participants’ pre and post-treatment assessments spanned an 8-week rehabilitation period, during which ankle and hip joint range of motion measurements were obtained using an electronic goniometer. Additionally, dynamic balance was assessed through the Y balance test, while ankle proprioception was evaluated using joint position sense measurements. The flexibility was assessed with an active straight leg raise test. RESULTS: Y balance, CAIT, and active straight leg raise test scores were improved in the eighth week in the thoracic mobility group (p&lt; 0.05), while only active straight leg raise test and CAIT scores were significantly different in the lumbopelvic stabilization group (p&lt; 0.05) according to intra group variables. In comparing the post-treatment scores between the groups, the thoracic mobility group had superior results in the joint position sense test for the right side of the hip and plantarflexion. (hip; TM: 70.71 ± 6.80, LS: 68.76 ± 5.50, plantarflexion; TM: 44.24 ± 7.28, LS: 38.30 ± 5.08). CONCLUSION: The findings suggest that while both interventions are effective in addressing various aspects of ankle instability, the thoracic mobility exercises may offer additional benefits, particularly in enhancing joint position sense, thereby providing valuable insights for the optimization of rehabilitation protocols for individuals with chronic ankle instability.

Cross-cultural adaptation of the Thoracic Outlet Syndrome Index for Turkish-speaking patients with thoracic outlet syndrome.

Considering that there is no specifically designed scale to measure quality of life (QoL) and level of functioning among Turkish-speaking patients with thoracic outlet syndrome (TOS), the aim of this study was to adapt the Thoracic Outlet Syndrome Index (TOSI) to the Turkish language (TOSI-TR) and analyze its psychometric properties in patients with TOS. Thirty-nine patients with symptomatic TOS were included in the study. The participants were assessed using the following measures: the QuickDASH, the Western Ontario Rotator Cuff Index (WORC), and a visual analog scale (VAS). The psychometric properties of the TOSI-TR were examined in terms of test-retest reliability, construct validity, convergent validity, and feasibility. The ICC2,1 of the TOSI-TR was 0.949 (95% CI: 0.903-0.973). The Kaiser-Meyer-Olkin value was found to be 0.716 with a significant result for Bartlett's sphericity test (p < 0.001). The TOSI-TR had a one-factor solution explaining 74.05% of the total variance. There was a significant correlation between TOSI-TR scores and QuickDASH (r = 0.762, p < 0.001), WORC (r =0.794, p < 0.001), and VAS (r = 0.663, p < 0.001) scores. The WORC and VAS scores were significant determinants of the TOSI-TR score, explaining 65.3% of the variance. There were no floor or ceiling effects. The TOSI-TR is a reliable, valid, and feasible questionnaire for the QoL and functional status in Turkish-speaking patients with TOS. We recommend this 15-item scale for optimal assessment in patients with TOS.

Biological Activities, Biosorption of Heavy Metals, and Stability of Lipopeptide Biosurfactant Produced by the Alcaligenes aquatilis Bacterium YGD-2906

Background: Biosurfactants are natural products produced by microorganisms. This study examined the antioxidant activity, biosorption of heavy metals, and stability of lipopeptide biosurfactant (BLA 2906) produced by the Alcaligenes aquatilis bacterium YGD-2906. Methods: Biosurfactant production was determined by using four techniques: hemolytic test, emulsion indices, oil spreading test, and drop collapse test. The biosorption capacity of our biosurfactant to chelate the different heavy metals. The antioxidant activity was evaluated by the reducing power, phosphomolybdate tests, and DPPH•, ABTS•+ radical scavenging assays and in the end, the stability of this biosurfactant was studied. objective: Study of the heavy metal biosorption, antioxidant activity, and stability study of lipopeptide biosurfactant BLA 2906 produced by Alcaligenes aquatilis YGD-2906. Results: A negative hemolytic test, emulsion indices of 63.11 % with crude oil, 23.66 mm of oil spreading test, and a positive drop collapse test. The lipopeptide biosurfactant BLA 2906 demonstrated its ability to chelate different heavy metals at pH = 7.2, which gave biosorption capacities of Cu (II), Fe (II), Pb (II), Cd (II), and Zn (II) of 43.34, 43.60, 50.00, 20.08 and 22.48 mg /g of BLA 2906, respectively. The total antioxidant capacity of BLA 2906 presented a value of 0.84 mg Eq Trolox / g DM for the reducing power. On the other hand, the result for the phosphomolybdate test showed a value of 1029.00 ± 3.66 μg / mL to cause a 50 % reduction of the reducing activity of the phosphomolybdenum for the BLA 2906. The result of ABTS+• scavenging activity was 10.46 %. DPPH radical-scavenging effects and BHA at varying concentrations showed that concentrations required to cause 50 % inhibition were 705.48 ± 3.89 μg / ml and 7.61 ± 0.11 μg / ml for this biosurfactant and BHA, respectively. The BLA 2906 showed high stability at different temperatures, pH, and salinity in terms of emulsification activity. Conclusion: The results obtained by the lipopeptide biosurfactant BLA 2906 are attractive to invest in future applications in different fields such as industry, environment and biotechnology.

Design of a 3 T REBCO Dipole Magnet Considering Screening Current Induced Magnetic Field and its First Test Result at 77 K

Design of a 3 T REBCO Dipole Magnet Considering Screening Current Induced Magnetic Field and its First Test Result at 77 K

Analysis of Vitamin C Content and Preferences for Modisco Pudding with the Addition of Crystal Guava Juice (Psidium guajava L Cultivar Kristal)

Background: Indonesia has made progress in achieving the target of reducing malnutrition cases, but 10.2% are still malnourished, according to data from The Global Nutrition Report 2020. Intake of micronutrients, one of which is vitamin C, affects the incidence of malnutrition cases. Vitamin C has the function of maintaining health through the immune system. One supplementary feeding program that can overcome cases of malnutrition is Modified Dietetic Skimmed Milk and Coconut Oil (Modisco). Modisco's reception is not very good, especially for toddlers, because it is in the form of liquid. Modisco pudding, with the addition of crystal guava juice, aims to improve the taste and increase the nutritional value of Vitamin C. Objective: The objective of the study is to analyze the content of Vitamin C in the preference test of Modisco pudding with the addition of crystal guava juice at 0%, 15%, 30%, and 45% concentration. Methods: This study used a quasi experimental design involving 4 treatments and 3 replications. The research subjects were 25 panelists of elementary school students. Results: The results showed the levels of Vitamin C in various proportions to be significantly different (p ≤ 0,05). The results of the preference test showed significant differences in the color, aroma, taste, and texture of the modisco pudding with the addition of crystal guava juice (p ≤ 0,05). Conclusion: The results showed that with more addition of crystal guava juice, the level of vitamin C increased, but the level of preference decreased. The most preferred Modisco pudding was X1 (addition of 15%) with a vitamin C content of 14,4 mg.

Factors predicting the outcome of arthroscopic debridement and microfracture technique in treatment of osteochondral lesions of talus

Aims and Scope: Osteochondral lesions of the talus (OLT) are common injuries that occur following ankle sprains and fractures. Surgical management, either through open or arthroscopic technique, is required to eliminate the pain and restore the ankle’s function. This study aims to evaluate the prognostic significance of demographic variables and lesion’s characteristics. Method and Techniques: In this study, 40 ankle (40 patients), who underwent arthroscopic debridement and microfracture technique to treat osteochondral lesion of the talus, were evaluated retrospectively after two years. The functional outcome of the ankle joint was assessed by using foot – ankle disability score, (FADS), pain analysing scale score (PASS), American orthopaedic foot and ankle society (AOFAS) score, and Ogilvie-Harris scaling system. Then the association between patients’ age and gender, and the lesions’ characteristics, including size, grade, and location, were evaluated. Results: Outcome results varied according to the scoring system, but all patients achieved satisfied outcome and pain relieve. Younger patients with smaller lesions achieved a better clinical result. All measures including PASS, AOFAS, Ogilvie-Harris, FADS appeared to be significantly better in smaller lesions. (P-value &lt;0.05) PASS and Ogilvie-Harris scales showed better results in younger patients. Ogilvie-Harris test result was notably superior in the lateral lesions. Conclusion: The patient’s age and size of the lesion are two prognostic factors of arthroscopic debridement and microfracture of OLTs. We believe arthroscopic management can be associated with a better outcome in lesions smaller than 1.5 cm in diameter and patients younger than 40-years-old. Level of Clinical Evidence: Level 2 – prognostic study

The Quality Analysis of Of Rolled Pancake with Carrot Extract Substitution as Natural Food Colouring

This research aims to analyze the effect of 0%, 15%, 30% and 45% substitution of carrot extract to the quality of rolled pancakes in terms of shape, color, aroma, texture and taste. This research was conducted in August 2023 at the Culinary Workshop, Department of Family Welfare Sciences, Faculty of Tourism and Hospitality, Padang State University. This type of research is a pure experiment using a completely randomized design method consisting of 4 treatments and 3 repetitions. The data used is primary data obtained from 3 expert panelists using an organoleptic test format on the quality of rolled pancakes with the substitution of carrot extract. The data obtained was then tabulated in table form and analysis of variance (ANOVA) was carried out. If F count &gt; F table then proceed with the Duncan test. The results of this research show that there is a significant effect of substitution of 0%, 15%, 30% and 45% carrot extract on the quality of color and aroma of rolled pancakes. The results of data analysis obtained the highest overall achievement scores, namely: neat shape 3.56 (45%), uniform shape 3.44 (30%), color 3.44 (45%), aroma 3.67 (45%), texture 3.67 (45%) and taste 4.00 (45%). The results of the quality test for rolled pancakes with the best carrot extract substitution were 45% (X3).

The Relationship Of Learning Attitudes With Learning Outcomes

This research was motivated by the researcher's observations of students' poor learning attitudes in the food preparation subject, students' scores from the Mid-Semester Examination on average were still below the KKM. This research aims to describe learning attitudes, student learning outcomes, and analyze the relationship between learning attitudes and learning outcomes for class XI culinary students in the culinary subject at SMKN 6 Padang. This type of research uses a correlational descriptive method. The population in this study was class XI Culinary students at SMK N 6 Padang, totaling 101 students. Data collection was carried out by direct questionnaire and via Google Form using a Likert scale. Based on the results of statistical calculations, it can be seen that the learning attitudes of class The results of the hypothesis test obtained tcount &gt; ttable, namely 4, 968 &gt; 1.984 and a significance value of 0.001 &lt;0.05. So it can be concluded that there is a significant relationship between learning attitudes and learning outcomes and the hypothesized results are (Ha) accepted.

Comparative studies on enzymatic efficacy and microbiological properties of Garbage Enzyme produced from various fruits and vegetables peels in biodegradation of cow dung

The present work was conducted to study the enzymatic potentials and microbiological properties of Garbage Enzyme produced from various fruits and vegetables peels. Completely randomized designed experiment was framed with seven treatments each with fruits and vegetable peels separately. All the treatments exhibited positive result for Amylase Test, Lipase Test, Cellulase Test, Urease Test, Protease Test, MR Test and Alcohol and low pH, indicating that Garbage enzyme produced from fruit and vegetable wastes contained mixture of enzymes, alcohol and acid brought about by microbial fermentation. Highest enzymatic efficacy was shown by T3- Pomegranate followed by T6- Banana. GE produced by vegetable wastes was less effective than fruit peels and maximum enzymatic activity exhibited by T1-Radish. A total of 27 amylase producing bacteria, 27 protease producing bacteria, 26 lipase producing bacteria, 26 cellulase producing bacteria 24 urease producing bacteria, 21 pectinase producing bacteria and 01 Amylase producing fungus was screened isolated from all the treatments. Garbage enzyme treatments in tray assay neutralized the alkaline pH of cow dung as garbage enzyme is acidic in nature. Highest Nitrogen (172 Kg/Hec) content was found when treated with garbage enzyme produced with banana peel. It is concluded that Garbage enzyme contains various enzymes, acid, and alcohol, can be utilized as a low cost alternative to biodegrade wastes to reduce pollution load of our environment. Keywords: Garbage Enzyme, vegetable and fruit wastes, enzyme activity, biodegradation

SAVI-based animated video for seismic material

Learning media supports effective and efficient learning. Meanwhile, seismic learning is deemed as a challenging geography course, thereby, requiring animated video as a medium to visualize abstract concepts into concrete ones. Thus, this study formulates animated learning videos using the SAVI approach for seismic material. It also assesses the effect of animated video media on student learning outcomes. The animation video was constructed using the ADDIE research model and tried out in a pre-experimental pretest-posttest type one group design. The trial was conducted involving 27 tenth grade students from Sunan Ampel Islamic Senior High School. The results of the validity test from the material expert indicate an 88 percent agreement rate, while the media expert shows an 87.3 percent agreement rate. The teacher's response questionnaire received a score of 97 percent, while the student responses received a score of 88%. After attending learning with animated video, the average student score increased from 51.31 to 83.77 in the pretest and posttest results. The data obtained from the normality test showed a normal distribution, while the t-test suggested significant results with sig. (2-tailed) 0.000 lees than 0.05. These results imply a significant difference in students' skills before and after the use of animated video media. In summary, the developed media is suitable for seismic learning, offering a positive impact on student learning outcomes.

Progressive Bilateral Ptosis in Adduction Deficit: True Internuclear Ophthalmoplegia (INO) or Pseudo-INO?

Abstract&#x0D; Introduction : Bilateral INO is a rare disease caused by a lesion in the medial longitudinal fasciculus (MLF) in the pons, resulting in adduction deficit. Progression to ptosis is rare and may confuse with pseudo-INO as in ocular myasthenia gravis (OMG). This case aims to report progressive ptosis in bilateral INO that mimics pseudo-INO.&#x0D; Case Illustration : A 36-year-old woman complained sudden binocular diplopia 4 days before admission. Bilateral adduction deficits (-3 and -2 of right and left eye, respectively) with nystagmus were seen. There was no ptosis. The patient was diagnosed with bilateral INO. One month later, the patient returned with bilateral ptosis. The marginal reflex distance 1 (MRD1) were 0 on both eyes. Post fatigue and ice pack test showed 2mm difference of MRD1. The single fiber electromyography (EMG) result came out negative with jitter &lt;10%. Brain MRI revealed lesions in the posterior pons and periaqueductal on the level of midbrain.&#x0D; Discussion : The MLF controls 6th and contralateral 3rd cranial nerve nucleus for horizontal gaze. Ptosis in INO can occurred due to central caudal subnucleus involvement in midbrain that innervates levator palpebra. The result of fatigue and ice pack test may be misleading, as those are not pathognomonic for OMG. The single-fiber EMG are valuable modalities to exclude pseudo-INO in this case.&#x0D; Conclusion : Progressive bilateral ptosis may occur in bilateral INO. Fatigue and ice pack test may give false- positive results leading to confusion with pseudo-INO, rather than true INO. Supporting examinations are needed to confirm the diagnosis.