Orbital Scan Research Articles

Application of ascorbic acid in the synthesis of rGO/micro-octahedral Cu2O nanocomposites and its effect on the wide linear response range of glucose detection

In this study, a simple and scalable method with the application of Ascorbic acid has been reported for the fabrication of decorated reduced graphene oxide by Cu2O micro-octahedrons (rGO/ micro-octahedral Cu2O nanocomposites) for non-enzymatic glucose sensor using differential pulse voltammetry (DPV) techniques. The structural study of rGO/ micro-octahedral Cu2O using detailed XRD analyses, Raman spectroscopy, FESEM imaging, EDX elemental mapping and BET-BJH analyses revealed that the application of ascorbic acid in the synthesis process enhances the morphology, surface area, charge transfer and electrocatalyst properties of the nanocomposite. XPS analysis revealed the significant reduction of GO with the distinct peak of C–C in the C 1 s orbital scan. Quenching of satellite peaks (Cu2+) in Cu 2p orbital scan accompanied by the appearance of Cu-C new bond were indications of CuO phase elimination and hybridization of rGO/Cu2O structure. The modified electrodes with Nafion showed a wide linear span of 1 µM- 9 mM for glucose detection, high sensitivity of 415 µA mM−1 cm−2 with low detection limit of 0.96 µM and significantly being selective among different species. The sensitivity measurement without Nafion as a Nafion-free modified electrode was still high as 24.8 µA mM−1 cm−2 with the same wide linearity range and low detection limit of 0.53 µM. The stability of 97.95% in signal change after 56 days and repeatability of the modified electrode with relative standard deviation of 4.06% were also obtained. The modified GC/rGO/micro-octahedral Cu2O electrode revealed its electrocatalytic activity toward glucose oxidation that was excellently competitive with HPLC measurement of glucose in human serum.

The Analysis of Web Server Security For Multiple Attacks in The Tic Timor IP Network

The current technology is changing rapidly, with the significant growth of the internet technology, cyber threats are becoming challenging for IT professionals in the companies and organisations to guard their system. Especially when all the hacking tools and instructions are freely available on the Internet for beginners to learn how to hack such as stealing data and information. Tic Timor IP is one of the organisations involved and engaged in the data center operation. It often gets attacks from the outside networks. A network traffic monitoring system is fundamental to detect any unknown activities happening within a network. Port scanning is one of the first methods commonly used to attack a network by utilizing several free applications such as Angry IP Scan, Nmap and Low Orbit Ion Cannon (LOIC). On the other hand, the snort-based Intrusion Detection System (IDS) can be used to detect such attacks that occur within the network perimeter including on the web server. Based on the research result, snort has the ability to detect various types of attack including port scanning attacks and multiple snort rules can be accurately set to protect the network from any unknown threats.

Detection and Analysis of C-Band Radio Frequency Interference in AMSR2 Data over Land

A simplified generalized radio frequency interference (RFI) detection method and principal component analysis (PCA) method are utilized to detect and attribute the sources of C-band RFI in AMSR2 L1 brightness temperature data over land during 1–16 July 2017. The results show that the consistency between the two methods provides confidence that RFI may be reliably detected using either of the methods, and the only difference is that the scope of the RFI-contaminated area identified by the former algorithm is larger in some areas than that using the latter method. Strong RFI signals at 6.925 GHz are mainly distributed in the United States, Japan, India, Brazil, and some parts of Europe; meanwhile, RFI signals at 7.3 GHz are mainly distributed in Latin America, Asia, Southern Europe, and Africa. However, no obvious 7.3 GHz RFI appears in the United States or India, indicating that the 7.3 GHz channels mitigate the effects of the C-band RFI in these regions. The RFI signals whose position does not vary with the Earth azimuth of the observations generally come from stable, continuous sources of active ground-based microwave radiation, while the RFI signals which are observed only in some directions on a kind of scanning orbit (ascending/descending) mostly arise from reflected geostationary satellite signals.

IQ\xb7SPECT technology and its clinical applications using multicenter normal databases

IQ·SPECT (Siemens Medical Solutions) is a solution for high-sensitivity and short-time acquisition imaging of the heart for a variable angle general purpose gamma camera. It consists of a multi-focal collimator, a cardio-centric orbit and advanced iterative reconstruction, modeling the image formation physics accurately. The multi-focal collimator enables distance-dependent enlargement of the center region while avoiding truncation at the edges. With the specified configuration and a cardio-centric orbit it can obtain a fourfold sensitivity increase for the heart at the center of the scan orbit. Since IQ·SPECT shows characteristic distribution patterns in the myocardium, appropriate acquisition and processing conditions are required, and normal databases are convenient for quantification of both normal and abnormal perfusion images. The use of prone imaging can be a good option when X-ray computed tomography (CT) is not available for attenuation correction. CT-based attenuation correction changes count distribution significantly in the inferior wall and around the apex, hence image interpretation training and additional use of normal databases are recommended. Recent reports regarding its technology, Japanese Society of Nuclear Medicine working group activities, and clinical studies using 201Tl and 99mTc-perfusion tracers in Japan are summarized.

The value of DCE-MRI in assessing the course of thyroid associated ophthalmopathy

Objective: To explore the feasibility of the semi-quantitative rectus extraocular muscle (EOM) parameters of dynamic contrast-enhanced magetic resonance imaging (DCE-MRI) in assessing the clinical course of thyroid associated ophthalmopathy (TAO). Methods: It was a retrospective case series study. A total of 136 cases of TAO were recruited from March 2011 to October 2012 in the Tianjin the first center hospital including 63 males and 72 females, aged 24.0-65.0 years, with an average age of (40.5±10.9) years. Forty healthy volunteers were recruited as control group (CG). According to clinical activity score (CAS), all TAO patients were divided into 2 groups, activity group (AG) and inactivity group (IAG). MRI and DCE-MRI orbit scan were performed in each subject. Drew time-intensity curves (TIC) by Siemens 3.0 MR (syngo) post-processing workstation. The semi-quantitative parameters of DCE-MRI were calculated. The semi-quantitative paramters based on TIC include early enhancement coefficient (EEC), maximum enhancement coefficient (Emax) and wash-out coefficient (WC(5min)). Kruskal-Wallis H rank test was used for comparing signal intensity among 3 groups, and Nemenyi test for pairwise comparison between groups. The DCE-MRI parameters (EEC, Emax, WC(5 min)) among groups were compared by one-way ANOVA, and Bonferroni t test is for pairwise comparison between groups. The diagnostic value of mean EEC, mean Emax, WC(5min) for assessment of the clinical course in TAO was analyzed by ROC curve. Results: There were significant difference in signal intensity (SI) of rectus EOM on T(2)WI among CG, AG and IAG, which is significantly different in 88 cases of AG including 45 cases of high intensity 51.1%, 23 cases of moderate intensity 26.1%, and 20 cases of low intensity 22.7%,compared with CG and IAG. EEC (P<0.05), Emax and WC5min values of rectus EOM of TAO group were significantly lower than those of CG(P<0.05), which values of rectus EOM of TAO active group of EEC are 0.63±0.06、0.61±0.05、0.56±0.09、0.57±0.09, and values of rectus EOM of TAO inactive group of EEC are 0.49±0.05、0.50±0.08、0.57±0.10、0.55±0.09. The values of rectus EOM of TAO active group of Emax are 1.35±0.09、1.28±0.09、1.21±0.17、1.25±0.10, and the values of rectus EOM of TAO inactive group of Emax are 1.04±0.06、1.05±0.10、1.20±0.19、1.16±0.11. The values of rectus EOM of TAO active group of WC(5 min) are 0.13±0.03、0.13±0.03、0.13±0.06、0.13±0.03 and the values of rectus EOM of TAO inactive group of WC5min are 0.08±0.02、0.79±0.03、0.11±0.06、0.09± 0.03. EEC (χ(2)=9.20, P<0.05), Emax and WC(5min) values of rectus EOM of TAO group were significantly lower than those of CG (P<0.05). EEC, Emax and WC(5min) values of medial rectus and inferior rectus EOM of IAG were significantly lower than those of AG(P<0.05). WC(5min) values of superior rectus EOM of IAG were significantly lower than those of AG (P<0.05). There were no differences in EEC and Emax values of lateral rectus and superior rectus EOM between IAG and AG (P>0.05). There were no differences in WC(5min) values of lateral rectus EOM between IAG and AG (P>0.05). The area under the curve (AUC) were 0.771, 0.879, 0.898 for mean EEC, mean Emax, and mean WC(5min), respectively. Conclusion: The semi-quantitative paramters of DCE-MRI can show the clinical activity of TAO patients and can be considered as the quantitative index of TAO activity staging. (Chin J Ophthalmol, 2017, 53: 430-435).

Etiopathogenesis of childhood proptosis

Aim: To study the etiology, presentation and management of proptosis in children less than 14 years of age. Materials and Methods: This is prospective interventional study conducted at the department of Oculoplasty and Orbital diseases of Sarojini Devi eye hospital, Hyderabad. Period of study was from August 2012 to July 2014. 120 eyes of 111 children presenting as proptosis to the department were included in the study. Adult cases of Proptosis were excluded from the study. All cases underwent a detailed proptosis evaluation by an experienced oculoplasty surgeon. CT scan of orbit, axial and coronal view, 2mm cut without contrast was modality of imaging in all cases. CT scan with contrast was done in selected cases. Complete blood picture and surgical profile investigations were done. Cases were posted for excision or incision biopsy under general anaesthesia. Histopathological diagnosis was obtained in required cases. Culture and sensitivity of pus was done in infective cases. Results: 111(14.83%) cases of childhood proptosis were there out of 748 cases of proptosis presented during the study period to the department. The Male to Female ratio was 55:46. 102 cases were of unilateral proptosis and 9 were bilateral. Common etiology for childhood proptosis was 28 congenital, 18 infective, 20 parasitic, 36 neoplasm, 6 secondaries and 3 trauma cases. Of 111 cases 28 had acute proptosis, 25 had Sub acute presentation and 58 cases had chronic presentation. Management of 111 cases was done as follows: 48 cases underwent surgery, 41 were managed medically, 10 cases were referred to Medical Oncologist and 12 cases of congenital crouzons disease and microphthalmos were not intervened. Conclusion: Childhood proptosis forms 14.83% of total proptosis cases presenting at department of Oculoplasty and Orbital diseases. Etiological spectrum is different when compared to adult Proptosis.(1) Keywords: Congenital, Infective, Neoplasm, Parasitic, Proptosis

Magnetic Resonance Imaging Characteristics of a Baerveldt Glaucoma Implant.

Evaluate for normative postoperative magnetic resonance imaging (MRI) characteristics of a Baerveldt Glaucoma Implant (BGI). Prospective case series. Seven subjects with uncontrolled glaucoma requiring a primary superotemporal BGI. Subjects prospectively underwent sequential MRI orbital scans without contrast at 0 to 2 weeks, 6 to 8 weeks, and 4 to 6 months after implantation of a BGI model 103-250. Masked to the postoperative time course, a radiologist measured bleb and implant characteristics. Linear measurements of the maximum bleb height at the anterior, middle, and posterior sections of the endplate were measured. Intraocular pressure (IOP) was correlated to bleb height. On axial T2-weighted images, the height of fluid below and above the BGI endplate increased from the initial to the final MRI images: 0.49 mm to 1.83 mm and 0.57 mm to 1.08 mm (middle 1/3), respectively. On coronal T2-weighted images, fluid below and above the BGI endplate increased from 0.47 mm to 1.53 mm and 0.49 mm to 1.38 mm, respectively. Maximum inverse correlation between bleb height and IOP was observed at the 6 to 8 week coronal T2 images (r=-0.963, P=0.002). Fluid collections and endplate characteristics are easily visualized with MRI. Dynamic changes occur over the early postoperative time course. Bleb height is inversely correlated to IOP at 6 to 8 weeks, but disappears at 4 to 6 months.

CT-Scan Findings of Orbital Mass Among Pediatric Patients at a Tertiary Care Hospital in Bangladesh

Background: CT-Scan for the detection of orbital mass among pediatric patients is very important noninvasive radiological modality. The purpose of the study was to find out CT-Scan findings of orbital mass among pediatric patients in a tertiary care hospital.Methodology: This is a cross sectional study was carried out in Ophthalmology and Radiology and Imaging department of National Institute of Ophthalmology (NIO) from January 2012 to December 2013. All the patient below 18 years of age presented with suspected orbital mass at Ophthalmology and Radiology and Imaging department of NIO and performed CT- Scan of orbit for diagnosis of the disease and also done histopathology after operation was enrolled in this study.Results: In this study it was observed that a total of 29 cases identified as malignant evaluated by CT, among them 27 cases were true positive and 2 cases were false positive. Benign was found in 41 cases evaluated by CT scan, out of which 1 false negative and 40 cases were true negative. The sensitivity in diagnosis of orbital tumor by CT was 93.3%.Conclusion: The sensitivity in diagnosis of orbital tumor by CT was high and is a useful method in the differentiation between benign and malignant orbital mass.Anwer Khan Modern Medical College Journal Vol. 8, No. 1: Jan 2017, P 17-23

Chromatin Accessibility Studied by Slow Scan FCS in the Eukaryotic Nucleus

DNA is one of the most important biological macromolecules, since it harbors the genetic information of the cell. In order to fit in eukaryotic cell nucleus, DNA is highly compacted and packed by histones in chromatin. Chromatin compaction has recently been shown to be related to cell epigenetic states[1] and levels of commitment [2]. It seems also to be involved in important processes like senescence and cancer [3,4]: it could be interesting to study chromatin degree of compaction in relation to cancer insurgence and progression.Fluorescence Correlation Spectroscopy (FCS) is a technique able to probe chromatin accessibility in living cells by measuring fast diffusion of molecules like EGFP in the range between microseconds to milliseconds. Here, in order to quantify local chromatin accessibility, we sample several positions within the nucleus by performing a slow orbital scan. The slow scan allows us to ignore the motion of the scanner and analyze the data as in single point FCS without losing temporal resolution. To extract the diffusion properties in distinct sub-nuclear compartments, we sort the sampled points based on the intensity value measured in the same or in another channel (e.g. Hoechst 33342) prior to averaging. In this way we can rapidly compare, for instance, the diffusion properties inside heterochromatin and euchromatin. We discuss the advantages and limitations of the method, and its application for comparing chromatin accessibility in cellular models of different cancer stages.[1] Boettiger A. et al., Nature, 2016 Jan; 418-22[2] Ricci M. et al., Cell, 2015 Mar; 1145-58.[3] Di Micco R. et al., Nat Cell Biol, 2011 Mar; 292-302[4] Sulli G. et al., Nat Rev Cancer, 2012 Oct; 709-20[5] Dross N. et al., PLoS One. 2009; e5041.

Kindle the Spindle: To Bring in Light a Rare Case of Eyelid Spindle Cell Sarcoma

Purpose: To bring in perspective a rare case of spindle-cell sarcoma of lid with intra-orbital metastasis. Methods: A seventy-five year old female presented with complaints of severe pain in right eye and right sided headache for 2 months along-with constant watering. She had a history of cataract surgery with IOL implantation in bag in right eye 4 months back. During the same time, a mass lesion was also removed from underside of right lower lid which was present for about 7-8 years. She was asthenic in built and was found to have pallor. On ophthalmic examination she was found to have Snellen’s visual acuity of 6/60 OD, 6/18 OS. Intra-ocular pressure was 37.5 mm of Hg OD, 18.6 mm of Hg OS. Ocular movements were restricted in lateral and superior gaze in right eye. On palpation stony hard, tender induration could be appreciated along the right infero-nasal lid margin. Fundus examination revealed chorio-retinal folds in inferior quadrant peripherally. No palpable lymph nodes were observed. CT scan brain and orbit was advised along-with routine blood investigations and IOP control medications. Results: CT scan revealed a heterogeneous cystic lesion measuring 17 × 16 × 21 mm in antero-inferior right orbit, abutting the globe and inferior rectus with thickening of uveo-scleral ring. The right globe was compressed and displaced supero-laterally. No bony erosion or infiltration of orbital fat or optic nerve was seen. Earlier histo-pathological report of excised lid tumor revealed low grade spindle cell sarcoma. Conclusion: Spindle cell sarcoma of lid is rare entity. This case report reveals a spindle cell sarcoma of lid with intraorbital metastasis.

Orbital Apex Syndrome with Central Retinal Artery Occlusion Following Tooth Extraction

A 39- year-old male, known diabetic presented with drooping of upperlid and visual loss in the left eye (LE) along with pain in the eye and periorbital region. This was preceded by tooth extraction 2 days back. There was inaccurate projection of rays in the left eye along with complete ptosis, proptosis, relative afferent pupillary defect (RAPD) and limitations of ductions. Fundoscopy revealed features of papillitis with central retinal artery occlusion (CRAO). The examination of the right eye was within normal limits. Patient had high blood sugar levels. Contrast enhanced computed tomography (CECT) scan of brain and orbit was suggestive of left paranasal sinusitis. The clinical and the radiological findings were suggestive of orbital apex syndrome with central retinal artery occlusion of the left eye (LE). The case was managed conservatively with systemic antibiotics, non-steroidal anti-inflammatory drugs and injection human insulin. Pain, proptosis and conjunctival chemosis subsided within 2 days but other features remained static. Dentogenic cause of orbital apex syndrome is very rare. We intend to discuss clinical features and management of such case.

Validity of CT-Scan for the detection of malignant orbital mass among pediatric patients.

Background: The validity of CT-Scan for detection of orbital mass among pediatric patients is very important noninvasive radiological modality. Objective: The purpose of the study was to find out the validity of CT-Scan to detection of orbital mass among pediatric patients with a view to develop it as an important radiological modality for the detection of orbital mass. Methodology: This is a cross sectional study was carried out in Ophthalmology and Radiology and Imaging department of National Institute of Ophthalmology (NIO) from January 2012 to December 2013. All the patient below 18 years of age presented with suspected orbital mass at Ophthalmology and Radiology and Imaging department of NIO and performed CT- Scan of orbit for diagnosis of the disease and also done histopathology after operation was enrolled in this study. Result: A total number of 70 patients clinically suspected cases orbital mass lesion who came in department of ophthalmology and Radiology and Imaging of National institute of ophthalmology (NIO), Dhaka, during the period of January 2012 to December 2013, were included in this study. In this present study it was observed that sensitivity 96.4%, specificity 95.2%, accuracy 95.7%, positive predictive values 93.1% and negative predictive values 97.6% of the CT scan evaluation for orbital mass lesion in pediatric population. Conclusion: The validity of CT-Scan for detection of orbital mass among pediatric patients is very important, it is noninvasive useful method in the differentiation between benign and malignant orbital mass.

Management of paediatric periorbital cellulitis: Our experience of 243 children managed according to a standardised protocol 2012–2015

IntroductionPaediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol. MethodsRetrospective audit of paediatric patients admitted with periorbital cellulitis, 2012–2015. ResultsTotal of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%. ConclusionsOur audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms.

Volumetric CT with sparse detector arrays (and application to Si-strip photon counters)

Novel x-ray medical imaging sensors, such as photon counting detectors (PCDs) and large area CCD and CMOS cameras can involve irregular and/or sparse sampling of the detector plane. Application of such detectors to CT involves undersampling that is markedly different from the commonly considered case of sparse angular sampling. This work investigates volumetric sampling in CT systems incorporating sparsely sampled detectors with axial and helical scan orbits and evaluates performance of model-based image reconstruction (MBIR) with spatially varying regularization in mitigating artifacts due to sparse detector sampling.Volumetric metrics of sampling density and uniformity were introduced. Penalized-likelihood MBIR with a spatially varying penalty that homogenized resolution by accounting for variations in local sampling density (i.e. detector gaps) was evaluated. The proposed methodology was tested in simulations and on an imaging bench based on a Si-strip PCD (total area 5 cm × 25 cm) consisting of an arrangement of line sensors separated by gaps of up to 2.5 mm. The bench was equipped with translation/rotation stages allowing a variety of scanning trajectories, ranging from a simple axial acquisition to helical scans with variable pitch. Statistical (spherical clutter) and anthropomorphic (hand) phantoms were considered. Image quality was compared to that obtained with a conventional uniform penalty in terms of structural similarity index (SSIM), image uniformity, spatial resolution, contrast, and noise.Scan trajectories with intermediate helical width (~10 mm longitudinal distance per 360° rotation) demonstrated optimal tradeoff between the average sampling density and the homogeneity of sampling throughout the volume. For a scan trajectory with 10.8 mm helical width, the spatially varying penalty resulted in significant visual reduction of sampling artifacts, confirmed by a 10% reduction in minimum SSIM (from 0.88 to 0.8) and a 40% reduction in the dispersion of SSIM in the volume compared to the constant penalty (both penalties applied at optimal regularization strength). Images of the spherical clutter and wrist phantoms confirmed the advantages of the spatially varying penalty, showing a 25% improvement in image uniformity and 1.8 × higher CNR (at matched spatial resolution) compared to the constant penalty.The studies elucidate the relationship between sampling in the detector plane, acquisition orbit, sampling of the reconstructed volume, and the resulting image quality. They also demonstrate the benefit of spatially varying regularization in MBIR for scenarios with irregular sampling patterns. Such findings are important and integral to the incorporation of a sparsely sampled Si-strip PCD in CT imaging.

Filariasis of the eyelid subcutaneous manifestation in Bangladesh

Purpose: We report a rare case of the eyelid subcutaneous filariasis in Bangladesh Methods: Through Ocular and systemic evaluation, CT scan of orbit and histopathological analysis plays an important role for diagnosis. Results: An11 yrs girl presented with right periocular swelling, moderate tenderness and the right eye could not be opened for the last 3 days. CT scan of orbit showed diffuse heterogeneous soft tissue swelling in both upper and lower eyelid which was suggestive of preseptal cellulitis. She was improved on conservative management. On clinical evaluation, we found a nodular swelling, firm in consistency and overlying skin was free, fixed to the tarsus in the most lateral part of right upper eyelid. Thyroid function test showed hypothyroidism. She was euthyroid after two months of treatment. Excision biopsy was done and the lesion was round, nodular, solid lesion. Histopathology report reviled filariasis of the eyelid. There were no features of filariasis on systemic evaluation. Conclusion: Filariasis may be found rarely in the eyelid. Painful eyelid swelling in patients should always raise the suspicion of filariasis.

A clinical study of retinoblastoma.

Aim:The aim was to analyze general incidence, age incidence, laterality, common mode of presentation, staging of the tumor, radiological evidence, histopathological confirmation, management and follow-up of cases, which were diagnosed as retinoblastoma.Design:Interventional case series study from April 1997 to March 2000.Materials and Methods:Detailed history regarding the symptoms such as white reflex, watering, pain, redness, protrusion of eyeball, squint, hyphema, and defective vision were obtained. Family history regarding consanguinity between parents, health of the siblings and other relatives were recorded. Ocular examination included vision, pupillary reaction, detailed fundus examination, ocular tension, and corneal diameter. Investigations included X-ray orbit and skull, computed tomography scan orbit and brain, B-scan orbit, serum and aqueous lactate dehydrogenase; enucleated eyes were subjected to holoprosencephaly (HPE). Enucleation, radiotherapy, cryotherapy and chemotherapy were modalities of treatment. The empty socket and the other apparently normal eye were examined carefully at each visit.Results:The incidence of retinoblastoma is less when compared to other diseases of the eye. There was no sex predilection. Most of the cases diagnosed were sporadic and unilateral. Age of onset is earlier for bilateral cases than unilateral cases. Consanguinity bears close relationship with bilateral involvement. Predominant clinical sign is white reflex in the pupillary area. Majority of cases presented in the second stage of the disease. Enucleation plays a greater role in the management of retinoblastoma. HPE should include several sections of the optic nerve to find out skip lesions.

The Silent Sinus Syndrome: A Collaborative Approach between Rhinologists and Oculoplastics- Case Report and Literature Review

The Silent Sinus Syndrome (SSS) is a rare phenomenon originally described in 1964 by Montgomery, which often occurs unilaterally in the maxillary sinus with opacification and collapse. It is characterized by ipsilateral enophthalmos and hypoglobus or mistakenly as an exophthalmos of the contralateral eye. The pathophysiology is caused by obstruction of the ostiomeatal complex with subsequent maxillary sinus hypoventilation and development of negative intra-sinus pressure resulting in bony changes and sinus collapse. Radiographic evaluation by the mean of CT scan orbits and paranasal sinuses as well as nasal endoscopic examination are mandatory in diagnosing such cases. Treating such cases require a collaborative multidisciplinary approach to ensure the best possible results. In this case report, we discuss this rare phenomenon in terms of clinical presentation, clinical and radiological evaluation and conclude with the optimal treatment approach.

English

BACKGROUND: Neurofibroma is usually associated with systemic neurofibromatosis, but can occur as isolated lesions. Subconjunctival neurofibroma without any associated features of neurofibromatosis I is of rare occurrence and hasn't been reported in literature till date. CASE: We report a case of an atypical presentation of neurofibroma, diagnosed on histopathologically, without any associated features of neurofibromatosis I. 60 year old male presented with painful swelling in inner aspect of right eye since 2 years. Systemic Examination was normal. Patient didn't have neurofibromas on or in the body anywhere else. Patient did not have Cafe-au-lait spots or Leisch nodules on iris. Patient didn't have hypertrophy or destruction of orbital bone/exophthalmos. CT Scan Orbit showed intensely enhancing oval mass of size 19x19x21mm in intraorbital extraconal compartment anteroinferior to eyeball s/o Nerve Sheath Tumour. Excision Biopsy of lesion was done and sent for histopathological examination which confirmed the diagnosis of Neurofibroma. CONCLUSION: Isolated Neurofibromatosis should not be excluded in absence of systemic features of Neurofibromatosis I.

Pitfalls of ophthalmic radiographic imaging.

Ophthalmologists are dependent on computed tomography (CT) and MRI to aid in the diagnosis and management of patients with orbital and visual conditions. Pitfalls in the imaging process can lead to inefficient care or patient harm. This review summarizes these problems and provides methods to reduce imaging errors. There has been exponential growth in the number of radiographic scans performed, resulting in increased awareness of the risks from medical radiation. Strategies to minimize radiation exposure include reducing the need for sequential scans, using appropriate technology, and substituting MRI for CT. Contrast administration can be associated with systemic reactions, renal disease, and thyroid dysfunction. Scan interpretation errors are reduced by the ophthalmologist reviewing the study and communication with the radiologist. Medical radiation exposure can be reduced by initially ordering the appropriate scan and substituting MRI for CT when possible. MRI is contraindicated in patients with certain implants and metallic foreign bodies. Noncontrast studies are adequate to evaluate many conditions and some patients should not receive contrast. Imaging errors can be reduced by the ophthalmologist personally reviewing the orbital scans and correlating the results with the clinical findings.

Longest Wooden Stick penetrating Sino-Orbital Region: Unbelievably Sparing Vital Structures

Longest Wooden Stick penetrating Sino-Orbital Region: Unbelievably Sparing Vital Structures Objective: To report a unique case of a longest known broken wooden stick penetrating into the Sino-orbital region in an oblivious patient. Method: Study of a case of forgotten foreign body (wooden stick) in sino-orbital region who, presented to us with discharging sinus at right upper eyelid near the medial canthus. CT Scan PNS and orbit revealed the wooden stick, which was removed intact surgically by external Lynch Howarth approach. Results: The surgical procedure and recovery was uneventful without any complication. Conclusion: Penetrating injuries of the Sino-orbital region are extremely rare. This paper sheds light on the importance of high index of suspicion for the presence of foreign body in unusual locations even in absence of history and early surgical removal leading to complete recovery. This case is peculiar because the wooden stick removed from Sino orbital region is the longest (9.5cms.x0.8cms.x0.8cms) reported as per our literature search and astonishingly it spared all the vital structures in spite of being in such a critical location.