Manual small incision cataract surgery primarily involves prolapse of nucleus into the anterior chamber followed by its extraction by one of the various methods of nuclear delivery. Large, hard nuclei and certain techniques like phacosandwich/phacofracture predispose to shallowing of anterior chamber, increasing the likelihood of endothelial damage. We describe a simple maneuver to protect this important layer by continuous infusion of 2% hydroxymethylcellulose through the anterior chamber maintainer(ACM)by the assistant during nuclear delivery which can be combined with any method of SICS. This is also useful in preventing endothelial damage by a novice surgeon during the learning phase

One of the most important parasites which frequently causes blindness in humans is the cysticercus cellulosae. Cysticercus cellulosae, the larval form of the pork tapeworm Taenia solium, is the causative organism of cysticercosis, in which humans are the intermediate hosts in the life cycle. Cysticercus cellulosae may become encysted in various bodily tissues, usually the eyes, central nervous system, and subcutaneous tissues. An immunologic reaction with fairly intense inflammatory signs and symptoms may be produced, and the surrounding structures may be compressed. Acquired strabismus, diplopia, recurrent redness, and painful proptosis are some of the clinical signs in patients with orbital cysticercosis. Diagnosis of cysticercosis is based mainly on orbital imaging because of its highly specific appearance. Medical therapy is the main stay of treatment.

Figure 1: Clinical photograph showing frontal bossing and mutiple milia on forehead; Figure 2: Broad nasal root, linear ulcerated pigmented lesion on lower lid of right eye; Figure 3: Multiple pigmented lesions on face and neck; Figure 4: Clinical picture showing multiple palmer pits; Figure 5 (a,b,c): Hughes tarsoconjuctival bridge flap procedure with post auricular skin grafting (stage 1); Figure 5 (d): Clinical photograph after division of tarsoconjunctival flap (stage 2); Figure 6: Histopathological picture showing features of basal cell carcinoma. (Thin arrow-basaloid cells, thick arrow-palisading)

Purpose: To study choroidal vascularity changes in active and inactive TED orbits by using high-definition optical coherence tomography (HD-OCT) and correlate the changes with the duration and severity of TED and Barrets’ index. Methods: A cross-sectional study wherein 37 TED orbits and 30 healthy control (HC) orbits were enrolled. Choroid was imaged using HD-OCT scans centered at the fovea, and subfoveal choroidal thickness (SFCT) was measured. The OCT images were analyzed using ImageJ software to calculate choroidal vascularity index (CVI) and associated choroidal perfusion indices. Results: The study included eight active, 13 non-inflammatory active (NIA), and 16 inactive TED orbits. The mean age was 39.73 ± 12.91 years, and the male: female ratio was 1.18:1. Intraocular pressure and CVI were higher, while SFCT was similar in TED on comparison to healthy orbits. CVI and SFCT were raised in active as compared to inactive TED. CVI and SFCT correlated positively with Barrets’ index and negatively with the duration of thyroid disease. The area under curve of CVI (95% CI: 0.651–0.864, P < 0.001) helped in differentiating TED orbits from HC, while CVI (95% CI: 0.780–0.983, P < 0.001) had the maximum discriminatory power in predicting the activity of disease. Conclusions: CVI has greater sensitivity than SFCT in differentiating healthy from TED orbits. The blood flow stagnation in active orbits, which improves during the course of TED and tends to worsen with increase in Barret’s index, can lead to choroidal vascularity changes. CVI and SFCT can act as adjunct to existing modalities for monitoring the disease activity.

In today's fast-moving digital era, video technology plays an important role. An effective video summarising approach is urgently needed to handle a lot of video data due to the ever-growing number of video content. In this paper, the authors have proposed, A hybrid summarization methodology for video summary evaluation using multimedia features (Text, Images, and Audio) that assess how well a video summary can keep the ranking of vital video frames, semantic data, and audio present in the original video. Video summary can be evaluated by ranking text, audio, and semantics of video frames, giving more accurate summarisation results. The proposed methodology works in three phases: The first part takes the text in the video, the second phase takes the audio to the file, and the last phase focuses on the video frames rather than images in the video. TVSum dataset has been used for the experimentation. F1 has been used as the evaluation metric for checking the efficacy and efficiency of the proposed methodology. The result shows that the proposed hybrid model achieves the highest F1 score of 69.9% and saves 75-80% of user time in watching video summaries instead of the whole video.

Paediatric orbital lesions encompass a wide spectrum of benign and malignant entities that can arise from different components of the orbit. Clinical symptoms and signs are often nonspecific, and imaging plays a crucial role in the diagnosis and management. Ultrasonography has a limited role and radiation is a major concern with CT especially in the paediatric population. MRI is the modality of choice that avoids the radiation hazard and provides superior soft tissue contrast. The lesions can be localized using the ‘compartment’ approach which helps to narrow the list of differentials. MRI also provides critical information for management such as presence of perineural spread and intracranial extension. This article depicts the spectrum of Magnetic Resonance imaging findings encountered in paediatric ocular and orbital lesions.

A 60-year-old male presented with typical iris coloboma and immature cataract in both eyes (BE) (Fig.1a). Fundus examination showed type-1 chorioretinal coloboma in the right eye (RE) and a combination of type 3,5 (Fig.1b) and disc coloboma in the left eye (LE) (Fig.1c) [Ida Mann classification]. The patient gained a best-corrected visual acuity of 20/200 in RE and 20/40 in LE following cataract surgery. A typical choroidal coloboma occurs secondary to incomplete closure of embryonic fissure at 6–8 weeks of gestation. The mechanisms proposed for atypical colobomas include persistent multiple aberrant clefts, rotation of the choroidal fissure, and incomplete closure of the superior ocular sulcus.[1] The simultaneous occurrence of multiple typical chorioretinal colobomas is postulated to be due to a defective and patchy closure of the embryonic cleft in the optic cup.[2]Figure 1: (a) Typical iris coloboma with immature senile cataract. (b) Triple fundal coloboma: disc coloboma with two chorioretinal colobomas connected by bridging retinal tissue. (c) Magnified view of the disc colobomaDeclaration of patient consent The authors certify that they have obtained all appropriate patient consent forms. In the form, the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed. Financial support and sponsorship: Nil. Conflicts of interest: There are no conflicts of interest.

A late adolescent girl presented with medically uncontrolled glaucoma and aphakia post-fire-cracker injury to the right eye. She underwent single-loop fixation of the posterior chamber intraocular lens (IOL) and Ahmed glaucoma valve (AGV) implantation with reduction of intraocular pressure (IOP) in the immediate postoperative period. She sustained second trauma 6 days later resulting in tube retraction and an IOP of 38 mm Hg. An anterior repositioning of the tube-plate complex was performed and IOP remained under control for 5 months. She then developed a tenon cyst and the IOP rose to 24 mm Hg, for which topical timolol and dorzolamide and digital massage were administered. The IOP was in the lower teens, sans medication and aided vision of 0.50 LogMAR at the 1 year follow-up. This case highlights the outcomes of single-loop fixation of IOL with AGV in a post-traumatic setting and subsequent management of complications.

BACKGROUND: Pterygium is very common in India and is usually removed by limbal conjunctival autograft transplantation (LCAT), which, despite being the first-line therapy, is still associated with recurrences of up to 18%. OBJECTIVES: To compare the safety and efficacy of topical cyclosporine A (CsA) and interferon (IFN) alpha-2b in the prevention of postoperative recurrence of pterygium. METHODS: A total of 40 patients with primary pterygium were randomized into two equal groups, Group C and Group I. Both the groups underwent LCAT, with Group C kept on topical cyclosporine 0.05% (CsA) 4 times daily and Group I on topical IFN alpha 2b 0.2 million IU 4 times daily postoperatively for 3 months. Pre- and posttreatment best-corrected visual acuity (BCVA), recurrence, and complications were assessed at day 1, week 1, 1 month, and 3 months. RESULTS: The mean preoperative BCVA of 0.51 ± 0.18 and 0.51 ± 0.23 improved to 0.13 ± 0.13 and 0.13 ± 0.13 in Group C and Group I, respectively, after 3 months of treatment (P < 0.0001). Recurrence was seen in 2 cases in Group C and in 1 case in Group I at 3 months. No significant complications occurred in either of the groups. CONCLUSION: Topical CsA and IFN Alpha-2b are newer efficacious adjuvants with LCAT for prevention of postoperative pterygium recurrence.

Purpose Our aim was to assess the sinonasal magnetic resonance imaging (MRI) features of acute invasive fungal rhinosinusitis (AIFRS) in coronavirus disease (COVID)-associated mucormycosis (CAM) and to correlate these with histopathology and patient outcome in terms of duration of hospital stay and survival at 10 weeks. Methods Twenty patients with histopathologically confirmed sinonasal CAM underwent MRI (including postcontrast T1-weighted and diffusion-weighted imaging). Histopathological findings (presence of coagulative necrosis, granulomatous reaction, and fungal burden) were recorded and all patients were followed up at 6 and 10 weeks. Statistical analysis was done using chi-square test and Fischer's exact test. Results Enhancement patterns seen in our subjects included homogeneous, heterogeneous, and lack of contrast enhancement (LOC), with LOC being the most common (65%). Diffusion restriction was found in 90% patients. Statistically significant correlation was found between LOC pattern and presence of coagulative necrosis (p-value = 0.007), extent of fungal hyphae (p-value = 0.047), and duration of hospital stay (p-value = 0.004). Restricted diffusion was also seen to correlate with a high fungal load (p-value = 0.007). Conclusion Our study describes the MRI findings of AIFRS in CAM and highlights the imaging features which may be surrogate markers for coagulative necrosis and fungal burden.

Thyroid eye disease (TED) is characterized by enlargement of extraocular muscles, an in-crease in retrobulbar fat, orbital fibrosis, and fluctuations in plasma thyroid hormone levels in most patients, often associated with raised autoantibody titers. The occurrence of orbital space conflict compromises the orbital perfusion, unchecked progression of which results in irreversible loss of visual acuity and visual fields. The quantitative assessment of orbital perfusion can be done by measurement of blood flow velocities in the superior ophthalmic vein (SOV), ophthalmic artery (OA), central retinal artery (CRA), and posterior ciliary artery by color Doppler imaging. The retinal and choroidal microvasculature is studied by opti-cal coherence tomography and optical coherence tomography angiography. The orbital and ocular perfusion fluctuates during the course of TED. Orbital congestion is reflected by the reduction or reversal of SOV flow and an increase in subfoveal choroidal thickness. The ac-tive phase is characterized by high blood flow velocities of the OA and CRA. The onset of dysthyroid optic neuropathy is associated with reduced arterial perfusion and reduction in parafoveal and peripapillary vascular density. Orbital decompression improves the SOV flow and decreases the resistivity index of CRA. Sequential evaluation of orbital hemodynamic changes can thus supplement the clinical scoring systems for monitoring and planning in-tervention in TED.(c) 2023 Elsevier Inc. All rights reserved.

The exponential increase in video consumption has created new difficulties for browsing and navigating through video more effectively and efficiently. Researchers are interested in video summarization because it offers a brief but instructive video version that helps users and systems save time and effort when looking for and comprehending relevant content. Key frame extraction is a method of video summarization that only chooses the most important frames from a given video. In this article, a novel supervised learning method 'TC-CLSTM Auto Encoder with Mode-based Learning' using temporal and spatial features is proposed for automatically choosing keyframes or important sub-shots from videos. The method was able to achieve an average F-score of 84.35 on TVSum dataset. Extensive tests on benchmark data sets show that the suggested methodology outperforms state-of-the-art methods.

Purpose: To evaluate the association between meibomian gland dysfunction (MGD) and primary chronic dacryocystitis (PCD) and the effect of dacryocystorhinostomy (DCR) on tear film stability and MGD. Methods: This prospective, interventional, non-randomized study involved 50 unilateral acquired PCD cases and 50 age-matched healthy controls. Patients with lid abnormalities, ocular trauma, previous ocular surgery, contact lens wearers, and chronic topical or systemic drug users were excluded from the study. After a detailed history, the ocular surface disease index (OSDI) was calculated. The ocular assessment included visual acuity, tear meniscus height (TMH), tear break-up time (TBUT), tear well diameter (TWD), Schirmer 1 test, meibomian gland (MG) expressibility, and meibography. PCD eyes underwent external DCR, and the tests were repeated after 8 weeks. Results: The mean age of PCD cases was 42.58 ± 12.74 years, the male: female ratio was 7:19, and the mean duration of epiphora was 2.2 ± 1 years. The MG expressibility grade of ≥2 was seen in 98% (49/50) PCD eyes, which was strongly associated with PCD as compared to controls (OR = 563, P = 0.00, 95% CI = 60.71–5229.70). MG loss ≥50% was seen in 62% (31/50) of PCD eyes and none of the control eyes. Following DCR, MG loss remained unchanged, and a significant decrease occurred in OSDI scores, TWD and Schirmer 1 values, and MG expressibility grade (Z = −6.85). The mean TMH decreased from 767.60 ± 331.60 µm to 384 ± 204.29 µm ( P = 0.004) post DCR. Conclusions: PCD is strongly associated with MGD. DCR reverses the functional MG changes with improvement in the tear film stability but no effect on MG loss.

With the massive expansion of videos on the internet, searching through millions of them has become quite challenging. Smartphones, recording devices, and file sharing are all examples of ways to capture massive amounts of real time video. In smart cities, there are many surveillance cameras, which has created a massive volume of video data whose indexing, retrieval, and administration is a difficult problem. Exploring such results takes time and degrades the user experience. In this case, video summarization is extremely useful. Video summarization allows for the efficient storing, retrieval, and browsing of huge amounts of information from video without sacrificing key features. This article presents a classification and analysis of video summarization approaches, with a focus on real-time video summarization (RVS) domain techniques that can be used to summarize videos. The current study will be useful in integrating essential research findings and data for quick reference, laying the preliminaries, and investigating prospective research directions. A variety of practical uses, including aberrant detection in a video surveillance system, have made successful use of video summarization in smart cities.

To study the orbital perfusion parameters of ophthalmic artery (OA) and central retinal artery (CRA) in inactive TED and the changes following surgical decompression. Non-randomised clinical trial. 24 inactive moderate-to-severe TED orbits of 24 euthyroid cases underwent surgical decompression and examined again at 3 months. The peak systolic velocity (PSV), end-diastolic velocity (EDV), and resistivity index (RI) of OA and CRA were evaluated using colour doppler imaging and normative database was established using 18 healthy controls. The mean age was 39.38 ± 12.56 years and male: female ratio was 1: 1.18. Intraocular pressure was higher, and CRA-PSV, CRA-RI, OA-PSV, and OA-EDV were lower in TED in comparison to heathy orbits. The CRA-PSV, CRA-EDV, OA-PSV, and OA-EDV negatively correlated with proptosis and duration of thyroid disease. The area under curve of OA-PSV (95% CI:0.964–1.000, p < 0.001) and OA-EDV (95% CI:0.699–0.905, p < 0.001) helped in differentiating TED orbits from HC, and in predicting the severity of disease. Post decompression, CRA-PSV, CRA-EDV, OA-PSV, and OA-EDV improved, with decrease in CRA-RI and OA-RI in both lipogenic and MO. The orbital perfusion is reduced in inactive TED. The changes in OA flow velocities can help in differentiating inactive TED from healthy orbits and progression of TED. Sequential orbital CDI of OA and CRA can serve as an objective tool for case selection and monitoring response to surgical decompression.

Purpose: To compare the effect of hard and soft splints on muscle activity and self-reported clinical outcomes in patients with moderate to severe tooth wear at different intervals. Materials and methods: Participants within the age range of 18–45 years having moderate to severe wear of teeth were allocated into group IHS (n = 8) receiving hard splints and group IISS receiving soft splints. Electromyography (EMG) activity of masseter and anterior temporalis were recorded during postural rest position (PRP) and maximum voluntary clenching (MVC) at baseline (T0), 24 hours (T1), 4 weeks (T2) and at 8 weeks (T3) with and without splint. EMG activity of controls with no or minimal tooth wear was recorded only at baseline. Nonparametric tests were used for within-group and intergroup comparisons, followed by post hoc analysis with Bonferroni correction. Results: Baseline EMG activity was higher in experimental groups than that of controls, but the difference was nonsignificant (p > 0.05). At 24 hours, both the groups showed significantly lower (p < 0.05) EMG activity with the splint as compared to without the splint. Hard splints led to decreased muscle activity, while soft splints led to an increase at 4 and 8 weeks as compared to baseline EMG activity of controls, and the difference was nonsignificant except for anterior temporalis during MVC in group IHS. The intergroup comparison revealed insignificant differences at all time intervals (p > 0.05), while it was significant for anterior temporalis in MVC at 4 and 8 weeks (p < 0.05). Conclusion: Muscle activity varied with different materials of the splint and duration of use. Both splints helped in the adaptation of muscles to new vertical dimensions of occlusion at 8 weeks with lesser variation between with and without splint position. The effect of the splint was more pronounced on the activity of the anterior temporalis than the masseter muscle. How to cite this article: Goel R, Jain V, Gupta C, et al. Effect of Hard and Soft Occlusal Splints on Electromyographic Activity of Masseter and Anterior Temporalis in Patients with Moderate to Severe Occlusal Wear: A Randomized Controlled Trial. Int J Prosthodont Restor Dent 2023;13(3):137–144.

Emotions are states of the nervous system that are connected to thoughts, sensations, behavioural reactions, and varying degrees of pleasure or annoyance. Failure to recognise emotions may result in communication failure. As a result, identifying emotion becomes crucial. Also, worldwide a total of about 577.8 million people speaks Hindi. Thus, this Speech Emotion Recognition system aims to detect emotion from Hindi audio. Here, the approach used is to extract audio-based as well as text-based features from the input audio speech to detect emotion. Experimentation is done with several machine learning algorithms like Random Forest, Support Vector Classifier and Logistic Regression applied to both audio and text datasets separately. The final model selected in each is the one that gave the highest accuracy respectively. 72% accuracy using Support Vector Classifier with GridSearchCV in the text dataset and 95% accuracy using Random Forest in the audio dataset is achieved. The combined results are used to identify four emotions which are neutral, angry, sad and happy, across a database of many different speakers.

In today's digital world, the task of video summarization has gained immense importance within the realm of multimedia analysis. This relevance is largely driven by the exponential expansion in multimedia content consumption, encompassing audio, video, and images, which is readily available on-demand through various digital platforms. Automatic video summary is the process of creating a brief synopsis that summarizes the video by displaying its most useful and relevant elements, so consumers may rapidly comprehend the primary concept of a video without having to watch the entire material. Currently, the selection of the video segments to be included in the final summary is done in a variety of ways. The task is to analyze the video's multimedia data in search of relevant clues that will aid in decision-making. The proposed method TAVM (text, audio, and video mode) in this paper will provide the video summary using different multimedia elements of text, audio, and frames. The proposed TAVM method can be separated into three parts. The process begins with Video Processing, where the BEiT vision transformer is employed to recognize objects within the chosen frame. Following that, Audio Processing comes into play, which uses speech-to-text converters to transcribe the audio content. Finally, in the last step, the Summary Builder utilizes the GPT-3-based OpenAI API to generate a summary of the content. The experimental analysis on the benchmark dataset SumMe demonstrates the effectiveness of the proposed approach.

Shalin Shah, Ruchi Goel Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, IndiaCorrespondence: Shalin Shah, Department of Ophthalmology, Guru Nanak Eye Centre, Maulana Azad Medical College, New Delhi, 110002, India, Tel +91 9409306175, Email shahshalinsss@gmail.com

Cataract is the most common cause of avoidable blindness in the world. While cataract surgery is continually evolving, manual small-incision cataract surgery (MSICS) still remains highly relevant, especially with the threat of the coronavirus disease 2019 (COVID-19) still looming large over the world. MSICS today has a renewed significance, since it does not involve the use of any advanced machinery and relies mainly on easily sterilizable instruments, thereby making it a safe and inexpensive option. A self-sealing valvular tunnel entry forms the basis of MSICS, and proper positioning and construction of the tunnel is imperative to the success of the surgery. With more and more people demanding spectacle independence after surgery, it becomes important to have a thorough understanding of the factors that may influence surgically induced astigmatism in MSICS. These include the incision location, size and shape, configuration of the sclero-corneal tunnel, pre-existing ocular pathology, role of sutures, amongst others. With proper knowledge, many of these factors can be modulated to achieve best results.