Clinical Characteristics of Migraine and Their Association With the Retinal Nerve Fiber Layer Thickness.

BACKGROUND: Migraine is characterized by recurrent episodes of unilateral, pulsating headaches. At the cerebral and ocular levels, it is recognized that the vascular narrowing and loss of blood flow are transient; however, the chronic nature of migraine may result in long-term functional and structural changes in these structures. It could result in axonal loss and an alteration in the thickness of the retinal nerve fiber layers (RNFL). This study aimed to measure the RNFL thickness, which provides a useful indication of the state of the axons and the loss of ganglion cells in migraine patients, and to find out if RNFL thickness and the clinical features of migraine are correlated. MATERIALS AND METHODS: Sixty patients with migraine and 60 age-gender-matched controls were recruited. A complete neurological and ophthalmological examination was performed, and spectral-domain optical coherence tomography (SD-OCT) was done to measure RNFL. RESULTS: All quadrants of the retina on both sides showed non-statistically significant differences in RNFL thickness between migraine patients and controls (p-value >0.05). Furthermore, in all retinal quadrants on both sides, there was no statistically significant difference in RNFL thickness between migraine patients with aura and those without aura (p-value >0.05). Significant correlations were found between the duration of migraine disease and the superior RNFL thickness of both eyes, as well as the inferior RNFL in the right eye. There was also a significant correlation between the headache attack duration and RNFL thickness of the superior retina (p<0.05), Conclusion: Our key finding was that when comparing migraine patients to controls, RNFL thickness did not significantly change; however, the duration of migraine disease did significantly affect RNFL thickness.

The Comparison of ChatGPT 3.5, Microsoft Bing, and Google Gemini for Diagnosing Cases of Neuro-Ophthalmology.

OBJECTIVE: We aim to compare the capabilities of ChatGPT 3.5, Microsoft Bing, and Google Gemini in handling neuro-ophthalmological case scenarios. METHODS: Ten randomly chosen neuro-ophthalmological cases from a publicly accessible database were used to test the accuracy and suitability of all three models, and the case details were followed by the following query: "What is the most probable diagnosis?" RESULTS: On the basis of the accuracy of diagnosis, all three chat boxes (ChatGPT 3.5, Microsoft Bing, and Google Gemini) gave the correct diagnosis in four (40%) out of 10 cases, whereas in terms of suitability, ChatGPT 3.5, Microsoft Bing, and Google Gemini gave six (60%), five (50%), and five (50%) out of 10 case scenarios, respectively. CONCLUSION: ChatGPT 3.5 performs better than the other two when it comes to handling neuro-ophthalmological case difficulties. These results highlight the potential benefits of developing artificial intelligence (AI) models for improving medical education and ocular diagnostics.

A Rare Case of Cytomegalovirus Retinitis in a Young Immunocompetent Patient.

Cytomegalovirus (CMV) is known to be the most common opportunistic infection in immunocompromised cases, and CMV retinitis is the most common ocular manifestation. Severe retinitis with involvement of the macula or retinal necrosis can lead to vision loss. Prompt diagnosis and treatment can restrict the disease's progression. We describe the case of a 30-year-old man who presented with the chief complaint of progressive diminution of vision in both eyes for 15 days. Diminution of vision was associated with fever and skin rashes. The patient had no history of diabetes, hypertension, tuberculosis, ocular trauma, ocular surgery, organ transplant history, history of immunosuppression, or previous drug history except paracetamol tablets for fever. On ocular examination on the day of presentation, the patient's best corrected visual acuity on Snellen's visual acuity chart was 6/12 and 6/24 in the right and left eyes, respectively. Fundus examination revealed a well-defined optic disc with peripapillary flame-shaped hemorrhages with exudates and an epiretinal membrane. On spectral domain optical coherence tomography (SD-OCT), macular edema was 469 µm and 421 µm in the right and left eyes, respectively. On serological examination, only cytomegalovirus IgG came out positive (1196.65 AU/ml). Based on the clinical findings, fundus examination, and lab investigations, the patient was diagnosed as having a systemic CMV infection with CMV retinitis, and treatment was started with intravenous ganciclovir. With timely diagnosis and management, the patient's vision was recovered. This is a rare case report regarding the development of CMV retinitis in a completely immunocompetent individual.

Descriptive Study of Headache as the Most Common Presenting Feature of Cerebral Venous Thrombosis.

OBJECTIVE: To study the etiology and clinical characteristics of cerebral venous thrombosis (CVT) patients with a detailed description of headache as a presenting feature. INTRODUCTION: CVT is an infrequent type of stroke with protean clinical manifestations. The most common presenting symptom in CVT is headache (>85%), followed by seizures and focal neurological deficits. METHODS: A total of 32 consecutive and confirmed patients of CVT were recruited after obtaining informed consent. CVT was diagnosed based on clinical and imaging parameters. Data regarding etiology, clinical symptoms, and signs with special mention of headache pattern, onset, site, character, severity (based on the visual analog scale), aggravating and relieving factors, as well as sinus involvement were recorded. RESULTS: A total of 32 patients (16 males and 16 females) with a mean age of 31.56 (SD = 14.31) years were recruited, out of which 31 patients (96.87%) presented with headaches. The mode of onset of headache was acute in 19.35%, sub-acute in 67.75%, and chronic in 12.9% of patients. Location was holocranial in 38.71%, hemicranial in 29.03%, frontal in 22.58%, and occipital in 9.68% of patients. Headache was severe in 38.7% and moderate in 61.3% of patients. Character was throbbing in 67.74%, heaviness in 25.8%, and band-like in 6.46% of patients. Headache was aggravated on bending forward in 58.06%, movement in 35.48%, coughing in 32.26%, straining in 25.8%, and standing in 16.12% of patients. The relieving factors of headache were lying down in 45.16%, sleeping in 45.16%, and sitting quietly in 9.86% of patients. CONCLUSION: CVT should be suspected in patients presenting with new-onset holocranial or hemicranial headaches of increasing intensity, thereby requiring early imaging and appropriate management.

Fluorescent excimers and exciplexes of the purine base derivative 8-phenylethynyl-guanine in DNA hairpins.

The ground- and excited-state electronic interactions between the nucleobase analog 8-(4'-phenylethynyl)deoxyguanosine, EG, with natural nucleobases and 7-deazaguanine, as well as between adjacent EG base analogs, have been characterized using a combination of steady-state spectroscopy and time-resolved fluorescence, absorption, and stimulated Raman spectroscopies. The properties of the nucleoside EG-H2 are only weakly perturbed upon incorporation into synthetic DNA hairpins in which thymine, cytosine or adenine are the bases flanking EG. Incorporation of the nucleoside to be adjacent to guanine or deazaguanine results in the formation of short-lived (40-80 ps) exciplexes, the charge transfer character of which increases as the oxidation potential of the donor decreases. Hairpins possessing two or three adjacent EG base analogs display exciton-coupled circular dichroism in the ground state and form long-lived fluorescent excited states upon electronic excitation. Incorporation of EG into the helical scaffold of the DNA hairpins places it adjacent to its neighboring nucleobases or a second EG, thus providing the close proximity required for the formation of exciplex or excimer intermediates upon geometric relaxation of the short-lived EG excited state. The three time-resolved spectroscopic methods employed permit both the characterization of the several intermediates and the kinetics of their formation and decay.

The Wnt pathway: emerging anticancer strategies.

The canonical Wnt cascade has emerged as a critical regulator of cancer cells. Activation of the Wnt signaling pathway has also been associated with stem cell, thus raising the possibility of its role in embryogenesis and in the proliferation of malignant cancer cells. Wnt pathway has been reported to be involved in normal physiological processes in adult animals and integrally associated with cancer cell growth and maintenance, thus has been harnessed to devise strategies for anticancer therapy. The presence or absence of some members in this pathway, such as ß-catenin, Axin or APC, has been found to involve in different types of tumors in human beings. Dysregulation of the canonical Wnt/ß-catenin signaling pathway, mostly by inactivating mutations of the APC tumor suppressor, or oncogenic mutations of ß-catenin, has been implicated in colorectal tumorigenesis. Further, elevated levels of ß-catenin protein, a hallmark of activated canonical Wnt pathway, have been significantly observed in common forms of human malignancies, indicating that activation of the Wnt pathway may play an important role in tumor development and hence could be a crucial consideration for drug development. The paper discusses the potential therapeutic and diagnostic strategies directing on Wnt pathways on the basis of recent patents and their analysis.