Paracentral Bitemporal Hemianopsia and Acquired Supranuclear Ocular Motor Paresis Following Cardiac Surgery.

Acquired supranuclear ocular motor paresis (ASOMP) is a rare complication following cardiac surgery, characterized by limited voluntary eye motility. The exact cause and development of ASOMP after cardiac surgery remain unclear. We report a case of ASOMP with paracentral bitemporal hemianopsia with optic atrophy after cardiac surgery, which, to our knowledge, is novel. The patient demonstrated bilateral ophthalmoplegia, with gradual improvement in voluntary smooth pursuit but persistent impairment in saccadic eye movements. Interestingly, the patient showed improved proprioceptive-driven pursuit of their own hand compared to pursuit or saccades following an examiner's hand. The visual field examination revealed a bilateral paracentral temporal hemianopic field defect. The underlying mechanisms of ASOMP and potential chiasmal ischemia in this case remain unknown. Clinicians should be aware of the possibility of ASOMP following cardiac surgery, with potential slow improvement over time.

Rhino-orbital mucormycosis.

PURPOSE OF REVIEW: The current article will update and review the clinical and radiological manifestations and management of rhino-orbital mucormycosis (ROM). RECENT FINDINGS: There has been an increase in cases of ROM worldwide, especially in India. Immunosuppression (especially diabetes mellitus) is a known predisposing risk factor for ROM. Delayed diagnosis and treatment of ROM can be vision or life-threatening. This article reviews the clinical and radiologic features, treatment, and prognosis of ROM with special emphasis on new and emerging therapies. SUMMARY: ROM is an angioinvasive fungal infection that affects the sinuses and orbits and may present to ophthalmologists. Clinicians should have a high index of suspicion for ROM, especially in patients with poorly controlled diabetes mellitus or other immunosuppression. Corticosteroid treatment (including the recent COVID-19 pandemic) may be a predisposing risk factor for ROM.

Public Awareness, Beliefs, And Attitudes Toward Bipolar Disorder In Saudi Arabia.

OBJECTIVES: To examine public's knowledge, beliefs, and attitudes toward bipolar disorder (BP) in Saudi Arabia (SA). METHODS: A cross-sectional survey was performed in 2016 in Riyadh, SA. The survey included sociodemographic characteristics and BP awareness scale. RESULTS: Of 416 participants, 49.5% had prior knowledge of BP, mainly from internet and social media, and 57% considered it to be common in SA. About half believed BP is caused by a neurophysiological or neurochemical imbalance and that it can be treated with psychiatric medications. Supernatural causes, weak faith, and weakness of character were considered causes of BP by 55%, 48%, and 40% of participants, respectively. Recreational activities and head bandaging by traditional therapists were considered viable treatment options by 55% and 41% of participants, respectively. Students and healthcare professionals scored significantly higher on awareness scale. Regarding attitude, a majority believed that persons with BP can work effectively (86%) , have to pull themselves together to get over it (47%), and consider it a shame to mention that someone in a family is affected by BP (32%). Regarding relationships, 22% were not willing to maintain a friendship and 39.3% were not willing to marry someone with BP. CONCLUSIONS: This study revealed suboptimal public awareness towards BP in SA. It identified several misconceptions and negative attitudes toward patients with BP. Further studies are needed to investigate potential public interventions to improve literacy of BP.

A Lower Level of Physically Demanding Work Is Associated with Excellent Work Ability in Men and Women with Neck Pain in Different Age Groups.

BACKGROUND: The aim of this study was to investigate which physical and psychosocial work demands were associated with excellent work ability in individuals with neck pain, and to investigate age and sex differences in these associations. METHODS: The study sample was obtained from the Statistics Sweden cross-sectional Work Environment survey and consisted of workers who reported neck pain after work (N = 3,212). RESULTS: The findings showed an association between excellent work ability and self-reported low exposure to lifting, twisted work posture, working with hands in shoulder level or higher, and leaning forward without support and combination of exposures containing these work demands. Low exposure to seated work and high demands showed a reversed association. The associations were present mainly among older workers and were generally stronger for men than for women. CONCLUSION: This study indicates that a lower level of physically demanding work is an important element to maintain excellent work ability, especially for the older worker with neck pain.

Effect of Nicotinamide on the Photolysis of Riboflavin in Aqueous Solution.

The photolysis of riboflavin (RF) in aqueous solution in the presence of nicotinamide (NA) by visible light has been studied in the pH range 1.0-12.0 and the various photoproducts have been identified as known compounds. RF has been determined in degraded solutions by a specific multicomponent spectrometric method in the presence of its photoproducts and NA. The second-order rate constants (k 2) for the bimolecular interaction of RF and NA range from 0.54 (pH 1.0) to 9.66 M(-1) min(-1) (pH 12.0). The log k 2-pH profile for the photolysis reaction follows a sigmoid curve showing a gradual increase in the rate of pH due to a change in the ionization behavior of the molecule. The lower rate in the acid region is probably due to protonation of the molecule since the cationic form of RF is less susceptible to photolysis than the neutral form. Similarly, a slowing of the rate in the alkaline region is due to anion formation of the molecule. NA is involved as an electron acceptor during the sequence of reactions and thus enhances the rate of photolysis of RF. Absorption and fluorescence measurements did not provide evidence for the complex formation between the two compounds under the present conditions.

Photolysis of riboflavin in aqueous solution: a kinetic study.

The kinetics of photolysis of aqueous riboflavin solutions on UV and visible irradiation has been studied in the pH range 1-12 using a specific multicomponent spectrophotometric method for the simultaneous determination of riboflavin and its major photoproducts (formylmethylflavin, lumichrome and lumiflavin). The apparent first-order rate constants for the photodegradation reactions in the pH range have been determined. The log k-pH profiles indicate that riboflavin has maximum photostability around pH 5-6, at which the rate of oxidation-reduction of the molecule is lowest. The cationic and anionic forms of riboflavin are non-fluorescent and less susceptible to photolysis than the non-ionised molecule as indicated by the relatively slow rates below pH 3.0 and above pH 10.0. The rate of photolysis is increased up to 80-fold at pH 10.0, compared to that at pH 5.0, due to increase in redox potentials with an increase in pH and consequently the ease with which the molecule is oxidised. The increase in rate at pH 3.0, compared to that at pH 5.0, appears to be due to the involvement of the excited singlet state as well as the triplet state in riboflavin degradation. The apparent first-order rate constants for the photolysis of riboflavin at pH 5.0-10.0 with UV and visible radiation are 0.185 x 10(-2) to 13.182 x 10(-2)min(-1) and 0.098 x 10(-2) to 7.762 x 10(-2)min(-1), respectively.