Lateral Inhibition: Are two hands better than one?

This study investigated the differences in amplitude discrimination capacity between two stimuli delivered to adjacent fingertips on the same hand (contralateral delivery) and stimuli delivered to two fingers on opposite hands (bilateral delivery). The measures were obtained in order to study the impact of lateral inhibition via interhemispheric connections on cortical centers on opposite sides of the somatosensory cortex in comparison to lateral inhibition occurring between adjacent cortical centers within the same hemisphere. Using the Cortical Metrics Brain Gauge™ device, amplitude discrimination capacity of 37 healthy subjects was assessed at several different durations, ranging from 40 to 500 msec, of vibrotactile stimulation delivered contralaterally and bilaterally. The results demonstrate a significant difference in amplitude discrimination capacity between the two conditions for stimulus duration of 200ms, with performance being better for the contralateral delivery of the stimuli than the bilateral condition for most tested durations. Task performance was roughly the same for the two conditions at the extremes of short (40ms) and long (500ms) stimulus durations. Amplitude discrimination capacity improved with longer stimulus durations in both bilateral and contralateral conditions. Though slight variation was observed at the level of each individual subject, overall, it is clear that local lateral inhibition plays a role in assessing the two stimuli delivered to the same hand that gives same-handed discrimination an advantage over two-handed discrimination. Additionally, the trends identified may be useful in guiding future experimentation that investigates clinical assessments of deficits in cortical processing that is mediated by callosal connections.

Incidence of Inguinal Herniotomy in Children. A Prospective Study at a Regional Hospital

Background: Inguinal hernia is one of the most common surgical conditions in children. Herniotomy is the surgery performed for a pediatric hernia and hydrocele. This study was done to know the demography and outcome of pediatric herniotomy at our center. Materials and methods: A prospective study on patients who underwent herniotomy from 10th May 2016 to 9th May 2017 was conducted at the Department of Surgery, Western Regional Hospital. Results: During this study 112 patients underwent herniotomy out of which 98 were boys while 14 were girls. 59(52.67%) patients had unilateral hernia, 40(35.71%) had unilateral hydrocele and 13(11.6%) had bilateral condition among which 8 had hernia and 5 had hydrocele. 69(61.6%) patients presented with a right-sided, 30(26.7%) with left-sided, and 13(11.6%) with bilateral conditions. 13 patients (11.6%) presented at the emergency with irreducible hernia. Two among the patient who underwent emergency herniotomy developed postoperative wound infection and one among the elective surgery had recurrence. Conclusion: Pediatric inguinal hernias and hydroceles are often difficult to diagnose clinically. Herniotomy is often performed by junior consultants who have no specific training in pediatric surgery. Timely planning of surgery is required to minimize preoperative complications.

Evaluation of the cervical vertebral anomalies in patients with cleft lip and palate in Aegean region of Turkey

Objective: To identify the cervical vertebral anomalies in patients with cleft lip and palate, and to compare unilateral and bilateral cleft lip and palate. Methods: The retrospective cohort study was conducted in 2018 at Department of Orthodontics, Ege University, Izmir, Turkey, and comprised non-deteriorated lateral cephalometric radiographs of non-syndromic patients which showed the entire cervical spine. The radiographs were divided into two groups, with group A having those of patients with cleft lip and palate exposure, and control group B having those with non-exposure. Within group A, unilateral and bilateral cleft lip and palate cases were compared. Data was analysed using SPSS 22. Results: Of the 220 subjects, 110(50%) were in group A with a mean age of 15±6.3 years, and 110(50%) were in group B with a mean age of 15±2.1 years. Within group A, 56(50.9%) subjects had unilateral and 54(49.1%) had bilateral cleft lip and palate. Cervical vertebral anomalies were found in 71(64.5%) patients and 45(40.9%) controls (p<0.001). Among those with bilateral condition, it was found in 41(75.9%) and in unilateral 56(56.6%) (p<0.05). Occipitalisation was 21(38.9%) in bilateral and 4(7.1%) in unilateral cases (p<0.001). Fusion was higher in bilateral patients 16(63%) compared to 23(41.1%) unilateral (p<0.05). Posterior arch deficiencies were found in 30(27.3%) patients in group A and 18(16.4%) controls in group B (p<0.05). Fusion was seen in 57(51.8%) group A patients and 33(30%) group B controls (p<0.001). Conclusion: Cervical vertebral anomalies were mostly found in patients with cleft lip and palate. Continuous....

Synovial Cysts and Myxomas in 16 Cats

This report describes the clinical and pathologic characteristics of cystic and myxomatous lesions of synovial joints in 16 cats. The average age was 13.4 years. The elbow was most commonly affected (12/16), and all lesions were unilateral. Degenerative joint disease was a frequent concurrent but bilateral condition. The lesions consisted of fluid-filled cysts lined by synoviocytes (3 cases), solid foci of stellate cells in a myxomatous matrix (2 cases), or a combination of the two (11 cases). In some cases there were areas of transition between the cystic and myxomatous lesions. Mitoses and other features of malignancy were rare to nonexistent. In the 13 cats with follow-up information, the lesion gradually increased in size over a period of years. None of the cats died or were euthanized because of this lesion. We propose that some cats with degenerative joint disease develop synovial cysts, which have the potential to transform to a synovial myxoma.

Valsalva retinopathy in pregnancy: an obstetric dilemma

Valsalva retinopathy is a unilateral or bilateral condition that occurs when increased intra-thoracic or intra-abdominal pressure transmitted to the eye causes a sharp rise in the intraocular venous pressure, and rupture of superficial retinal capillaries. Pregnancy is known to be a risk factor for Valsalva retinopathy. A 29-year-old G2A1 at 38 weeks of gestation previously normotensive presented with unilateral sudden decrease in vision of 1-day duration. Fundoscopy revealed pre-retinal and vitreous hemorrhage of right eye. A diagnosis of Valsalva retinopathy of pregnancy was made after excluding other probable causes for hemorrhage. She had an elective cesarean section with no further deterioration of vision or recurrence of hemorrhage.

A rare presentation of exudative macroaneurysms in unilateral Eales’ disease

Background: A case of exudative macroaneurysms in unilateral Eales’ disease is reported. ‘Eales disease’ is an idiopathic bilateral occlusive periphlebitis with neovascularisation and mostly presents with vitreous hemorrhage. Case: A 30 year old male presented with diminution of vision in left eye (6/36) for 1 month. Slit Lamp examination of both eyes revealed normal anterior segment. Fundus examination of left eye with + 90 D lens revealed reddish lesions at the macula with surrounding circinate exudation. On peripheral examination hemorrhages were seen along with vasculitis in the superotemporal quadrant.The right eye fundus was normal.All laboratory investigations were found within normal limits. Conclusion: Eales’ disease is mostly a bilateral condition but this case is rare as there is uniocular involvement with exudative macroaneurysms.Laser therapy was instituted which was effective in management of this condition with restoration of normal visual acuity.There was no relapse on follow up for 2 years.

Bilateral sudden sensorineural hearing loss: review

Introduction:Unilateral and bilateral sudden sensorineural hearing loss represent different disease entities. The unilateral condition is more common and predominantly idiopathic, and up to 65 per cent of patients spontaneously recover hearing. Conversely, the bilateral condition is rare, mostly associated with serious systemic conditions, and has a higher prevalence of morbidity and mortality.Methods:A literature search using the PubMed database was conducted using the MeSH terms ‘sudden’, ‘bilateral’ and ‘sensorineural hearing loss’.Results:One hundred and three reported cases of bilateral sudden sensorineural hearing loss were identified. The condition is most often associated with toxic, autoimmune, neoplastic and vascular conditions. A younger age of onset, with a bimodal age distribution, was seen for bilateral sudden sensorineural hearing loss, compared with the unilateral condition. Patients with the bilateral condition had more profound hearing loss, with poorer recovery and a 35 per cent mortality rate. Vestibular symptoms were also less common than in the unilateral condition.Conclusion:The presentation of bilateral sudden onset sensorineural hearing loss is a medical emergency requiring thorough and urgent investigation to exclude life-threatening and reversible conditions.

Bilateral Sturge Weber Syndrome- a rare case report

Background: Sturge-Weber syndrome is a rare congenital neuro- oculo- cutaneous disorder. Objective: To report a very rare unusual case of bilateral manifestation of Sturge Weber syndrome. Case: We report an unusual case of a 17-year-old female with advanced stage of bilateral glaucoma associated with facial nevus extending to the other half of the face as well and bilateral intracranial calcification. Conclusion: Sturge -Weber syndrome can manifest as a bilateral condition. Nepal J Ophthalmol 2013; 5(9):129-132 DOI: http://dx.doi.org/10.3126/nepjoph.v5i1.7841

Three-Year Postimplantation Auditory Outcomes in Children with Sequential Bilateral Cochlear Implantation

Objectives: We report on the auditory abilities and speech performance in quiet and noise of 35 children with sequential bilateral cochlear implantation after 3 years of bilateral implant use. Methods: Testing was done in bilateral and both unilateral listening conditions. The assessments took place before the second implantation and at several time intervals after fitting. As different auditory tests were used, the children were categorized by their age at the second implantation: Younger or older than 6 years. Results: The pure tone averages for the bilateral condition were significantly better than those for either unilateral condition after 12 months of bilateral implant use and remained so from that test interval onward. The speech recognition outcomes in quiet and noise also improved significantly for almost all children after 36 months, although a linear regression analysis showed a beneficial effect of younger age at first implantation on the speech-in-noise results. Conclusions: Bilateral cochlear implantation offered advantages to all children in comparison with the first implant — Even the children who received the second implant after the age of 6 years. Compared to the younger children, the older children needed a longer adjustment period to gain bilateral benefit. However, they obtained similar results after 2 years of bilateral implant use.