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Vaidehi D Bhatt,1 Kalpana D Bhatt,1 Deepak C Bhatt,1 Supriya Dabir,2 Jay U Sheth,3 Tos TJM Berendschot,4 Roel J Erckens,4 Carroll AB Webers4 1UBM Institute, Mumbai, India; 2Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 3Department of Retina Services, Shantilal Shanghvi Eye Institute, Mumbai, India; 4University Eye Clinic Maastricht, Maastricht, The NetherlandsCorrespondence: Vaidehi D Bhatt, UBM Institute, A/1 Ganesh Baug, Dadar, Mumbai, 400019, India, Tel +91-9821525810, Email vaidehibhatt94@gmail.comPurpose: Cysticercosis, caused by Taenia solium larvae, can affect various ocular and extraocular structures, leading to significant morbidity. Ultrasound B-scan imaging plays a pivotal role in diagnosing and classifying cysticercosis lesions. The aim of the study was to describe the ultrasound B-scan characteristics of ocular and extraocular cysticercosis, proposing a classification system based on anatomical localization to enhance understanding and management.Patients and Methods: A retrospective study of consecutive cases with intraocular or extraocular cysticercosis was conducted from January 1993 to December 2023 in Mumbai, India. B-scan ultrasound was performed by an experienced imaging specialist. Descriptive statistics were used to summarize demographic characteristics and the proportion of cysticercosis in each anatomical location. Cysticercosis lesions were classified based on anatomical location observed during imaging.Results: Amongst the 56 eyes evaluated, intraocular posterior segment involvement (n=25) and extraocular involvement (n=31) were observed. Extraocular cysticercosis predominantly affected the medial rectus muscle (40%), followed by the inferior rectus (28%), lateral rectus (20%), and superior rectus muscles (12%). Orbital cysts were localized in the posterior extraconal (50%), anterior extraconal (34.33%), and intraconal (16.67%) regions. Intra-vitreous cysticercosis (n=9) exhibited thin-walled cysts with minimal inflammation, progressing to thickened cyst walls in the late stages. Sub-hyaloid cysticercosis (n=8) showed initial thin vitreous detachment, progressing to thickened vitreous adhesions. Sub-retinal cysticercosis (n=9) without retinal detachment indicated early disease, while cases with detachment suggested disease progression.Conclusion: The proposed anatomical classification system based on B-scan ultrasound features provides a structured approach to categorizing cysticercosis lesions, enhancing understanding and management in ophthalmic practice.Keywords: cysticercosis, ultrasound, orbit, vitreous, retina

Vaidehi D Bhatt,1 Deepak C Bhatt,1 Kalpana D Bhatt,1 Supriya Dabir,2 Tos TJM Berendschot,3 Roel J Erckens,3 Carroll AB Webers3 1UBM Institute, Mumbai, India; 2Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 3University Eye Clinic Maastricht, Maastricht, the NetherlandsCorrespondence: Vaidehi D Bhatt, UBM Institute, A/1 Ganesh Baug, Dadar, Mumbai, 400019, India, Tel +91-9821525810, Email vaidehibhatt94@gmail.comPurpose: This study aims to explore the diagnostic utility of ultrasound B-scan while introducing the “Triangle” sign as a novel indicator. It also validates the sign’s efficacy in distinguishing between choroidal detachment (CD) and suprachoroidal hemorrhage (SCH) from retinal detachment (RD) and vitreous hemorrhage (VH).Patients and Methods: Retrospective analysis of consecutive cases of total CD and SCH undergoing B-scan at a single tertiary imaging center. The study examined the presence of the “Triangle” sign (a hypoechoic/anechoic triangular shape of vitreous noted anterior to the optic disc) in total CD & SCH, categorized cases by subtype and etiology, and its role in differentiating from RD and VH.Results: Thirty-six eyes with a total CD and SCH were analyzed. Amongst the cases of total SCH 31 (86.1%), (58.1%) were linked to intraocular surgery, and (41.9%) were linked to post-traumatic events. The “Triangle” sign was consistently present in all 36 eyes, with additional findings indicating concurrent VH (52.8%) or RD (5.6%). Among the 31 eyes with total SCH, 58.3% initially had detectable choroidal membrane seen on B scan, while 41.7% did not. Despite this, the “Triangle” sign was consistently visible in all 36 eyes, and monitoring with B-scans revealed choroidal membrane as the hemorrhage resolved.Conclusion: The “Triangle” sign is a distinctive and reliable ultrasound feature for total CD and SCH diagnosis, offering clarity in challenging cases where traditional methods face limitations.Keywords: choroidal detachment, suprachoroidal hemorrhage, ultrasound B-scan

Vaidehi D Bhatt,1 Kalpana D Bhatt,1 Deepak C Bhatt,1 Supriya Dabir,2 Tos T J M Berendschot,3 Roel J Erckens,3 Carroll AB Webers3 1UBM Institute, Mumbai, India; 2Department of Retina, Rajan Eye Care Pvt Ltd, Chennai, India; 3University Eye Clinic Maastricht, Maastricht, the NetherlandsCorrespondence: Vaidehi D Bhatt, UBM Institute, A/1 Ganesh Baug, Dadar, Mumbai, 400019, India, Tel +91-9821525810, Email vaidehibhatt94@gmail.comPurpose: Ocular cysticercosis, caused by Taenia solium larvae, presents significant public health challenges, especially in regions with poor sanitation. Traditional imaging techniques often fail to detect anterior segment cysticercosis accurately, necessitating the exploration of more advanced diagnostic modalities like Ultrasound Biomicroscopy (UBM).Patients and Methods: A retrospective observational analysis was conducted on 18 eyes from 14 patients with cysticercosis involving the anterior segment. UBM imaging was performed using a Sonomed VuMax HD ultrasound biomicroscopy machine with a 50 MHz probe.Results: In the study, 18 eyes from 18 patients were analyzed, revealing 12 cases of conjunctival cysticercosis, 4 of anterior chamber cysticercosis, and 2 of iris cysticercosis. Patients averaged 37.89 (± 16.2) years, with a male predominance. Conjunctival cysts appeared as clear masses, occasionally eliciting inflammatory reactions. Iris involvement caused thinning near the angle, while anterior chamber cysts could displace the lens, leading to iris bombe in some instances.Conclusion: UBM emerges as a valuable diagnostic tool for anterior segment cysticercosis, providing detailed imaging superior to traditional methods. Its cost-effectiveness and accessibility make it particularly valuable, especially in resource-constrained settings. Future research should focus on validating UBM’s diagnostic accuracy and exploring its role in monitoring disease progression and treatment response.Keywords: ultrasound biomicroscopy, cysticercosis, Taenia solium, anterior segment

The performance of all active photonic devices today is greatly limited by loss. Here, we show that one can engineer a low loss path in a metal-clad lossy multi-mode waveguide while simultaneously achieving high-performance active photonic devices. We leverage non-Hermitian systems operating beyond the exceptional point to enable the redistribution of losses in a multi-mode photonic waveguide. Consequently, our multi-mode waveguide offers low propagation losses for fundamental mode while other higher order modes experience prohibitively high losses. Furthermore, we show an application of this non-Hermitian waveguide platform in designing power-efficient thermo-optic phase shifters with significantly faster response times than conventional silicon-based thermo-optic phase shifters. Our device achieves a propagation loss of less than 0.02 dB μm−1 for our non-Hermitian waveguide-based phase shifters with high performance efficiency of P π ⋅ τ = 19.1 mW μs. In addition, our phase shifters have significantly faster response time (rise/fall time), τ ≈ 1.4 μs, compared to traditional silicon based thermo-optic phase shifters.

– Selection criteria used in all three randomized trials are predictive of a complete cytoreduction and not the benefit of surgery– Post-hoc & prespecified subgroup analyses indicate that not all patients undergoing secondary cytoreduction benefit from it– Post-hoc and sub-group analysis should be performed separately for patients undergoing a complete gross resection– Impact of incomplete cytoreduction on quality of life and subsequent therapy needs further evaluation– Future randomized trials should use surgical prognostic factors like disease sites and extent as stratification factors

Introduction: Ultrasound-guided manipulation and reduction (M&R) of the distal radius fractures (DRF) is believed to improve radiographic indices due to real-time feedback of fracture alignment. The objective of this trial was to compare volar tilt, radial inclination, and radial height on radiographs between Ultrasound guided and conventional (landmark-guided) M&R. Materials and methods: A total of 79 distal radius extraarticular fractures in adults were randomised to Ultrasound guided and conventional (landmark-guided) M&R. The radiograph parameters described above were compared before and after M&R in both groups. Results: Except for volar tilt (P=0.05 difference in difference), there was no difference in both the groups on radiograph parameters i.e. radial inclination and radial height. We estimated a reduction in the incidence of mal-reduction by 49% (Risk ratio 0.51) and an absolute risk reduction of 22% through USG-guided reduction. We evaluated a number needed to treat 4 through USG-directed M&R of DRF to prevent one unacceptable reduction. There were 9 (22%) and 18 (46%) (P=0.70) unacceptable reductions in USG-guided and landmark-guided M&R. Conclusion: Adding USG guidance to conventional landmark-based closed reduction methods is not beneficial for the accuracy of fracture reduction in Colle’s fracture. However, improved volar tilt in sonographic-directed M&R needs further studies to determine the clinical significance.

Never formally colonised by Western powers, Thailand is a rapidly developing nation in Southeast Asia. To outsiders, the assumption might be that Thailand is a homogenous Thai-speaking Buddhist country. However, such over-simplistic views ignore diversity and the existence of de facto multilingualism and multiculturalism on the ground. This linguistic landscape (LL) study explores a unique and sociolinguistically compelling area called ‘Little Arabia’ (Soi Arab) in the heart of Bangkok, where elements of both Islamic and Buddhist civilisations meet. The existence of this Middle Eastern enclave creates a sense of contrasts on linguistic, religious, and cultural levels. Because of globalisation and spurred by (medical and sex) tourism, this area boasts a number of halal restaurants, hotels, travel agencies, stores, pharmacies, and clinics. This gives rise to an interesting sociolinguistic ecology, featuring an ‘ethnic’ economy which caters to the needs of tourists and businessmen hailing from the Arab world. Drawing on authentic photographic data, this study explores how various linguistic practices give the area a unique identity. More specifically, we reveal how various languages (including Arabic, Thai, and English) are mobilised and combined in ways that illustrate translation practices evidenced within the enclave for particularised marketing, commercial, and communication purposes. Theoretically and conceptually, the term ‘machine-translated multilingualism’ is coined to capture the growing trend for businesses to resort to translation software for multilingual communication, which may result in non-standard translations and orthographic forms. This study contributes to a growing body of sociolinguistic research examining LLs in global cities and commercial hubs in the Global South, particularly those arising from ‘South-South’ population flows.

Obesity and its related complications have become a pressing public health issue, requiring personalized nutritional and lifestyle interventions. Nutrigenetic diets utilize genetic information to tailor dietary recommendations based on an individual's genetic variations. This case-control study aimed to evaluate the impact of a nutrigenetic diet on weight loss and clinical parameters. Three groups were included: obese individuals following a nutrigenetic diet (n = 27), obese individuals following a generic diet (n = 23), and a control group of individuals with a normal body mass index (BMI) (n = 19). Based on polygenic risk scoring, personalized diet plans were developed that considered various genetic traits such as the impact of high amounts of protein on weight loss, the impact of low amounts of carbohydrates on weight loss, the risk of a high body fat percentage, the impact of a calorie restriction on weight loss, lactose intolerance, and gluten intolerance. By assessing a subject's risk scores, a personalized diet was created. Measurements taken at baseline and after four months included weight, BMI, body fat, lean mass, fasting blood sugar levels, total cholesterol, triglycerides, thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), and uric acid. Results showed significant differences favouring the nutrigenetic group in weight (p < 0.001), BMI (p < 0.001), and body fat percentage (p = 0.05) when compared to the control and the generic diet groups. Additionally, the nutrigenetic group exhibited significant improvements in triglycerides (p = 0.003). Moreover, the within-group effect among nutrigenetic subjects showed a significant weight reduction (p < 0.001), BMI (p < 0.001), body fat percentage (p < 0.001), fat mass (p < 0.001), fasting blood sugar level (p = 0.019), and uric acid (p = 0.042). These findings suggest that a nutrigenetic diet may yield more effective weight loss and improved clinical parameters compared to a generic diet.