Atypical Bilateral Posterior Semicircular Canalolithiasis - A Case Series.

Barany Society includes bilateral typical posterior semicircular canal benign paroxysmal positional vertigo (PSC-BPPV) in its classification of multicanal subtype. In the past decade, less-common and atypical subtypes of PSC-BPPV, like short-arm and non-ampullary arm posterior semicircular canalolithiasis, have emerged, requiring the conduct of conventional and auxiliary positional tests on both sides to uncover their bilaterality. Authors hereby report three atypical less-common subtypes of bilateral PSC-BPPV, discussing their clinicodemographic profiles, management by repositioning maneuvers and physical therapy, and follow up.

Apogeotropic Posterior Semicircular Canal BPPV-A Case Series from South Rajasthan.

Apogeotropic variant of posterior semicircular canal benign paroxysmal positional vertigo (-PSC-BPPV) is a rare peripheral vestibular disorder, characterized by paroxysms of positionally triggered dizzy spells associated with non-positional disequilibrium. It is diagnosed by observing characteristic diagnostic oculomotor responses (torsional downbeating positional nystagmus) during positional testing (Dix-Hallpike and enhanced straight head hanging tests), in conjunction with a response to physical therapy. Much rarer anterior semicircular canal benign paroxysmal positional vertigo (ASC-BPPV) elicits identical oculomotor responses during positional testing.

Inversion Test and Sitting-Up Oculomotor Patterns in Patients with Graviceptive Heavy Posterior Cupula - A Case Series.

A graviceptive heavy posterior cupula typically results from cupulolithiasis and clinically manifests as short vertigo spells when the head moves in the provocative position. Half-Hallpike test (HHT) in posterior cupulolithiasis (PSC-BPPV-) elicits an upbeating ipsitorsional nystagmus (UBITN), which lasts more than a minute as per the consensus criteria developed by the Barany Society. In the last decade, cases with canalolithiasis in the short arm of the posterior semicircular canal (PSC-BPPV-), wherein the otoconial debris falls on the utricular side of the posterior cupula on getting up from supine, rendering it heavy (graviceptive), have been reported.

Vestibular Rehabilitation of the Persons affected by Benign Paroxysmal Positional Vertigo (BPPV) by Physical Therapy and Repositioning Maneuvers.

Vestibular rehabilitation therapy (VRT) mainly comprises physical therapies that encourage head, eye, and truncal movements, accelerating the recovery of patients with acute peripheral labyrinthine dysfunction. VRT aims to improve vestibular hypofunction by reinforcing vestibulo-ocular, vestibulospinal, and vestibulocollic reflexes. An asymmetry in peripheral vestibular inputs from the pair of membranous labyrinths to the central nervous system frequently results from vestibular lithiasis, causing benign paroxysmal positional vertigo (BPPV).

Bifacial Dye-Sensitized Solar Cells Utilizing Visible and NIR Dyes: Implications of Dye Adsorption Behaviour.

Bifacial dye-sensitized solar cells (DSSCs) were fabricated utilizing dye cocktails of two dyes, Z-907 and SQ-140, which have complementary light absorption and photon harvesting in the visible and near-infrared wavelength regions, for panchromatic photon harvesting. The investigation of the rate of dye adsorption and the binding strengths of the dyes on mesoporous TiO corroborated the finding that the Z-907 dye showed a rate of dye adsorption that was about >15 times slower and a binding that was about 3 times stronger on mesoporous TiO as compared to SQ-140. Utilizing the dye cocktails Z-907 and SQ-140 from ethanol, the formation of the dye bilayer, which was significantly influenced by the ratio of dyes and adsorption time, was demonstrated.

Nonpolymer Organic Solar Cells: Microscopic Phonon Control to Suppress Nonradiative Voltage Loss via Charge-Separated State.

Recent remarkable developments on nonfullerene solar cells have reached a photoelectric conversion efficiency (PCE) of 18% by tuning the band energy levels in small molecular acceptors. In this regard, understanding the impact of small donor molecules on nonpolymer solar cells is essential. Here, we systematically investigated mechanisms of solar cell performance using diketopyrrolopyrrole (DPP)-tetrabenzoporphyrin (BP) conjugates of C4-DPP-HBP and C4-DPP-ZnBP, where C4 represents the butyl group substituted at the DPP unit as small p-type molecules, while an acceptor of [6,6]-phenyl-C-buthylic acid methyl ester is employed.

Lying-Down Nystagmus (LDN) - When a Lateralizing Sign of Secondary Importance Attains Ascendancy in the Diagnosis of Horizontal Semicircular Canal Benign Paroxysmal Positional Vertigo (HSC-BPPV).

Background: The diagnosis of horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV) mainly depends on the elicitation of asymmetric horizontal positional nystagmus on rolling head to either side, during the diagnostic supine roll test (SRT). The asymmetry in the strength of the elicited horizontal positional nystagmus during SRT is explained by the Ewald's second law and is crucial for lateralizing the affected ear. Rarely the elicited horizontal positional nystagmus on the head roll to either side during the SRT is of symmetric strength.

A case of apogeotropic horizontal canal benign paroxysmal positional vertigo that transformed to the geotropic variant during treatment with Appiani maneuver, followed by successful treatment with Gufoni maneuver.

Lesions at three possible sites can masquerade as apogeotropic horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV), namely: 1) short anterior (ampullary) arm canalolithiasis; and 2) culpulolithiasis, which may be either canal (Cup-C) or utricle-sided (Cup-U). There are no clinical methods or investigations to determine the exact pathological site when a patient with a history compatible with HSC-BPPV is found to have apogeotropic positional nystagmus on the supine roll test. Therefore, the treatment of apogeotropic variant of HSC-BPPV not only poses difficulties but the therapeutic options need to be tailored according to the ostensible localization of the pathology.

Case report: Congenital absence of the dens.

A 36-year-old man presented with headache and right upper and lower limb weakness for 10 days. MRI revealed absence of the odontoid process of the C2 vertebral body, with resultant atlantoaxial dislocation along with myelomalacic changes involving the cervicomedullary junction.

Acro-osteolysis and mononeuritis multiplex as a presenting symptom of systemic angiitis of Wegener's type.

Wegener's granulomatosis is a multisystem disorder involving small- and medium-sized vessels, leading to granuloma formation and involvement of upper and lower respiratory tract with or without glomerulonephritis. However, limited forms of angiitis and granulomatosis of the Wegener's type with oligosymptomatic and atypical site involvement are known to occur. We present here a rare case of limited form of angiitis and granulomatosis of Wegener's type who presented sequentially with spontaneous resorption of digits with acro-osteolysis and mononeuritis multiplex over a period of 10 months.

Kawasaki disease--Indian perspective.

Kawasaki disease is a syndrome of unknown etiology affecting children below 5 years of age and is a leading cause of acquired heart disease in many developed countries. Incidence of this disease in India is extremely low as evidenced by the meagre case reports. Complications due to this disease in Indian patients are still rarer.