An Uncommon Case of Isolated Superior Rectus Palsy.

Head injury associated with orbital trauma is commonly encountered in day-to-day practice. We report a rare case of orbital trauma resulting in isolated orbital "roof blow" in fracture in a 14-year-old child. The patient presented to us with diplopia and limitation of elevation of right eye after orbital trauma. Computed tomography of the orbits (2 mm sections) did not reveal fracture of the orbital floor. However, there was orbital roof "blow in" fracture with fracture fragment impingement on the superior rectus muscle. Patient was treated conservatively and spontaneous recovery of ocular motility was noted after a month.

Forehead against Resistance (FAR): Preliminary Findings from A Clinical Alternative to Shaker's Type of Exercise.

BACKGROUND: Reduced UES opening is a well-known risk factor for dysphagia. The Shaker exercise and the CTAR are the widely used intervention strategies to bring about effective UES opening. But there are well-known difficulties with the clinical use of these two exercise regimes. The present study proposes a clinical alternative to Shaker's exercise and CTAR called the forehead against resistance (FAR) and its variants without altering the central principles of these two regimes. The aim of the present study was to investigate the efficacy of FAR and its variants in bringing about UES opening. METHOD: The study used a comparative cross-sectional study design, with the nonrandomized convenient sampling that included 27 healthy adults. MBS was carried out in the anterior-posterior and lateral views, while the participants performed FAR and its variants. The UES diameter was measured in the baseline and with the subjects performing FAR maneuver and its variants. RESULTS: The result revealed that the participants had greater UES opening on FAR and its variant than the baseline swallow. Also, mean values of UES opening were greater for FAR with chin tuck when compared to FAR alone, although there was no significant main effect with exercise. CONCLUSION: FAR and its variant could be one of the options for increasing UES opening in individuals with dysphagia.

Comparison of anatomical risk factors for noncontact anterior cruciate ligament injury using magnetic resonance imaging.

PURPOSE: To compare the significance of the tibio-femoral geometrical indices (notch width index, medial and lateral tibial slopes) and patellar tendon- tibial shaft angle in predicting non-contact ACL injuries and to compare these factors between genders. METHODS: Retrospective case control study evaluating 66 MRI knee of patients of age group of 18-60 years with 33 cases of noncontact ACL injury and 33 age matched controls. Notch width index, medial and lateral tibial slopes and patellar tendon tibial shaft angles were calculated and compared for statistical significance and was also compared between the genders. ROC curve was for plotted for the significant factors. RESULTS: Statistically significant difference was seen in notch width index and patellar tendon tibial shaft angles with cases showing a narrow notch width index and an increased patellar tendon tibial shaft angle. Gender comparative results showed no statistically significant differences. ROC curve plotted for NWI showed an optimal cut off value of 0.263 with a sensitivity of 88% and a specificity of 52%. ROC curve plotted for PTTS angle showed a cut off value of 26.7 degrees with a sensitivity of 67% and a specificity of 49%. CONCLUSION: Narrow Notch width index and increased Patellar tendon tibial shaft angle are predictors of ACL injury. PTTS angle which has been studied as a function of knee flexion angle, can itself be an independent predictor of ACL injury (at a constant knee flexion angle).