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-cu) 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-sa), 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. Such patients complain of sitting-up vertigo, associated with a constant disequilibrium, and anteroposterior truncal oscillations are recorded by ad hoc posturography in many of these patients. The oculomotor patterns generated in such patients during the HHT may be identical to those resulting from PSC-BPPV-cu. Rarely do the two conditions (PSC-BPPV-cu and PSC-BPPV-sa) coexist. Nine cases of graviceptive heavy cupula were diagnosed at our center over a period of 6 months from September 1, 2022, to March 31, 2023, with their characteristic diagnostic oculomotor patterns, distinguishing features, and management discussed. We propose a grading system for the inversion test during the HHT that reliably distinguishes PSC-BPPV-cu from PSC-BPPV-sa, as well as when the two conditions coexist.

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

Apogeotropic variant of posterior semicircular canal benign paroxysmal positional vertigo (apo-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. Propter hoc, response to physical therapy at short-term follow-up is crucial in distinguishing the apo-PSC-BPPV from ASC-BPPV. We are presenting a case series of seven patients of apo-PSC-BPPV (of which three were bilaterally affected), who attended our otoneurology center, between February 1, 2023, and July 31, 2023. Demographic profile, clinical course, and physical therapy with responses at short-term follow-up at 1 hour and after 24 hours are discussed.

Vitamins in Cereals: A Critical Review of Content, Health Effects, Processing Losses, Bioaccessibility, Fortification, and Biofortification Strategies for Their Improvement.

Around the world, cereals are stapled foods and good sources of vitamins A, B, and E. As cereals are inexpensive and consumed in large quantities, attempts are being made to enrich cereals using fortification and biofortification in order to address vitamin deficiency disorders in a vulnerable population. The processing and cooking of cereals significantly affect vitamin content. Depending on grain structure, milling can substantially reduce vitamin content, while cooking methods can significantly impact vitamin retention and bioaccessibility. Pressure cooking has been reported to result in large vitamin losses, whereas minimal vitamin loss was observed following boiling. The fortification of cereal flour with vitamins B1, B2, B3, and B9, which are commonly deficient, has been recommended; and in addition, region-specific fortification using either synthetic or biological vitamins has been suggested. Biofortification is a relatively new concept and has been explored as a method to generate vitamin-rich crops. Once developed, biofortified crops can be utilized for several years. A recent cereal biofortification success story is the enrichment of maize with provitamin A carotenoids.

Evaluation of Anthocyanin Content, Antioxidant Potential and Antimicrobial Activity of Black, Purple and Blue Colored Wheat Flour and Wheat-Grass Juice against Common Human Pathogens.

The present study aimed to analyze the antioxidant and antimicrobial activity of anthocyanins extracted from colored wheat flour and wheat-grass juice against human pathogens. The total anthocyanin content and antioxidant potential in colored wheat flour and wheat-grass juice extracts were significantly higher than white flour and wheat-grass juice extracts. Ultra-performance liquid chromatography showed the maximum number of anthocyanin peaks in black wheat, with delphinidin-3-o-galactoside chloride, delphinidin-3-o-glucoside chloride, and cyanindin-3-o-glucoside chloride as the major contributors. Among flour extracts, maximum zones of inhibition against Staphylococcus aureus (MTCC 1934), Pseudomonas aeruginosa (MTCC 1434), Escherichia coli, and Candida albicans (MTCC 227) were produced by black flour extract, having the highest anthocyanin content. It exhibited a minimum microbicidal concentration (MMC) of 200 mg/mL against E. coli and C. albicans; and 100 and 150 mg/mL against S. aureus and P. aeruginosa, respectively. Black and purple flour extracts exhibited a minimum inhibitory concentration (MIC) of 50 mg/mL against S. aureus and P. aeruginosa. White flour extracts did not show MMC against E. coli and C. albicans. Among wheat-grass juice extracts, black wheat-grass was most effective and showed an MIC of 100-150 mg/mL against all pathogens. It exhibited an MMC of 200 mg/mL against S. aureus and P. aeruginosa. Hence, anthocyanin-rich colored wheat could be of nutraceutical importance.