bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling and Manufacturing of Complex Architectural Elements of Concrete Using Industrial Robots in Formwork Fabrication
Authors: Usmanov Vjačeslav , Fakhri Danila , Jogl Marcel , Kolář Karel
Published: August 2020

The article is aimed at the description of design, 3D modelling and simulation of technology for processing and fabrication of the formwork for complex concrete structures. The process of fabrication of complex-shaped elements from the special composite concrete mixture with application of several sophisticated software, technologies and industrial robot KUKA Agilus is also described in this work. The RHWC (Robotic Hot Wire Cutter) technology fully matches the prior aspects of the Industry 4.0 concept. The study consists of four parts. The first part simplified describes the mathematical apparatus of parametric modelling for complex concrete surfaces in Rhino 6.0 software. During the research two figures was precisely designed and modelled. The second part is aimed at the description of contemporary architectural trends in complex concrete structures manufacturing, modelling and analysis of ability to implement the complex-shaped surfaces with the RHWC technology. The third part describes the materials for technology. Expanded Polystyrene foam was chosen as the optimal material for the fabrication of formwork for complex-shaped concrete structures for its cost, weight and processability, as well as the special composite cement mixture which fully met all the requirements for its fluidity and smoothness. The fourth part is demonstration of the whole fabrication process, formwork treatment and concrete pour. This work also contains all necessary aspects for meeting the quality requirements on architectural concrete.
MANAGEMENT OF PEDIATRIC RHEUMATOLOGICAL DISEASES DURING THE OUTBREAK OF COVID-19: OUR EXPERIENCE
Authors: Gallizzi Romina , Sutera Diana , Mazza Francesca , Spagnolo Alessandra , Pajno Giovanni Battista
Published: August 2020

Since the COVID-19 epidemic has evolved rapidly also in Italy, specialists in pediatric rheumatology have found themselves addressing the problems of their patients and in particular how to manage the risk of infection and immunosuppressive treatment. This work aims to make known the experience of our center.
Assessment of P-Delta Effect on High Rise Building with Outriggers and Belt Truss
Authors: Y Priyanka, S Soundarya and V Bhargavi
Published: August 2020

The behaviour of structures, when subjected to critical loads is a complex phenomenon and is basically
dependent on the type of forces/loads acting on the structure, magnitude of force, direction etc. Generally, the
analysis of buildings is done by using linear elastic methods, which is first order structural analysis. The
first order analysis is performed by assuming small deflection behaviour where the resulting forces, moments
and displacements take no account of the additional effect due to deformation of the structure under vertical
loads prior to imposing lateral loads. In the traditional first order analysis of structures, the effects of change
in the structure actions due to structure deformations are neglected. However, when a structure deforms, the
applied loads may cause additional actions in the structure that are called second order or p-delta effects.
P-delta effect is secondary effect on structure. It is also known as ‘Geometric nonlinearity effect’. As number
of storey’s increases, P-delta effect becomes more important. In this study the P-delta effect on skyscraper is
studied. Linear static analysis (without P-delta effect) and nonlinear static analysis (with P-delta effect) on
high rise buildings having outrigger with belt truss is carried out. For the analysis G+55 composite
skyscraper is modelled. Earthquake load is applied on model of structure as per IS-1893(2002) for zone II in
ETABS software. Load combinations for analysis are set as per IS-456(2000). Bending moment of column,
story displacement with and without P-delta effect is calculated and compared for both models.
Study on Strength Characteristics by using Fully Recycled Coarse Aggregate Concrete at Various Atmospheric Conditions
Authors: S Naveen Kumar and P Ganga Prasad
Published: August 2020

A large amount of construction waste has been dramatically increased in the last decade and
environmental concerns on the recycling of waste has been increased. Mostly nowadays developing countries
are demolishing some million tons of concrete wastages from the old buildings. So they are using Recycled
aggregates for future construction. In this paper recycled coarse aggregate used 100%. In our research work,
we have collected the demolition waste from our village cement concrete road was demolished for the purpose
of renovation. The demolished road is of M20 grade concrete and age of concrete is 8years.
Nowadays construction of any concrete structure requires huge amount of natural coarse aggregate. So
they are using demolition waste, to reduce the cost of purchasing natural coarse aggregate.
Recycled coarse aggregate are separated from the demolished waste by using equipment's. To improve the
quality of recycled coarse aggregate by using treatment method's. The recycled coarse aggregates are weak
in drying of shrinkage and creep. To control the drying of shrinkage and creep by using fly ash etc .The
strength characteristics of natural coarse aggregate and recycled coarse aggregates. Recycled coarse
aggregate are successful utilization in many countries such as European, American and Russia. This paper
present's the investigation of strength characterstics due to effect of various temperature changes such as
sulphate attack, acid attack , sea water and normal water.
Monogenetic Trematode Infentations in Indian Cat Fishes of River Gomati at District Sultanpur Uttar Pradesh, India
Authors: Mishra Surya Prakash
Published: August 2020

Nutrients deficiency is one of the major challenges facing our country. Fishes are good source of aquatic
food that provides nutrients and gives nourishment to the human`s body and promotes growth. This study
was carried out to determine the prevalence of monogenean ectoparasites on fresh water cat fishes of river
Gomti at district Sultanpur (U.P.), in a bid to suggesting ways of curbing them. Total 720 fishes consisting of
180 Magur (Clarias), 180 Singhi (Heteropneustes), 180 Parhin (Wallago), and 180 Tengar (Mystus) were
screened using standard parasitological procedures. Higher infestation was recorded in Parhin (Wallago)
and lower infestation recorded in Singhi (Heteropneustes). Larger fishes recorded higher infestation than
smaller ones. Therefore, routine check of physico-chemical qualities and monitoring of parasitic status of fish
in river Gomti would reduce the mortality and loss in fish production.
Distributed Adaptive Virtual Impedance for Reactive Power Sharing in Microgrid
Authors: Harini M and Dr.S.Chitra
Published: August 2020

The concept of microgrid has been developed to realize flexible coordination control among Distributed
Generation (DG) units, improve the power quality supplied to customers. The problem such as the power
quality and the system stability due to the intermittency of the renewable energy sources and the fluctuating
load profile. The reactive power sharing done by droop control method but reactive power is not accurately
shared if there is a local load at each DG. In this paper adaptive virtual impedance control is used to improve
the power control stability and sharing performance of real and reactive power sharing is compared by using
MATLAB/Simulink environment. Simulation results shows the effectiveness of the proposed method is
achieving load reactive power sharing and the voltage restoration is settles in less time.
Retropharyngeal Hematoma Secondary to Minor Blunt Trauma Neck: A Rare Case Report
Authors: Paul Dipten , Sen Shubhrakanti , Palai Avishek , Mukherjee Monoj
Published: August 2020

Introduction

Traumatic retropharyngeal hematoma is rare, but can be lethal, if not identified and managed promptly. It isclinically important because of the close proximity of the retropharyngeal space to the upper airway.

Case report

A case of upper airway obstruction in a 75 year old man due to a large retropharyngeal hematoma following minor injury to neckis presented.Progressive dysphagia, hoarseness and dyspnoea developed over time. Emergency tracheostomy and subsequent surgical drainage was performed.

Conclusion

Retropharyngeal hematoma is a rare but potentially lethal problem that can be faced in an emergency department. Clinicians should be alert to the potential occurrence of this cause of acute or delayed airway collapse. Thus, an awareness of the possibility of airway obstruction secondary to massive hematoma formation after an asymptomatic interval is needed.
A Novel Technique of Branchial Fistula Tract Delineation and Excision In Children Allergic To Dyes
Authors: Banerjee Swagatam , Sarkar Saurav , Ghosh Sanjoy , Chakravarty Sharmistha , Sikder Biswajit
Published: August 2020

IntroductionBranchial arch fistula which results from a second arch anomaly is rarely seen in practice. The patients usually seek medical advice for persistent discharge from an opening in the neck or mucopurulent discharge from the opening of an infected fistulous tract. The treatment of choice for such a fistula is excision.

Materials and MethodsA total of seven patients were operated for branchial fistula between 2010 and 2012. Among them, three children could not undergo a fistulogram due to allergy to the dye used and hence they were selected for our modified procedure.

Surgical ProcedureA 3-0 or 4-0 polypropylene (Prolene™) thread was inserted into the fistulous tract. Both the ends of the tract were secured with the thread and the sinus tract was dissected out under gentle traction.

ResultsThe patients who were allergic to dye could not have preoperative fistulograms and per-operative injection of dye was also avoided. The blue colour of the polypropylene thread inserted in the fistula tract helped in tracing and excision of the sinus tract. No major complications occurred during or after fistulectomy and the post-operative recovery was uneventful. No recurrence was seen in the scheduled follow-ups.

ConclusionSurgical excision of branchial fistulas in children with allergy to dyes can be challenging. Insertion of a polypropylene thread into the fistula tract makes its subsequent dissection easy with minimal disruption of adjacent structures.
A Rare Variety of Adenoid Cystic Carcinoma involving Submandibular Salivary Gland
Authors: Ghosh Sanjoy Kumar , Samaddar Saikat , Banerjee Swagatam , Mukherjee Diptanshu
Published: August 2020

IntroductionAdenoid cystic carcinoma, an uncommon malignant salivary gland neoplasm, is known for its long clinical course, indolent growth, neural invasion, local recurrence and late distant metastasis. Three distinct histological patterns have been identified, amongst which, solid pattern is the rarest one having the worst prognosis.

Materials And MethodsA case of sixty year old male patient presented with a swelling in the left side of the neck, below the jaw gradually enlarging during the last three years. FNAC from the neck swelling was suggestive of benign adenoma of the salivary gland, possibly basal cell adenoma or pleomorphic adenoma. Submandibular gland was excised. Histopathological examination confirmed the solid pattern of adenoid cystic carcinoma, which is the rarest among the three distinct histological subtypes of the malignancy.

DiscussionAdenoid cystic carcinoma is well known for its perineural spread. In cases of submandibular gland adenoid cystic carcinoma, surgical wide excision is very much possible and in T1 or T2 cases post-operative radiotherapy may not be needed. In our case, post operative radiotherapy was given for best local control, as the tumour showed histopathlogical solid variety, grade III pattern, which is known to have the worst prognosis.
SYNCHRONOUS SQUAMOUS CELL CARCINOMA OF EXTERNAL ACOUSTIC MEATUS FOLLOWING PIGMENTED BASAL CELL CARCINOMA OF CHEEK -A RARE OCCURRENCE
Authors: Ghosh Debangshu , Sannigrahi Rajarshi , Basu Sumit Kumar , Basu Parna
Published: August 2020

Introduction: A synchronous second primary malignancy as squamous cell carcinoma of external acoustic meatus following basal cell carcinoma of cheek is reported with their management and review of literature.

Case Report: Pigmented basal cell carcinoma of cheek was managed successfully by wide local excision followed by flap reconstruction and subsequently diagnosed squamous cell carcinoma of external acoustic meatus by concurrent chemoradiation after initial surgical debridement.

Conclusion: Second primary malignancy as squamous cell carcinoma of external ear canal is rare after basal cell carcinoma of cheek though there is anatomical vicinity. Surgery in case of basal cell carcinoma and concurrent chemoradiotherapy in case of external ear canal squamous cell carcinoma is the mainstay of treatment.
A Rare and Unusual Cause of Epistaxis
Authors: Mallick Ajay , Bhalla Vijay , Roy Ravi
Published: August 2020

INTRODUCTION:  Leeches are blood sucking parasites of the phylum Amelida subgroup Hirudinea. Leech infestation is known as hirudiniasis. Endoparasitic infestation by leech is rarely reported in literature. The parasites enter the body by bathing or drinking infected water. They attach to the mucosa of the aerodigestive tract and suck blood whereby greatly increasing in size, with resultant clinical symptoms.

CASE REPORT: A 52 year male presented with unilateral epistaxis and nasal obstruction. Nasal examination revealed a live leech. The leech was found lodged in the nasopharynx. The patient was unaware of the leech in his body. The leech was removed alive with the use of a nasal endoscope under local anaesthesia. 

DISCUSSION : Leech infestation is a rare cause  of epistaxis. Absence of pain and difficult visualisation make the diagnosis difficult and delayed. There are various methods described in literature to remove leeches from the body. General anaesthesia may be required for its removal especially in children and when the leech is lodged in the tracheobronchial tree.

CONCLUSION : The aim of presentation is to report a rare unusual cause of epistaxis, leech infestation of the nasopharynx and method of removal of the leech safely under local anaesthesia.
Unusual Presentation of Granulomatosis With Polyangitis (Wegener's Granulomatosis)
Authors: Ghosh Anirban , Saha Somnath , Chattopadhyay Sarbani
Published: August 2020

Objective: To present a case of unusual presentations of granulomatosis with polyangitis (Wegener’s granulomatosis) with parotid swelling and intractable otitis externa.

Material and method: A 22-year-old male patient presented with left sided otitis externa with left sided parotid swelling and bilateral nasal obstruction for last two weeks. CT scan of paranasal sinuses showed homogenous mass in both maxillary antra and nasal cavities. FNAC from the parotid swelling was suggestive of granulomatous disease and endoscopic biopsy from the nasal mass showed features of granulomatosis with polyangitis (Wegener’s granulomatosis). CT scan of chest revealed multiple cysts within the lung parenchyma; urine examination showed RBC and pus cells. Renal biopsy showed focal segmental glomerulonephritis. c-ANCA was highly positive and thus the diagnosis of Wegener’s granulomatosis was made.

Result: Patient received cyclophosphamide and prednisolone immunsuppressive therapy for one year, which showed marked clinical improvement.

Conclusion: Granulomatosis with polyangitis (Wegener’s granulomatosis) is not an uncommon entity for otolarygologists. Its usual presentation mimics chronic rhinosinusitis; but presentations like otitis externa and parotid swelling are rare for this disease.
An uncommon experience during removal of a foreign body from ear of a child
Authors: Ghosh Sanjoy Kumar , Chaudhury Abir
Published: August 2020

A difficult to extract geoid bead was successfully removed from the middle ear cavity by threading it with monofilament polypropylene without drill-out of the bony annulus or widening the isthmus of the external auditory canal.
A Clinical Study on the Influence of Sinusitis in Chronic Suppurative Otitis Media
Authors: Dhanasekaran Sellappampatty Veerappapillai , Nair Jiji Sanjeevan , Raja Komathi , Gopalakrishnapillai Govind Krishnan , Chandran Abhilash Kuniyath , Radhakrishnan Shankar
Published: August 2020

Introduction

Diseases of the nose and paranasal sinuses are known to influence the middle ear conditions. In the evaluation of the patients with chronic otitis media, radiological, endoscopic, and other auxiliary diagnostic tools may have their roles in the objective assessment of the patients, and to rule out lesions of the nasal cavity and the nasopharynx as potential aetiological factors.

Materials and method

This cross sectional observational study was conducted for a period of two years to establish the role of sinusitis as focus of sepsis in patients with tubotympanic type of CSOM. All patients in the age group of 20-40 years with more than 2 months of ear discharge and with a hearing loss of 25- 40 db and  diagnosed as tubotympanic type of CSOM were included in our study. Patients who had features of mastoiditis on X-ray and also with persistent ear discharge even after treatment with oral and topical antibiotics were subjected (n=70) to diagnostic nasal endoscopy and computed tomography of paranasal sinuses. 

Result

Among the 100 patients of CSOM, 70% had features suggestive of sinusitis. Deviated nasal septum (40%) was the most common pathology among the study population. Majority (54%) of them had mucopurulent type of ear discharge. The CT findings of the paranasal sinuses revealed that 48.5% of the study population had grade I type of involvement of the PNS. 54.2% of the patients had a large central perforation and the middle ear mucosa was found to be edematous for 65.7% of the patients.

Discussion

Coexistence of deviated nasal septum and chronic rhinosinusitis with discharging CSOM is at par with several other studies conducted in other parts of the world.

Conclusion

Deviated nasal septum, enlarged middle turbinate, medialised uncinate associated with sinusitis are the predisposing factors in the development of CSOM.  So assessment for sinusitis in the treatment of CSOM should become a routine practice.
Long Term Success of Endo-DCR with Silicone Tube Catheter (STC) versus Endo-DCR without STC: A Comparative Study
Authors: Ray Bidhan , Datta Debabrata , Roy Pijush
Published: August 2020

Introduction  

Epiphora  caused by  mechanical block at puncta, canaliculi, lacrimal sac and nasolacrimal duct need surgical correction. EndoDCR  is gaining  popularity over conventional surgery. This study aims at evaluating the role of Silicone Tube Catheter (STC) to improve the long term outcome of endoDCR .              

Materials and Method  

This retrospective study was conducted on 58 consecutive endoDCR surgeries between 2012 and 2014. 22 subjects had endoDCR without STC, 36 subjects had endoDCR with STC, of whom in 20 cases STC was removed in  3 weeks and in 16 cases in  12 weeks. Clinical and endoscopic data collected post-operatively after 3 weeks,12 weeks and at 1 year. Analysis was done on intention to get suggestion for better result from endoDCR operations.                                          

Results  

Complications were identified as early and late. Complications like granulations, synaechia, echymosis, eyelid haematoma and surgical emphysema were searched for in every follow up. Development of obliterating scar was the main cause of failure. Epistaxis was negligible. No retrobulbar haematoma or rectus injury was noted. Minor synaechia between middle turbinate and nasal wall noted in 13.6 to 20%  of cases in all groups. Granulations were more in cases had STC for 12 weeks but managed with conservative measures. Obliterating scar was slightly less in this group in comparison to other groups.                                        

Discussion   

The present study emphasises the use of indwelling STC in endoDCR for a longer period .
Tinnitus Among Medical Students Using Personal Sound System
Authors: Sasidharan Syam , Rai Sheetal , Somayaji Gangadhara
Published: August 2020

Introduction

Statistical data on prevalence of tinnitus in India and on the relationship between exposure to recreational sound/music and the presence of tinnitus are scarce. This study was conducted to assess relationship between tinnitus and the use of personal sound system(PSS) in medical students.

Materials and Methods

A questionnaire based study was conducted on 100 randomly selected medical students to assess their sound habits with the use of PSS. Information on commonly used intensity, frequency, duration of use, type of earphones and severity of tinnitus was sought. Conventional frequency audiometry (0.25-8kHz) was also performed.

Result

The prevalence of tinnitus was found to be 33%, which was on the higher side of the global prevalence data. All the medical students surveyed in this study used personal sound system. Majority of the students (45%) used PSS less than 1 hour daily. More than 60% of the students complaining of tinnitus preferred louder settings in their PSS.

Discussion

The most common personal sound system used was mobile phones. No statistically significant association was seen with relation to the type of personal sound system, the type of ear phone used, average duration of use and hearing loss. Tinnitus was found to have statistically significant association with volume in our study with majority having tinnitus listening to higher levels of sound.

Conclusion

Use of personal sound system is common in medical students. Though duration of use of the personal sound system was not associated with the complaint of tinnitus, exposure to louder sounds had statistically significant association with tinnitus.
Kimura's Disease: A Rare Cause of Postauricular Swelling
Authors: Das Suman Kumar , Singh Mukesh Kumar , Kundu Indranath , Ghosh Swapan Kumar
Published: August 2020

Introduction

Kimura’s Disease is a chronic inflammatory disorder of lymph node which is very rare in Indian population.

Case Report

A 15 year old boy with multiple postauricular swelling for 18 months presenting in OPD and diagnosed having eosinophilia. Then excision biopsy was taken, which indicates Kimura’s Disease. Patient was treated with high dose of corticosteroid.

Conclusion

Kimura’s disease, though rare should be kept in mind for treating a patient with lymphadenopathy with eosinophilia or high IgE level, because it can spare the patient unnecessary invasive procedure.
Maxillofacial Prosthesis: A Review of Treatment Concepts for Better Prosthesis Prognosis
Authors: Prasad Sanjay
Published: August 2020

Maxillofacial prosthesis currently finds itself experiencing more change than at any other time over past 50 years of its recognized existence. Rehabilitation of facial defect, either congenital or acquired, is a difficult challenge for the surgeon as well as prosthodontist. The prosthodontist is limited by the properties of the materials available for facial restorations, the mobility of soft tissue surrounding the defects, the difficulty of establishing retention for large prosthesis, and the patient ability to accept the outcome. However, the acceptance of prosthesis recently has improved remarkably due to better coordination between surgeon and prosthodontist and introduction of dental implant which has dramatically improved the retention and esthetic that result from accurate and repeatable positioning of the implant, and the ease of maintenance.  Dramatic improvement in the acceptance of prosthesis is seen if the prosthodontist participation can begin early in the course of patient care which ultimately will increase the quality of life (QoL) of the patient.
A Study of Efficacy of Intraoperative Application of Mitomycin-C in Endoscopic Dacryocystorhinostomy
Authors: Sharma Harikesh , Mallick Ajay
Published: August 2020

Introduction

Common cause for failure of endonasal dacryocystorhinostomy is closure of the intranasal ostium usually due to granulation tissue formation. Attempts have been made to improve the success rate of lacrimal surgery by using different methods like using balloon catheters, lasers and antimetabolites. This study aims to see change in success rate with and without the use of using Mitomycin-C in endonasal Dacryocystorhinostomy (DCR) surgery.

Materials and Methods

Sixty patients of acquired chronic dacryocystitis with nasolacrimal duct blockage, in the age group of 11-50 yrs were taken for study. Patients were alternatively divided into two groups A & B (30 patients in each group). Endoscopic dacryocystorhinostomy with Mitomycin-C application was performed in Group A and without Mitomycin-C application in Group B patients. Subjective assessment for symptomatic improvement and objective analysis obtained from results of syringing. The result data was subjected to Student’s t test and x2analysis.

Result

Age of patients varied from 11 to 50 yrs. The male to female ratio was 7:8 in group A while 2:3 in group B. The commonest age group was between 21 -30 years in both the groups. After 12 month follow up the success rate was 93% in both the groups. The results between the groups were found to be statistically not significant (p>0.05).

Conclusion

Mitomycin C was used in this study to assess its efficacy in improving the results of endoscopic DCR. Mitomycin C did not have significant effect on the outcomes of endoscopic DCR surgery for chronic dacryocystitis.
Autopolypectomy of a Vocal Cord Polyp
Authors: Ahmed Saud , Hussain Altaf , Nadeem Basharat , Ali Faroq
Published: August 2020

Introduction

Vocal cord polyps commonly occur in those with a history of vocal abuse. Patients with large lesions generally undergo microlaryngeal surgery under general anaesthesia. This unique case report highlights a strange scenario where the patient coughed out a fleshy mass during his morning walk and which was later confirmed as a vocal cord polyp. 

Case Report

A 62 year old male with a history of hoarseness of voice for 3 months presented to the ENT OPD holding a chunk of tissue which was apparently coughed out by him during his morning walk. After the incident, his symptoms had immediately improved. A videolaryngoscopy showed a congested spot on the right vocal cord being the probable site of origin of the lesion. On Histopathological examination, the tissue was reported as a vocal cord polyp.  The patient was managed conservatively but the lesion recurred at the same site after a month for which a microlaryngeal excision was performed.

Discussion

Vocal cord polyps are fairly common in ENT practice and usually present to the clinic with hoarseness of voice. Polyps that are small are usually managed conservatively by voice therapy alone whereas large polyps require surgical excision. This unique case report highlights a strange clinical scenario where the patient coughed out a large vocal cord polyp (Auto-polypectomy) during a bout of acute cough. This event saved him a surgery at the first instance, but eventually had a recurrence and had to undergo an excision under GA.
Late Oesteoradionecrosis of Mandible Five Years after Radiotherapy for Carcinoma Base of Tongue
Authors: Mozumder Somesh , Dubey Shirish , Dam Aniruddha , Bhowmick Anup Kumar
Published: August 2020

Introduction

Osteoradionecrosis (ORN) is a process where irradiated bone undergoes necrosis and becomes exposed through soft-tissue. It is a late effect of radiotherapy. Early presentation within 2 years, is thought to be related to high dose of Radiation therapy, whereas late presentation is usually secondary to trauma and delayed wound healing with in compromised tissue.

We present a case of late presentation where there was no history of trauma to the associated region; therefore making the case unique.

Case report                                             

50 years old male patient from rural Bengal presented with history of invasive squamous cell carcinoma (SCC) of right base tongue with bilateral cervical nodal metastasis treated with external beam radiotherapy of 70 Gy in 35 fractions in 2009. In April 2014 he developed pain in the right side of lower jaw with foul breath and progressive difficulty and pain while opening mouth. Biopsy established the diagnosis of oesteoradionecrosis.

Discussion

ORN can be spontaneous, but most commonly results from tissue injury. The absence of reserve reparative capacity is a result of the prior radiation injury. The irradiated mandible, periosteum, and overlying soft tissue undergo hyperemia, inflammation, and endarteritis.

Conclusion

During follow up any lesion suspicious of recurrence or second malignancy with clinical features of pain, swelling, trismus, halitosis, mucosal ulceration, bare bone etc a differential diagnosis of oesteoradionecrosis should be kept in mind, even long time after radiotherapy & absence of trauma.
Reconstruction of Head and Neck Defects with Lower Trapezius Myocutaneus Flap
Authors: Mozumder Somesh , Dubey Shirish , Chatterjee Kinshuk , Kumar Priyadarshan , Khandelwal Ankit , Dam Aniruddha , Bhowmick Anup Kumar
Published: August 2020

Introduction

 High lateral and posteriorly based defects are challenging to reconstruct as mobilization of conventional pedicled flaps is difficult. This study was done to evaluate the usefulness of lower trapezius myocutaneous flap (LTMC) in selected cases as a reconstructive alternative to other pedicled flaps which have positional and technical disadvantages and/or in cases where free flap is not possible.

Materials and Methods

Ten cases of locally advanced (T3 and T4) high and laterally placed head and neck carcinoma (8 cases of SCC involving posterior scalp, ear lobule, skin anterior to tragus and 2 cases of locally advanced salivary gland malignancies involving parotid glands) irrespective of sex had been selected. Due to non-availability of plastic surgeon in the institute none of the patient could be subjected to free flap reconstruction. All the patients received post operative adjuvant radiotherapy and were followed up on a monthly basis for six months at least.

Results

                     Out of total 10 cases 5 underwent wound infection and dehiscence at recipient site. In 3 cases there were donor site seroma. In 2 cases healing was uneventful.  However in all cases the flap was healthy and flap survival was 100%. There was no flap contracture in long term follow up.

Conclusion                      

The LTMC flap is ideal for mentioned defects because of its anatomical location, abundant blood flow, minor donor-site morbidity, and long pedicle. The LTMC flap, though less commonly used, is a precious option in situations where free flaps and other pedicled flaps are not feasible.
Tracheal Stenosis After Endotracheal Intubation and Percutaneous Dilatational Tracheostomy
Authors: Herdini Camelia , Surono Agus , Supomo Supomo , Fedriana Jessica
Published: August 2020

Introduction

Tracheal stenosis is an abnormal narrowing of the tracheal lumen which affects adequate airflow and caused by an inflammatory complication such as endotracheal intubation and percutaneous dilatational tracheostomy (PDT). Incidence of tracheal stenosis following endotracheal intubation and PDT was 8-44%.

Case Report

A 24 year old female presented with dyspnea and hoarseness after traffic accident. She was intubated for 2 weeks then followed by PDT for 3 weeks. The laryngoscopy examination after PDT extubation showed tracheal stenosis at the second-third tracheal ring with left vocal fold granuloma. Cervical computed tomography demonstrated a mass at vocal cord and narrowing of tracheal caliber at the first thoracic vertebra disk, above the stoma of PDT.The granuloma was excised and tracheal stenosis was removed by tracheal resectionand end-to-end anastomosis. 

Discussion

Tracheal stenosis is one of important sequelae after endotracheal intubationand PDT. Tracheal resection and primary anastomosis may be considered as an option for surgical management of tracheal stenosis.
Endoscopic Dacryocystorhinostomy: Advantage over External Approach
Authors: Basak Bijan , Biswas Kaustuv Das , Biswas Subhradev , Choudhary Ankit
Published: August 2020

Introduction

Although external DCR was considered to be the Gold Standard treatment for NLD obstruction, endoscopic DCR appears to give comparable results,  with the advantage of the absence of external facial scar and no disruption of the medial palpebral ligament or the angular facial vessels. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy (DCR) and compare with the outcome of external DCR, based on data available on literature search.

Materials and Methods

In this prospective, longitudinal, interventional study, 67 cases of chronic dacryocystitis were operated endoscopically from January 2017 to December 2018. All patients were documented about detailed medical and operative history, thorough medical check up including ocular and ENT examination. Level of obstruction of nasolacrimal duct (NLD) was diagnosed by lacrimal syringing and probing.

Surgery was performed under local anaesthesia except in uncooperative patients where general anaesthesia was used. 0˚ & 30˚ endoscopes were used in surgery. The surgical outcomes and complications were recorded, analyzed and compared to those of external DCR from available literature.  

Results

The overall success rate of endoscopic DCR was 94.7%, which is closely comparable to external DCR.

Conclusion

Endoscopic DCR is an effective and safe alternative to external DCR, with comparable results and better patient satisfaction.
Endoscopic 3-S Technique Tympanoplasty: Taking the Convention a Step Ahead
Authors: Janweja Mridul , Hazra Sayan , Das Arindam , Dubey Arya Brata
Published: August 2020

Introduction

Endoscopic Surgery has immense potential for middle ear surgery and is currently favoured by many surgeons. The 3 (vascular) Strips/ 3 Flap Tympanoplasty with operating microscope is popular but Endoscopic 3-Flap Tympanoplasty remains less explored. Hence this study was conducted to compare advantages and disadvantages of Endoscopic and Microscopic 3-Flap Tympanoplasty.

Materials and Methods

Forty two patients with large/subtotal perforation of tympanic membrane were divided into two equal groups (Group A & B). Endoscope was used in Group A, whereas, operating microscope in Group B. Temporalis fascia was the graft material in all patients. Patients were followed up for six months. Pre and post-operative audiograms, post-operative pain, graft uptake, time taken for surgery and intra-operative visualization convenience were compared.

Results

Mean Air-Bone Gap closure at the end of six months was 9.23 dB (SD-0.88 dB) in the endoscope group and 8.95 dB (SD-0.66 dB) in microscope group whereas the graft uptake rate was 95.2% and 90.2% respectively. Post-operative pain, cosmesis, ease of doing surgery and time taken for surgery were better in ‘Endoscope’ as compared to ‘Microscope’ group.

Conclusion

The three flaps produce adequate exposure in very large or subtotal perforations, very thin anterior rim or with anterior bony overhang. Results in terms of mean hearing gain and graft uptake were comparable. In terms of morbidity (post-op pain), recovery (return to routine activity), mean duration of surgery and cosmesis, endoscopic surgery produced better outcome.
LA CULTURA LABORAL: UNA MIRADA PARA LOS DIFERENTES CONTEXTOS DE SOCIALIZACIÓN
Authors: Mendoza Tauler Laura , Leyva Figueredo Alberto , Martínez Cuba Orlando
Published: August 2020

LABOR CULTURE: A LOOK AT THE DIFFERENT CONTEXTS OF SOCIALIZATIONRESUMENEl resultado que se presenta constituye una alternativa de trabajo para fortalecer el desarrollo de la cultura laboral desde la selección misma de los contenidos que deben ser aprendidos, y que incluye los significados que son transmitidos históricamente, las normas, los valores, el actuar diario de los estudiantes y docentes, las creencias, las ceremonias y las tradiciones compartidas por todos los miembros de la comunidad educativa. Se requiere, por tanto, que los estudiantes muestren una actitud laboriosa y responsable ante las tareas que se les encomiendan, valoren la importancia del trabajo del hombre y del suyo propio, manifiesten respeto y admiración por los oficios y profesiones más necesarias; en sentido general que se preparen para la vida. No constituye un resultado acabado, pues al encontrarnos ante un fenómeno polisémico como el que se está investigando se requiere del trabajo investigativo desde la relación con la significación social, práctica e individual que tienen los estudiantes desde el desarrollo de las actividades laborales.PALABRAS CLAVE: cultura laboral, contextos de socializaciónABSTRACTThe result presented is an alternative work to strengthen the development of the labor culture from the selection of the contents to be learned, which includes the meanings that are transmitted historically, norms, values, daily action of Students and teachers, beliefs, ceremonies and traditions shared by all members of the educational community. It is therefore necessary that the students show a laborious and responsible attitude to the tasks entrusted to them, to value the importance of the work of the man and of his own, to show respect and admiration for the most necessary professions and professions; In the general sense that they prepare for life. It is not a finished result, because when faced with a polysemic phenomenon such as the one being investigated requires research work from the relationship with the social, practical and individual significance that students have since the development of work activities.KEYWORDS: labor culture, contexts of socialization.
PROTOCOLOS DE DESINFECCIÓN DE EXPLANTES DURANTE LA MICROPROPAGACIÓN DE Cedrela odorata L.
Authors: Jiménez González Alfredo , Zhindón Ganchozo Bertha Azucena , Indacochea Ganchozo Blanca Soledad , Ramos Rodríguez Marcos Pedro
Published: August 2020

EXPLANTATION DISINFECTION PROTOCOLS DURING THE MICROPROPAGATION OF Cedrela odorata L.RESUMENLa contaminación microbiana es uno de los problemas más graves en la micropropagación de las especies vegetales, tanto en la investigación como en la micropropagación comercial. Tal contaminación puede ser producida por microorganismos endofíticos o microorganismos introducidos durante la manipulación de laboratorio. El presente trabajo se realizó con el objetivo de evaluar tres protocolos de desinfección de explantes para la micropropagación de Cedrela odorata L., en el laboratorio de biotecnología vegetal de la Universidad Estatal del Sur de Manabí. La metodología aplicada se basó en el montaje de un diseño experimental en bloque completamente al azar. Se evaluaron tres tratamientos para la desinfección de explantes, obteniéndose con éxito el 95.64% de explantes establecidos en el segundo tratamiento, en el que se utilizó un protocolo de desinfección basado en Etanol al 50% (C2H6O), Hipoclorito de Sodio (NaClO) en el 25% de su concentración. Tiempo de inmersión de 60 segundos. Existen diferencias estadísticas altamente significativas en los protocolos utilizados para la desinfección de explantes de Cedrela odorata. Sólo un tratamiento, T2, fue el que presentó la mayor eficiencia durante el experimento.PALABRAS CLAVE: Propagación, especies amenazadas, madera tropical.ABSTRACTMicrobial contamination is one of the most serious problems in micropropagation of plant species, both in research and in commercial micropropagation. Such contamination may be produced by endophytic microorganisms or microorganisms introduced during laboratory manipulation. The present work was carried out with the objective of to evaluate a disinfection protocol of explants for the micropropagation of Cedrela odorata L., in the plant biotechnology laboratory of the Southern State University of Manabí. The applied methodology was based on the assembly of an experimental design in block completely at random. Three treatments were evaluated for the disinfection of explants, successfully obtaining 95.64% of explants established in the second treatment, in which a disinfection protocol based on 50% Ethanol (C2H6O), Sodium Hypochlorite (NaClO) in 25% of its concentration, with a time of immersion of 60 seconds. There are statistically significant differences in the protocols used for the disinfection of Cedrela odorata explants. Only one treatment, T2, was the one that presented the highest efficiency during the experiment.KEYWORDS: propagation, threatened species, tropical timber.
A CULTURA DO MILHO: NITROGENIO E INOCULAÇÃO COM BACTÉRIAS PROMOTORAS DE CRESCIMENTO
Authors: Zambrano Gavilanes Freddy , Souza Andrade Diva , Rodrigues Silva Helder Rodrigues Silva , Bravo Zamora Roberto , Cedeño Palacios Carlos
Published: August 2020

O milho (Zea mays L.) é uma das culturas mais importantes do mundo. O nitrogênio (N) é considerado un dos nutrientes maíz requerido pela cultura do milho, estando relacionado com a sua produção, entretanto, sujeito a perdas no solo por lixiviação, escoamento superficial e volatilização, provocando prejuízos ambientais. A aplicação de bactérias promotoras do crescimento de plantas (BPCPs), para o incremento da produção agrícola é una das alternativas mais importantes para depender menos dos fertilizantes químicos. As BPCPs estimulam a fixação biológica do nitrogênio (FBN). Algumas espécies do gênero Azospirillum têm essa capacidade além de produzir hormônios promotores de crescimento favorecendo a cultura do milho e outras Poáceas
ASOCIACIÓN ENTRE DIABETES MELLITUS Y CIRROSIS HEPÁTICA. JIPIJAPA. MANABI.ECUADOR
Authors: Fernández Águilar María Emilia , Palma Franco Ramón , Placencia López Bárbara Miladys , Merino Conforme Monserrate Cristina
Published: August 2020

La presente investigación se desarrolló con el objetivo de revisar la asociación entre diabetes y cirrosis hepática en pacientes ecuatorianos. Se realizó un estudio descriptivo, longitudinal, retrospectivo. Se seleccionaron los 64 enfermos atendidos en consultas de gastroenterología entre enero 2015 y enero 2018, en el Hospital Ambulatorio del Seguro Social de Jipijapa, Manabí, Ecuador, con diagnóstico de cirrosis y diabetes mellitus, mayores de 20 años. Se revisaron las historias del Modelo AS 400 y se recolectaron los datos necesarios, analizándose causas etiológicas, diagnóstico y fecha de debut de la diabetes, fallecimiento o diagnóstico de hepatocarcinoma. Para el análisis estadístico se utilizó la tabla de frecuencia en el software SPSS versión 22.0 para Windows. La cirrosis hepática estuvo asociada a la diabetes en el 45% de los pacientes y fue más frecuente entre los de más de 60 años y del sexo masculino. Según el tiempo de diagnóstico, el 34,37% tenía diagnóstico de diabetes antes de conocer que sufrían de cirrosis, mientras el 7,81% debutaron diabéticos después de la cirrosis. La esteatohepatitis por diabetes mellitus asociada al alcoholismo, se observó como la causa más frecuente de cirrosis (34,48%). El 13,79 % presentó carcinoma hepatocelular y el 17,25 % de los pacientes fallecieron.
Implikasi Hukum Terkait Dengan Pelaksanaan Pasal 24 Undang-Undang Nomor 41 Tahun 2004 Tentang Wakaf
Authors: Fataruba Sabri
Published: August 2020

Article 24 of Law Number 41 Year 2004 on Wakaf states that wakaf with testament both orally and in writing can only be done if witnessed by at least 2 (two) witnesses who meet the requirements. The statement that wakaf with a will, either orally or in writing can only be done if witnessed by at least 2 (two) witnesses fulfilling the requirements as meant in Article 24 of Law Number 41 Year 2004 above means that if the endowers with oral or written testimony is not witnessed by at least 2 (two) witnesses who fulfill the requirements, it will have a legal effect on the validity of the waqf status. However, after the following articles and / or paragraphs of Law Number 41 Year 2004 along with their explanation, as well as Government Regulation Number 42 of 2006 on Implementation of Law Number 41 Year 2004 About Wakaf, Â there was notÂ  found any article explains what legal implications would be if the wakaf testament is not witnessed by at least 2 (two) witnesses who meet the requirements. Therefore, in order to overcome the incompleteness resulting in the ineffectiveness of Article 24, if there are any concrete events related to the will of judgment submitted to the court to be resolved, the judge shall be able to use the method of legal discovery, either according to the science of law or according to Islamic law appropriately, so it can provide legal certainty for justice seekers.
Interaksi Antara Negara Dan Desa Adat Dalam Konstruksi Negara Kesatuan Republik Indonesia
Authors: Bakarbessy Andress Deny
Published: August 2020

Indonesia is a unitary state that determines all regions of the country without exception constituting a unity of administrative and legal territory. However, in the territory of Indonesia there are also regions and unity of customary law communities, in this case the traditional village which has special characteristics that are special because it has existed before the formation of the State and has the right of origin in the administration of its government, and is recognized and respected by the State, so that the interaction between the State and customary villages allows conflicts between State law and customary law and traditions in the administration of government. For this reason, an ideal interaction between the State and the traditional village is needed which can create harmony and balance between the Country and the traditional village.
Peran Aktif Masyarakat Hukum Adat Dalam Pembangunan Ekonomi
Authors: Matuankotta Jenni Kristiana
Published: August 2020

The active role of the customary law community in the process of economic development is very large supported by abundant natural wealth spread across the archipelago. This considerable potential will be better and can be supported by reliable human resources. Customary law communities can be included to participate in economic development. Empowerment of indigenous peoples with their local knowledge through economic development based on local wisdom can provide support, use and management of natural resources while maintaining the strength of their customary law, their spiritual abilities and the beliefs they embrace.
Aspek Hukum Hak Cipta Terhadap Buku Elektronik (E-Book) Sebagai Karya Kekayaan Intelektual
Authors: Labetubun Muchtar Anshary Hamid
Published: August 2020

Intellectual Property Rights basically have economic value. Therefore it is not excessive if the results of human intellectual work are given adequate legal protection. Through this way Intellectual Property Rights will get a decent place as one form of rights that has economic value. E-Book is included as a protected work because it is an adaptation of the initial creation in the form of a book that each has its own copyright after being realized in a real form.