bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental study on penetration characteristic of submerged steam jet in quiescent water
Authors: Sun L. , Shi E.-B. , Wang Ch. , Hao R.
Published: April 2019

The direct contact condensation is an effective way to rapid depressurization for light water reactor, such as pressure suppression pool, for which the characteristic of steam plume is a key parameter to evaluate the efficiency of depressurization. In this paper, a series of visualization experiments are described which investigate the characteristic of steam plume, the influence of jetting direction, air mass fraction, water temperature, diameter of jet on the steam plume were analyzed. The results show that, the dimensionless steam plume length increased with the increase of inlet pressure and water temperature for pure steam submerged jet, a correlation was set up to predict the dimensionless penetration length and the predicted errors were within the band of ±15%. Furthermore, the penetration length decreased with the rise of air mass fraction due to buoyancy force, the penetration length increased with the increase of inlet pressure, and the jet penetration length for vertical jet is longer than horizontal jet about 25% at the same inlet pressure and air mass fraction.
Profil Kemampuan Koneksi Matematika Siswa SMP dalam Memecahkan Masalah Matematika Ditinjau dari Gender
Authors: Apriyono Fikri
Published: April 2019

ABSTRAKPenelitian ini bertujuan untuk mendeskripsikan profil kemampuan koneksi matematika dalam memecahkan masalah matematika ditinjau gender. Pemilihan subjek laki-laki dan perempuan berdasarkan tingkat kemampuan yang setara dilihat dari tes kemampuan matematika dan nilai rapor. Penelitian ini menggunakan metode kualitatif dimana data yang diperoleh berupa kata-kata tertulis atau lisan dari orang-orang dan perilaku yang dapat diamati. Teknik pengumpulan datanya dilakukan dengan pemberian tes pemahaman konsep dan wawancara. Dalam penelitian ini diamati siswa laki-laki dan perempuan SMPN 4 Jember kelas VIII. Peneliti melakukan wawancara pada kedua subjek penelitian. Wawancara tersebut direkam kemudian hasilnya ditranskripkan dan dikodekan. Untuk memperoleh data yang valid, data yang diperoleh ditriangulasi. Kemudian data yang valid dianalisis untuk memperoleh kesimpulan. Hasilnya berupa kemampuan koneksi matematika siswa SMP kelas VIII pada materi aljabar dan geometri.ABSTRACTThis study aimed to describe the profile of mathematics connection ability to solve problems in terms of gender. Selection of male and female subjects based on equal ability level viewed from math skills tests and grades. This study uses a qualitative method where data is obtained in the form of words written or spoken of the people and the behaviors that can be observed. Data collection techniques were conducted by giving the concept understanding tests and interviews. This study observed both boys and girls in class VIII of SMPN 4 Jember. The researcher conducted interviews to both the research subjects. The interview was recorded and then the result was transcribed and coded. To obtain valid data, the data obtained were triangulated. Then the valid data were analyzed to obtain valid conclusions. The result is the mathematics connection ability class VIII of junior high school students of on the algebra and geometry matter. This article illustrates preparation of your paper using MS-WORD. Papers should not be numbered.Keywords: Connection Mathematics, problem solving, Gender, qualitative method
DIAGNOSIS KESALAHAN MAHASISWA DALAM PROSES PEMBUKTIAN BERDASARKAN NEWMANN ERROR ANALYSIS
Authors: Ekayanti Arta
Published: April 2019

Penelitian ini bertujuan untuk menganalisis kesalahan mahasiswa dalam menyelesaikan soal geometri euclide khususnya pada kasus pembuktian. Analisis yang digunakan berdasarkan pada Newmann Error Analysis yang meliputi reading error, comprehension error, transformation error, process skill error dan encoding error. Subyek penelitian ini adalah mahasiswa program studi pendidikan matematika Universitas Muhammadiyah Ponorogo yang sedang menempuh mata kuliah geometri euclide pada semester ganjil tahun akademik 2016/2017. Jenis dan pendekatan dalam penelitian ini yaitu jenis penelitian deskriptif dengan pendekatan kualitatif. Teknik pengumpulan data yang digunakan dalam penelitian ini dengan metode dokumentasi, tes dan wawancara. Analisis dilakukan dengan menganalisis hasil tes kemudian wawancara dengan beberapa mahasiswa dengan tipe kesalahan yang berbeda-beda. Berdasarkan hasil penelitian, diperoleh kesimpulan bahwa kesalahan mahasiswa terletak pada kesalahan teori/konsep dasar serta ketidaklengkapan justifikasi pada setiap langkah yang digunakan dalam pembuktian.This research aim to analyse the student error, when they solve the problems of euclidean geometry especially proofs. That is based on Newmann Error Analysis, such as error reading, error comprehension, error transformation, error skill process and error encoding. This research was conducted toward the student of Mathematic Department, Teacher Training and Education Faculty, Muhammadiyah University of Ponorogo who studied euclidean geometry in 2016/2017. This research was descriptive research with qualitative approach. Documentation method, interview and test was used to gathering data. The analysis process had been doing by analysed the student result test, and then interviewed with some student with different error type. The result of this research was misconception of previous concept and incompletely the justification of every proofs step.
Inflammatory Pseudotumor of an Orbito-Maxillary Mass Masquerading as a Malignancy
Authors: Da Silva Maria Cristina C. , Romualdez Joel A. , Martinez Norberto A.
Published: April 2019

Objective: To present a case of a benign orbito-maxillary tumor behaving as an invasive,

expansive malignancy.

 

Design: Case report

 

Setting: A tertiary care hospital in Metro Manila

 

Patient: A 4-year-old boy with a seven month history of right orbito-maxillary mass, proptosis and epiphora.

Result: A series of biopsies were done before a definite diagnosis was made due to inconsistencies in the histopathologic findings, clinical picture, and the radiologic presentation of the case. After diagnosis, appropriate intervention resulted in a dramatic decrease in the size of the mass. At present, the patient is disease-free and asymptomatic.

 

Conclusion: Histopathologic diagnosis of Inflammatory Pseudotumor is difficult and differentiating it from malignant tumors is often a concern for otolaryngologists and pathologists. In spite of an initial malignant biopsy result, the combination of clinical signs and symptoms and radiologic findings of an infiltrative mass lesion, should not discount the possibility of a benign entity such as Inflammatory Pseudotumor for which treatment is conservative.

 

Keywords: Orbito-Maxillary Mass, Inflammatory Pseudotumor, Pseudotumor, Orbital Pseudotumor
Open Reduction and Fixation in Acute Laryngeal Trauma Under Endoscopic Guidance
Authors: Cabudol Jaren R. , Romualdez Joel A. , Guevara Eutrapio S.
Published: April 2019

Acute laryngeal trauma is a great challenge for the otoloaryngologist. Early recognition, accurate evaluation and proper treatment may be crucial to immediate survival and long-term function.

 

Objective: To describe an endoscopically-guided open reduction and adaptation plate fixation of an acute laryngeal fracture secondary to vehicular accident.

 

Methods:

 

Study Design: Surgical Innovation/ Case Report

Setting: Tertiary Hospital in Metro Manila

 

Results: Post-operative follow-up showed good vocal fold function and arytenoid position, with no food regurgitation, signs of aspiration or penetration on fiberoptic endoscopic evaluation of

swallowing.

 

Conclusion: Endoscopic guidance allows higher magnification minimizing iatrogenic mucosal damage during manipulation.

 

Keywords: laryngeal trauma, endoscopic technique, rigid fixation, fracture
The Correlation of Results between Pure Tone Audiometry and the Virtual Audiometer: A Simulated Air-Conduction Clinic-based Audiometer
Authors: Javellana Anne Elizabeth M. , Casile Ray U.
Published: April 2019

The virtual audiometer (VA) is a software application that simulates a pure tone audiometer by delivering tones of different frequencies and intensities by air conduction.

 

Objective: To determine correlation between hearing thresholds measured by virtual and pure tone audiometry and degree of agreement in their hearing loss classification. 

 

Methods:  Analytic, cross-sectional study set in a Philippine tertiary institution.  Subjects were recruited from the outpatient department in September 2005 and comprised of cooperative, clinically normal and abnormal hearing individuals.  Thirty-two subjects made 64 total ears tested (n=64), giving 0.90 correlation at 0.05 level of significance (a) (p = 0.05) and 99% power. Each subject underwent pure tone and virtual audiometry, the average thresholds calculated, and degree of hearing loss categorized according to classification by the World Health Organization (WHO).  Results were not revealed until both examinations were completed.  Data were stratified by frequency and compared by Pearson’s correlation, while Kappa statistics determined degree of agreement between WHO grades of hearing impairment.

 

Results:  Average age was 40.2 years, with 20-80 year range and 18.5 years standard deviation. Nine subjects were male while 23 were female (M:F ratio = 0.39).  Of 64 ears, 34 were clinically normal and 30 abnormal.  Pearson’s correlation demonstrated significant positive correlation between virtual and pure tone thresholds with 99% confidence at 0.05 level of significance. Kappa statistics also showed significant degrees of agreement in WHO grades by both instruments, meaning VA will probably categorize hearing loss in the same manner as pure tone audiometry.

 

Conclusion:  A strong positive correlation exists between hearing thresholds measured by virtual and pure tone audiometry with a significant degree of agreement in hearing loss classification.  This supports the possibility of using the virtual audiometer as a clinic-based, air-conduction audiometer for screening and monitoring. When used in conjunction with other examinations, valuable information on over-all integrity of the audiologic system may be ascertained.

 

Key words:  audiometer, audiometry, air-conduction, hearing test, hearing screening, hearing monitoring
Collar Size as Predictor of Obstructive Sleep Apnea
Authors: Veloro Lyra V. , Sarte Michael Alexius A. , Castañeda Samantha S.
Published: April 2019

Objective: This study focuses on evaluating the relationship between physical findings, particularly collar size and Body Mass Index (BMI), and polysomnographic parameters in male patients seen at a Sleep Disorders Laboratory, suspected to have Obstructive Sleep Apnea (OSA). 

 

Methods:

Design: Cross-sectional study

Setting: Academic tertiary private hospital

Participants:  Charts of 149 adult male patients referred for polysomnography between July 1, 2005 and June 30, 2006 were reviewed.  Height, weight, and external neck circumference measurements were obtained.  The data from polysomnography results were noted and correlated with the physical measurements. 

 

Results: The mean collar size for the OSA group was 42.03 cm with a mean BMI of 29.14 while the mean collar size for the normal group was 39.05 cm with a mean BMI of 25.36.  A significant difference was noted in both the collar size and body mass index (BMI) between the OSA group and the normal group (p<0.005).  Results showed a significant correlation between collar size and BMI.  Collar size and BMI measurements were also correlated with increasing severity of sleep apnea in the OSA group.  The ³40 cm collar size among male adults with symptoms of OSA was 80% sensitive and 67% specific with a positive predictive value of 94% in predicting true OSA.

 

Conclusion: This study suggests that the external neck circumference and the degree of obesity determined through BMI measurement may be important predictors of sleep apnea in adult Filipino males suspected to have OSA.  Given the high probability of having true OSA in symptomatic male adults with a collar size ³ 40 cm, outright definitive management may be opted for in these patients, while those with a collar size < 40 cm may need to undergo further confirmatory tests.

 

 

Keywords: obstructive sleep apnea, external neck circumference, collar size, body mass index, polysomnography, obesity
Primary Lymphoma of the Temporal Bone: The First Locally Reported Case
Authors: Uy Julie Ann G. , Jugo Jose Carlos Z. , Acuin Jose M.
Published: April 2019

Objective: To report a case of primary non-Hodgkin’s T-cell lymphoma in the temporal bone in a pediatric patient, discussing clinical presentation and course, diagnostic evaluation and management in the light of published literature.  

Methods:

Design: Case report

Setting: Private tertiary university hospital

Patient: One

Results: An 8-year-old female with a 10-month history of otalgia and ipsilateral headache developed facial paralysis, unresponsive to topical otic drops and oral antibiotics. Imaging revealed mastoid sclerosis, tegmental and ossicular erosions, and an attico-antral mass which was excised through exploratory tympanomastoidectomy. Final histopath following immunohistochemical corroboration was T-cell lymphoma.

Conclusion: Primary malignant lymphoma of the temporal bone may initially present with otalgia and headache unresponsive to conventional medical management. Ominous signs like facial paralysis should heighten the suspicion of malignancy warranting prompt imaging of the temporal bone.  Histopathologic evaluation of all mastoidectomy specimens should be mandatory especially in children, and special stains performed as needed. Patients with T cell NHL should undergo chemotherapy and may warrant closer follow up for tumor recurrence and disease progression.     

 Keywords: non-Hodgkin's lymphoma, Temporal bone
Pediatric Endoscopic Sinus Surgery in a Tertiary Government Hospital: Patient Profile and Surgical Indications
Authors: David Michael Joseph C. , Vicente Gil M. , Chua Antonio H.
Published: April 2019

Objective: To describe the clinical and demographic profile of patients who underwent pediatric Endoscopic Sinus Surgery (ESS), and the indications for which the procedure was performed.

Methods:

Design: Cross-sectional Study

Setting: Tertiary Government Hospital

Subjects: Using the medical record registry, all patients below 18 years of age who underwent ESS under the Department of Otorhinolaryngology – Head and Neck Surgery of a tertiary government hospital in Metro Manila between December 31, 1999 and January 1, 2008 were reviewed. The age, sex, clinical presentation, and indications for doing ESS, and extent of surgery done were described. The Lund MacKay Grading for nasal polyposis and Scoring for sinusitis were also applied and cross-referenced.

Results: Twenty-seven children aged 7 to 17 years underwent ESS. The mean age was 12.9 years, with most (15 patients) belonging to the adolescent age group (13-17 years). Male to female ratio was 1.45:1. The mean interval from onset of symptoms to the first outpatient consultation was 1.5 years; the most common presenting symptoms were nasal obstruction (85.2%) and discharge (59.3%).

All of the patients who underwent pediatric ESS had chronic rhinosinusitis: either with nasal polyposis (85.2%), an antrochoanal polyp (11.1%), or both (3.7%). The Lund Mackay Grading for nasal polyps and sinusitis scores were cross-referenced: patients with larger, grade III nasal polyps tended to have more extensive sinus disease than those with grade II polyps. On their first consultation, the patients tended to present with extensive nasal polyp and sinus disease, indicating the need for surgery.

All patients with CRS and nasal polyposis underwent polypectomy with ethmoidectomy, uncinectomy and maxillary antrostomy, with additional frontal sinusotomy for a 17 year old male and a 17 year old female, both with grade 3 polyposis. The three patients who had antrochoanal polyps underwent polypectomy with uncinectomy and maxillary antrostomy. There were no operative complications such as cerebrospinal fluid leak and orbital injury reported.

Conclusion: Most of the patients who underwent pediatric ESS were older children who were brought for consultation with long-standing, extensive nasal polyp and sinus disease or with antrochoanal polyps, necessitating surgical management. Patients with larger polyps tended to have more extensive sinus disease. They all underwent conservative surgery, with extent of the procedure limited to the extent of the disease present. Efforts to raise public awareness about chronic rhinosinusitis and nasal polyposis in children may result in seeing such cases at an earlier, conservatively treatable stage

 

Keywords: Pediatric Endoscopic Sinus Surgery, Nasal Polyposis in Children
Extramedullary Plasmacytoma of the Nasopharynx: A Rare Tumour with 7-Year Follow Up
Authors: Azman Mawaddah , Gendeh Balwant Singh , Ali Siti Aishah Mat
Published: April 2019

Objective: To report a case of extramedullary plasmacytoma, a rare localized tumour involving

the head and neck region in a 56-year -old gentleman.

 

Methods:

Design: Case Report

Setting: Tertiary University Referral Center

Patient: One

 

Result: The patient presented with a 5-month history of right-sided nasal obstruction and intermittent epistaxis in 2003. Nasal endoscopy revealed a friable, dark red mass arising from the roof of the nasopharynx, occluding the right choana. No invasion of adjacent tissues or cervical lymphadenopathy was evident. A biopsy of the mass was diagnosed as plasmacytoma. Serum and urine electrophoresis failed to detect any monoclonal bands. All other screening tests to rule out multiple myeloma were negative. These findings confirmed the diagnosis of extramedullary plasmacytoma. He recieved radiotherapy to the nasopharynx of 50 Gy for a total of 23 fractions. No recurrence was noted at 7-year follow-up.

 

Conclusion: Extramedullary plasmacytoma of the nasopharynx represents a tumour with good prognosis but requires long term follow up in anticipation of local recurrence and progression to Multiple Myeloma.

 

Keywords: extramedullary, plasmacytoma, nasopharynx
Primary Malignant Parotid Lymphoma: Two Case Reports with Different Disease Progression and Treatment
Authors: Hashim Noor Dina , Yunus Mohd Razif Mohamad , Abdullah Asma , Baki Marina Mat , Husain Salina , Ami Mazita
Published: April 2019

Objective: To describe our experience in managing two cases of primary malignant parotid

lymphoma.

 

Methods:

Design: Case Report

Setting: Tertiary University Referral Center

Patients: Two

 

Results: Both patients underwent superficial parotidectomy. Despite recurrence in one, the disease was controlled with conservative management. However, the disease was more aggressive in the other, requiring additional chemo-radiotherapy.

 

Conclusion: Malignant parotid lymphoma may present with varying stages, grades and clinical courses, requiring different management approaches. The treatment options are based on grading and staging at diagnosis and should be implemented depending on individual case.

 

Keywords: Parotid neoplasms, malignant lymphoma
Sinonasal Mucosal Melanoma: An Enigma
Authors: Ullah Hidayat , Baig Mirza Qaisar
Published: April 2019

Objective: To report two cases of mucosal melanoma of the sinonasal cavity from India and

review the literature emphasizing current important clinical and biologic aspects of this tumor.

 

Methods:

Design: Case Report

Setting: Tertiary Public Referral Hospital

Patients: Two

 

Results: Two patients presenting with progressive unilateral nasal obstruction over three to six

months, respectively, were diagnosed to have sinonasal mucosal melanoma. The mass involved

the nasal cavity and maxillary antrum in both patients. The first patient deferred radiotherapy for

four months until pulmonary metastasis became evident, necessitating palliative chemotherapy;

the second patient underwent surgical excision and radiotherapy.

 

Conclusion: In spite of aggressive therapy, the prognosis for people with mucosal melanoma

is extremely poor. Surgery remains the mainstay of treatment, although adjuvant radiation

therapy has recently had an increasing role in the treatment of mucosal melanoma. A clear

understanding of the pathophysiology of this disease may yield more specific immunotherapy

and chemotherapy techniques. A multicenter prospective study is required to objectively assess

the optimal treatment regimen.

 

Keywords: mucosal melanoma, sinonasal cavity
Bilateral Antro-Choanal Polyps in an Elderly Female
Authors: Sen Indranil , Mukherjee Ankur , Saha Jayanta , Mandal Satadal , Sinha Ramanuj
Published: April 2019

Objective: To report the first case of primary bilateral antro-choanal polyps in the elderly age group.

 

Methods:

       Design: Case Report

       Setting: Tertiary Government Hospital

       Patient: One

 

Result: A 60-year-old, non-allergic female with progressive bilateral nasal obstruction was subsequently diagnosed with bilateral antro-choanal polyps. Endoscopic sinus surgery was performed and the patient remained asymptomatic on one year follow-up.

 

Conclusion: Antro-choanal polyps can occur bilaterally in the elderly age group.

To the best of our knowledge, this is the first reported case of primary bilateral antro-choanal polyps in an elderly female.

 

Keywords: antro-choanal polyp; bilateral; elderly; female
Undifferentiated Nasopharyngeal Malignancy with Immunohistochemical Features of Diffuse Large B Cell Lymphoma and Undifferentiated Carcinoma: A Collision Tumor?
Authors: Gelera January E. , Martinez Norberto V.
Published: April 2019

Objective: To describe an unusual presentation of undifferentiated nasopharyngeal malignancy with immunohistochemical features of both diffuse B-cell lymphoma and undifferentiated carcinoma.Methods:     Design: Case Report     Setting: Tertiary Private University Hospital     Patient: OneResults: A 49-year-old female whose initial nasopharyngeal biopsy interpretation was diffuse large B-cell lymphoma underwent three cycles of Rituximab, Cyclophosphamide, Hydroxydaunomycin, Oncovin and Prednisone (R-CHOP). Post-chemotherapy ComputedTomography (CT) scan of the nasopharynx revealed no change in tumor size or appearance. Repeat nasopharyngeal (NP) biopsy findings suggested an epithelial tumor lineage or post chemotherapy reactive mucosal epithelial cells. No residual lymphoma was noted and immunostaining was positive for cytokeratin. The patient underwent 35 fractions of radiotherapy. Re-evaluation by Magnetic Resonance Imaging (MRI) with contrast after four months showed significant tumor shrinkage. Repeat NP biopsy revealed necrotic tissues with foci of high-grade squamous cell carcinoma. Two months after the biopsy, repeat MRI with contrast of the nasopharynx and neck showed increase in the bulk of the nasopharyngeal tumor with inferior extension to the level ofthe orophaynx and possible contralateral involvement. A nasopharyngectomy via left maxillary swing was performed and the final histopathology was undifferentiated carcinoma.Conclusion: Undifferentiated malignancies of the nasopharynx may contain lymphoma or carcinoma and rarely, both lineages in coexistence. In such cases, the possibility of a collision tumor should be considered. Immunohistochemical distinction is important for treatment and prognostication.Keywords: nasopharyngeal carcinoma, undifferentiated tumor, undifferentiated carcinoma, nasopharyngeal lymphoma, collision tumors, immunohistochemistry, Diffuse large B-cell lymphoma,secondary malignancy
Juvenile Angiofibroma Protruding from the Nasal Cavity
Authors: Fong Voon Hoong , Yunus Mohd Razif Mohamad
Published: April 2019

Objective: To describe a case of juvenile angiofibroma with unusual protrusion out of the nasal cavity, and its management with surgery and radiotherapy.

Methods:

            Design: Case Report

            Setting: Tertiary Public Referral Centre

            Patient: One

Results: A 17-year-old gentleman presented with a huge tumor protruding from his left nostril, diagnosed with juvenile angiofibroma stage IIIA by MRI and angiography. Following successful pre-operative embolization, the protruding mass was ligated and truncated, followed by surgical resection via external approach. Post-operative residual tumor was treated with adjuvant radiotherapy. There was no evidence of recurrence after 9 months.

Conclusion: A high index of suspicion is of paramount importance in the diagnosis of JA and avoids the possibility of an unwarranted biopsy, which could spell disaster. The most useful tools for diagnosis are MRI and arterial angiography. Treatment is primarily surgical. Irradiation therapy has been reported to achieve satisfactory outcomes, especially for unresectable residual disease and/or intracranial extension, where total surgical resection is unlikely to be attained without unacceptable morbidity.

Keywords: juvenile angiofibroma, juvenile nasopharyngeal angiofibroma, head and neck tumor.
Carcinoma ex Pleomorphic Adenoma in the Parapharyngeal Space
Authors: Pal Sudipta , Pati Sampurna , Saha Somnath , Saha Vedula Padmini
Published: April 2019

Objective: To present a case of carcinoma ex pleomorphic adenoma in the parapharyngeal

space and discuss its management.

 

Methods:

Design:            Case Report

Setting:           Tertiary Government Teaching Hospital

Subjects:         One

 

Results:  A 40-year-old male patient with dysphagia for three months and a left-sided mucosa-covered oropharyngeal mass was found to have a prestyloid parapharyngeal lesion on CT Scans. Fine Needle Aspiration Cytology (FNAC) revealed a pleomorphic adenoma. With a past history of parapharyngeal pleomorphic adenoma excised transorally three years before, the present mass was excised by mandibular swing approach. Post-operative recovery was uneventful, but the final histopathological report was carcinoma ex pleomorphic adenoma.

 

Conclusion: Malignant transformation should be suspected in recurrent salivary tumors in the parapharyngeal space. Provided there was truly no pre-existing malignant focus in the originally-excised tumor, and that early recurrence was not due to inadequate initial excision, this patient had a rare condition where the same tumor underwent malignant transformation within 3 years only. To the best of our knowledge, such an early transformation to malignancy of a minor salivary gland tumor of the parapharyngeal space has not been reported in the English literature.

 

Keywords: carcinoma ex pleomorphic adenoma, pleomorphic adenoma, carcinoma,  parapharyngeal space, malignant, transformation, minor salivary gland tumor,  mandibular swing
Tokyo Declaration on Research Integrity and Ethical Publication in Science and Medicine in the Asia Pacific Region
Authors: WPRIM APAME IMSEAR
Published: April 2019

We, the participants in the Joint Meeting of the Asia Pacific Association of Medical Journal Editors (APAME), the Index Medicus for the South-East Asian Region (IMSEAR), and the Western Pacific Region Index Medicus (WPRIM) held in Tokyo from 2 to 4 August 2013:

 

CONSIDERING

That overwhelming data in science and medicine may differ in their reliability and that quality control is important for compiling scientific and health information;

That equitable circulation of scientific and health information is facilitated by fair collaboration among policy makers, researchers, and industry sectors including pharmaceuticals and publishers;

That APAME, IMSEAR, and WPRIM are important collaborative initiatives that can implement global guidelines for publication and dissemination of scientific and medical knowledge in an equitable and ethical manner;

 

CONFIRM

Our commitment to endorse that scientific and medical knowledge is imperishable and should not be assessed or evaluated by only economic or temporal considerations;

Our commitment to improve quality and reliability of scientific and medical knowledge through the IMSEAR and WPRIM;

Our commitment to publish reliable and high-quality information by education of researchers, implementation of fair review processes, and organization of networks through APAME;

Our commitment to collaborate with publishers, academic or public libraries, and research bodies to achieve equitable and ethical publication and dissemination of scientific and medical knowledge;

 

COMMIT

Ourselves, to publishing reliable and high-quality information, thereby setting the ethical standard for our colleagues, editors, and librarians in the Region;

Our publishers, to disseminating scientific and medical knowledge fairly and impartially through digital library services including, but not limited to, IMSEAR, WPRIM, and the Global Health Library;

Our organization, APAME, to building further networks, convening conferences, and organizing events to educate and empower editors, peer reviewers, and authors to achieve internationally acceptable, but regionally realistic, scholarly standards.

 

4 August 2013, Tokyo

 

This declaration was adopted at the 2013 Convention of the Asia Pacific Association of Medical Journal Editors (APAME) held in Tokyo from 2 to 4 August 2013. It is concurrently published by Journals linked to APAME and listed in the Index Medicus for the South East Asian Region (IMSEAR) and the Western Pacific Region Index Medicus (WPRIM). Copyright © APAME. www.wpro.who.int/apame   apame@wpro.who.int
Effects of Type 3 Thyroplasty on Voice Quality Outcomes in Puberphonia
Authors: Chowdhury Kanishka , Saha Somnath , Pal Sudipta , Chatterjee Indranil
Published: April 2019

Objective: To assess effects of type 3 thyroplasty on outcomes of voice quality in puberphonia.

Methods:

Design: Prospective Cohort

Setting: Tertiary Referral Hospital

Participants: 6 patients with puberphonia who failed voice therapy, aged 16-25 years, who consulted at the ENT Outpatient department between September 2010 and September 2012, underwent type 3 thyroplasty.

Pre-operative and 6-month post-operative voice analysis by voice recordings, Voice Handicap Index (VHI), GRBAS score and real time acoustic analysis (perturbation) using Dr Speech software (University version 4.0, Voice Tech Corporation, USA [Tiger Electronics]) using habitual fundamental frequency (F0), jitter % and shimmer % as parameters, were performed.

 

Results: Mean pre-operative VHI and GRBAS scores were 53 and 75.67 respectively whereas post-operative scores were 29 and 25.00 respectively. (P-value for VHI was 0.004 and that of GRBAS was 0.00). On acoustic analysis, mean pre-operative habitual fundamental frequency (F0), jitter % and shimmer % was 245.82 Hz, 0.21 and 2.34 respectively whereas post-operative mean was 140.78 Hz (P = 0.00), 0.19 (P = 0.04) and 1.52 (P = 0.00) respectively.

 

Conclusion: The mainstay of treatment of puberphonia is voice therapy. Thyroplasty provides a suitable management option in those cases who fail to respond by voice therapy.

 

Keywords: puberphonia, thyroplasty, laryngeal framework surgery, voice analysis
Drain verus No Drain After Thyroidectomy: A Preliminary Prospective Randomized Controlled Trial
Authors: Alamani Jefferson A. , Reala Elias T. , Castañeda Samantha S. , Chua Antonio H.
Published: April 2019

Objective: To evaluate the necessity of placing a drain in post-thyroidectomy patients, we aimed to determine whether insertion of a passive drain, as compared to no drain, in post-thyroidectomy patients, would significantly affect hematoma formation, wound infection, wound dehiscence and length of hospital stay.

Methods:

Study Design:            Prospective randomized controlled trial

Setting:                       Tertiary government training hospital

Subjects:                     Patients who underwent thyroidectomy for various thyroid pathologies were divided into two postoperative treatment arms: one group with insertion of a passive drain, and another group without a drain. Hematoma, wound infection, wound dehiscence, and length of hospital stay were the outcomes measured per treatment arm.

 

Results: A total of 66 patients were evaluated. There were 54 females (81.81%) and 12 males (18.18%). The mean age for the drain group was 44.88 years and 43.67 years for the no drain group. Four patients developed complications in the drain group and 2 developed complications in the no drain group. The rate of complications between both groups was not statistically significant.  The mean hospital stay of the drain group was 3.15 days, which in the no drain group was 2.51 days. The difference in length of hospital stay was statistically significant.

 

Conclusion:   There was no difference in the development of complications among the drain and no drain group. Thyroidectomy without surgical drains was associated with a significant reduction in hospital stay compared to thyroidectomy with routine placement of drains.

 

Keywords: Surgical drainage / methods, hematoma / prevention and control, postoperative complications / prevention and control, thyroid disease / surgery, thyroidectomy / methods
Auditory Steady State Response (ASSR) Frequency-Specific Thresholds with Absent Auditory Brainstem Response (click-ABR) Test Results among Filipino Children
Authors: Villarta Romeo L. , San Agustin Maria Luz M.
Published: April 2019

Objective: Determine the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results.

 

Methods:

This is a cross-sectional study analyzing the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results. The study population comprised of 99 pediatric patients referred for hearing assessment using electrophysiologic techniques at the Ear Unit of the Philippine General Hospital. The subjects underwent hearing threshold evaluation using both evoked-potential techniques (click ABR and ASSR) within a 1-month period from January 2009 to March 2014. The ASSR results of patients with absent click-ABR were collected and analyzed.

Results: There were 99 patients who underwent both ABR and ASSR. Of the 65 patients with absent ABR thresholds results, 13 patients had unilateral absent ABR while 52 had bilateral absent ABR results. The data of hearing tests from the combined 117 ears with absent ABR hearing tests were collected.

The proportion of children with ASSR thresholds with absent ABR per frequency were:

500 Hz - 45/117 (38.5 %);

1000 Hz - 76/117 (64.0 %);

2000 Hz - 63/117 (53.8 %); and

4000 Hz - 41/117 (35.0 %).

The proportion of children with ASSR thresholds with absent ABR per number of frequencies were:

4 frequencies - 19/117 (16.2 %);

3 frequencies - 32/117 (27.4 %);

2 frequencies - 22/117 (18.8 %); and

1 frequency - 44/117 (37.6%)

Conclusion: In the absence of click- ABR response, ASSR may provide information about the levels of severe to profound hearing loss among children.  The criteria of selection of candidates for intervention (hearing aids or cochlear implantation) should include results from hearing evaluation not only from behavioral and ABR thresholds but also from ASSR thresholds.  This may ensure that exclusion of some children with severe and profound hearing loss who may benefit from the intervention will be minimized.

 

Keywords: profound sensorineural deafness, evoked response audiometry, hearing thresholds
Response from the Authors
Authors: David Reylan B. , Lim William L.
Published: April 2019

Dear Sir:

We would like to express appreciation for the comments given as well as for sharing your research findings in relation to the case.

We agree that a neurological problem must be properly ruled out most expecially when there is a delayed onset of neurological symptoms with progression over time.  

Indeed, the presence of vocal fold dysfunction in children should make one consider CNS pathologies most common of which is the Arnold- Chiari Malformation.

However, the following are our reasons for concurring with the pediatric neurology service in not requesting imaging:

Aside from vocal fold paralysis, no other neurological symptom or finding was noted such as presence of swallowing and feeding difficulties, dizziness or uncoordination usually present in brainstem pathologies manifesting with vocal fold paralysis such as Chiari Type I1,2

Previous and subsequent neurological examinations showed a bilaterally intact gag reflex which somewhat made the possibility of a CNS lesion affecting the vagus unlikely. No findings indicative of cerebellar dysfunction (such as dysdiadokinesia) were noted

Thank you very much.

 

Reylan B. David, MD

reylandavid@gmail.com

William L. Lim, MD
The Use of a Soft Gel Capsule as a Medium for Modified Barium Esophagogram in Detecting Esophageal Foreign Body
Authors: Arenga Philip Jan P. , Villanueva Joebert M.
Published: April 2019

Objective:       To test a soft gel capsule with barium sulfate as a medium for modified barium esophagogram in detecting esophageal foreign body.

Methods:

Study Design:             Preliminary Diagnostic Test Assessment;

Consecutive Convenience Sample

Setting:                       Tertiary Government Hospital

Participants, Patients or Population: Soft gel capsule with barium sulfate was pilot tested on patients with a history and diagnosis of radiolucent foreign body ingestion between June 1 and November 30, 2014.

Results: Seven patients (6 males, 1 female; aged 26 – 61 years) underwent the procedure. In all seven, the enhanced capsule immediately stopped above the level of the esophageal foreign body, easily identifying the exact location of the obstruction. Foreign bodies included 1 embryonated duck-egg white “balut”, 5 chunks of pork meat and 1 claspless denture.  All were successfully marked by the capsule on fluoroscopy and documented on X-ray. Esophagoscopy under general anesthesia was successfully performed after fluoroscopy in all patients.

Conclusion:    We were able to improvise a new medium for use in modified barium esophagograms that was easy to prepare and that rendered good radiographic imaging and localization of radiolucent foreign bodies. A randomized trial in comparison to the prevailing test may confirm our findings further. Meanwhile, we recommend exploring the procedure in other hospitals as an alternative to barium-soaked cotton in the diagnosis of radiolucent esophageal foreign bodies

Keywords: soft gel capsule, barium suphate, esophagogram, esophageal foreign body
Complications of Head and Neck Reconstructive Surgery Using Axial Pedicled Flap
Authors: Dy Alexander Edward S. , Alfanta Eduard M. , Chiong Armando M.
Published: April 2019

Objectives: Axial flap surgery is associated with numerous complications. The purpose of this study is to determine the frequency of these complications, and identify possible factors contributory to their occurrence.

 

Methods:

Study design:       Cross-sectional study

 

Setting:                 Tertiary public university hospital

 

Subjects:              Records of all patients who underwent axial pedicled flap reconstruction at the otorhinolaryngology ward of our tertiary public university hospital from January 2013 to July 2015 were retrospectively reviewed, and data consisting of age, sex, diagnosis, disease stage, smoking history, alcohol intake, co-morbidities, past operations, pre-operative hemoglobin and albumin, total operative time, total blood loss, location and total area of the surgical defect, and length of hospitalization were tabulated.  All complications were listed. Data were analyzed for any potential trends.

 

Results: A total of 38 patients underwent axial pedicled flap reconstruction in the study period. Nineteen out of 38 (50%) cases involved complications. The most common complication was infection. Most of the complications occurred in males with history of alcohol intake, advanced cancer stage, significant blood loss, recurrent tumors, low pre-operative hemoglobin and albumin levels, and a large area of surgical defect.

 

Conclusions: The complication rate for axial flap surgery in our series was significant at 50%. Potential risk factors identified were male gender, advanced cancer stage, tumor recurrence, alcohol intake, low pre-operative hemoglobin and albumin levels, significant blood loss, longer operative time, and a larger surgical defect.

 

Keywords: surgical flaps, myocutaneous flap, axial flap, complications, risk factors
Arnica Montana and Blood Loss, Surgical Field Bleeding and Operative Time in Endoscopic Sinus Surgery: A Randomized-Controlled Trial
Authors: Salinas Michael Luke T. , Bato Charmagne Ross E.
Published: April 2019

OBJECTIVE: To determine the association of Arnica montana and blood loss, surgical field bleeding and operative time in endoscopic sinus surgery among adults with chronic rhinosinusitis with nasal polyposis.

METHODS:

STUDY DESIGN: Single-blinded Randomized Controlled Trial

SETTING:     Tertiary government hospital

PARTICIPANTS: Forty-one (41) adults aged 19-76 years old with chronic rhinosinusitis with nasal polyposis and meeting inclusion criteria were randomly divided into two groups, Arnica and control. The former took 5 sublingual Boiron® Arnica montana 30C pellets, 12 hours then 1 hour prior to surgery; the latter did not. Both groups had routine oxymetazoline and lidocaine-epinephrine decongestion. Intraoperative blood loss, surgical field bleeding quality and operative time were assessed by blinded surgeons and anesthesiologists.

RESULTS: Mean estimated blood loss was 187ml (SD 100.14) for controls versus 72ml (SD 12.59) for the Arnica group; (p < 0.05). Mean operative time was 3.55 hours (SD 1.25) for controls and 3.44 hours (SD 1.57) for the Arnica group; (p=0.9). Surgical field bleeding was graded slight with 75% needing occasional suctioning (grade 2) and 25% needing frequent suctioning (grade 3) in the Arnica group, versus moderate bleeding with more frequent suctioning (grade 4) in 71% and slight bleeding but needing frequent suctioning (grade 3) in 29% of controls.

CONCLUSION: In this randomized clinical trial, Arnica montana was associated with less blood loss and less surgical field bleeding compared to controls, but there was no difference in mean operative times.  Arnica montana may be effective in reducing blood loss and improving surgical field quality during endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis.

KEYWORDS: Arnica montana, hemostasis, surgical
Adult Acute Epiglottitis: An Eight - Year Experience in A Philippine Tertiary Government Hospital
Authors: Cruz Melanie Grace Y. , Almazan Natividad A.
Published: April 2019

Objective: To review cases of adult acute epiglottitis in a tertiary government hospital and describe the clinical presentations, diagnostics performed, management and outcomes.

Methods:

Study Design:            Retrospective Chart Review

Setting:                       Tertiary Government Hospital

Subjects: Records of patients admitted by or referred to the Department of Otolaryngology Head and Neck Surgery with a diagnosis of acute epiglottitis from January 2008 to August 2014 were identified from the department census and charts were retrieved from the Hospital Record Section and evaluated according to inclusion and exclusion criteria.  Information regarding demographic data, clinical features, laboratory and other diagnostic examinations, medical management, and length of hospital stay were collected.

Results: There were 20 cases in seven years and eight months. Most were male, 18 to 37-years-old, presenting with dysphagia, odynophagia and a swollen epiglottis on laryngoscopy. Abnormal soft-tissue lateral radiographs of the neck and leukocytosis were seen in 73 % and 83% respectively. Intravenous antibiotics and corticosteroids were administered in all cases, and mean hospital stay was 11.2 days.

Conclusion: Adult acute epiglottitis should be highly suspected in patients presenting with dysphagia, odynophagia, and muffling of the voice even with a normal oropharyngeal examination. History of respiratory infection, co-morbidities, smoking and alcohol intake, concomitant laryngeal pathology and supraglottic structure insults contribute to development of the disease.  Laryngoscopy is still the gold standard in diagnosis. Airway protection is mandatory but prophylactic intubation or tracheostomy are not advised.  Intravenous antibiotics are necessary and corticosteroids may be of benefit. 

Keywords: epiglottitis, supraglottitis, epiglottis, adult, Philippines
Motorcycle related cranio-maxillofacial injuries at a tertiary hospital in the Philippines
Authors: De la Cruz Rhodieleen Anne R. , Tuazon Rene S.
Published: April 2019

OBJECTIVE: To describe the type and determine the number of motorcycle related cranio-maxillofacial injuries that were seen by the ORL service in the emergency room of a tertiary hospital from January 2013 to December 2013

 

METHODS

Study Design:         Cross sectional retrospective chart review

Setting:                     Tertiary National University Hospital 

Subjects:                  One hundred nine charts of patients seen at the emergency room from January 2013 to December 2013 were reviewed

 

RESULTS:  Of the 109 charts of patients involved in vehicular accidents, there were 76 documented cases of motorcycle related accidents. Of these, 91% involved males and 9% involved females. Seventy one percent did not wear helmets, of whom 36% were young adult males between the ages of 18-30 years. Those that wore helmets had a total of 27 different facial fracture sites: 19% zygomatic tripod fractures, 15% temporal bone fractures and 11% with no fractures noted. Among those who did not wear helmets 75 fractures were noted. Twenty four percent were tripod fractures, 15% temporal bone fractures and 12% maxillary fractures. Only one did not incur any fractures.

 

CONCLUSION: Most cranio-maxillofacial fractures seen at the emergency room were from motorcycle related injuries (70%).  Despite implementation of Republic Act 10054 (The Motorcycle Helmet Act of 2009) majority of motorcycle-related accidents are still incurred by riders without helmets.

 

Keywords: cranio-maxillofacial fractures, motorcycle accidents, helmet, tripod fracture, temporal bone fracture
Diagnostic-To-Treatment Interval and Disease Progression among Head and Neck Cancer Patients Undergoing Surgery
Authors: Lapiña Gerard F. , Castañeda Samantha S.
Published: April 2019

Objectives: To determine whether the interval from pathological diagnosis to treatment is significantly delayed, and the presence or absence of disease progression occurring in those with, and without treatment delay, among head and neck cancer patients in our institution.

Methods:

Study Design:            Retrospective Chart Review

Setting:                       Tertiary Government Hospital

Subjects: Medical records of 70 patients with newly diagnosed head and neck cancer who underwent primary surgery from January 2011 to December 2015 were retrieved and available data were extracted. 

Results:  A total of 28 patients were included in this study.  Majority of the cancers were in the larynx (42.9%) and oral cavity (42.9%).  The mean diagnostic-to-treatment interval (DTI) was 54 days, but 5(17.8%) out of the 28 had a DTI of more than 60 days. Four (80%) with a DTI more than 60 days had an upstage during surgery while 4 (17.4%) patients with DTI less than or equal to 60 days also had an upstage. 2 (60%) patients with treatment delay had tumor progression compared to 5 (21.7%) of those without treatment delay.  Only 1 (20%) out of the 5 patients with treatment delay had increased nodal metastasis in contrast to 8 (34.8%) of those who did not have treatment delay.

Conclusion:  A number of patients undergoing surgery in our institution experienced delay to initiate treatment of more than 60 days and majority of these patients were noted to have disease progression. However, even patients with treatment prior to 60 days had increases in tumor stage, which may suggest that the interval aimed for should be shorter than 60 days.

Keywords: head and neck cancer, treatment delay, diagnostic interval, tumor progression