bluuebunny/crossref_metadata_2025 huggingface dataset:
Émile Borel et Henri Lebesgue : chronique d’une rupture annoncée
Authors: Gispert Hélène
Published: May 2024

Figures majeures des mathématiques au début du xxe siècle, Émile Borel et Henri Lebesgue ont échangé une abondante correspondance que Lebesgue rompt en décembre 1918. Une vingtaine de lettres de Lebesgue durant la guerre permettent de rendre compte de la singularité des itinéraires de ces deux mathématiciens pendant ces années et des effets des conditions d’exception, de violence et de brutalité auxquelles ils furent confrontés. Si, dès avant, des lettres pointent des différences majeures dans la façon dont ils exercent leur métier et conçoivent le rôle du mathématicien dans le monde savant et dans la société, la guerre semble avoir accentué et exacerbé ces dissonances entre les deux hommes, mais aussi entre les deux savants, dont les trajectoires, durant ces quatre années, s’éloignent spectaculairement.
Introduction - Des mathématiciens au travers de la Grande Guerre : un voyage au milieu des trajectoires
Authors: Aubin David
Published: May 2024

Ce numéro des Cahiers François Viète aborde l’étude de la Grande Guerre, telle qu’ont pu la vivre quelques savants et mathématiciens français, en analysant leurs trajectoires individuelles. Cette focalisation a pour but de resituer le savant comme agent individuel dans des événements collectifs et d’illustrer différentes générations et positions en 1914 : les jeunes combattants comme Henri Eyraud, les experts mobilisés au service de la défense nationale comme Charles Nordmann ou Albert Châtelet, les mathématiciens dans la force de l’âge tels que Henri Lebesgue et Émile Borel, ainsi que les savants plus âgés comme Jacques Hadamard, Robert-Émile Bourgeois ou Gaston Floquet. Ces études mettent en évidence les continuités et ruptures qui marquent leurs trajectoires au travers de la Grande Guerre.
Écrire pour le théâtre : modes de production et professionnalisation de l’auteur de théâtre brésilien dans la première moitié du XXe siècle
Authors: Vertchenko Henrique Brener
Published: May 2024

Occupant une position fondamentale dans les circuits de production et de transmission de textes pour le monde du spectacle, l’auteur de théâtre au Brésil a développé, dans les premières décennies du XXe siècle, des pratiques d’écriture uniques. Pour comprendre ce que signifiait alors écrire pour le théâtre, nous analyserons les conditions de base dans lesquels ce métier était exercé – avec la production de pièces à un rythme presque industriel –, ainsi que l’insertion des auteurs dans le milieu intellectuel et les ressorts de leur professionnalisation croissante.
Affinités futuristes : Aldo Palazzeschi dans la bibliothèque de Mário de Andrade
Authors: Klein Adriana Iozzi , Stefani Cláudia , Hass Juliana , Jesus Maurício Paschoareli de
Published: May 2024

Cet article traite de la relation entre le modernisme de Mário de Andrade et le futurisme d’Aldo Palazzeschi à travers l’étude d’ouvrages présents dans la bibliothèque de l’auteur brésilien et de certains de ses écrits publiés au tournant des années 1920. L’analyse d’une partie de ce vaste corpus montre que Mário de Andrade a lu attentivement des œuvres de Palazzeschi telles que L’Incendiario et Il Codice di Perelà, parues à l’époque où l’auteur florentin était lié aux futuristes, et qu’il s’est reconnu dans des prémisses structurant ces productions. Il s’agit ici des premiers résultats d’une étude en cours, qui retrace les connexions entre futurisme italien et modernisme brésilien et témoigne du dialogue, encore peu exploré, entre deux auteurs fondamentaux pour la construction esthétique au sein des avant-gardes du XXe siècle.
Traumatisme culturel et victimes de la dictature sous le gouvernement Bolsonaro
Authors: Vitorino Matheus , Goulart Barbara
Published: May 2024

Cet article porte sur la Commission d’amnistie au Brésil, l’organisme chargé d’indemniser les victimes de la dictature militaire. Notre objectif est de comprendre ce que l’on appelle la déconstruction du traumatisme, qui nécessite la mobilisation de présupposés moraux et politiques, autant pour critiquer, que pour soutenir les travaux de la Commission d’amnistie. Pour cela, nous avons analysé des discours publics prononcés lors des commissions législatives et des séances plénières de la Chambre des députés, sous le gouvernement Bolsonaro.
« Nous nous voulons vivantes, libres et sans peur » : une analyse du processus d’adoption de la loi Maria da Penha au Congrès national brésilien
Authors: Sanchez Beatriz Rodrigues
Published: May 2024

Comment fonctionne le lien entre la présence de femmes au parlement et l’approbation de projets de loi en faveur de l’égalité de genre ? Pour répondre à cette question, je me suis intéressée au processus d’adoption de la Loi Maria da Penha au Congrès national du Brésil. Sur le plan méthodologique, j’ai réalisé une étude de cas en m’appuyant sur l’analyse de documents et d’entretiens. Celle-ci a permis d’identifier des mécanismes qui contribuent à articuler la représentation descriptive et la représentation substantive des femmes. Parmi ces mécanismes figurent : la capacité à traduire les demandes des mouvements en normes juridiques, le soutien du pouvoir exécutif, la formation de coalitions majoritaires au sein du pouvoir législatif, l’implication des mouvements féministes dans la défense de la proposition et l’occupation par des fémocrates de fonctions de leadership au sein du parlement.
Activités saunières et artisanat des alliages cuivreux à la transition des deux âges du Fer sur le littoral atlantique : le Parc Savari à Guérande, Loire-Atlantique
Authors: Bellanger Patrick , Cornec Joël
Published: May 2024

L’opération de fouille archéologique préventive conduite en 2008 sur une surface d’environ 16 000 m² a mis au jour des vestiges dont la chronologie comprend le Néolithique moyen la transition entre le premier et le second âge du Fer et plus succinctement La Tène finale et l’Antiquité.La principale phase d’occupation se caractérise par un site d’habitat implanté en tête de vallon et daté de la transition entre le Hallstatt final et La Tène ancienne. De nombreux vestiges attribués à cette période ont été découverts : probables bâtiments d’habitation, greniers et constructions diverses, lambeaux de sols, chemins, enclos, foyers, structures de combustion à vocation vraisemblablement artisanale et structures liées à une production salicole. Le mobilier collecté, tant domestique (céramiques, une cuillère ou un creuset en terre cuite, un fragment de bracelet en schiste) qu’artisanal (éléments de briquetage, fragments de tuyères, moules de bronzier, fusaïoles), ainsi que les données paléoenvironnementales fournies par les analyses palynologiques témoignent de l’intérêt scientifique du site du Parc Savari.
Agile Tech
Authors: Eswaran Ushaa , Eswaran Vishal , Eswaran Vivek , Murali Keerthna
Published: May 2024

This chapter delves into the core practices of agile software development, with a focus on crafting user stories and prioritizing features to align IT projects with customer needs effectively. It explores techniques for transforming customer requirements into actionable user stories that drive development efforts. Additionally, the chapter examines various prioritization frameworks, such as Kano Model and MoSCoW, to ensure that the most valuable features are delivered first. Through real-world case studies and practical examples, the chapter aims to equip readers with a comprehensive understanding of these crucial agile practices. The conclusion highlights the benefits of adopting a customer-centric approach and the importance of continuous collaboration between development teams and stakeholders for successful agile project delivery.
Beyond Scrum
Authors: Bhattacharya Saurabh , Shukla Kasturi , Shukla Amit
Published: May 2024

Agile project management (APM) is essential to guiding projects toward success, as demonstrated by the quick evolution of project management techniques in the face of shifting organizational environments. This investigation is driven by research questions that aim to identify emerging patterns and modifications in APM procedures. This study examines current advancements by taking the time frame for literature inclusion into account, which makes it a relevant and contemporary analysis. Results highlight the diversity of Agile methods, including modifications within approaches like Kanban and Lean, SAFe (Scaled Agile Framework), Extreme Programming (XP), DevOps with Agile, and Large-Scale Scrum (LeSS). The review clarifies how organizational cultures are changing and highlights how a cooperative and open atmosphere is necessary to support the changing APM paradigm. Moreover, the amalgamation of obstacles encountered by establishments when using agile methodologies beyond Scrum drives conversations toward practical remedies and approaches
Evaluating Waterfall vs. Agile Models in Software Development for Efficiency and Adaptability
Authors: Gupta Subir , Dutta Pushan Kumar , Roy Soumojit , Bhaduri Aparna , Maji Kalyan , Choudhary Abhik , Sarkar Asmita
Published: May 2024

This chapter comprehensively compares the Waterfall and Agile software development models, focusing on methodologies, effectiveness, and adaptability for different projects. Using research and case studies, it details each model's unique traits, strengths, and limitations, offering insights for managers, developers, and stakeholders. The Waterfall Model follows a linear, sequential approach divided into phases: requirements, design, implementation, testing, deployment, and maintenance. Its systematic nature suits projects with fixed, well-defined requirements where predictability is crucial, allowing effective resource management. In contrast, Agile is flexible and iterative, broken into short cycles emphasizing client involvement and teamwork. Ideal for dynamic environments with evolving requirements, it supports innovation, customer satisfaction, and user-focused solutions through regular client feedback. In conclusion, the document advocates for a flexible application of these methodologies, encouraging leaders to adapt based on project demands.
Challenges and Opportunities in Green Finance
Authors: Manoharan Geetha , Nithya G. , Razak Abdul , Sharma Seema , Ashtikkar Sunitha Purushottam
Published: May 2024

Carbon-intensive industries like steel cause climate change. Corporate carbon reduction is needed to fight climate change. This enormous project requires green funds. Circular, energy-efficient, and climate-friendly funding. Modern projects' green financial pros and cons are discussed here. Despite its obstacles, this report explores India's green finance potential. Climate change surprises affect finances, time, and frequency. Despite obstacles, worldwide initiatives like the Financial Stability Board's four building blocks—disclosures, data, vulnerability assessments, and regulatory practices—are strengthening the financial system. Strong frameworks need similar disclosures to enhance decision-making. This argument concerns ISB and Climate-related Financial Disclosures Task Force. The SEC and RBI improved stock exchange-listed firm transparency. In India, “green deposits,” ESG funds, and internal carbon pricing show green finance's potential. PPP maintains investment. Control and adapt to changing situations. India's economic and environmental interests drive green financing.
Revolutionizing Healthcare
Authors: Varpe Aishwarya , Dash Aiswarya , Kumar Ranjit
Published: May 2024

The healthcare sector has undergone a significant transformation with the emergence of telemedicine and remote monitoring technologies. Telemedicine uses technology to provide healthcare services from a distance, breaking down geographical barriers and making medical care more accessible. In this chapter, the author provides a foundational understanding of these innovations, starting with an overview of telemedicine and remote patient monitoring. Then the author explores their applications in healthcare, encompassing virtual consultations, real-time patient data monitoring, diagnostics, treatment adherence, and chronic disease management. The exploration spans various applications of telemedicine, from real-time video consultations to AI-driven diagnostic support. Furthermore, its benefits, addressing challenges, including privacy considerations and regulatory frameworks, underscoring the need for a balanced approach to ensure equitable, secure, and patient-centric solutions, technological limitations, future trends, and some case studies are discussed in this chapter.
Using CNN for Brain Tumor Diagnosis
Authors: Kulkarni Shravani , Bhosale Piyush Amol , Das Susanta
Published: May 2024

Brain tumor diagnosis has been revolutionized with the advent of deep learning technique: CNN. The chapter explores the application of CNN in the medical diagnosis of brain tumor using MRI and CT scan images. Initially, the simplified explanation of CNN with basic architecture is shown. Later, the operational mechanism of CNN is explained which is which serves in brain tumor detection with high accuracy and precision. It mimics human perception and analyzes intricate details within images that signify the presence of an ailment. In the later part, the concept of brain tumors is discussed along with the importance of early detection of brain tumors is also highlighted outlining the impact on individuals. In the subsequent part, the training process of CNN to detect brain tumors is discussed to equip readers with the requisite knowledge and skills to train the model. Demonstrating the relationship between CNN and medical imaging techniques, this chapter aims to reduce the complexity in the process of brain tumor detection, highlighting the transformative potential of CNN in healthcare services.
Shaping the Future of Healthcare With BERT in Clinical Text Analytics
Authors: Chaudhari Archana Kedar
Published: May 2024

Over the last two decades, electronic health records (EHRs) have evolved as a crucial repository for patient health data, encompassing both structured and unstructured information. The objective of EHR is to enhance patient care, and also to serve as tool for reducing costs, managing population health, and supporting clinical research. Natural language processing (NLP) has emerged as a valuable tool for analyzing narrative EHR data, particularly in named entity recognition (NER) tasks. But traditional NLP methodologies encounter challenges to analyze biomedical text due to variations in word distributions. Recent advancements in NLP, specifically bidirectional encoder representations from transformers (BERT), offer promising solutions. BERT utilizes a masked language model base and bidirectional transformer encoder architecture to learn deep contextual representations of words. The work provides an overview of the BERT algorithm, its architecture, and details of and its varaints like BioBERT and ClinicalBERT for various clinical text classification applications.
AI in Bioinformatics and Computational Biology
Authors: Kausar Amna , Kausar Afrah , Das Susanta
Published: May 2024

The integration of artificial intelligence (AI) techniques with bioinformatics and computational biology has enabled unmatched insights into complex biological systems and processes. This has paved the way for groundbreaking innovations in biomedicine and biotechnology, with the potential to revolutionize drug discovery, personalized medicine, and therapeutic strategies. AI algorithms, including machine learning, deep learning, natural language processing, and data mining, have proven to be powerful tools for analyzing large biological datasets and extracting meaningful insights. Collaborations between computer scientists, biologists, and clinicians are essential in harnessing the potential of AI in biology and medicine. Ongoing research and interdisciplinary collaboration are crucial to address ethical challenges such as data privacy, patent laws, and the bioethics of AI algorithms. Future advancements in AI algorithms tailored for bioinformatics applications hold immense promise in enhancing data quality and interpretability and driving transformative innovations in healthcare.
MMD Fence GAN Unsupervised Anomaly Detection Model Based on Maximum Mean Discrepancy
Authors: Niu Lu , Li Zhenping , Li Shaobo
Published: May 2024

Due to data imbalances and the complexity of data, identifying outliers can be challenging. To address this issue, this paper introduces a new unsupervised model called MMD Fence GAN. An improved loss function is incorporated into the generator to enhance anomaly detection accuracy. In the loss function of the generator, there are three main components: the encirclement loss limits the generated samples to lie at the decision boundary of the normal samples. The central dispersion loss maximizes the decision boundary's range. By measuring the maximum mean discrepancy between the generated samples and the given samples, the sample dispersion loss avoids issues like model collapse and outliers. Two datasets validate the effectiveness of the model: On the 2D synthetic dataset, it converges faster and pinpoints decision boundaries more precisely than Fence GAN. Both F1-score and recall improve over traditional and advanced deep learning methods on the KDD99 dataset.
Nurse Educators, Clinical Nurses and Students’ Knowledge, Attitude and Practice towards Nursing Education in Bhutan
Authors: Moktan Manikala , Devi Elsa Sanatombi
Published: May 2024

Background:

In Bhutan, the Health School started in 1972 providing a 2-year certificate course for community health workers, assistant nurses and assistant technicians. In 1982, the Diploma course for nurses commenced and was assisted by the RAK College of Nursing Faculty, New Delhi, India, in formalising the curriculum and also carried out the evaluation of the first batch of nursing students.

Objective:

The study assesses the knowledge, attitude and practice (KAP) of nurse educators (NEs), clinical nurses and students undergoing the Diploma in Nursing and Midwifery training towards nursing education in Bhutan.

Methods:

The methodology was a quantitative study using a self-administered questionnaire. The first section had demographic data, and the second had questions on KAP. The participants were NEs, students and clinical nurses. The study was done in the nursing institute, the national hospital and the district hospitals. The instrument, i.e. questionnaire, had a five-point Likert scale from ‘excellent, good, fair, poor, to very poor’

Results:

In the results, students rated the KAP of NEs and clinical nurses as ‘good’. On the contrary, the attitude of students towards ‘gaining knowledge from the clinical area’ and their ‘eagerness to learn nursing’ are rated ‘fair’

Conclusion:

The KAP provides a detailed view of the status of nursing education, and the data obtained from the study provide strong baseline information for nursing education in the future.
Tissue microarray based immunohistochemical study of TLE1 in synovial sarcoma and its histologic mimics
Authors: Sivakoti Sumitra , Uppin Shantveer G , Uppin Megha S , Tara Roshini P , Prayaga Aruna k. , Challa Sundaram
Published: May 2024

Background and Aims:

Molecular analysis is gold standard for diagnosis of synovial sarcoma (SS) but use of these ancillary techniques is limited by many practical issues like cost and limited resources. Several studies analyzed TLE1 as a diagnostic immunohistochemical marker for synovial sarcoma and few studies disagreed. The objective of the study was to evaluate immunohistochemical expression of TLE1 in synovial sarcoma and its histological mimics.

Methods:

The study included a total of 63 cases; of which 28 were synovial sarcomas (SS) and 35 its histologic mimics. A tissue microarray was constructed from these cases and subjected to TLE immunostaining. Nuclear immunoreactivity of TLE1 was graded as 0, 1+, 2+ and 3+ based on intensity and percentage of cells.

Results:

All SS except one (27/28; 96.4%) were positive for TLE 1. These included 18 of monophasic spindle cell type (94.7%), 5 biphasic type (100%), followed by two each (100%) of poorly differentiated and calcifying type of SS. Of the other tumours 2 GISTs (50%), 2 haemangiopericytoma (66.7%), 2 schwannomas (50%) and one mesenchymal chondrosarcoma (33.3%) were positive for TLE1.

Conclusion:

TLE 1 is a highly sensitive marker with reasonable specificity for synovial sarcoma. Awareness of TLE1 expression in other tumours, is important to avoid misdiagnosis.
Malignant mesothelioma
Authors: Patel Tarang , Aswal Priyanka
Published: May 2024

Introduction:

Malignant mesothelioma is an aggressive neoplasm arising from serosal lining and has a poor prognosis. Definite diagnosis requires confirmation through a biopsy; however, it is sometimes difficult on microscopic evaluation alone and requires the use of a wide panel of immunohistochemical markers. So, immunohistochemistry (IHC) is of paramount importance and must be routinely used for a definite diagnosis. Till date, very few studies on morphology and detailed IHC markers of mesothelioma have been reported from India.

Aims:

To analyze the histomorphological findings of malignant mesothelioma, study the utility and role of the various immunohistochemical markers.

Material and Methods:

A total of 76 cases of mesotheliomas diagnosed at a tertiary cancer center in Udaipur were analyzed retrospectively from January 2015 to January 2020. Comprehensive data were analyzed including demographic, clinical, radiological, histopathological features along with a wide panel of IHC markers.

Results:

Mesothelioma occurs over a wide age range from 40 to 70 years. It most commonly involved pleura in 68 cases (89.47%) with very few cases from the peritoneum. On computed tomography (CT) scan, nodular pleural or peritoneal thickening was present. On microscopy, the most common histopathological type was epithelioid mesothelioma (58 cases, 74.3%) followed by sarcomatous (9 cases, 12.8%), deciduoid (6 cases, 8.6%), and 3 cases of biphasic (4.3%). On IHC, WT1, mesothelin, and calretinin markers were positive in 85.91%, 80%, and 93.33% cases of mesothelioma, respectively. Other markers were helpful to rule out differential diagnosis in difficult scenarios.

Conclusion:

Therefore, the correlation of histopathology with clinico-radiological findings and judicious use of a panel of IHC markers is required for routine evaluation and definite diagnosis. IHC is also useful in situations with similar morphological spectrum in specific locations.
MUC1, CK20, and CDX2 immunohistochemical markers can sub-classify periampullary carcinomas into pancreaticobiliary, intestinal, and mixed subtypes
Authors: Manohar K. Murali , Sasikala M. , Anuradha S. , Ramji C. , Sashidhar R. B. , Rao G. V. , Pradeep R. , Reddy D. Nageshwar
Published: May 2024

Introduction:

Pancreaticobiliary subtype of Periampullary carcinoma (PAC) has a poor prognosis in comparison to the intestinal subtype. We assessed the potential of cytokeratins and mucin markers to classify the sub-types of periampullary tumors and compared them with the survival data to identify markers that may predict prognosis.

Methodology:

PAC tumor tissues were obtained from 94 patients undergoing Whipples Pancreaticoduodenectomy. Paraffin-embedded tissues were immunostained with cytokeratins CK7, CK20), mucins (MUC1, MUC2, MUC5Ac), and CDX2 antibodies. The survival status of patients was obtained as follow-up up to 5-years of surgery. The Receiver Operating Character Curve (ROC) analysis was used for detecting sensitivity and specificity. The survival data were analyzed using the Kaplan-Meier survival curve.

Results:

Tumors were initially categorized on the basis of histological classification as pancreaticobiliary (n = 46), intestinal (n = 35) and indeterminate (n = 13). Further, using immunohistochemical markers (MUC1, CK20, and CDX2), we gave systematic classification of IHC-PB (n = 51), IHC-Int (n = 30) and IHC-Mixed (n = 13). The interobserver analysis showed good agreement between histologic and IHC type with a kappa value of 0.554. Combined expression of CK20, MUC1 and CDX2 accurately classify the mixed type of tumor. Overall survival rate and duration were 74.4% and 44.95 ± 2.29 months. Survival analysis for subtypes reveal, pancreaticobiliary tumors have low survival (27.9 ± 1.63 months) than mixed type (35.5 ± 0.45 months) and intestinal-type (52.92 ± 2.18 months). Among these, intestinal-type have better survival. Only TNM Stage III (tumor staging as per American Joint Committee on Cancer classification) and perineural invasion have been associated with predicting poor survival in PAC patients.

Conclusion:

Our results suggest that the combined expression of MUC1, CK20 and CDX2 could serve as markers to diagnose histological inconclusive specimens as mixed subtype tumors.
Comparative analysis of chromogenic vs clot.based one stage APTT assay for determination of factor VIII level
Authors: Baig Mirza Asif , Swamy KB
Published: May 2024

Background:

In the laboratory, factor VIII can be measured by three different methodologies, such as one-stage clotting assay, two-stage clotting assay, and chromogenic assay. These assays differ in ease of use, variety of reagents available, sensitivity to mild hemophilia A, and interference from lupus anticoagulants (LACs). Certain factor VIII gene mutations can cause discrepancy in results between one-stage activated partial thromboplastin time (APTT) and chromogenic assays.

Materials and Methods:

The coagulometer for factor VIII assay is Sysmex CS-5100. All data were expressed as mean ± standard deviation (SD).

Results:

A total of 135 cases were studied. Of these, 100 cases were of mild hemophilia A diagnosed by molecular genetics and, 15 cases were positive for LAC, which were confirmed by dilute Russell Viper venom test. Clot-based one-stage APTT assay showed 65% sensitivity and 80% specificity in diagnosing mild hemophilia A cases and out of 15 LAC cases, it showed false positivity in five cases. Chromogenic assay showed 85% sensitivity and 90% specificity in diagnosing mild hemophilia cases and was 100% specific in excluding LAC cases.

Conclusions:

One-stage APTT assay is the most commonly used test for determining factor VIII levels but chromogenic assay are considered as the gold standard and recommended as the reference method by European Pharmacopoeia and ISTH subcommittee. Mild hemophilia A patients with missense mutations show discrepancy between the one-stage clot-based APTT assay and chromogenic assays for determination of factor VIII level and this can lead to misdiagnosis or misclassification of mild hemophilia A. Therefore, it is recommended that both the assays should be used in the evaluation of mild hemophilia cases.
A Case of Mastoiditis Complicated with Bezold Abscess in the Only Hearing Ear
Authors: Goh Siang Poon , Hashim Noor Dina , Zaki Faizah Mohd , Abdullah Asma
Published: May 2024

Bezold abscess (BZ) is defined as a deep neck abscess as the result of mastoiditis with mastoid tip erosion after otitis media (OM). Despite its rare occurrence due to the early intervention of ear infection with antibiotics, diligently looking for this complication is important, especially in the immunodeficient population. The utilization of radio imaging remains crucial in the management of acute OM with complications. The contrast-enhanced computed tomography facilitates the diagnosis and provides a glimpse of the disease extension. Early recognition and intervention are vital for a good outcome. The authors present a case report of a mastoiditis complicated with a BZ in the only hearing ear. The risk factors, presentations, and treatment options are discussed, along with the review of the literature.
Effect of Spectrally Modified Speech on Speech Perception of Native Speakers of Marathi
Authors: Rathna Kumar S. B. , Patil Prajakta Prafulla , Saxena Udit , Bapuji Mendem , Chacko Gish
Published: May 2024

Objective:

We investigated the effect of spectrally modified speech on speech perception of native speakers of Marathi.

Methods:

A total of eight word-lists with each list consisting of 25 words in Marathi were used as speech stimuli. The speech stimuli in List 1, List 2, List 3, List 4, List 5, List 6, and List 7 were spectrally modified by filtering them at 500 Hz, 1000 Hz, 1500 Hz, 2000 Hz, 2500 Hz, 3000 Hz, and 3500 Hz cutoff frequencies, respectively. The speech stimuli in List 8 were unfiltered. The speech identification score (SIS) testing was performed as a measure of speech perception using eight word-lists on a total of 125 normal hearing native speakers of Marathi in the age range between 18 and 25 years.

Results:

The results revealed that there was a statistically significant effect of spectral modification on speech perception. An increase in cutoff frequency of speech stimuli was analogous to increase in speech perception performance. The normal range of SIS (90%–100%) was achieved for speech stimuli filtered at 2500 Hz cutoff frequency.

Conclusion:

Although speech is a broadband signal, the findings of this study suggest that the spectral information till 2500 Hz is sufficient for optimum perception of speech of Marathi.
Facial Nerve Palsy - A Rare and Underrecognized Neurological Manifestation of Rhino-Orbito-Cerebral Mucormycosis with Potential for Misdiagnosis
Authors: Ojha Tarun , Gupta Priyanshi , Kataria Vaishali , Sharma Kanika
Published: May 2024

Rhino-orbito-cerebral Mucormycosis is a rapidly aggressive disease having various clinical presentation like facial pain, nasal stuffiness, headache, retro-orbital pain, orbital swelling, ophthalmoplegia and visual loss. Multiple cranial nerves can be involved, however facial nerve palsy has been rarely reported. We aim to highlight the involvement of facial nerve as a presenting symptom. Mucormycosis should be kept as a differential in these cases for rapid diagnosis and treatment initiation to provide a good overall outcome.
Canalplasty in Tympanoplasty – Functional and Surgical Outcome
Authors: Verma Ravneet Ravinder , Verma Ravinder
Published: May 2024

Background:

During repair of central perforations of tympanic membrane, annulus should be visible in a single view. It helps in better placement of graft. To attain this, the bony canal is enlarged.

Materials and Methods:

Eighty patients with dry central perforation were selected during the period 2010–2020. Sixty patients with dry central perforation underwent tympanoplasty Type 1 with canalplasty and twenty patients were subjected to tympanoplasty Type 1 only. The method, operative procedure, and words of wisdom to give good results and prevent complications are described.

Results:

Patients with canalplasty had better postoperative results, and the success rate is improved as compared to only myringoplasty. The primary outcome measure of canalplasty with tympanoplasty procedure is complete re-epithelization and provision of a dry ear in 95%, whereas the final outcome without canalplasty was 90%.

Conclusion:

The aim of the canalplasty is to create a wide, patent, and physiological bony ear canal. Canalplasty helps to have better visualization, better postoperative care, better exposure for ossiculoplasty, time gain during graft placement, prevent lateralization, and promotes healing. It does improve the surgical outcome in tympanoplasty Type I.
A Comparative Study between Topical Versus Combined (Systemic Plus Topical) Therapy in Ciprofloxacin-Sensitive Chronic Suppurative Otitis Media (Tubotympanic)
Authors: Parmar Sandip M. , Chauhan Sapna , Mittal Shweta , Chaudhary Meenu
Published: May 2024

Introduction:

Chronic suppurative otitis media (CSOM) is defined as a chronic inflammation of the middle ear and mastoid cavity, which presents with recurrent ear discharge or otorrhea through a tympanic perforation.

Aim:

The study aimed to compare the effectiveness of topical versus combined (systemic and topical) therapy in ciprofloxacin-sensitive CSOM (tubotympanic).

Materials and Methods:

A hospital-based prospective study of 100 patients aged >18 years with clinically diagnosed CSOM (tubotympanic type) was conducted. After aural toilet, patients were randomly assigned to one of the two treatment groups: Group A (topical ciprofloxacin ear drops) Group B (topical plus oral ciprofloxacin). These patients were received 1 week of treatment and followed up on day 3 and day 7. Statistical comparisons were performed using Chi-square test.

Results:

In this study, maximum numbers of patients were found in the age group of 20–29 years. Patients in Group A (topical ciprofloxacin ear drops) showed less side effects in comparison to Group B (topical plus oral ciprofloxacin). Forty-one (82%) patients showed improvement in Group A, whereas 43 (86%) patients in Group B.

Conclusion:

Topical ciprofloxacin drops were as effective as combined (oral plus topical ciprofloxacin) and that the addition of oral drug did not have any beneficial effect adding only to the side effects and to the cost of treatment.
Congenital Mastoid Cholesteatoma of Adult Patient Masquerading as Complicated Otitis Media – A Case Report and Literature Review
Authors: Ramamourthy Balaji , Ramavat Anurag Snehi , Hage Neemu , Govind Arun
Published: May 2024

The study highlights the management protocol of a large mastoid cholesteatoma presenting with sudden-onset facial palsy mimicking a complicated otitis media and literature review. Congenital cholesteatoma may affect various regions of the temporal bone, the mastoid process being the least frequently involved. The diagnosis is often missed, specifically when the patient presents with features of mastoiditis. Radiology plays an important role in clenching the diagnosis. Congenital (mastoid) cholesteatoma manifesting with features of complicated otitis media is a rare occurrence and needs familiarity to facilitate early diagnosis and appropriate management.
Utricular Dysfunction by Subjective Visual Vertical after Canalolith Repositioning Maneuvers for Posterior Semicircular Canal Benign Paroxysmal Positional Vertigo
Authors: Sanji Rajiv Ranganath , Patil Sanjay B. , Channegowda Chandrakiran , Ishwarya R. , Rakshitha R.
Published: May 2024

Introduction:

Residual vestibular dysfunction is a common sequela of benign paroxysmal positional vertigo (BPPV), causing morbidity even after the resolution of vertigo with otolith repositioning maneuvers. The subjective visual vertical (SVV) measurement is used to detect the vertical spatial disorientation which may be associated with utricular dysfunction. We used the bucket test to measure possible residual utricular dysfunction in patients with BPPV after successful treatment of BPPV with canalolith repositioning maneuvers.

Objective:

(1) To document the presence of utricular dysfunction after canalolith repositioning maneuvers for posterior semicircular canal BPPV using bucket test for SVV. (2) To compare the difference in residual utricular dysfunction represented by SVV after Epley's and Semont's maneuvers.

Study Design:

Prospective, clinical, single center, cross sectional study. Methods: Sixteen consecutive patients attending ENT OPD at a tertiary care hospital for canalolith repositioning maneuvers for posterior semi circular canal BPPV underwent bucket test for SVV on the first follow up after a single physician directed maneuver for the correction of BPPV.

Results:

Sixteen bucket test results were analyzed after repositioning manoeuvres – twelve of which were Epley's maneuver and four were Semont's maneuver. Fourteen had a deviation of SVV more than 2° s. There was a significantly lower mean deviation of SVV following Semont's maneuver versus Epley's maneuver.

Conclusion:

There is a residual vertical spatial disorientation following repositioning maneuvers which contributes to dizziness after treatment. Our new finding was a lower mean deviation in SVV after Semont's compared to Epley's maneuver. Larger studies are required to confirm our findings with better statistical weight.
Managing Eustachian Tube Dysfunction with Balloon Catheterization
Authors: Tan ST , Hashim Noor Dina , Abdullah Asma
Published: May 2024

Objective:

Eustachian tube dysfunction (ETD) is not commonly acknowledged until it leads to sequelae within the middle ear. Thus, treatments are focusing on treating active middle ear diseases repetitively rather than identifying possible fundamental causes. This study aims to report a preliminary local experience in treating ETD using balloon dilatation.

Methods:

This prospective, randomized controlled study was conducted in a tertiary academic center. Sixteen patients who were identified with symptoms of ETD were recruited. Six who had failed initial medical therapy underwent balloon dilatation of Eustachian tube (BDET); meanwhile, ten subjects were recruited into the medical treatment group. The primary efficacy endpoint was the comparison of reduction from baseline in overall 7-item Eustachian Tube Dysfunction Questionnaire (ETDQ-7) score. Added endpoints were normalization of tympanogram and improvement of tympanic membrane appearance at 2 weeks, 6 weeks, and 3 months after intervention.

Results:

The median in reduction of overall ETDQ-7 score for the interventional group was 2.93 (2.14, 3.14) versus 0.43 (0, 0.86) for the control group. Reduction in overall ETDQ-7 score showed a significant improvement at 6 weeks which was persistent at 3 months post balloon dilatation (P < 0.05). Similarly, the BDET group demonstrated changes in tympanogram at 6 weeks and 3 months post balloon dilatation (P < 0.05). Tympanic membrane appearances were similar at the end of the study in both the groups.

Conclusion:

BDET is a promising precise treatment for patients who present with symptoms of ETD. The improvement of symptoms it provides may increase the readiness for it to be introduced as a standard practice in local settings and beyond.
Correlation of Eustachian Tube Dimension and Chronic Otitis Media
Authors: Varghese Sherin , Goutham MK , Saldanha Marina , Aroor Rajeshwary , Uppoor Raghuraj , Bhat Vadisha Srinivas
Published: May 2024

Background:

Eustachian tube (ET) is a dynamically intricate and poorly accessible structure connecting the nose and the middle ear. Although chronic otitis media (COM) is multifactorial disease, ET dysfunction is an important but overlooked predisposing factor. With newer evidence into the dynamics and prognostic factor in outcome of middle ear surgeries, it has become a focus of research. Our study aims to evaluate the various ET parameters using high-resolution computed tomography (HRCT) scan with multiplanar reconstruction technique. These parameters were compared between the diseased and normal ears to evaluate any association between the ET parameters and middle ear disease.

Materials and Methods:

It is a retrospective study of 66 HRCTs, with 47 HRCTs of COM and rest were controls. ET parameters including (a) ET-angle, (b) length, (c) pretympanic diameter, and (d) diameter at isthmus are measured accurately using HRCT temporal bone.

Results:

ET angle was significantly obtuse in COM group (154.81° ± 6.33°) when compared with the controls (149.99° ± 6.24°) with P < 0.001. Similar observation in ET angle was noted in diseased ear (154.54° ± 5.79°) in unilateral COM when compared with contralateral ear (149.56° ± 6.87°) (P = 0.001). ET was longer in COM group (3.44 ± 0.31) when compared with controls (3.4 ± 0.35). Pretympanic diameter and diameter at isthmus were greater in control group.

Conclusion:

The obtuse ET angle and narrow pretympanic diameter may contribute to the pathogenesis of COM. These measurements may be useful in the assessment of ET function preoperatively and might help in determining the surgical outcome. HRCT of temporal bone with multiplanar reconstruction is an effective tool to measure ET dimensions accurately.
Role of Tympanoplasty on Eustachian Tube Dysfunction in Chronic Otitis Media – Mucosal Disease
Authors: Ravikumar Aishwarya , Kamath P. Shrinath D. , Goutham MK , Bhat Vadisha , Aroor Rajeshwary , Sreesan P. S.
Published: May 2024

Aim:

To assess the Eustachian tube function (ETF) in chronic otitis media (COM)-mucosal disease and the role of tympanoplasty in ETF.

Materials and Methods:

A longitudinal study from January 2019 to June 2020 which comprised of 110 patients diagnosed with COM– mucosal disease was carried out in a tertiary care referral hospital. They were divided into mucosal active (n = 34) and mucosal inactive (n = 76) groups. Preoperative ETF was assessed with immittance audiometry by Toynbee's method. All patients underwent tympanoplasty with or without cortical mastoidectomy depending on the disease status. Postoperatively between 8 and 12 weeks after successful graft uptake, ETF was tested by William's test.

Results:

Out of 110 patients, 29 had Eustachian tube dysfunction preoperatively and 27 had normal ETF posttympanoplasty ± cortical mastoidectomy. Mc Nemer test was applied and P value was found to be < 0.01 denoting a highly significant difference between the pre and postoperative ETF.

Conclusion:

Tympanoplasty with or without cortical mastoidectomy has a therapeutic effect on ET dysfunction in COM-mucosal disease.
The Presence of Atypical Auditory Brainstem Response Waveforms in a Child with Normal Hearing
Authors: Rashid Mohd Fadzil Nor , Zakaria Mohd Normani , Romli Maziah , Mohamad Wan Najibah Wan , Awang Mahamad Almyzan
Published: May 2024

Auditory brainstem response (ABR) is an objective test typically carried out to estimate behavioral hearing thresholds among difficult-to-test children. The latencies of ABR waveforms are commonly used for hearing diagnosis. The available ABR normative data are utilized as guidelines by clinicians to identify the prominent peaks of ABR. In this paper, atypical ABR waveforms of a normal child were reported. Several useful points were highlighted from the present case report to guide clinicians to appropriately interpret the ABR results.
Hearing Aid Interventions and Its Effect on Hearing Handicap Inventory for Elderly Score Among Elders with Bilateral Hearing Impairment
Authors: Kaur Navjot , Kalyani C. Vasantha , Mudgal Shiv Kumar , Athira B. , Gaur Rakhi , Varshney Saurabh
Published: May 2024

Background:

Several elderly populations face impairment in hearing, difficulty in following discussions in the presence of multiple talkers, understanding the speech of unfamiliar people, understanding fast speech, and understanding speech in noisy environments. Many hearing rehabilitation programs came into the picture for the help of the elderly population. The aim of the meta-analysis was to assess the effect of hearing aid interventions on hearing handicap inventory for elderly (HHIE) scores among elders with bilateral hearing impairment in randomized controlled trials (RCTs).

Materials and Methods:

Two independent reviewers searched for full-text RCTs from worldwide online databases named PubMed and Google Scholar. Studies from January 2000 to January 2022 in the English language conducted among humans were considered. The search strategy contains PICO format in which P-elders with bilateral hearing impairment, I-hearing aid intervention, C-placebo, O-HHIE scores as outcome measures.

Results:

A total of 28 trials were identified from online databases using PICO format further on evaluation 8 trials with a total of 445 participants were included for the final meta-analysis of the study. The pooled results after sensitivity analysis revealed that 7 trials had a significant reduction in mean difference (MD) of HHIE score among elders with bilateral hearing impairment (MD-2.21 (95% confidence interval [CI] = −4.24 to −0.19), P = 0.03 with heterogeneity (I
2 = 48%, P = 0.07) in the fixed-effect model. The Stratified analysis was also done between subgroups as HHIE-social/situational and HHIE-emotional scores shows no significant difference among subgroups for the reduction in a MD of scores −5.34 (95% CI −7.05, −3.64), P = 0.03 without any heterogeneity (I
2 = 0%, P = 0.97) with use of fixed-effect model.

Conclusion:

The findings of the meta-analysis revealed that any type of hearing aids interventional program is found to be effective in reducing HHIE scores. It indicates that these interventions result in a reduction in social and emotional consequences due to hearing loss among elders with bilateral hearing impairment. Adherence to the hearing rehabilitation programs is highly recommended by the researchers to improve social and emotional aspects of life among elders.
A Camouflaged Brain Abscess with Zygomatic Abscess – A Bizzare Presentation in Chronic Suppurative Otitis Media
Authors: Hajare Priti S. , Singh Yashita , Veenish Keerthana , Das Salonee S.
Published: May 2024

Intracranial complications of chronic suppurative otitis media (CSOM), even though rare, can have a simultaneous occurrence of multiple complications. An 8-year-old child, a case of CSOM (squamosal) with zygomatic abscess, was referred to us with HRCT temporal bone showing left otomastoiditis and 7 days of higher intravenous antibiotics. The patient was treated with modified radical mastoidectomy and incision and drainage of the abscess. On the 4th postoperative day, he developed focal neurological deficits which confirmed a brain abscess on magnetic resonance imaging on the same side. It was further managed by neurosurgeons. Here, we report this unusual presentation of multiple complications of CSOM.
Window Deroofing with Dental Roll Suturing for Pseudocyst Pinna, Simple Solution for Notorious Disease
Authors: Beesanahalli Yogeesha S. , Ramya K. , Ajith K. M. , Maradi Nagaraj , Bai R. Latha
Published: May 2024

Background:

Pseudocyst of the pinna is a benign cystic lesion on the lateral surface of the pinna with no definitive etiology or treatment. Various methods are currently used to manage this disease. Most of the treatment options are prone to disease recurrence and are associated with cosmetic sequelae. We report 16 cases of unilateral pseudocyst that were treated with window deroofing and pressure dressing with dental roll suturing.

Aim:

This study aimed to study the effectiveness of window deroofing with dental roll suturing in the treatment of pseudocyst of the auricle with respect to recurrence and postprocedural sequelae.

Materials and Methods:

A prospective study at a tertiary care center for 2 years, which included 16 patients with a diagnosis of pseudocyst pinna. All the patients were treated by excising a small triangular piece of skin along with perichondrium, followed by dental roll suturing for pressure dressing; and were followed up after 1 week and 1 month of surgery.

Results:

All 16 cases were completely relieved of the disease at the end of 1 month. None of our patients had a recurrence and only 2 cases (12.5%) showed thickening of the pinna skin.

Conclusions:

The surgical treatment by window deroofing with dental roll suturing technique gave a reliable result in all cases of pseudocyst pinna with no evidence of recurrence and acceptable cosmetic results.
Absent Stapedius Muscle and other Rare Congenital Ossicular Anomalies
Authors: Upadhyay Madhukar , Goyal Sunil
Published: May 2024

Conductive hearing loss due to ossicular anomalies is generally associated with external auditory canal dysplasia. Congenital ossicular anomalies in isolation are rare and often have a delayed diagnosis, particularly if unilateral. In such cases, the predominant symptom is conductive hearing loss and otosclerosis is usually the major differential diagnosis. We present a series of three cases of congenital ossicular chain anomaly. These patients were initially diagnosed as a case of otosclerosis. However, the diagnosis was revised based on intraoperative findings and managed accordingly.