bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of comparison of maternal and fetal outcomes in spontaneous labour and induced labour
Authors: Mankar Apurva A. , Murthy Bhaskar K. , Patil Vaibhav B.
Published: September 2021

Background: There has been consistent proportionate increase in the cases of induction of labor, but both maternal and neonatal effects of it remain poorly analysed previously. The present study was undertaken with the objective of comparison of maternal and fetal outcomes between groups of patients undergoing induction of labor and those having spontaneous labor.Methods: In this comparative prevalence study, the participants selected by predefined criteria were divided into 2 groups on the basis of progression of labor. They were spontaneous labor (group A) and induction of labor (group B). All the participants were assessed for various relevant maternal and neonatal outcomes and valid comparisons drawn.Results: A total of 1300 participants were studied. Proportion of patients requiring caesarean section was significantly higher in induction group (39.17%) against the spontaneous labor group (15.37%), with fetal distress being the commonest indication in both groups. The commonest complication noted was postpartum hemorrhage (PPH) (2.96% in group A and 1.98% in group B, p<0.05). Mean birth weight of babies was 2.76±0.42 kgs in spontaneous labor group and 2.68±0.48 kgs in induction of labor group (p>0.05). Incidences of NICU admissions and neonatal deaths were significantly higher in induction of labor group.Conclusions: Induction of labor should be employed judiciously by assessing the maternal and fetal condition and confirming relevant indication and should only be done if continuation of pregnancy is relatively more hazardous to either mother or baby.
Acute cholecystitis in pregnancy: a case report
Authors: Bordo Žanis , Bērziņa Arta , Miskova Anna , Zeiza Kaspars
Published: September 2021

We presented here a case report of a 37-years-old woman, G3 37+5 weeks pregnant with acute abdominal pain, whose diagnosis is unclear, but there are signs of liver disfunction, and for this reason a C-section is performed. She is later diagnosed with acute cholecystitis and therefore a cholecystectomy is performed.
A rare case report on double J stenting in a rare case antepartum patient with right sided hydronephrosis and hydroureter
Authors: Chavan Niranjan N. , . Shikhanshi , Chouhan Tulika , Kampoowale Shreya
Published: September 2021

Gestational hydronephrosis (GH) is caused due to dilatation effect of the progesterone as well as physical pressure of the gravid uterus. In pregnancy, its management is challenging as routine radiological investigations and surgical treatments cannot be performed due to the potential harm to the foetus. Women who fail to respond to conservative methods require intervention. Acute hydronephrosis and renal colic are common aetiologies for loin pain, and can lead to severe form of urinary tract infection affecting perinatal outcome. Double J (DJ) stenting during pregnancy is safe, requiring no intra-operative imaging, and inserted under local anaesthesia. It provides good symptom relief, low complication rate, efficient and safe modality for women with refractory symptoms. Multidisciplinary approach to this procedure is advised.
Dying uterus, uterine artery ligation-a curse or a blessing? a rare case report
Authors: Lewis Preeti Frank , Raghav Mridula , Sehgal Roopali Sanjay
Published: September 2021

Uterine necrosis is a rare life-threatening condition reported in few case reports associated with uterine artery embolization for uterine fibroids or postpartum hemorrhage. We report a case of hemorrhagic uterine necrosis in a 22-year-old primipara day 4 post emergency caesarean section who presented with breathlessness, abdominal distension and severe anaemia. Patient underwent emergency exploratory laparotomy 2 hours after the caesarean section with intraoperative findings suggestive of rectus muscle hematoma, bilateral uterine artery ligation was done for atonic PPH. On clinical examination uterus was corresponding to 28-30 weeks gestation size with guarding and tenderness. Ultrasonography revealed bulky uterus. CT abdomen with pelvis with contrast was done with findings suggestive of hemorrhagic ischaemic myometrial necrosis. An emergency exploratory laparotomy was performed with intraoperative findings of uterus size of 30 weeks gestation with diffuse congestion, gangrene of bilateral tubes and ovaries. Obstetric hysterectomy with bilateral salpingo-oovarectomy was done. Patient was discharged on postoperative day 9. High index of clinical suspension, prompt CT imaging and exploratory laparotomy on time proved life-saving.
Insight into the knowledge, attitude and practices of hand hygiene with alcohol based hand rubs in a public sector tertiary care hospital of a developing country
Authors: Balkhi Fizra , Nasir Aamna , Asghar Ayesha , Patel Farhan , Zafar Marium , Nasir Anum
Published: September 2021

Background: Health care worker’s hands are mostly responsible for transmission of healthcare associated infections (HCAI). In such instances, alcohol based hand rubs have been endorsed by WHO as the gold standard for hand hygiene for visibly clean hands; whereas, for visibly dirty hands soap and water is recommended. In developing countries (like Pakistan), affected people frequently exceed 25%. However, limited infrastructure in these countries hinders the performance of hand hygiene, but the use of alcohol-based hand rubs in such adverse situations is a practical solution to these constraints.Methods: In January 2021, we initiated a 12 week cross-sectional study in a public sector tertiary care hospital of Karachi, Pakistan. All participants were given a self-designed questionnaire with a consent form thereby giving us permission to use the data. Data was analyzed using statistical package for the social sciences (SPSS version 23).Results: 84.3% of the participants had received prior instructions on hand hygiene; however 71.7% respondents did not have access to alcohol based hand rubs. When questioned if they followed WHO’s five moments of hand hygiene, only 50.5% use alcohol based hand rubs before patient contact; 88.6% used it after patient contact; 83.2% after body fluid exposure risk; 77% before an aseptic task and 78.6% after contact with patient’s surroundings.Conclusions: There is a dire need for concerned authorities to enforce proper hand hygiene in public hospitals of developing countries in order to curb health care associated infections and prolonged hospital stays.
Household expenses in healthcare and its coping mechanism in rural Nepal
Authors: Shrestha Aliza , Nepal Susmita , Poudyal Aassmi
Published: September 2021

Background: In Nepal, the most frequent mode of payment for health care is household expenditure. It accounts for more than half of all health-care expenditures. In addition, the study intends to investigate household expenditure on health care and its coping mechanisms in Nepal's rural districts.Methods: This is a quantitative, cross-sectional study in which 410 households were chosen using a multiple sampling procedure. The research study region was chosen using a purposive sampling strategy. The two wards for the study were chosen by a lottery system. The estimated households were then chosen using a systematic random selection technique. A semi-structured questionnaire was utilized to gather data, and a face-to-face interview with the household head was undertaken to obtain the data. SPSS version 20 was used to analyze all of the data.Results: The overall household health expenditure in Miklajung rural municipality was determined to be 31.7% in the previous six months, with the biggest expenditure in medicine/drugs or pharmacies, followed by in-patient care and health treatment abroad. Income/savings was discovered to be a major coping mechanism used to deal with household expenditure and was found to be significantly associated in a bivariate analysis with type of illness, age, and more with a confidence interval of 95% in a bivariate analysis.Conclusions: At the conclusion of the investigation, we discovered that people spent the most money on medicines and drugs, followed by in-patient hospital care. According to the findings, a significant portion of the target group used their income and savings to cover unexpected healthcare costs.
Understanding the oral health beliefs and behaviours among the tribal population of Chamarajanagar district, Karnataka
Authors: Ray Shibani Sushmitha , Doddaiah Sunil Kumar , N. Chandan , M. R. Narayan Murthy
Published: September 2021

Background: Regardless of the improvements in the field of healthcare, there is a section of people who live away from civilization known as ‘indigenous people’ or ‘tribals’. Information regarding oral health status is instrumental in the planning and implementation of oral health policies and programmes related to promotion of oral health. The aim of the study was to understand the oral health beliefs and behaviour of the tribal population of Chamarajanagar district.Methods: A cross‑sectional survey of 256 tribals of Chamarajanagar district was conducted. A modified WHO oral health questionnaire (2013) was utilized to collect the data. The recorded data was statistically analysed using the Statistical Package for the Social Sciences version 24.Results: Based on the age-category, majority of them belonged to the age group of 35-44 years. All the participants belonged to the sub-caste of Soligas. The results showed that the perceived barriers for seeking oral health care are high and poor utilization of the oral health care services were observed, but the participants had good knowledge regarding oral health which increases the cues for action.Conclusions: The results of the study suggest that the participants might have favorable compliance for oral health promotional programs.
Assessment of nutritional status of children (12-36 months of age) in urban area of district Rohtak, Haryana: a cross-sectional study
Authors: Kalhan Meenakshi , Kaushal Pankaj , Chayal Vinod , Sachdeva Aman , Yadav Garima , Phogat Vinay , Bansal Kanika , Bansal Kanika , Kaushik Anil
Published: September 2021

Background: Children 1-3 years of age are most vulnerable to the vicious cycles of malnutrition, disease/infection and resultant disability all of which influence the present condition of a child at the microlevel and the future human resource development of the nation at the macrolevel.Methods: Urban field practice area attached to the department of community medicine, Pt. B. D Sharma PGIMS, Rohtak being served by 14 anganwadi centres out of which 8 anganwadi centres were selected randomly. From each selected anganwadi centre, 22 children of 1-3 years of age group were selected by simple random sampling, thus, a sample of 176 children were included in the study.Results: Overall prevalence of undernutrition in our study was found as follows: wasted 14.1%; underweight 20.0%; stunted 24.1%. Inverse relation between prevalence of undernutrition and educational status of mother was observed. Children who were >3 in birth order had high prevalence of wasting, stunting and underweight. Children with low birth weight were having higher percentages of wasting, stunting, and underweight. Children who took supplementary nutrition regularly from AWC were less likely to be undernourished.Conclusions: Every endeavor should be made to combat the outcomes of undernutrition through multipronged approach such as growth monitoring, nutritional supplementation etc., Also, present study findings reinforce the importance of proper infant and child feeding practices and appropriate maternal care in prevention of childhood undernutrition.
A cross sectional study on COVID-19 vaccine acceptances and barriers to vaccination in district Jhansi
Authors: Arya Vimal , Chowksey Mahendra
Published: September 2021

Background: The long-term control of the pandemic COVID-19 pandemic hinges on the uptake of vaccine and high immunization uptake is critical. Vaccine hesitancy is one of the top 10 threats to global health. Hesitancy will be a challenge to curbing this pandemic.Methods: A cross‐sectional study was done among the population in Jhansi where data was collected through an online questionnaire using Google forms and was distributed using social media platforms. Total of 220 data was collected.Results: 80.2% of the respondents were willing to get vaccinated. 78.9% of the respondents have taken previous vaccinations by the government. 70 of them trust government health care departments and media (82.2%) is the least trusted platform regarding vaccination. Majority agreed to the perceived benefits of COVID-19. 80.3% were willing to take free vaccination. 46.9% were willing to pay for COVID vaccine.Conclusions: The scenario in Jhansi was positive towards the vaccination drive and majority of them were willing to get vaccinated. But strategies must be made effective in terms of elevating the barriers to vaccination.
A study of nasal carriage of methicillin-resistant staphylococcus aureus in patients undergoing hemodialysis in a tertiary care hospital of Punjab
Authors: Dhillon Prabhjot Singh , Sharma Vishal , Brar Manpreet Kaur , Thakur Durgesh , Rishu Rupali , . Rishu , Kansal Rinkal
Published: September 2021

Background: Infection is one of the major problems encountered in hemodialysis patients. The mortality rate among the patients undergoing hemodialysis remains unsatisfactorily high. Hemodialysis patients have higher nasal carriage rate of Staphylococcus aureus than the healthy population. In long-term hemodialysis patients, colonization is a significant problem and is associated with an increased risk of the bloodstream infections. The antimicrobial resistance to this pathogen is increasing rapidly, and the consequences of methicillin resistance for the outcomes of Staphylococcus aureus infections are drastic.Methods: Two swabs were collected from anterior nares of patients undergoing hemodialysis, and then these swabs were transferred to microbiology laboratory for processing. Isolated strains were subjected to antimicrobial susceptibility testing using Kirby-Bauer disc diffusion. Methicillin resistance was detected by using cefoxitin disc. Inhibition zone diameters were measured as per CLSI criteria. Vancomycin screen agar test was done. Brain heart infusion agar plates containing 6 µg/ml of vancomycin were used. S. aureus ATCC 29213 was used as reference strain.Results: It was observed that 38% (38/100) of the hemodialysis patients were carriers of S. aureus followed by CoNS, followed by aerobic spore bearers. All the S. aureus isolates (100%, 38/38) were methicillin-resistant (MRSA).Conclusions: Staphylococcal nasal carrier status in hemodialysis patients along with antibiotic susceptibility testing should be done in routine and infection control practices should be followed to prevent the transmission of MRSA among chronic hemodialysis patients.
Utilization of diabetic retinopathy screening among diabetic patients at a tertiary care hospital in Kerala, India
Authors: Kumar Sona Sabitha , Kamaladevi Lathika Vasu , Valsan Sruthi Mankara
Published: September 2021

Background: Diabetes is a major public health concern that affects nearly 463 million (9.3%) of global adult population. Diabetic retinopathy, which affects around 35% of all diabetic patients, is the fifth leading cause of preventable global blindness. This study was done to determine the status of diabetic retinopathy screening and the factors that influence its uptake among diabetic patients attending a tertiary care setting in Kerala, India.Methods: 200 patients with diabetes mellitus on physician care were enrolled for a questionnaire-based survey which collected information on patient demographics, education, occupation, patient’s awareness of retinopathy, screening, diabetic blindness and their source of such knowledge.Results: 83% were aware that diabetes can result in vision loss. 61% were aware that diabetic blindness is preventable. 42% patients were aware of screening options for retinopathy. The awareness of retinopathy screening was significantly associated (p=0.0001) only with duration of diabetes.Conclusions: Awareness of diabetic retinopathy among diabetic patients in Kerala was sub optimal. Better patient education and use of mass media can increase awareness on diabetes retinopathy screening programs.
An assessment of alcohol consumption using the alcohol use disorders identification test: self-report version questionnaire among students pursuing professional courses
Authors: Khan Huma , Mishra Saurabh , Pandey Abhinav , Pandey Abhinav , . Abhijeet
Published: September 2021

Background: Harmful use of alcohol is accountable for 7.1% and 2.2% of the global burden of disease for males and females respectively. Alcohol is the leading risk factor for premature mortality and disability among those aged 15 to 49 years, accounting for 10% of all deaths in this age group. Objectives of current study were to assess the prevalence of alcohol consumption students pursuing professional courses and to know the factors associated with alcohol consumption among study participants.Methods: Current study is a cross sectional study with sample size of 410 (male: 49%, female 51%). The alcohol use disorders identification test self-report version by WHO was taken as study tool. Data Collection was done online through Google forms and data analysis was done using SPSS trial version.Results: Mean age of the participants was 21.95±3.03 years. Prevalence of alcohol consumption was found in 17.1% study participants.Conclusions: Alcohol use varies among different academic streams across varied socio demographic backgrounds. Interventions including in campus counselling are need of the hour.
Awareness of nursing assistants regarding COVID-19 epidemiology and preventions: a hospital based cross-sectional study
Authors: Sasikala Arunima Baby , Vasisht Pranav V. , D. Indu , N. Sorna P. , M. Malathi
Published: September 2021

Background: COVID-19 is a disease caused by a beta coronavirus belonging to the larger family coronaviruses. It is very important that health care workers have adequate knowledge regarding COVID-19 and epidemiological characteristics for disease prevention. This study was meant to assess awareness of nursing assistants working in a tertiary care institution in Kerala regarding COVID-19 infection, modes of transmission, symptoms, isolation, and preventive measures instituted for self-protection and hospital sanitation. The objectives of this study was to assess the awareness including the knowledge attitude and practices of hospital staff about basic infection control practices and epidemiological characteristics.Methods: The study was conducted in medical college, Thiruvananthapuram. Study objective was to study awareness of nursing assistants working in the hospital about COVID-19 preventive measures and epidemiology. Participants selected by simple random sampling with sample size 100. Data was collected using semi structured questionnaire was entered into MS Excel and analysis done using appropriate statistical software. Total score calculated for each of the questions for each participant by summing up the responses for each choice in the question, individual domain and grand total scores calculated. Finally a grand total was calculated for each participant.Results: Out of total participants 77 (68.8%) scored between 35-49 (good), 36 (31.2%) (average) between 18 and 34, and 0 below 18 (poor).Conclusions: The results obtained indicate the nursing assistants had good knowledge about COVID-19 epidemiology which will prevent hospital infections of COVID-19.
COVID-19 and all-cause-mortality; differential trends between countries and selected states of India
Authors: Menon Jaideep C. , Suseela Rakesh P. , Bharti Omesh K. , Mishra Kaushik , Swain Basanta , Raina Sunil , John Denny , Janakiram Chandrasekhar , Banerjee Amitava
Published: September 2021

By 22nd January 2021, the Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus had infected over 98 million and 10.6 million individuals globally and in India, with 1.7 million and 153, 067 deaths, respectively. Case Fatality rates (CFR) due to coronavirus disease 2019 (COVID 19) have varied significantly between countries. In order to understand the true impact of the pandemic, we should report coronavirus (COVID-19) mortality in the context of all-cause and non-COVID-19 mortality, and compare with previous years. The consequences of the pandemic have been, and will be, different in different settings within and across countries. To compare the all-cause mortality in the year 2020 with previous years in three selected states of India correlate it to the burden of COVID19 and compare all-cause mortality between three states of India to four high income countries. We provide quantitative data in three states across India (Himachal Pradesh, Kerala and Odisha) and compare with high-income countries to illustrate the importance of context-specific data monitoring and public health responses. There was a 1.9% increase in deaths, with 2.8% decrease in births in 2020, compared to 2019 in Himachal Pradesh, 13.3 and 9.2% decrease in Kerala and 16.7% and 21.4% decrease in Odisha. There was a direct correlation of all cause mortality to CFR on comparison between three states of India and despite the enormous burden of COVID19 in India all-cause mortality was lower compared to previous years in addition to the CFR due to COVID 19 being lower than in selected HICs.
Ogilvie’s syndrome following cesarean delivery: a case report
Authors: Mahmood Syed Uzair , Zaidi Maheen , Zaidi Syeda Kashaf , Tariq Hanaa , Umer Mohammad Yasir
Published: September 2021

Ogilvie’s syndrome (OS) or acute pseudo-obstruction of the large bowel, is a rare condition and the true incidence is unknown. We present a case of acute colonic pseudo-obstruction (OS) post cesarean section in a 35-year-old patient with fetal distress, following cesarean delivery at term under general anesthesia. On the second postoperative day, she complained of abdominal distension, pain, nausea, vomiting, bloating and no passage of stool. As the patient's condition did not improve, she continued to have persistent abdominal distention. A plain abdominal film was taken and abdominal ultrasound was done, which showed massive gaseous distention of the bowels without fluid level. At laparotomy, a huge distended gut, pussy flakes on intestine, and massive dilatation of the whole colon were found. Postoperatively, the patient was managed with fluids, antibiotics, nutritional support, etc., along with the standard guidelines for management of peritonitis. The patient recovered and was discharged after 1 day of intensive care unit management to the ward. The need for awareness about the syndrome and early diagnosis is emphasized.
Anemia prevalence and factors associated among pregnant women in India
Authors: Simon N. H. , Akinola Ajoke , Kumar Neha Dinesh
Published: September 2021

The objective of this review is to evaluate the prevalence of anemia and factors associated with Anemia among pregnant women in India. A search was conducted through electronic databases PubMed, google scholar and l Medline, non-electronic databases were also search for articles published between 2017 to 2021. PRISMA guided the reporting of items. All articles were included in qualitative analysis. A total of nine (9) studies (N=7,29,485) conducted among pregnant women in India were included in this review. The overall prevalence of anemia ranged from 23.16% to 81.8%, mild anemia reported in three studies ranged from 35.0% to 60.6%, moderate anemia from 8.0% to 49.5% and severe anemia ranged from 1.4% to 6.9% only. Education status of both wife and husband, maternal age, occupation, income, residence, dietary habits, parity, child spacing, attendance of ANC services and interventions nutrition programs were the main factors associated with the hemoglobin status of the pregnant women. The prevalence of anemia was high among the study participants. Sociodemographic factors were associated with Hb levels of the women. Efforts should be made to encourage women to attend antenatal services (ANC) and nutritional programs should also cover pregnant women.
Knowledge, attitude and practices pertaining to healthy lifestyle in prevention and control of chronic diseases: a rapid review
Authors: Naaz Saba
Published: September 2021

With the emergence of non-communicable diseases (NCDs), healthy lifestyle has become critical to not only reduce the burden of NCDs, but also to prevent complications and severity of these diseases. Knowledge, attitude and practices (KAP) pertaining to healthy lifestyle play an important role in determining the occurrence and progress of NCDs. KAP elements are interrelated and dependent on each other. While awareness campaigns provide necessary information to people on healthy lifestyle, how well this information is utilised is a grey area. The objective of this rapid review is to understand the relationship between KAP elements pertaining to healthy lifestyle among individuals who are at risk of developing NCDs and those who are living with NCDs. For this purpose, a rapid review of articles available on Google scholar and Pubmed was conducted. Articles focusing on KAP elements pertaining to healthy lifestyle from the year 2015-2021 were reviewed. Findings from the reviewed studies suggested that people have knowledge about the harmful effects of unhealthy diet, physical inactivity, tobacco and alcohol. People have a positive attitude towards healthy lifestyle, however, being knowledgeable and having a positive attitude did not translate into practicing healthy lifestyle due to multiple barriers to translate existing knowledge into practice. Since practice scores are poor among people, existing behaviour change strategies must be re-examined. An epistemological analysis of existing human behaviour with identified barriers and facilitators to adopt healthy lifestyle can help in formulating sustainable and effective social and behaviour change interventions.
Medical and surgical outcome of retropharyngeal abscess and its prognosis
Authors: Alwagdani Ashwag M. , Alwabel Saga K. , Alyami Batool H. , Rajkhan Abdullah A. , Alshehri Abdulaziz A. , Aloufi Mohammed S. , Alandijani Hamza A. , Alsaeedi Bassam R. , Alshaikh Roqia M. , Aldhammen Abrar A. , Alnemer Rashed A.
Published: September 2021

Although retropharyngeal abscess is not a common condition, it can impact the quality of life of the affected patients, and can even be life-threatening. Asphyxia, upper respiratory tract obstruction, and respiratory distress might then develop secondary to this abscess which continues to grow even larger increasing the seriousness of the complications. Surgical incisions and long-course medical and antibiotic therapies have been described in the literature for the management of retropharyngeal abscess. In this study, the literature review discusses the surgical and medical treatment of retropharyngeal abscesses and the predicted prognosis of the disease after treatment based on evidence obtained from studies in the literature. Early presentation and management are important in achieving better outcomes and enhancing the prognosis. Therefore, patients should be aware enough of the symptoms that might suggest the presence of a retropharyngeal abscess. Using intravenous antibiotics can achieve favorable outcomes. However, some adverse events might be associated and the treatment might not be completed as a result of reduced patient compliance. Surgical management is also efficacious and can be done by different approaches as discussed earlier. Nevertheless, it can also be associated with some complications. Therefore, providing optimal care for these patients should be considered in all scenarios to enhance the prognosis.
Endoscopic endonasal dacryocystorhinostomy-an experience in a tertiary care hospital
Authors: Gujrathi Atishkumar B. , Kamble Paritosh A. , Khadkekar Shashin , Gadpayale Nishikant , Paikrao Yogesh , Kurande Harshada , Rathod Indutai
Published: September 2021

Background: Dacryocystorhinostomy is a surgical procedure by which the lacrimal flow is diverted into the nasal cavity by making an opening in the lacrimal sac when the nasolacrimal duct gets blocked. The operation can be carried out using either an external or endonasal surgical approach.

Methods: This is a clinical observational study done on 50 patients with chronic dacryocystitis with obstruction at the level of sac or nasolacrimal duct. This study was conducted at Dr. Shankarrao Chavan government medical college, Nanded, during the period of 2 years (2018-2020). Patients were evaluated and operated for endoscopic endonasal dacryocystorhinostomy.

Results: The mean age of studied cases was 33.92±12.13 years. The M:F ratio was 0.78. Epiphora was the predominant complaint in all cases 100%. Swelling of lacrimal sac was present in 24% cases and Pain on affected side was present in 18% cases. 6% patients had fistula on the side of block. 12% patients had mucocele and 14% patients had pyocele on the affected side. Left and right side was involved in 54% and 40% cases respectively. The disease presented bilaterally in 06% cases. 80% patients had no complications after endonasal endoscopic dacryocystorhinostomy (EEDCR) surgery. Rate of surgical success was 92%.

Conclusions: Nasolacrimal duct obstruction is more common among females and in middle aged persons. EEDCR is treatment which provides patients relief from the symptoms without any scar and also preserves nasolacrimal pump system with high success rate. It may prove better surgical technique in chronic dacryocystitis.
Comparative study on efficacy of SNOT 22 outcome in nasal surgery using teflon splinting for chronic rhinosinusitis
Authors: K. B. Sajitha , B. Vibha , Thomas Norma
Published: September 2021

Background: CRS is defined as inflammation in the nose and paranasal sinus and it is characterized by two or more cardinal symptoms. There is a growing need for a simple, reliable, system-specific standardized outcome measure that can help us explore CRS in a more uniform way and help us to take into account patients’ HRQoL. SNOT covers a broad range of health and health-related quality of life problems including physical problems, functional limitations, and emotional consequences.

Methods: we report a case series of 60 patients, divided into 2 groups of 30 each. 1st group underwent FESS+septoturbinoplasty while the 2nd group underwent FESS+septoturbinoplasty with teflon splinting. Patients were asked to score their symptoms on SNOT 22 questionnaire pre-operatively and post-operatively.

Results: Significant changes were noted in nasal related and quality of life domain and less significant changes noted in ear/facial related and psychological domains in group 2.

Conclusions: patient-based outcome measures like SNOT 22, is helpful tool for quantifying changes in symptoms and useful for predicting post-operative improvement. It is both patient and researcher-friendly.
Evaluation and management of ear itching: our experience
Authors: Vallur Srujan , Raghavan Anil , Jagdeeswaran V. U. , Gampa Pawan Kumar
Published: September 2021

Background: Itching of ear is a common presenting symptom in clinical practice. Ear itching has many underlying causes which needs detailed evaluation. The aim of the study was to determine the incidence of ear itch and the aetiological factors and various management options associated with ear itch.

Methods: A retrospective observational cohort study was done in two centres over a period of one year in patients with ear itch in ENT outpatient were included. Sampling method used was systematic sampling. The details regarding the age, gender and co-morbidities of the patients were recorded. The ear was clinically examined.   

Results: A total of 2143 patients presented to outpatient, 210 (9.8%) presented with ear itching. The mean age (SD) of the study patients were 46.8 years (15.6). The gender distribution showed a male:female of 1:1. Comorbidities included hypertension (27.14%), diabetes (8.57%) and combination of both in 8.1%. Mean±SD of duration of study subjects was 4.3±1.6 months. The common aetiologies were otomycosis (30%), wax deposition (25.24%) and otitis externa (14.29%). Diabetes was predominantly associated with otomycosis (68.57%, p<0.0001). In our study, prevalence of ear itching was 9.8% with common aetiologies were otomycosis, wax deposition and otitis externa. There was significant association of diabetes mellitus with otomycosis.

Conclusions: Ear itching is a symptom that needs detailed history, careful clinical evaluation and management. Patient’s quality of life will largely improve if ear itching is dealt with all possible aetiologies and appropriate management.
Clinicopathological profile and treatment outcomes of patients presenting with epistaxis: a hospital-based cross-sectional study in Southern railway headquarters hospital, Chennai
Authors: K. Thirupathi , Preetham A. P. , Feshan Musarrat
Published: September 2021

Background: Epistaxis (nose-bleed) is one of the commonest emergencies presenting to an otolaryngological emergency that affects up to sixty per cent of the population in their lifetime; in this, six per cent needs medical care.

Methods: Hospital-based cross-sectional study carried between October 2018 to January 2020 in the department of ENT at Southern Railway Headquarters Hospitals, Perambur, Chennai.

Results: The mean age of the subjects was 47.76±23.01. Females were less affected compared to males with 1.68:1 male: female ratio. The results of ENT examination/anterior rhinoscopic examination revealed that all 153 (100%) subjects had anterior epistaxis and 5 (3.27%) had posterior epistaxis. 143 (93.46%) had deviated nasal septum. Diagnostic nasal endoscopy revealed that 90 (58.82%) had deviated nasal septum to the left, and 55 (35.94%) had to the right. The majority of subjects, i.e., 86 (56.21%), were managed conservatively, followed by 52 (33.99%), 5 (3.27%), and 1 (0.65%) patient were given treatment with anterior nasal packing, anterior and posterior nasal packing, and cauterization respectively. Whereas 9 (5.88%) subjects needed a surgical mode of treatment to manage their epistaxis.

Conclusions: Findings revealed that the incidence was high in elderly individuals, with male preponderance over females. Anterior epistaxis more commonly occurred in comparison to posterior epistaxis. Our research supports the conservative management methods’ credibility in the epistaxis treatment. The practice of simple nasal packing is the commonest conservative approach that has a high rate of success. As a result, this method will be the best choice for epistaxis management.
Diagnosing chronic rhinosinusitis: a comparative study between diagnostic nasal endoscopy and computed tomographic scan paranasal sinuses
Authors: Parmar Dharmishtha H. , Maniyar Hiten R. , Patel Hetna A.
Published: September 2021

Background: The term ‘rhinosinusitis’ refers to a heterogenous group of disorders characterized by inflammation of mucosa of the nose and paranasal sinuses. The National Institute of Allergy and Infectious Diseases (NIAID) have recently mentioned that 136 million people of India suffer from chronic rhino sinusitis.

Methods: A total 50 patients with symptoms of rhinosinusitis were investigated with both diagnostic nasal endoscopy and CT scan paranasal sinuses and their findings were scored with particular scoring system and compared with each other.  

Results: Out of 50 patients, 90% patients were diagnosed on CT scan and 84% patients were diagnosed on nasal endoscopy. By considering CT scan as accurate procedure and correlating nasal endoscopy with CT scan, sensitivity was 88.88%, specificity was 60%, positive predictive value was 95.23%, negative predictive value was 37.5%, and p value was 0.004671, which was significant at p<0.05, indicates that CT paranasal sinuses is more accurate than diagnostic nasal endoscopy in diagnosing chronic rhinosinusitis.

Conclusions: Both diagnostic nasal endoscopy and CT paranasal sinuses are important pre-operative evaluation tools in detecting pathology and both are complementary to each other. But CT paranasal sinuses are more convenient than endoscopy according to this study.
A systematic review of complications of attico-antral type of chronic suppurative otitis media in our region
Authors: Khadkekar Shashin , Benny Libin Mathew , Gujrathi Atishkumar B. , Gadpayale Nishikant , Paikrao Yogesh
Published: September 2021

Background: Chronic suppurative otitis media (CSOM) is a very common disease that should be carefully treated, as severe complications can develop. Despite the significantly decrease incidence of CSOM-related complications since the introduction of antibiotics, this clinical problem has not been eliminated.

Methods: This was an observational study conducted including 60 cases of attico-antral type of CSOM and its complications. Detailed study of determinants of attico-antral type of CSOM and its complications were studied. The various options in the management of disease and its complications with their outcomes were studied.  

Results: Majority of study participants belonged to lower socio-economic group. intra-temporal complications were most common complications and most of the patients required canal wall down surgery. Majority patients had complete recovery of the disease without recurrence during 3 months of follow-up.

Conclusions: Our study concluded majority of the patients belonged to the low socioeconomic status. It was also clear from the study that timely intervention in the form of early diagnosis and administration of proper treatment resulted in complete recovery of majority of patients.
Challenges in managing complex chronic middle ear disease: MERF experience
Authors: Natarajan Kiran , Devaraju S. Aruna , Shrivastava Anubhav , Ramasamy Swathi , Sampathkumar Raghunandhan , Kameswaran Mohan
Published: September 2021

Background: Chronic otitis media is one of the commonest conditions managed in otolaryngology practice. In developing countries such as India, advanced disease presentation is often seen mostly owing to lack of awareness of the disease and its potential complications, long distance between the patient’s home and the treatment centre, causing delay in treatment. Surgical management is the mainstay of treatment of chronic otitis media.

Methods: The aim of this study was to retrospectively analyze the patients with complex chronic middle ear disease, who underwent tympanomastoid surgery. Forty-seven patients (4.9%) out of a total of 968 patients with chronic otitis media presented with complex advanced disease and challenging intra-operative situations at our tertiary referral centre between January 2016 to December 2020. The extent of disease, associated complications, challenges in surgical management, and the eventual outcomes were studied in detail.

Results: Among these forty-seven patients, there were 24 males and 23 females. Of the 47 patients, 8 were children (17%). Extensive cholesteatoma causing facial palsy, labyrinthine fistula, dural involvement, internal auditory meatus involvement, extensive granulations extending into the inner ear through the oval or round window, extensive tympanosclerosis was noted in these patients. All patients underwent surgical management, and achieved satisfactory outcomes.

Conclusions: Advanced chronic otitis media has the potential to pose various challenges during tympanomastoid surgery. Appropriate planning for surgery aiming at complete disease clearance, meticulous after-care and long-term surveillance result in favorable outcomes.
Giant unicystic ameloblastoma of maxilla-successful endoscopic management
Authors: Mohanty Sanjeev , Vergis Manu , V. Devipriya , G. Haripriya , Nallapaneni Lakshmi Shree , Nallapaneni Pravilika Parachur
Published: September 2021

This 32-year-old male patient presented with complaints of restricted mouth opening and gross facial asymmetry owing to the massive jaw swelling on the right side. After a thorough examination, a diagnosis of unicystic ameloblastoma of maxilla. Although, the standard of care surgical approach was through Weber-Fergusson incision, a concerted attempt to excise the tumour with the minimally invasive endoscopic route was made successfully. The patient was symptom free now with complete resolution of swelling on a regular follow up post operatively. This case report highlighted the modern day protocol of organ preservation concepts in surgical management of a rare tumour in otolaryngology practice
External auditory canal osteoma: a case report
Authors: S. Sneha , Gajapathy Sowmya , G. Srikanth , V. Ramesh , Poduval Jayita Das
Published: September 2021

External auditory canal (EAC) osteomas are rare, solitary benign unilateral lesion. Small lesions are incidentally diagnosed and larger lesions produce symptoms of pain, ear discharge and defective hearing. Diagnosis is made based on a combination of clinical history and examination, radiographic imaging, and histopathology. They are usually confused with exostosis which are multiple, bilateral, smooth-bordered, broad-based lesions without deep extension. We present a case of 21-year-old male patient who came to our outpatient department, with complaints of left ear blocking sensation for past 6 months. On evaluation, it was diagnosed as left EAC osteoma and the same was excised via post-auricular approach. This case is being presented for its rarity
Current treatment of post-tonsillectomy pain: a review
Authors: Swain Santosh Kumar
Published: September 2021

Tonsillectomy is one of the most common surgical procedures performed by an otorhinolaryngologist. This surgery is done more in the pediatric age group. Although tonsillectomy is safe and effective surgery, it is usually associated with significant post-operative pain. Analgesics used for post-tonsillectomy pain is often inadequate. Severe throat pain following tonsillectomy has been documented for decades. Patients or parents/caretakers often worry about such severe pain in the home. The pain following tonsillectomy is usually intense and long-lasting. The severe post-tonsillectomy pain often overstrains the patient, family, and hospital staff. Regular changes in the analgesic armamentarium, particularly in pediatric patients are making the treatment of post-tonsillectomy pain more challenging. Pain following the tonsillectomy period continues to be a highly debated issue and an area of active research. Throat pain in the post-tonsillectomy period can result in significant morbidity among patients. There are different analgesics available; each one has its risk profile and side effects when used for controlling post-tonsillectomy pain. This review article discusses on recent management of post-tonsillectomy pain. This article reviews the epidemiology, pathophysiology, impact of post-tonsillectomy pain, and details of medications used for controlling post-tonsillectomy pain.
Sexual dimorphism in digital dermatoglyphics: A qualitative analysis of bengali hindu population, West Bengal, India
Authors: Chandra Dolai Mohan , Maity Dipanwita
Published: September 2021

Dermatoglyphic characteristics for identification of sex play an important role in forensic and medico-legal purposes. Hence, it considered to be the most precise and reliable indicators for personal and gender identification. Such types of information on Bengali speaking Hindu population are very scanty. This was tempted the present authors to assess the sex-wise variation of digital dermatoglyphic traits in a sample from West Bengal, India.

A total 168 participants were recruited to obtain basic information and fingertip impression of the participants. Impressions were taken by using Ink method (Calcutta Ink) and examined with hand-lens.

The mean age for male participants was 31.30 ±16.13 and for females it was 32.11±13.30. The loop pattern is observed more frequent (46.13%) compared to whorl (36.25%), arch (10.89%) and composite (6.72%). Females have a more loop (47.84%) and arch (12.26%) patterns than males (43.48% and 8.79% respectively. The whorl (39.85%) and composite (7.88%) patterns are observed more frequently in males as compared to females (33.92% and 5.98% respectively). Furuhata’s Index is more frequent in males (91.64) than females (70.9) but both the Dankmeijer’s and Poll’s Index are higher in females (36.13 and 25.61 respectively) than males (22.05 and 20.21 respectively). However, in case of Pattern Intensity Index there is slightly a sex difference for males and females (12.32 and 11.57 respectively).

It was concluded that differences in the finger print pattern, combinations and indices can be used as an important tool for the determination of sex in medico-legal and forensic purposes.
A Cognitive History of Roman Britain: New Opportunities?
Authors: Baryshnikov Anton
Published: September 2021

The article is focused on the issue of how forward-looking cognitive history of Roman Britain is. Studies of the province are experiencing a veritable boom in theoretical inquiry and debate, which gives a sense of the discipline's rapid and qualitative development. Nevertheless, most of the publications are well within a familiar framework of cognition and interpretation, dating back to the long-criticized theory of Romanization. It is only through new approaches, among which the cognitive approach can play an important role that we can go beyond these established boundaries, raise new problems and develop new answers to old questions. The author gives a brief overview of several pieces of work that are close to cognitive historiography in their essence and content. Even the few of them, addressing the cognitive theory, show the high potential of this approach and its importance for future Romano-British studies.
Again to the Question of the Specifics of Humanitarian Knowledge in the Light of the Issues of Comparative Civilizational Studies
Authors: Shemyakin Yakov
Published: September 2021

The author of the article aims to reveal the content of M. M. Bakhtin's statements about the specificity of the humanities in the light of the problems of comparative civilizational analysis in the context of modern cognitive research. The focus is on Bakhtin's idea that in the humanities the criterion is not the accuracy of cognition, but the depth of penetration. Acording to the author, the sense in which Bakhtin uses the term “depth” is the basis on which a man's process of creating his world unfolds. And this basis is nothing other than dialogical communication, which is treated as an analogue of the life process in the “world of people”. According to the author, the content of this communication is a polylogue of three paradigms of universal (heritage of archaic, the first “axial time” according to K. Jaspers and the second “axial time” - the era of modernization according to Sh. Eisenstadt and others) and local dimensions of any human existence at all levels ranging from the individual to civilization. Revealing the meaning of the second component of Bakhtin's original metaphor, the author emphasizes that we are talking about “penetration” into the spiritual space of the “Other”, i.e. another participant of the dialogue. In this case the depth of penetration into the “other” human reality presupposes the maximum possible completeness of coverage of this reality. Therefore, the criterion of the depth of penetration into the “Other” is the degree of coverage of all the basic dimensions (levels) of its structure. The author analyzes this structure, highlighting its main components.