bluuebunny/crossref_metadata_2025 huggingface dataset:
Autologous bone reconstruction as sandwich technique in pediatric posterior fossa surgery: finding a noble eightfold path for developing countries
Authors: Singh Suyash , Bhaisora Kamlesh Singh , Srivastava Arun Kumar , Behari Sanjay
Published: August 2019

Background: Sub-occipital craniotomy in pediatric population is difficult owing to uneven surface of growing calvaria and thin dura. Our novel technique using autologous bone chips and gelfoam bridges the two standard techniques. In this study, we intend to compare the surgical outcome in pediatric posterior fossa tumours.Methods: We included patients, operated via midline sub-occipital approach, from January 2013 to October 2018 and grouped them, on basis of whether or not sandwich reconstruction was done. We compared pseudomeningocele, post-operative headache, CSF leakage and postoperative hydrocephalus requiring CSF diversion. The aesthetic outcome was assessed using Stony Brook scar evaluation scale (SBSES).Results: 124 patients, divided into group A (n=53), group B (n=58) and group C (n=13) based on technique of surgical closure. The sandwich closure is significantly better in terms of both aesthesis and post-operative pain (p<0.05). There was a trend showing that sandwich closure decreases risk for pseudomeningocoele, wound infection, CSF leak and post-operative hydrocephalus. Median SBSES Score in group B was 4 compared to 2 in group A and patients were significantly more satisfied.Conclusions: The uniform bone coverage with sandwich closure provides nearly similar reconstruction to craniotomy. All risks of using drill over pediatric calvaria are eliminated and advantages are carried. The bony barrier prevents adhesion and decreases both immediate and delayed headache. The technique is not only technically easier and aesthetically better, but also has better long term satisfactory results with possibility of neo-bone formation.
Challenges faced in handling the medico-legal cases in a selected teaching hospital
Authors: Gurpur Naseel N. , Saldanha Sunita , Shet Nagaraj , Sharma Prajna
Published: August 2019

Background: Doctor comes across certain ‘Medico-Legal’ problems at one time or the other during the practice of his/her profession. Reporting a medico legal case (MLC) is one of the legal responsibilities of all doctors to ensure that immediate action is taken by the police and maximum evidence is collected by them. This study was undertaken to assess the knowledge and attitude of the staff in dealing medico-legal case in tertiary care hospital and to find the challenges faced by them while handling the medico-legal cases.Methods: A cross sectional Study was conducted at Yenepoya Medical College Hospital, Mangalore among the Staff working in Accident and Emergency Department during the study period of 6 months.Results: The study was conducted among 116 study participants, most 108 (93.1%) were in the age group of 20-29 years and 77 (66.4%) were females. It was seen that only 3 (2.6%) of them correctly answered 17-20 questions out of 20 questions that were asked. Knowledge regarding MLC case was much high among CMO compared to others which was statistically significant with p value <0.0001. Challenges faced by the study participants were patients or the patient party not willing for MLC, delayed treatment due to the confusion, answering the court, handling the police and the violent public in few cases.Conclusions: Knowledge on dealing with MLC and a proper counseling session for patients of MLC cases can help to overcome various challenges faced while dealing with any MLC case.
Awareness about Mahatma Jyotiba Phule Jan Arogya Yojna among the residential population of an urban community: a cross sectional study
Authors: Sapkal Ashwini B. , Deshpande Swati
Published: August 2019

Background: The Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) is a unique health insurance scheme which meets the health expenses of the below poverty line / above poverty line families for identified diseases. Lack of awareness regarding the same hinders the beneficiaries from availing the services. Hence studying this and other factors will play an important role in facilitating the access of these beneficiaries to utilize this scheme.Methods: 384 participants were included in the study using proportionate sampling. This is a community based cross sectional study done in the urban field practice area of a tertiary care hospital.Results: 95.57% respondents were having yellow / orange ration card and they were eligible for availing MJPJAY scheme. Awareness about MJPJAY is 51.70% in the age group >55 years. 54.9% of the respondents were aware that the scheme was meant for BPL families while 34.6% respondents did not know about the requirements of the same.Conclusions: Lack of awareness about MJPJAY is the major factor for non-availability of services under this scheme.
An etiological and antifungal profile of candidemia in children
Authors: Kaur Ravinder , Jaggi Sahiba , Dhakad Megh Singh , Rawat Deepti
Published: August 2019

Background: Candidemia causing increased mortality rates and emergence of antifungal drug resistance needs an urgent intervention to salvage immunocompromised and severely ill patients. This study aimed to isolate and identify Candida species and evaluate their antifungal susceptibility profile from blood stream infections in children.Methods: Fungal cultures from blood recovered positive for yeasts were subcultured on Sabouraud dextrose agar. Suspected purified colonies of Candida were confirmed and identified upto species level by both conventional and automated techniques. Antifungal susceptibility testing of isolates was evaluated using agar based E-test method for fluconazole, voriconazole and caspofungin on Mueller-Hinton agar supplemented with 2% glucose.Results: Total of 43 isolates of Candida species were recovered from blood samples. Non albicans Candida species accounted for 88.30% of cases; whereas 11.60% of cases were caused by C. albicans, C. tropicalis (39%) was the most frequent isolate recovered in candidemia patients followed by C. parapsilosis (18%), C. albicans (12%), C. glabrata (12%), C. kefyr (9%), C. pelliculosa (5%), and C. krusei (5%). Antifungal susceptibility results revealed Caspofungin demonstrated good activity against all Candida spp. C. parapsilosis followed by C. tropicalis and C. glabrata demonstrated high resistance to fluconazole. For voriconazole, maximum resistance was shown by C. tropicalis as compared to others.Conclusions: Candidemia is a threatening prognostic sign in children and an important entity in our hospital. Identification of Candidaspecies and antifungal sensitivity testing is a must to select a suitable and effective antifungal therapy to abrogate the emerging resistance to antifungals.
A study on the distribution of disabilities among the population residing in the endosulfan exposed area in Dakshina Kannada district of Karnataka
Authors: Badiger Sanjeev , Jacob Ankeeta Menona , Bangaraiah Arunkumar Sagar , Bhandary Satheesh Kumar , Hegde Smitha , Kumar Pavan
Published: August 2019

Background: Endosulphan was extensively sprayed in the cashew plantations in over 90 villages in Dakshina Kannada district for almost two decades before a ban was imposed. Areas where Endosulfan spraying was carried out, disability screening camps were conducted. The study aimed at describing the distribution of attendees of the disability screening camps among the population residing in the Endosulfan exposed area of Dakshina Kannada district of Karnataka, India.Methods: A cross sectional descriptive was undertaken with the permission of district health authorities by specialists in the villages of five taluks, on the patients attending the disability screening camps conducted in the year 2014-15. The patients were consecutively listed and classified based on the Persons with Disabilities Act, 1995 and analysed using SPSS version 20.0.Results: Of the 4214 patients who attended the screening camps for disability held in the taluks mentioned above, 2190 (52.0%) were males. The most common affected age groups were between 5-19 years of 1606 (38.1%). The most common disability was intellectual disability (including cerebral palsy) in 2474 (58.7%) followed by physical disability seen in 384 (15.5%). Infertility was seen among 297 (7.09%) of the attendees of the screening camps. The total number of cancers patients attending the screening camps was 71 (1.6%), and 21 (0.5%) were cancers related to the reproductive tract, and 6 (0.1%) had breast cancer.Conclusions: The most common age groups reporting with disabilities to the screening camps conducted by the district health authorities in Endosulfan sprayed villages of Dakshina Kannada district belonged to 5-19 years, and the most common disability was intellectual disability.
Nomophobia: mobile phone dependence among students of a medical college in Central Odisha, India
Authors: Ashe Swetaleena , Routray Dipanweeta , Giri Rama Chandra
Published: August 2019

Background: Nomophobia, stands for “no mobile phone phobia". The tremendous increase in mobile phone usage among youngsters has led to negative impact on their mental health status. Current study aims at finding out the prevalence of nomophobia (mild, moderate, and severe), various health related conditions and independent risk factors of severe nomophobia among medical students of a tertiary care college and Hospital of Central Odisha.Methods: A cross sectional study carried out among 450 students of a medical college of Central Odisha. Simple random sampling was done. Predesigned pretested questionnaire including Nomophobia questionnaire (NMP-Q) was used for data collection. Data was analyzed using SPSS and logistic regression was used to evaluate the independent risk factors of severe nomophobia.Results: Out of 450 students, 246 (54.6%) were boys and rest were girls. Nomohobia was universally present and students suffering from mild, moderate and severe form of nomophobia comprised of 33 (7.3%), 327 (72.7%) and 90 (20%) respectively. Independent risk factors of severe nomophobia were fourth year of study and above (aOR=2.69), use of costly handsets (aOR=4.56), monthly bill of more than rupees 500 for cell phone use (aOR=6.09) and anxiousness of staying updated with news all the time (aOR=4.86).Conclusions: Nomophobia is a highly prevalent condition among the medical students found across age groups, gender and socio-economic status which depends on phone usage. It is recommended that screening and proper counselling should be available in order to decrease the burden and create awareness about nomophobia among the medical students.
A cross sectional study of tobacco use among the college students of B. G. Nagara, Karnataka
Authors: Raja N. Sabari
Published: August 2019

Background: Tobacco is a leafy plant grown around the world with its addictive substance nicotine. It becomes the need of the hour to provide enough evidence on the correlates of tobacco use in the community to assist government policy makers, health professionals and the public in developing realistic models towards effective tobacco control to cater to sections of community in need. The present study was conducted to determine the prevalence and the pattern of tobacco use among the college students and to find out the reasons for the tobacco use among the college students.Methods: A descriptive cross sectional study was conducted among various college students of B. G. Nagara with 1003 subjects selected. Data was collected with a pre-tested, semi-structured questionnaire and analysed. Results were expressed in percentages and proportions.Results: The overall prevalence of tobacco use among the study subjects was found to be 5.8% and was exclusively among male students only. Cigarette smoking was the most commonly used form of tobacco, used by 89.7% of the tobacco users and the major reasons for initiation of tobacco use were due to friends (58.6%).Conclusions: Present study showed that the prevalence of tobacco use (5.8%) was lower when compared to state and national average. But since majority of users were in the age group of 19 to 21 years and were away from their homes, strict measures should be enforced in hostel and college premises banning its use and sale.
Association of dietary habits with obesity among school adolescents in Central India
Authors: Namdev Garima , Mishra Mahesh Kumar , Narkhede Vinod
Published: August 2019

Background: The growing prevalence of obesity among school adolescents is a major public health concern. It can be seen mostly as a result of modifiable risk factors like lack of required physical activity and rapid change in dietary habits among them.Methods: The present cross sectional descriptive study was done among adolescents studying in schools (government and private) of Bhopal city. School adolescents were classified as obese and non-obese as per the WHO criteria used for obesity in South East Asia Region (SEAR). Pre-tested, self-administered questionnaire was used to collect data which comprised of socio demographic information and various dietary habits like frequent consumption of fast & fried food, bakery products and little dietary behavior.Results: Out of total 6.6% obese school adolescents, majority of them consume fast foods (82%), fried foods (89%) and bakery products (79.5%) and all of these were positively associated with increased risk of obesity. Few eating behaviours like skipping breakfast, frequent snacking and eating outside were also found positively associated.Conclusions: There is definitely a major role of dietary habits for increased risk of obesity among school adolescents. So, it is the need of hour to create awareness among school adolescents regarding their dietary habits.
A community based study of scenario of glaucoma in Aligarh, India
Authors: Ahmad Syed Zulfequar , Ahmad Anees , Khalique Najam , Alvi Yasir
Published: August 2019

Background: Glaucoma is the leading cause of irreversible blindness worldwide and is second only to cataracts as the most common cause of blindness overall. In the developing world, the prevalence of glaucoma is expected to rise even more dramatically as the population of adults has doubled within a span of few decades. So this study was done with an objective of finding out the prevalence of glaucoma among adults aged 40 years and above in the field practice area of the Department of Community Medicine, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh.Methods: A cross-sectional study was carried out for the duration of one year. A total of 680 persons were interviewed and examined by a trained ophthalmologist for detailed eye examination including visual acuity, refraction and slit-lamp bio-microscopy, intraocular pressure (IOP) by Keeler Pulsair non-contact tonometer confirm by applanation tonometry, gonioscopy, and dilated fundus examination after ruling out the risk of angle closure. Anderson criteria were used to diagnose glaucomatous visual field defect.Results: In our study population, the IOP of the majority of population lied in 11-15 mm Hg with a mean IOP of 13.42±4.09 mmHg. In regard to optic disc examination, a cup to disc ratio of >0.6 was found in 35 eyes. According to the predefined criteria, a total of 31 subjects were diagnosed as glaucoma in either one or both eyes. The overall prevalence of glaucoma was found to be 4.6% (31/680), with the prevalence of primary open angle glaucoma, primary angle closure glaucoma, normotensive glaucoma and secondary glaucoma as 1.3%, 1.2%, 1.2% and 0.9% respectively.Conclusions: The prevalence of glaucoma is quite high in an elder population of Aligarh. This should warrant more intensive activities, focusing not only on early diagnosis and management of glaucoma but also include strengthening preventive ophthalmic care.
A study to assess nutritional status and related factors among children of 6 months to 5 years in residing at field practice area of B. J. Medical Collage, Ahmedabad
Authors: Patel Hely Bharatbhai , Patel Vaishali Chandrakant , Patel Hetal Y. , Parmar Rajan K. , Patel Alpesh
Published: August 2019

Background: Under nutrition continues to be an important public health problem, inspite of several nutrition intervention programs in India. The present study was carried out to know the prevalence of underweight, stunting and wasting among 6 months to 5 years children and to assess nutrition status and related factors among study population.Methods: A community based cross sectional study using stratified random sampling. Total 165 samples were taken from 5 field practice area of B. J. Medical College, Ahmedabad. From each area 33 random samples were taken.Results: Out of 165 children 80 and 85 were male and female. The prevalence of underweight, stunting and wasting was 45%, 46% and 29% respectively. SE class IV and V, low birth weight, higher birth order, late age of starting complementary feeding, parents education were significantly associated with undernutrition.Conclusions: The risk of undernutrition is higher in field practice area of B. J. Medical College, Ahmedabad. There is a need to strengthen promotion of maternal nutrition; maternal education and improving household socio-economic condition along with health care services may improve nutritional status of children.
Clinico-pathological profile of paediatric head and neck cancers in Tanzania: Findings from the country’s largest tertiary hospital
Authors: Abraham Zephania Saitabau , Ntunaguzi Daudi , Kahinga Aveline Aloyce , Swai Henry , Mithe Siwillis , Massawe Enica Richard
Published: August 2019

Background: Head and neck cancer is the sixth most common cancer in the world and the largest burden occurs in developing countries where such burden of infectious diseases is also high. Data on the clinico-pathological profile of paediatric head and neck cancers is scarce in Tanzania. To the best of our knowledge, this is the first study in Tanzania to characterize such profile.

Methods: A hospital based descriptive cross sectional study was conducted involving 180 pediatric patients at Muhimbili National Hospital. Data collected was analyzed using SPSS program version 21.  

Results: A total of 180 paediatric patients were recruited where 61.1% were males with a male to female ratio of 1.57:1 and majority fell into the 0-5years age range (53.9%). Ten primary anatomical sites were found with the neck (cervical lymph node) (36.1%) predominating followed by the orbit/eye (34.4%) and the least common site was parapharyngeal space (0.5%). The neck was more affected in patients aged 6-11 years with a diagnosis of lymphomas (98.5%) whereas the orbit was affected predominantly in those aged 0-5 years (90.3%) by retinoblastoma (79%). The predominant histocytopathological variant was lymphoma (52.8%) and the least was Langerhans cell histiocytosis (0.6%). Lymphomas and retinoblastoma occurred commonly in males (70.53% and 53.06% respectively) but sarcomas showed no gender predilection. Lymphomas (32.6%) and retinoblastomas (93.9%) predominated in patients aged 6-11 years and 0-5 years respectively.

Conclusions: Lymphomas, retinoblastomas and sarcomas were more predominant in paediatric patients similar to what has been reported in various reports elsewhere.
Mismatch negativity in children with cochlear implant
Authors: Hamid Mai , Kotait Mona Ahmed , Kolkaila Enaas Ahmad
Published: August 2019

Background: Cochlear implant provides a great opportunity for children with severe to profound sensorineural hearing loss to restore normal hearing. Identifying mismatch negativity (MMN) in cochlear implant recipients helps to assess the role of central auditory structures in processing speech stimuli in those patients. The objective of the present study is to evaluate tone and speech discrimination in cochlear implanted children using mismatch negativity test.

Methods: MMN was recorded in 35 children. They were divided into two groups. Control group consisted of 15 normal hearing children, their age ranged from 3-11 years. Study group consisted of 20 children fitted with unilateral CI, and their age matched the control group. Two oddball paradigms were used; the first was tone bursts (1000 Hz as standard stimulus and 1050 Hz as deviant stimulus). The second was synthesized speech stimuli (/da/ as standard stimulus and /ga/ as deviant one). Both paradigms were presented at 75dB SPL.

Results: All cochlear implanted children included showed MMN on using both oddball paradigms. Comparing results of both groups revealed statistically significant differences in MMN latency and amplitude. There was a significant positive correlation between MMN latencies and the implantation age as well as the duration of hearing loss before implantation.

Conclusions: MMN provides an objective tool to assess the auditory discrimination abilities in cochlear implanted children which may help in their rehabilitation and also in the optimum setting of their devices.
Correlation of tympanic membrane perforations with hearing loss
Authors: Aneesa Mirza , Siraj Samreen , Ali Arshid
Published: August 2019

Background: Tympanic membrane perforations are common cause of hearing loss. This study was designed to analyze the relation between tympanic membrane perforation and hearing loss.

Methods: In this prospective study, patients with dry tympanic membrane perforations of safe type were included. The patients were divided into groups in according to size, site and duration of perforation.  

Results: 49 patients with 70 dry tympanic membrane perforations were studied. Data was analyzed statistically using paired t-test. Hearing loss increased as the size of perforation increased. Posterior quadrant perforations were associated with more hearing loss as compared to anterior quadrant perforations. Also duration of disease was in linear relation with mean hearing loss.
Conclusions:The degree of conductive hearing loss as a result of tympanic membrane perforation would be expected with the size, site and duration of perforation.
 
Does hearing loss relate to gestational diabetes mellitus?
Authors: Kwatra Devanshu , Kumar Sunil , Singh Gautam Bir , Biswas Ratna , Upadhyay Prabhakar
Published: August 2019

Background: This study aims to check if gestational diabetes mellitus leads to changes in hearing.

Methods: A prospective hospital based observational study was performed with total 60 subjects in age group of 18-40 years in the Department of Otolaryngology and Head and Neck Surgery and the Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi between November 2016 to March 2018. Subjects were divided in two groups. The first group included 30 pregnant women with diagnosed gestational diabetes mellitus and the second group had 30 pregnant women not having gestational diabetes mellitus. Pure-tone audiometry and impedance audiometry was performed twice in all the subjects, first during the antepartum period and second time during the postpartum period.  

Results: Significant difference was seen between the average of air conduction threshold values at speech frequencies between the two groups during both antepartum and postpartum period.

Conclusions: The alterations in hearing sensitivity in air conduction between the two groups can be attributed to gestational diabetes mellitus.
A study of auditory brainstem evoked responses in type 1 and type 2 diabetes mellitus patients with normal hearing
Authors: Goyal Isha , Singh Manjit , Singh Baldev , Singh Kamal Dev , Sachdeva Parul
Published: August 2019

Background: Diabetes mellitus (DM) is one of the most common metabolic disorders with millions of cases world-wide. Its effect on functioning of the central nervous system (CNS) and the peripheral nerves is a matter of current neurological research. Our study aimed to find out changes in auditory brainstem responses if any, in patients with type 1 and type 2 DM patients with apparently normal hearing.

Methods: 50 cases each of type 1 and type 2 diabetic patients with normal hearing were chosen along with 50 healthy controls. Pure tone audiometry and brainstem evoked response audiometry (BERA) was performed in all cases. The BERA results were interpreted for the latencies of waves I, II, III, IV and V and inter-peak latencies I-III, I-V and III-V.  

Results: Significant delay in absolute latency of wave I, III, IV, V and inter-peak latencies I-V and III-V was seen in Type 1 diabetic patients. In Type 2 diabetic patients, latencies of waves I, II, III, IV and V and inter-peak latencies I-III, I-V and III-V were significantly delayed. There was no statistically significant difference in latency delay between type 1 and type 2 DM. No relation was found with the duration of DM.

Conclusions: BERA is a non-invasive and easy to perform test that can detect minor CNS changes and can be used to detect peripheral (auditory nerve) and central neuropathy in diabetics even in absence of clinical signs and symptoms of deafness.
Comparison of thyroid gland involvement in contrast enhanced computed tomography of the neck and histopathology and the necessity of thyroidectomy in patients with laryngeal and hypo pharyngeal cancer
Authors: Kathar M. Mohamed Abdul , Michael Rajiv , Shyam Aparna
Published: August 2019

Background: The aim of this study is to assess the thyroid gland involvement in the preoperative contrast enhanced computed tomography (CECT) of neck with histopathology (HPE) in determining the indications for ipsilateral thyroidectomy in patients undergoing total laryngectomy in laryngeal and hypopharyngeal cancers.

Methods: Forty patients diagnosed clinically with stage 3 laryngeal and hypopharyngeal cancer were subjected to CECT of neck. Patients with cartilage erosion and extra laryngeal spread on CECT (T3, T4a) were routinely taken for total laryngectomy, partial pharyngectomy and hemi thyroidectomy. Specimens were sent for histopathological analysis and which was compared with preoperative CECT scan.  

Results: Of the forty cases, only four patients had thyroid gland involvement in CECT scan and 2 of the 40 had thyroid gland involvement in histopathology. Of the four patients where the CT scan which showed infiltration of the thyroid gland, none had thyroid gland involvement in histopathology. In two patients where thyroid gland was involved in histopathology, CT scan failed to pick up the thyroid gland involvement. Those two patients with histologically proven thyroid gland involvement identify as transglottic malignancy with cartilage erosion and extra laryngeal spread.

Conclusions: Our study concludes that an ipsilateral hemi-thyroidectomy is probably still indicated in transglottic cancer with cartilage invasion and/or extra laryngeal spread.
Association of external nose deformity in individuals with nasal septal deviation
Authors: Hubballi Ravi Kishore , Koujalagi Shruthi Manohar
Published: August 2019

Background: Deviated nasal septum presents a challenge as often functional problems as well as aesthetic deformities must be addressed. Deviated nasal septum can be a result of varying pathologies and etiologies. Classifying the nasal deviation enables the surgeon to choose the appropriate operative intervention. This study is intended to know the association of external nose deformity in patients with deviated nasal septum.

Methods: 100 patients were attending to the Department of ENT, Vijayanagara Institute of Medical Sciences, Ballari with deviated nasal septum, septal dislocation, septal spur and external nose deformity. Deviated nasal septum was classified as per the classification proposed by Mladina. External nose deformity was classified into 5 types proposed by Yong Jo Jang’s classification depending on the orientation of 2 horizontal units (bony pyramid and cartilaginous subunits) with respect to facial midline.  

Results: Out of 100 patients with deviated nasal septum, external nose deformity was present in 61% of the patients. Significant association was present between the deviated nasal septum and external nose deformity (p=0.01).

Conclusions: Type II (33%) deviated nasal septum was most common followed by Type VII (31%). Among the external nose deformity, Type I was most common followed by Type V. Type II deviated nasal septum was associated most commonly with Type V external nose deformity, Type VII deviated nasal septum with Type I external nose deformity and Type IV deviated nasal septum with Type I/II external nose deformity in equal frequency.
A rare case report of aural myiasis in a 24-day old neonate in Tanzania
Authors: Abraham Zephania Saitabau , Ntunaguzi Daudi , Kahinga Aveline Aloyce , Lengine Emmanuel Ole , Mhamilawa Lwidiko Edward , Massawe Enica Richard
Published: August 2019

Aural myiasis refers to the infestation of the ear by the larvae of certain dipterous flies. The disease-producing flies prefer a warm and humid environment and higher incidence occur in tropics and subtropics of Africa and America. Aural myiasis is rare during neonatal life and children with tendencies of poking the ear need immediate review by otorhinolaryngologists for thorough otological review. The objective is thus to report the case of a 24-day old neonate who was diagnosed to have aural myiasis upon otoendoscopy at a private health facility in Tanzania. This is the first reported case of neonatal aural myiasis in our country. Neonates with tendencies to poke ears and with irritability should be handled with care by having immediate Otorhinolaryngologist review to exclude aural pathologies such as aural myiasis. Removal of the maggot, instilling ototopical antibiotics admixed with aural antiseptics, systemic antibiotics and close follow up for meticulous aural toilet remains the main stay in management of aural myiasis.
Extranasopharyngeal angiofibroma in an adolescent male: a case report
Authors: Arulappan Lourdes Albina Siluvai
Published: August 2019

A 16 year old male presented with complaints of obstruction in the right side of nose for 15 days, 4 episodes of unprovoked bleeding from right nasal cavity for one week. The epistaxis was sudden in onset. CT revealed polypoidal mass in the right nasal cavity, filling inferior 1/3rd of the right anterior nasal cavity, with attachment to the nasal septum. Endoscopic excision of the mass was done in toto and histopathological examination report showed it to be an extra nasopharyngeal angiofibroma.
Microscope assisted coblation tonsillectomy: a safe and effective surgical technique
Authors: Swain Santosh Kumar , Das Alok , Nahak Bulu , Behera Ishwar Chandra
Published: August 2019

Coblation is a new technology used in soft tissue surgery. This technique uses lower energies than standard bipolar diathermy. It does ablation at lower temperature which causes less damage to the surrounding tissues and also less post-operative pain. Microscope assisted tonsillectomy is a new surgical technique and established as a suitable and standard method of tonsillectomy. Microscope-assisted coblation tonsillectomy reduces the intra-operative and post-operative hemorrhage, post-operative pain and decrease the hospital stay, so that help in an early improvement of the patient. This technique is associated with less pain and quick return to normal diet and daily activity of the patient. This technique is an effective and safe technique for doing tonsillectomy. Surgeons can also operate with precision in enlarged and magnified view in microscope or endoscope assisted tonsillectomy. Moreover, this technique makes it easier to educate the students. The purpose of this review article is to discuss the principle, techniques, outcome, advantages and limitations of microscope assisted coblation tonsillectomy. 
Hacia una gestión de conocimiento incluyente
Authors: Rodríguez Zambrano Hernando
Published: August 2019

En la presente editorial, se plantea un tema de gran importancia relacionado con la Gestión del Conocimiento(GC), como proceso facilitador en la transmisión de capital intelectual y experiencias, producidas por laspersonas y organizaciones, con el fin de aprender y generar nuevo conocimiento. Al respecto, el conceptode Gestión del conocimiento, aparece a finales del siglo XX, con el desarrollo de modelos gerenciales, queinvolucraban temáticas sobre la gestión de calidad total, la innovación continua, la organización, entre otras,apareciendo, además, la cultura crítica de que el conocimiento debería propagarse, en lo posible con accesoabierto. Ahora bien, con el modelo actual de globalización económica y con el desarrollo acelerado de nuevastecnologías de la información y de la comunicación (TIC), se ha facilitado el intercambio de la información yel conocimiento, adquiriendo especial relevancia la Gestión del conocimiento (GC), como un nuevo modelogerencial; donde, el individuo, las empresas y las organizaciones, deben ajustarse a las nuevas situaciones decambio para generar ventajas competitivas, expresadas en mejores resultados de productividad, creatividad,innovación, responsabilidad social, entre otras. (Gómez, Pérez & Curbelo, 2005).
O culto a Wagner
Authors: De Oliveira Sidnei
Published: August 2019

Quanto ao processo de tradução de um texto, neste caso traduzido do alemão para o português, é importante ressaltar o conhecimento do tema abordado, bem como a figura do autor e a teoria ou o pensamento desenvolvido para a sua época, uma vez que muitos vocábulos utilizados em uma determinada língua não possuem tradução real sobre o seu significado na língua portuguesa. Logo, o tradutor tem como artifícios a seu favor no trabalho de tradução, não apenas o conhecimento da língua, mas a importância que o autor e sua obra teve na época que foi redigido o texto ou postumamente. Algumas palavras deixam de ser utilizada ou substituídas por outras com o decorrer de anos, décadas e séculos. Isso é perceptível, por exemplo, quando nos deparamos com textos antigos, no caso de Hanslick, importante escritor e crítico de estética pertencente ao século XIX. As alterações não são apenas por questões de revisões ortográficas, mas também por tópicos relacionados à própria cultura que a língua amalgama conforme a prática e a vivência do cotidiano dessa mesma cultura. Outro exemplo para melhor compreensão se dá em pensamentos e teorias filosóficas, a saber, termos específicos de uma determinada filosofia, pois um mesmo vocábulos possui outro conceito quando é desenvolvido em uma concepção filosófica e teoria discrepante de um pensador para outro pensador. Estes são apenas alguns dos impasses que o tradutor convive durante o trabalho de tradução.
An Analysis of the Effect of Plunger Barrel Performance of High Pressure Pumps and Fuel Against the Main Engine Injector Performance
Authors: Tjahjono Agus , Fonsula Andromeda Vega , Wiwoho Boedojo , Afandi Saifudin
Published: August 2019

This study aimed to analyze the magnitude of the performance correlation value of a plunger barrel of high pressure pump (X1) and fuel (Y1) in the main engine injector performance (Y). This study applied SPSS (Statistical Package for the Social Sciences) analysis which produces quantitative data to describe the object under the study. The data were collected through a questionnaire by using a Likert scale approach. The results showed that the X1 coefficient on variable Y was moderate but the correlation value of X2 to Y was low. The correlation value of the influence of variables X1 and X2 together on the variable Y was also low. This variable can be used as an analysis in assessing the performance of the main engine injector in commercial vessels.
Students and Teachers’ Perception of Using CBT Seagull Training Lab for Learning Maritime English in PIP Semarang
Authors: Handayani Andarini , Shinta Dewi Irma
Published: August 2019

This study attempts to explore how students and teacher perceive the usefulness of Computer Based Training (CBT) Seagull Training Lab software for teaching, and learning Maritime English in PIP Semarang. This software is used by Marine Navigation, Marine Engineering and Port and Shipping Department’s students. The study adopted the Technology Acceptance Model (TAM) by Davis (1989) focusing on the perceived acceptance of the software. This study employed the survey research design with simple random sampling as the sampling technique. The questionnaires and interviews were used as the method of data collection. The population participated are 374 students and 3 teachers. The data were analyzed and interpreted descriptively. The analysis was done under 4 headings: perceived of ease, perceived usefulness, attitude towards using, and behavior intention to use. The results show that students and teachers perceived the software both positively and negatively. It also reveals that a positive impact of the usage has a positive impact on teaching. Moreover, the negative perception is also uncovered.
Human Resource Development Implementation As A Development of Regional Tourism Development in Central Java
Authors: Guritno Bambang , Aprilliyani Renny , Listyorini Hani
Published: August 2019

The tourism sector is one of the mainstay sectors of the Indonesian government to generate foreign exchange, therefore the use, development, management, and financing of tourism areas must receive serious attention from the government by involving the role of government institutions, related stakeholders and participation of all levels of society in various policies and programs to be taken. This study tries to examine the description of good governance concepts and practices, institutional processes and procedures, development financing for the development of the tourism sector that is associated with education to improve the quality of human resources in the tourism sector. The approach used in this study is a qualitative approach with descriptive methods. Sources of data were obtained from field observations, interviews, group discussions and are expected to be able to encourage the development of regional tourism, especially destinations around the community through empowering the surrounding community to set destinations well. In order for all aspects of tourism management to work properly, the role of local government is needed in providing education support and support in the field of tourism, so it can fill the shortage of experts who will be placed in institutions or industries related to local tourism.
The Improvement of Impact on Manganese Steel for Bucket Tooth Product
Authors: Wismo Winarto Eko , Darmo Suryo , Santoso Nugroho , Dwi Setyana Lilik
Published: August 2019

The bucket tooth is one of an excavator components made of manganese steel used to dig and load land into a truck or elsewhere. The impact of the bucket tooth product needs to be increased so that it has longer lifetime. The objective of this research is to know the right composition of manganese in order to obtain the optimal impact strength. Varying the composition of manganese from 11,2% to 15,1% wt Mn are carried out in an induction furnace. Mechanical tests carried out include microstructure observation, impact and hardness testing. The structure of austenite dominates manganese steel with an average grain size of 60 μm (11,2% Mn) and increases up to 45% for the contents of 15,1% Mn. The lowest impact strength (0,08 J/mm2) in specimens with 11,2% Mn, increases up to 42% (0,142 J/mm2) in specimens with 15,1% Mn. The increase of impact strength is affected by grain size and austenite stability. The hardness of manganese steel with 11,2% Mn (330 VHN) increases up to 376 VHN with 15,1% Mn.
Computer-Based Application As A Social Media To Improve Safety Traffic Knowledge Of Junior High School Students (Case Study Of Smp N 1, Smp N 4 And Smp N 5 Ciamis)
Authors: Dewa Gede Tantara Tesa Putra I , El Husna Iksiroh , Indira Anindya Gunawan Kadek
Published: August 2019

Road traffic safety education through campaigns and counseling has often been carried out by Politeknik Keselamatan Transportasi Jalan (PKTJ) Tegal as an educational institution that focuses on safety. The campaigns were given to students who are in kindergarten to high schools/ vocational high schools and also the general public by Computer Based Application (CBA). The most difficult campaign was done for Junior high school students. This study aims to make CBA as a medium of campaign in improving understanding of traffic safety. The method used is an experiment with One Group Pre test-Post test. Data collection technique was Purposive Sampling. The research samples were 82 students who come from three different junior high schools. Data collection used test methods (Pre-test and Post-test). The results show that there was an increasing result from i.e; from the low category to high, so that it can be concluded that CBA improves understanding of traffic safety in students of class VIII SMP N 1, N 4 and N 5 Ciamis.
Analysis of Log Cargo Handling Management
Authors: . .
Published: August 2019

Log cargoes are bulk cargoes and could be loaded in holds on the deck. Logs have their own characteristics and particular treatments, especially when loaded on the deck. In this case, loading logs was conducted in two ports where specific skills and good preparation were needed because there was a possibility on missing cargo calculation. There are some methods of cargo calculation which were carried out manually and using the program. This research used fishbone and descriptive qualitative analysis. The purpose of this research was to make log cargo handling easier, more effective and efficient for one port to another port. The result showed that the implementation of loading management was done in four stages including planning, organizing, actuating and evaluating. In the first port, logs are loaded in holds and not contained fully. Then in the second port, the rest of logs were completely loaded on the deck. There is a difference on the cargo calculation because of the ontaking value of hydrostatic table.
Risk Assessment Operation of Auxiliary Steam Boiler on Pertamina Tanker Vessel
Authors: . Nasri
Published: August 2019

Auxiliary steam boiler system is always included in hazard identification process and risk operation. Hazard is a source of the damage of the human, process, properties and environment. The risk is an explanation of advantage or disadvantage possibility such as financial, physical damage, or accident as activity consequence. In this case, risk is the appeared consequences and likelihood. HAZOP (Hazard and Operability Study) method was used to identify hazard potency at Auxiliary steam boiler. HAZOP identification was determined by 11 (eleven) study nodes on Auxiliary steam boiler system. HAZOP characteristic is systematic; it uses structured or higher arrangement based on the instructions and HAZOP team’s idea to continue and make sure whether the safeguard is suitable for the object being tested. Further, two-sided risk computation was done on Auxiliary steam boiler system until the risk frequency and risk consequence were found. Research results indicated 11 (eleven) types of consequences with the highest level, which further needs mitigation process to decrease the risk level from Auxiliary steam boiler system. This is to prevent the change of risk of each study node for minimized risk.
Performance Analysis of Signaled Intersections to Improve Safety in Depok Intersection, Depok City
Authors: Widyawan Sony , Prayogo Darul , . Rukman , Ayu D P Diajeng , Rokhim Abdul
Published: August 2019

Transportation problems are one of the issues faced in Depok, especially at intersections. The problems of traffic congestion and conflict often occur at intersections, especially at Depok intersection in which one of the efforts made to reduce the conflicts is made by managing the intersection. The method used in analyzing intersection performance is the use of calculations at IHCM, while the analysis of traffic conflicts to determine the seriousness of traffic conflicts is to use traffic conflict techniques (TCT) compared to the conflicts. Recommendations are made with a scheme using the selection of 3 phases and 3.5 phases then making a comparison with the third phase and choosing the most appropriate scenario. From the recommendation scheme made using the VISSIM 10 PTV software, the most appropriate scheme is obtained by using three-phase settings. The results of phase 3 simulations are effective in reducing the number of traffic conflicts and service levels are still in good condition.
Human Resource Development Implementation As a Development of Regional Tourism Development in Central Java
Authors: Guritno Bambang , Aprilliyani Renny , Listyorini Hani
Published: August 2019

The tourism sector is one of the mainstay sectors of the Indonesian government to generate foreign exchange, therefore the use, development, management, and financing of tourism areas must receive serious attention from the government by involving the role of government institutions, related stakeholders and participation of all levels of society in various policies and programs to be taken. This study tries to examine the description of good governance concepts and practices, institutional processes and procedures, development financing for the development of the tourism sector that is associated with education to improve the quality of human resources in the tourism sector. The approach used in this study is a qualitative approach with descriptive methods. Sources of data were obtained from field observations, interviews, group discussions and are expected to be able to encourage the development of regional tourism, especially destinations around the community through empowering the surrounding community to set destinations well. In order for all aspects of tourism management to work properly, the role of local government is needed in providing education support and support in the field of tourism, so it can fill the shortage of experts who will be placed in institutions or industries related to local tourism.
Crew Capability Assessment in Using Portable Fire Extinguisher during Fire Drill Implementation on MV. Vinca
Authors: . Andromeda , Fonsula Vega , Handoko Mohammad
Published: August 2019

Years ago, a fire extinguisher was invented as an active fire protection device used to extinguish or control fires in emergencies. On board, fire extinguisher plays an important role to prevent and overcome any danger or threat resulted from a fire. Thus, crew’s capability in using the fire extinguishers is highly needed. In this case, crews are supposed to be trained in using the fire extinguisher by implementing a fire drill (at least once a month). However, in fact, in this research, it was found that most of MV. Vinca’s crews were not aware of fire-fighting procedure especially on how to use the portable fire extinguisher. This phenomenon was the reason why this research was conducted focusing on the crew’s low capability in using portable fire extinguishers during the fire drill implementation. The data were collected through observation, structured interviews, documentary studies, and library research. The data were then analyzed by using Fault Tree Analysis (FTA) and Urgency, Seriousness, Growth (USG). Based on the analysis, it was found that the crews had a low capability in using a portable fire extinguisher. There were some reasons: (1) They lacked the knowledge and understanding about portable fire extinguisher; (2) The fire drills were not seriously carried out; (3) The portable fire extinguishers were in bad condition due to the absence of periodic and regular maintenance. In order to overcome the problem, training and guidance for the crews about the various types of portable fire extinguisher and their uses are highly needed; fire drills need to be performed seriously. Moreover, regular maintenance to the fire-fighting equipment also needs to be carried out.