bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparing the outcome of patients discharged in early postoperative period, with patients discharged at late postoperative period in a tertiary care hospital
Authors: Marimuthu Kavitha , Loganathan Malarvizhi
Published: June 2017

Background: It has become common practice to discharge women from hospital early after caesarean section, to satisfy their wishes or to reduce workload the objectives of this study were to determine women’s satisfaction, and rates of wound infection, maternal readmission, and early postnatal depression. Postnatal hospital stay has two main objectives; the first, to identify any complication for both mother and newborn and the second, to provide the necessary support to the new mother for her return home. The two main reasons for this change in the service provided are to improve women’s satisfaction during this period and to reduce the cost to the health system.Methods: Retrospective study from January 2016 to January 2017 in a tertiary care hospital. Patient underwent Lower Section Caesarean Section (LSCS) were grouped into 2 groups. Group I- patients discharged on 5th post-operative day (POD). Group II-patient discharged at 8th POD. 500 patients were included in each group. Patient discharged on 5th POD was instructed about the warning symptoms of puerperium about fever, breast engorgement, wound discharge, foul smelling vaginal discharge, and advised for suture removal in nearby health facility.Results: Those who discharged at 5th POD (500) were followed through phone at 10th POD and only 498 could be traced and complications and satisfaction was made in discharge proforma. Of 500 patients discharge at 5th POD only 498 responded to phone call. Wound infection was found in 2 patients of those 2, both were asked to attend the post- natal clinic and found to have mild wound induration with minimal wound discharge which responded well to oral anti biotic and daily dressing in nearby health facility.Conclusions: In developing countries like India 70% of the patients undergo delivery in government hospitals. Most of them were belong to low socio-economic status and they have to go to daily work for their daily needs. If a patient is admitted for a prolonged period in a hospital the helping members who come to hospital, have to stay along with the patients and they will lose their daily income which will create debt to the family which in turn causes economic burden and psychological stress. This will reflect on the post-natal nutrition to the mother and baby.
Comparison of Dubowitz scoring versus Ballard scoring for assessment of fetal maturation of newly born infants setting
Authors: Singhal Sangeeta , Bawa Ritu , Bansal Shivani
Published: June 2017

Background: Different scoring systems based on neurological and physical examination are used in the neonatal units for assessment of gestational age. Assessment of gestational age is very much helpful in labelling the newborn to be preterm, term or post – term and to assess the further outcome of the newborn infants. Present study was performed to test the accuracy and reliability of the Ballard scoring system as compared to Dubowitz scoring system on 250 newborn infants and their correlation with the gestational age as calculated from first day of mother’s last menstrual period. In infants of 38 weeks onwards correlation of gestational age was done with the extension of plantar creases over sole.Methods: Infants studied were selected from infants born in Muzaffarnagar Medical College and Hospital Muzaffarnagar and those infants admitted to the neonatal intensive care unit. First of all methods of eliciting different criteria were experienced by examining several newborn infants and then Dubowitz and Ballard scoring system were performed separately and gestational age assessed. crease was measured, using metallic scale from base of great toe after stretching the sole.Results: Gestational ages estimated by Ballard scoring system and Dubowitz system strongly correlated with the gestational ages computed from the date of mother’s last menstrual period. The coefficient of correlation calculated between Ballard and Dubowitz scoring system showed perfect positive correlation on the regression line.  Association of gestational age with the length of sole crease was also very significant.Conclusions: The clinical test of maturation described by Ballard et al and which is evaluated in the present study, takes a balanced look at physical and neurological maturation and included those items found to be most useful regardless of the presence or absence of diseased state.
Giant dermoid cyst of ovary in postmenopausal woman: a case report
Authors: Ghose Seetesh , G. Chandana , Rathod Setu , John Lopamudra B.
Published: June 2017

A 49 year, miltipara, post-menopausal woman complains of pain abdomen and breathlessness for one week. On abdominal examination, there was a firm mass. MRI showed multi-loculated cystic lesion suggestive of ovarian dermoid cyst. Patient underwent TAH and BSO.
Thrombocytosis: can it be used as a marker for tuberculosis?
Authors: Rathod Suman , Samel Dinesh Ramesh , Kshirsagar Prasita , Pokar Muddasir
Published: June 2017

Background: Tuberculosis is a major health problem in India. Early diagnosis and prompt treatment is the key to control this menace. Hence to improve diagnosis in peripheral region, it is imperative that other methods are used to supplement the diagnostic This study aimed at assessing the reactive thrombocytosis in patients with tuberculosis admitted in medicine ward of RGMC and CSMH, Kalwa, Thane, India.Methods: This study was conducted from 1st January 2016 up to 31st June 2016.  Data was collected from the PM register and also from Post mortem records, entered in MS Excel and analyzed.Results: Newly discovered, 112 patients, diagnosed on basis of sputum AFB positivity, chest x-ray changes, pleural fluid, ascitic fluid and CSF analysis reports suggestive of tuberculosis were selected to be the cases, out of which 50 were males (44.6%) and 62 females (55.4%)and, 127 non-tuberculous patients admitted for other causes who did not have any symptoms or signs of tuberculosis were randomly selected to be the control group of the study. The ages of the patients ranged from 14 to 76 years old. Thrombocytosis was detected in 84 (75%)of the Tb patients, whereas only 3 (2.3%) in Non-Tb Patients. The erythrocyte sedimentation rate (ESR) was increased by more than 20 in 97.4% of the patients.Conclusions: The changes in these parameters (platelets count and ESR) may reflect a reaction to the inflammatory condition. Therefore, in endemic areas, the presence of such haematological peripheral blood changes may raise the suspicion of pulmonary tuberculosis.
The measurement of blood pressure in winter season and its co-relation with blood pressure after cold exposure in summer season: a cross-sectional study in Gauhati medical college and hospital, Guwahati, Assam, India
Authors: Chakrabarty Mousumi , Bora Bonti
Published: June 2017

Background: The aim of the study was to correlate the change in blood pressure in winter season to that in summer season after exposure to localized cold stimuli.Methods: Basal blood pressure in healthy males of 20-40 years was recorded during winter season by conventional method using sphygmomanometer and stethoscope. During summer, the same subjects were taken and their baseline blood pressure was recorded. Thereafter their feet were immersed in cold water at 12 degree centigrade and blood pressure was recorded at 5 minutes and 10 minutes interval. The systolic and diastolic BP during winter, summer (baseline), and after 5 minutes and 10 minutes of cold exposure was compared. P value <0.001 as obtained by using student t test (student graph pad) was taken as significantResults: It was observed that systolic and diastolic BP showed a significant increase (p<0.001) in response to the cold stimuli. The increase was comparable to the rise in BP during winter.Conclusions: Present study has revealed a higher systolic and diastolic BP in winter and in summer after cold stimuli than baseline summer BP; So we conclude that subjects with borderline hypertension who are more likely to develop higher BP in winter season are also likely to develop high BP after cold stimuli in summer season.
Analysis of autopsies conducted for deaths due to accidental trauma: a ten years record-based study
Authors: Ghadge Mangesh Ramchandra , Samel Dinesh Ramesh
Published: June 2017

Background: Trauma is a largely preventable cause of death. Trauma can be avoided and death can be averted if timely medical services are made available. Hence it is important to know the causes of trauma, the factors associated with it and the types of fatal injuries associated with these causes.Methods: A ten years record based study of the autopsies conducted in the Forensic Medicine department of a rapidly growing metropolitan area was undertaken from the autopsy registers and post mortem records.Results: It was noted that the young age groups of 16 to 30 years and 31 to 40 years are most vulnerable. Major cause of trauma was road traffic accidents, followed by fall from height. Other causes are Rail accidents, domestic accidents, building collapse and industrial accidents. Head injuries and shock with hemorrhage are the major causes of death due to trauma.Conclusions: Overall, males and younger population forms a major proportion of trauma victims. Among female victims the major causes of trauma were domestic accidents and house collapse and among male victims road traffic accidents, fall from height and railway accidents were major causes.
Nutritional status of underfive children of Mumbai suburban region
Authors: Ghane Vaishali R. , Kumar Ranjith
Published: June 2017

Background: Children below five years of age are an at-risk population due to their susceptibility to malnutrition. They contribute significantly for malnutrition related morbidity and mortality, especially in India. Malnutrition in under-five children belonging to middle or low-income group urban or suburban population is more severe and compounded compared to its rural counterparts. The objective of the study was to assess the nutritional status of under-five urban children. To study correlation of determinants like birth weight, exclusive breastfeeding, immunization status, maternal education and socioeconomic status with nutritional status of under five children.Methods: The prospective cross-sectional study included 315 under-five children attending paediatric outpatient department of upcoming new tertiary care hospital in Mumbai. Anthropometric assessment for underweight, wasting and stunting was calculated based on age, weight and height measurements.Results: As per WHO classification, moderate underweight (W/A) was present in 74 (23.49%) and severe underweight in 38 (18.71%). Wasting (W/H) in the form of moderate acute malnutrition (MAM) was noted in 64 (20.32%) and severe acute malnutrition (SAM) in 42 (13.33%). Height for age revealed moderate stunting in 37 (11.75%) and severe stunting in 5 (1.59%). The sociodemographic determinants birth weight, exclusive breastfeeding, immunization status, maternal education and socioeconomic status had statistically significant association with malnutrition.Conclusions: Malnutrition is common between age of 12 to 24 months. Underweight was the commonest type of malnutrition followed by wasting and stunting. None of the patient was overweight. Quality antenatal care to reduce incidence of low birth weight, exclusive breast feeding, and appropriate weaning, complete, immunization, improvement in maternal education and socioeconomic status can reduce the incidence of malnutrition.
An extraordinary variation in origin of inferior alveolar nerve and its clinical significance: a case report
Authors: Jha Shweta , Khorwal Gitanjali , Kalra Sunita
Published: June 2017

Infratemporal fossa is a clinically significant site for delivery of local anaesthesia during dental procedures and maxillofacial surgeries. An extraordinary variation involving formation of inferior alveolar nerve was revealed during routine dissection of infra temporal region for teaching undergraduate medical students. Inferior alveolar nerve was seen to be incongruously originating from two separate roots from the posterior division of mandibular nerve. Furthermore, these two roots of inferior alveolar nerve were divulging unusual relationship with the maxillary artery. Superficial root of inferior alveolar nerve was coursing superficial to second part of maxillary artery and deep root was found to be emerging posterior to this part of maxillary artery. Additionally, deep root was sending a well-defined twig which when traced was found to be communicating with Lingual nerve. This unusual type of variation of Inferior alveolar nerve in this region may result in atypical symptoms of pain, numbness, headaches, interfere with outcome of injection of local anaesthesia and even surgical interventions in the infratemporal fossa.
Psoas abscess due to mycobacterium tuberculosis: a case report
Authors: Khorgade Ranjana R. , Bhise Pramod R. , Deshmukh Mukta M.
Published: June 2017

Iliopsoas abscess (IPA), a collection of pus in the iliopsoas compartment that has traditionally been classified into primary and secondary according to its origin, is an infrequent condition worldwide. Mostly active TB is confined to the lung, but approximately 15% are extrapulmonary. The most common types of extrapulmonary TB are, in descending order of frequency, pleural, lymphatic, bone and joint, genitourinary, miliary disease, meningitis, and peritonitis. Tuberculosis (TB) remains as one of the leading opportunistic infection in patients in developing countries. Here we report a rare case of psoas abscess of tubercular origin in patient who presented with back pain and limping. Diagnosis is done based on history, physical examination, plain radiology, microbiological investigation and CT scan of abdomen which revealed a large psoas abscess caused by M. tuberculosis. Patient was diagnosed as psoas abscess due to Mycobacterium tuberculosis and treated empirically with DOTS category I and significant functional improvement was noted on follow up.
Hearing impairment in rural area of Himalaya: prevalence and etiology
Authors: Guleria Trilok C. , Mohindroo Shobha , Azad Ramesh K. , Mohindroo Narender K.
Published: June 2017

Background: Hearing impairment is most frequent sensory deficit in human population. The disease burden estimations based on sound epidemiological research provide the foundation for appropriate public policy focus and measures for effective management of disease conditions. Data regarding the magnitude of hearing impairment in our country is limited and the literature search revealed that no such studies have been conducted in this region.

Methods: A community based cross sectional observational study was carried out among the 306 individuals in rural area of Shimla district, Himachal Pradesh. Information was obtained by a structured questionnaire, clinical ENT examination and audiological tests after obtaining informed consent.  

Results: The study group had 52.6% males and 47.4% females. Maximum 26.5% of individuals were in the age group of 31-45 years. Mean age was 36.56±18.83. The prevalence of hearing impairment was 16.7%. Among individuals with hearing loss, maximum 52.9% were in the age group of ≥60 years. Sensorineural hearing loss was found in 68.6%, maximum 56.9% had mild hearing loss. Among majority of individuals with hearing loss cause was presbyacusis 52.9% followed by infectious ear disease 33.3%.

Conclusions: In the present study, prevalence of hearing loss was found to be 16.7% and predominantly mild sensorineural or conductive type of hearing loss. An early intervention and quality patient education is necessary for prevention of hearing impairment in majority of cases.
A comprehensive study on cartilage tympanoplasty in adhesive otitis media
Authors: Selvan V. Saravana , Karuppasamy C.
Published: June 2017

Background: The surgical management of adhesive otitis media is debatable. Adhesive otitis media progressing to cholesteatoma cannot be predicted, and hearing remains normal until later in the disease course. Hence surgery is done only when there is hearing loss or frank cholesteatoma develops, where an extensive surgery may be needed. Earlier intervention is often avoided due to near normal hearing levels at this stage in some cases. Aim of the study was to hearing results and intactness of neotympanum who have undergone cartilage tympanoplasty with or without ossicular reconstruction are reported for patients with adhesive otitis media

Methods: This is an open labelled randomised study conducted in Madras Medical College after getting approval from the Institutional Ethical Committee. The study was conducted during the period of November 2011 to April 2013. A total of thirty patients (thirty one ears) aged thirteen-forty eight years underwent cartilage tympanoplasty with or without ossicular reconstruction. Tympanotomy was followed by cartilage reconstruction of the tympanic membrane, with ossicular reconstruction if there is any ossicular discontinuity

Results: The outcome measures were post-operative pure tone average, air-bone gap for three frequencies (five hundred, thousand, two thousand hertz) compared to pre-operative levels. There was a statistically significant improvement in hearing. Neotympanum was found to be stable significantly during follow up.

Conclusions: Therefore cartilage tympanoplasty with or without ossiculoplasty is effective for adhesive otitis media.
Correlation of HRCT mastoid with clinical presentation and operative findings in ear diseases
Authors: Chintale Sambhaji G. , Kirdak Vilas R. , Jatale Sonali P. , Shaikh Kaleem
Published: June 2017

Background: HRCT is found to be extremely useful for evaluating the ear diseases involving the external auditory canal, middle ear cavity, vertical segment of facial nerve canal, vestibular aqueduct, tegmen tympani, sigmoid sinus plate, sinodural angle, carotid canal, jugular fossa, infra and supralabrynthine air cells and temporomandibular joint. Our main objective was to correlate the clinical presentation and operative findings of ear diseases with HRCT mastoid.

Methods: This study is done in our institute otorhinolaryngology dept. from April 2014 to April 2016. This is prospective study involves 36 patient belonging to different age and sex groups with high suspicious of ear diseases. We have taken detail history of each patient with complete ear nose throat examination done and after that all patient were investigated with routine blood investigation, X-ray and HRCT mastoid to correlate clinical finding and subjected for operation to compare operative findings with HRCT finding.  

Results: Determined using Pearson chi square test indicated a statistically significant correlation between HRCT temporal bone with clinical presentation and operative findings of ear diseases (p<0.05).

Conclusions: With the advent of modern high-resolution CT scanners, detailed demonstration of temporal bone anatomy is practically possible now. We have been able to identify many significant structures not demonstrated by any of the known imaging modalities. The improved contrast and soft tissue a definition possible with HRCT has resulted in production of excellent images of soft tissue lesions in air spaces. Hence HRCT appears to be the diagnostic modality of choice for cholesteatomas and other soft tissue lesions in middle ear.
Clinical and audiological study of chronic suppurative otitis media tubotympanic type
Authors: G. Priyadarshini , Murali Sowmiya , James Febin
Published: June 2017

Background: Chronic suppurative otitis media (CSOM), tubotymapanic type, despite a commonly encountered disease in otorhinolaryngology has many controversies involved. This study was aimed at bringing few of these aspects to limelight.

Methods: The study was conducted in Otorhinolaryngology department, Aarupadai Veedu Medical College and Hospital, Pondicherry, India between September 2015 - August 2016. Total of 207 ears of 180 patients with CSOM tubotympanic type were included. Selected patients were subjected to ENT examination and pure tone audiometry after obtaining history.  

Results: In this study 35.9% patients belonged to 4th decade and 29.4% to 3rd decade. Among patients with discharge for more than 30 years, 68.8% had moderately-severe hearing impairment and those with discharge for less than 10 years, 60.2% had mild hearing loss. Among patients with large central perforation, 51.4% had moderately-severe hearing loss and those with small central perforation, 68.4% had mild hearing loss. Hearing loss was nearly same in anterior and posterior perforations. On chi square test p value was 0.0874 i.e. >0.05, difference insignificant.

Conclusions: In our study most patients were in 4th decade, incidence is equal in both genders. Hearing loss is directly proportional to disease duration and perforation size. Site of perforation does not influence hearing loss.
Parental perception of benefits from cochlear implantation in children with multiple impairments
Authors: Chavan Sumedha , Nandurkar Aparna
Published: June 2017

Background: Cochlear implantation (CI) in children with hearing impairment and an additional disability was not included in candidacy criteria earlier. With advances in technology and by taking into consideration the rehabilitation-pedagogic point of view, it is made possible to implant such children. In the Indian context, very few studies have documented benefits of CI in children with multiple impairments, whether measured or perceived by parents or families. Considering the number of children with additional impairments being implanted, it will be useful to conduct such a study, aimed at obtaining parents’ perceptions about benefits of cochlear implants in children with multiple impairments.

Methods: The present study is a survey of 31 children (3-15 years) using CI and having multiple disabilities. An ICF based questionnaire was developed and used to record parents’ perception of benefits in terms of language development, speech perception, social interaction, communication skills (non-verbal and verbal), education, general tasks and demands, interpersonal interactions and relationships and family dynamics.  

Results: Benefits were reported by all parents in all the domains i.e. listening, communication, learning and applying knowledge, interpersonal interactions and relationships and environmental factors. However, more parents reported consistent benefits in listening and interpersonal interactions. Most parents reported overall benefits from cochlear implantation in their children with multiple impairments.

Conclusions: Results of this study can be helpful in estimating outcomes from CI in children with multiple impairments. Such information can be used during pre-CI counselling to facilitate development of realistic parental expectations about the benefits of CI in their children with multiple impairments. As results are based on parental reports, overestimation of perceived benefits may be present in some instances.
Combined endoscopic endonasal and subciliary approach in revision DCR cases
Authors: S. V. Manjunatharao , M. M. Rajshekar
Published: June 2017

Background: Study conducted to know surgical outcome of combined endoscopic endonasal and subciliary approach in revision DCR cases and complications associated with the procedure.

Methods: Prospective, single-blinded, randomized, interventional study is carried out in Tertiary level center from August 2009 to April 2016. Totally 18 patients (11 female and 7 male) were involved in the study who has undergone previous DCR (11 external DCR and 7 endoscopic DCR). The results were analyzed at end of the 3rd and 6th month both subjectively and objectively.  

Results: All the 18 patients who underwent combined approach were relived from epiphora. None of the patients developed any complications following surgery.

Conclusions: The combination of endoscopic and external approach gives benefits of the both approaches giving huge advantages in revision cases. It gives excellent visualization of the surgical field, ability to correct internal nasal pathologies, make clear rhinostoma, workprecisely on fibrosed lacrimal sac and nearly no external scar. It provides good team work opportunity between otorhinologist and ophthalmologist.
A comparative study of smartphone based app with free field hearing for possible use as a screening test
Authors: Swami Himanshu , Bhargava Aditya , K. Sabarigirish , M. Arvind B.
Published: June 2017

Background:Hearing loss is an invisible injury that has been viewed as an acceptable by-product of military service. It is imperative to detect hearing loss at early stage to take immediate remedial measures. In Indian armed forces the current method of assessment of hearing is primarily by Free Field Hearing which is obsolete and has numerous shortcomings. We contucted a study using free iOS application to detect hearing loss. The objectives of the study were to investigate the validity and reproducibility of app based hearing assement and free field hearing with clinical pure tone audiometer as gold standard. It is cross sectional intra-subject comparative study

Methods:The study was conducted at CHAF where 200 patients were accrued. Hearing assessment was carried out by Pure Tone Audiometry (PTA) which is gold standard. Thereafter these patients were subjected to hearing assessment by using windows application “freehearingtestsoftware.com” and by free field hearing (FFH).  

Results:Hearing assessment by FFH and hearing check app was compared with PTA. Hearing check app was found to be more sensitive than FFH (98% and 73%). Both modalities had high specificity (95% and 99%). The test retest reproducibility measured with Pearson correlation coefficient was high (0.99) with hearing check app.

Conclusions:Smart phone application like Hearing check app is a cheap and effective way to assess hearing with reasonable accuracy. It’s high sensitivity and high test retest reproducibility makes it an ideal tool for screening and early detection of hearing loss replacing out-dated free field hearing.

 
Sialolithiasis and deep neck infection after the submandibular gland excision
Authors: Çeliker Metin , Beyazal Çeliker Fatma , Terzi Suat , Dursun Engin
Published: June 2017

Sialolithiasis is a common disease and mainly affects the submandibular glands and the Wharton's duct. Recurrent sialolithiasis is a rare condition. Despite submandibular gland excision, sialolithiasis which requires recurrent sialolithectomy causing also deep neck infections is even rarer. Herein, a 57-year-old female patient, who had recurrent sialolithiasis in Wharton's duct despite submandibular gland excision and sialolithectomy performed 10 years ago and sialolithectomy for Wharton's duct calculi performed 2 years and one year ago via transoral approach, is presented. The patient had also deep neck infection requiring hospitalization and underwent transoral sialolithectomy and marsupialization of the duct after medical treatment. The present case study aimed to present with radiological modalities the recurrent sialolithiasis also causing deep neck infections despite submandibular gland excision, and to indicate the causes of recurrence and the points to be remembered for prevention.
Second branchial arch anomaly: case series of two
Authors: Behera Sanjaya Kumar , Dalmia Deepak , Amlekar Ashay
Published: June 2017

Branchial apparatus develop between the 3rd and 7th weeks of embryonic life. There are 5 mesodermal arches separated by invaginations of ectoderm and endoderm. During development the second arch grows caudally to cover the third and fourth arches and the second, third, and fourth pharyngeal clefts eventually fusing with the lower neck. The enclosed II, III, and IV clefts are called as the cervical sinus. If this process does not occur for some reason then it gives rise to branchial cyst, sinus or fistula. We are presenting two cases of second branchial arch anomaly. In first case there was bilateral branchial fistula with right side fistula associated with branchial cyst. In second case there was unilateral right side branchial fistula. We operated both the cases by giving step ladder incision. In second case we find fistulous track opening in the tonsillar bed. Both the patients recovered well with no recurrence since 1 year. Brachial cleft cyst is a common cause of soft tissue swelling in the neck of a young adult. They generally occur unilaterally and are typically seen in the lateral aspect of the neck. It is clinically apparent in late childhood or early adulthood. In older adults with this presentation, it is important to exclude metastatic lymphadenopathy, lymphoma or tuberculosis.
A rare case of dysphonia in mitochondrial myopathy
Authors: Kumari Abha , Goyal Sunil , Malik Virender , Singh Takhellambam Biram , Paramasivan Vijay Krishnan , Kameswaran Mohan
Published: June 2017

The mitochondrial myopathy consists of diverse group of disorders which is characterized by primary dysfunction of mitochondrial respiratory chain leading to muscle disease. The involvement of larynx is very rare and only few cases have been reported in the literature. This study presents the fourth published case of dysphonia in the setting of mitochondrial myopathy. A patient with dysphonia with laryngeal involvement in mitochondrial myopathy is presented with literature review. A 43 year old man presented with progressive dysphonia and muscle weakness. Laryngeal examination showed bilateral adductor weakness of vocal cords and biopsy revealed findings typical of mitochondrial myopathy (MM). He underwent conservative trial for dysphonia with no relief and subsequently medalization thyroplasty showed some improvement in dysphonia. Mitochondrial myopathy should be considered in the differential diagnosis of dysphonia for early diagnosis and management.

 
Vestibular nerve compression: role of auditory brainstem response and cervical vestibular evoked myogenic potentials
Authors: Valame Deepa A. , Gore Geeta B.
Published: June 2017

The objective of the study was to evaluate the role of ABR and cVEMP in the diagnosis of vestibular compression syndrome (VCS) and to study the association of test results with the MRI findings. This is a case-report of four patients with VCS using case-study approach. Four patients with varying degrees of indentation of vestibulo-cochlear nerve by the anterior inferior cerebellar artery (AICA) loops were studied. Episodic rotatory vertigo was reported by three cases and two cases complained of tinnitus but the characteristic low-frequency ‘type-writer’ type of tinnitus was seen in only one. All cases showed evidence of retrocochlear pathology on ABR although two had normal peripheral hearing status. The cVEMP abnormalities noted were absence of cVEMP and reduced amplitude of cVEMP as compared to instrument-specific age-matched norms; only one case with no indentation of vestibulo-cochlear nerve had normal cVEMP tracings. Presence of AICA loops on the MRI by itself need not necessarily indicate vestibular compression syndrome. However when MRI excludes any other pathology in cases with symptoms such as unilateral sensorineural hearing loss, tinnitus, vertigo; vestibular compression could be the etiology. The likelihood of abnormal test findings is greater when the loop causes indentation of the nerve. 
An interesting case of fronto cutaneous fistula
Authors: Sriraman Gurumani , Yaadhava Krishnan RajPrakash Dharmapuri , Raja Roopak Visakan
Published: June 2017

Fronto cutaneous fistula is a very rare entity which usually occurs as a complication of long standing frontal sinusitis leading to frontal bone osteomyelitis. Its incidence has decreased due to the wide spread use of antibiotics. In this era we would like to report a rare case of fronto cutaneous fistula secondary to sino nasal malignancy. A 65 year old female presented to the ENT out patient service of our Hospital with complaints of discharging sinus in the left forehead for 2 months. There was blurring of vision in the right eye for one year .She was a known diabetic. General examination showed that there was a mild swelling around the right orbit and the right eye was significantly proptosed. Routine ENT examination revealed that there was a suspicious nasal mass in the right nasal cavity on anterior rhinoscopy later confirmed by diagnostic nasal endoscopy. Ear and Throat were normal. Neurology opinion was obtained which stated that the findings were suggestive of an intracranial Space occupying lesion extending into the right orbit. Urgent CT was ordered. Routine laboratory investigations were normal except the ESR value which was 60 mm at end of 1 hour. CT scan showed a sinonasal mass existed centered over the right nasal cavity extending into the surrounding sinuses, near complete erosion of lamina papyracea with extension into right orbit. Biopsy of was done. The biopsy showed squamous cell carcinoma with poorly to moderately differentiated cells. However as the patient was not willing for surgery, hence chemoradiation was advised.
Sarcomatoid carcinoma a rare variant of squamous cell carcinoma of larynx: a case report
Authors: Guleria Trilok C. , Mohindroo Shobha , Mohindroo Narender K. , Azad Ramesh K.
Published: June 2017

Sarcomatoid (spindle cell) carcinoma is a rare variant of squamous cell carcinoma (SCC). It compromises of 2–3% of laryngeal cancers. Tumor arises from the oral cavity, tonsil, larynx and pharynx. Majority of these tumors are polypoid or pedunculated and tend to cause obstructive symptoms. These tumors are often detected at an early stage, removed by polypectomy during diagnosis and tend to have a very good prognosis. In this case report, 76 years male who presented with progressive hoarseness of his voice and pain in throat. The patient underwent direct laryngoscopy with excision of the malignant mass and received radiotherapy. 
Molecular diagnosis of pediatric tumors
Authors: Mukherjee Tanushri , Mukherjee Soma , Dutta Rajat
Published: June 2017

Pediatric tumors are challenging in the context of best diagnosis, treatment, and prognosis. For tumors which have a genetic association or a cancer predisposition syndrome, the prognosis depends on accurate diagnosis. The application of molecular genetics to pediatric tumors has resulted in better diagnostic and prognostic factors for patient management. Molecular diagnostic techniques, such as reverse transcription polymerase chain reaction and fluorescence in situ hybridization (FISH), have become important tests for childhood tumors. Targeted therapies are aimed at specific translocations which are detected by FISH. Molecular techniques help in monitoring of minimal residual disease in childhood tumors.
Artificial intelligence in fighting cancer: A short review and trends
Authors: Rebolledo-Mendez Jovan David
Published: June 2017

The current trends of artificial intelligence (AI) and machine learning, specifically the amazing success achieved by artificial refurbished neural network architecture deep learning (DL), algorithms used like in alpha go, could greatly benefit cancer detection, personalized cancer treatment, and cancer drug discovery. New models like DL have recently arrived and are offering a leap step into classifying cancer types and even potential drug discoveries. These targeted AI will continue emerging and will build up toward the final fight of cancer: When AI, with the help of advance sensors that will provide data, can diagnosis cancer in stage zero.
Establishing etiopathogenesis in Epstein-Barr virus associated malignancies using chromogenic in situ hybridization
Authors: Patkar Ashwini
Published: June 2017

Background: Epstein–Barr virus is a human herpes virus ubiquitously infecting 90% of world population and causing 1% of tumors worldwide. The objectives were to establish etiopathogenesis in the Epstein-Barr virus (EBV) associated malignancies reported in our laboratory using the gold standard test, i.e., chromogenic in situ hybridization (CISH) for Epstein-Barr virus - encoded RNA (EBER). Aims and Objectives: We performed CISH on 244 cases of associated malignancies in the year 2013–2016, the decision was taken after H and E diagnosis and immunohistochemistry confirmation. Observation and Results: In the period of 2013–2016, 253 cases were evaluated by CISH for EBER. The age range in our study was 5–88 years with the mean age of 41.8 years, a slight male predominance was noted with male: female ratio of 1.5:1. CISH in 61 Classical Hodgkin lymphoma cases of 90cases were positive Conclusion: EBER ISH is the single best histochemical assay for defining EBV - related neoplasia. It is likely that emerging technologies such as gene expression profiling and proteomics will identify patterns of viral and human gene expression correlating with diagnosis, prognosis, and outcome in response to therapy.
Want Sustainable Productivity? Incentivize Investments in Innovation
Authors: Basu Dr. Ron
Published: June 2017

Research and development (R&D) and innovations derived from R&D have been argued to be the engine of economic growth for hundreds of years. With supporting data, the paper establishes the vital role of innovation in the value chain and sustainable growth of economies. In order to convert these strategies into the tangible outcome, we need right tools, skills, and funding. Tools are provided by research methodologies underpinned by the application of project management principles. Skills come from higher education and training in science, engineering, and technology. The sources of funding are mainly from the governments and private industries where the latter provides the major share. To generate additional funding, the author argues that governments should offer a tax break to multinational companies for additional investment in R&D above the threshold of R&D intensity. For the ‘post- Brexit’ United Kingdom a new R&D strategy is of particular importance when the supply of the EU research money will discontinue.
Perception of Palm Oil Clusters Development in Cameroon
Authors: Thierry Belinga , Jun Zhou , Long Wei , Samuel Yannick Gahe Zimy , Le Temps Ngomah
Published: June 2017

The aim of this research paper is to find the factors that influence the development of palm oil clusters in Cameroon using a survey made among 296 individuals. From the regression model, we find that palm oil production, agribusiness schools, market development, palm wine production and clusters development by area have a negative and significant impact on palm oil clusters development in Cameroon, implying that the government and financial institutions have to do more in order to have the palm oil clusters well developed in Cameroon.
Links Between Antidepressants and Suicide and Homicide: Commentary on Bouvy and Liem
Authors: Carey Timothy A. , Salter Amy
Published: June 2017

The use of appropriate robust statistical methods can provide important insights into the impact of pharmacological interventions. There is a long-standing, controversial, and unresolved debate regarding the association between antidepressant medication use and violent or aggressive behaviors. In particular, both suicide and homicide have been linked to antidepressant use. Various claims have been made that antidepressant use increases the risk of suicide and homicide, whereas counterclaims suggest that antidepressant use decreases these risks. Bouvy and Liem (2012) have entered this debate with an analysis of population-level, longitudinal data from the Netherlands. They report a significant negative linear association between lethal violence and prescriptions of antidepressants in the Netherlands. Their analysis, however, is flawed in numerous ways. So much so, in fact, that defensible conclusions cannot be made and use of this research to counter mounting evidence that antidepressants are linked with violent and aggressive behavior may have dangerous consequences.
Comparison of Reed and Water Lettuce in Constructed Wetlands for Wastewater Treatment
Authors: Yasar Abdullah , Zaheer Ayesha , Tabinda Amtul Bari , Khan Marryam , Mahfooz Yusra , Rani Shakeela , Siddiqua Ayesha
Published: June 2017

In the present study two designs, vertical and horizontal systems, were used and two different plant species, Water Lettuce (Pistia stratiotes) and Reed plant (Phragmites karka), compared for their removal efficiency. The vertical system appeared to be more stable and efficient for almost all the parameters. The vertical system, planted with Water Lettuce, showed percentage removal efficiency for BOD, phosphate and chloride as 82, 95.4, and 51, respectively, whereas turbidity and total suspended solids removal efficiencies were almost the same. However, fecal coliform removal by the Water Lettuce was 98.8% for both designs (vertical and horizontal), showing the ability of the plant to uptake nutrients and release toxins for pathogen disinfection. It appears that the vertical system could be the better option, planted with Water Lettuce, or with both plants in a co‐culture environment.
Genetic and Environmental Interactions Modify the Risk of Diabetes-Related Autoimmunity by 6 Years of Age: The TEDDY Study
Authors: Krischer Jeffrey P. , Lynch Kristian F. , Lernmark Åke , Hagopian William A. , Rewers Marian J. , She Jin-Xiong , Toppari Jorma , Ziegler Anette-G. , Akolkar Beena ,   the TEDDY Study Group
Published: June 2017

OBJECTIVE

We tested the associations between genetic background and selected environmental exposures with respect to islet autoantibodies and type 1 diabetes.

RESEARCH DESIGN AND METHODS

Infants with HLA-DR high-risk genotypes were prospectively followed for diabetes-related autoantibodies. Single nucleotide polymorphisms (SNPs) came from the Illumina ImmunoChip and environmental exposure data were by parental report. Children were followed to age 6 years.

RESULTS

Insulin autoantibodies occurred earlier than GAD antibody (GADA) and then declined, while GADA incidence rose and remained constant (significant in HLA-DR4 but not in the DR3/3 children). The presence of SNPs rs2476601 (PTPN22) and rs2292239 (ERBB3) demonstrated increased risk of both autoantibodies to insulin (IAA) only and GADA only. SNP rs689 (INS) was protective of IAA only, but not of GADA only. The rs3757247 (BACH2) SNP demonstrated increased risk of GADA only. Male sex, father or sibling as the diabetic proband, introduction of probiotics under 28 days of age, and weight at age 12 months were associated with IAA only, but only father as the diabetic proband and weight at age 12 months were associated with GADA only. Mother as the diabetic proband was not a significant risk factor.

CONCLUSIONS

These results show clear differences in the initiation of autoimmunity according to genetic factors and environmental exposures that give rise to IAA or GADA as the first appearing indication of autoimmunity.
Projektovanje automatskih skladišta u farmaceutskoj industriji
Authors: Kosanić Nenad
Published: June 2017

U radu su predstavljene neke osnovne smernice za projektovanje automatskih skladišta u farmaceutskoj industriji: vrste skladištenog materijala, uslovi čuvanja materijala, osnovne karakteristike podsistema za prijem materijala, osnovne karakteristike podsistema za komisioniranje i zahtevani ambijentalni uslovi. Predstavljen je analitički model za određivanje očekivanih vremena ciklusa dizalice kod automatskih skladišta opsluživanih dizalicama sa regalima dvostruke dubine, budući da je ovo, verovatno, najčešće korišćena tehnologija skladištenja u podsistemu glavnog skladišta u farmaceutskim fabrikama. Usled izuzetne važnosti ispunjenja savremenih zahteva za distribucijom malih, frekventnih porudžbina, predstavljeni su analitički modeli za određivanje očekivanih vremena ciklusa kod automatskih skladišta za male terete opsluživanih dizalicama i automatskih skladišta za male terete opsluživanih skladišnim vozilima, koja definišu protok transportnih jedinica kroz sistem. Svi navedeni modeli mogu poslužiti projektantima i inženjerima koji se ovim problemima bave u praksi, kao i proizvođačima ovih sistema, da odrede meru uspešnosti projektnih rešenja, odnosno, da garantuju potencijalnim korisnicima najvažnije performanse sistema.
Mogućnost odgovara zdravstvenih ustanova na industrijske akcidente-primer zdravstvene ustanove u opštini Obrenovac
Authors: Lapčević Zoran , Brankov Borjan , Nenković-Riznić Marina , Pucar Mila , Mandić-Rajčević Stefan , Jovanović Mića
Published: June 2017

U skladu sa opštim načelima datim kroz Sendai i Hjogo konvencije u oblasti upravljanja rizici-ma u uslovima katastrofa (Hyogo and Sendai Framework for Disaster Risk Management) izazvanim prirodnim i antropogenim faktorima, na teritoriji opštine Obrenovac sprovedeno je istraživanje spremnosti zdravstvenih ustanova da odgovore na potencijalne industrijske akcidente. Lokalne zdravstvene ustanove su javni objekti koji predstavljaju prvi nivo u hijerarhiji pružanja pomoći lokalnom stanovništvu u slučaju industrijskih hazarda manjih ili većih razmera. S tim u vezi, stepen njihove opremljenosti predstavlja imperativ u upravljanju rizicima od katastrofa na nekom području. Kroz istraživanje indeksa bezbednosti lokalne zdravstvene ustanove u Obrenovcu (doma zdravlja) utvrđene su postojeće mogućnosti za odgovor na industrijske katastrofe i dat predlog mera koje bi trebalo sprovesti u cilju unapređenja kvaliteta usluga u slučaju akcidenata. Kroz rad će biti prikazana metodologija u oblasti definisanja otpornosti zdravstvenih objekata, kroz utvrđivanje indeksa bezbed-nosti bolnica (hospital safety index), propisanog od strane Svetske zdravstvene organizacije, mogućnost primene ove metode evaluacije na zdravstvenim ustanovama u Srbiji, prezentovani rezultati istraživanja i dat predlog mera za prevazilaženje organizacionih, tehničkih i arhitekonsko-građevinskih problema u objektima zdravstvene ustanove u Obrenovcu.
Eksperimentalna aparatura za simulaciju sagorevanja biomase i kontrolu azotnih oksida
Authors: Mladenović Milica , Marinković Ana , Paprika Milijana , Repić Branislav
Published: June 2017

Iako se sagorevanje biomase promoviše sa stanovišta očuvanja životne sredine zbog značajno manje emisije štetnih gasova nego pri sagorevanju najzastupljenijeg domaćeg fosilnog goriva-uglja, eksperimenti sagorevanja više tipova biomase su pokazali da se i ovim sagorevanjem emituje izvesna količina polutanata koju je potrebno kontrolisati. Emisija azotnih oksida (NOx) je jedan od najvećih izazova u tom pogledu. Poznavanje i kontrolisanje emisije ovih oksida prilikom sagorevanja biomase je neophodno radi uspostavljanja korektnih zakonskih normi u pogledu granične emisije i za razvoj što kvalitetnijih tehnologija za sagorevanje ove vrste goriva. U tom cilju u radu je dat opis eksperimentalne aparature, koja ima za cilj da ispita efikasan način za redukciju NOx-a u dimnim gasovima upotrebom sekundarnih mera denitrifikacije. Takođe su dati i termički proračuni parametara sagorevanja u eksperimentalnom adijabatskom ložištu.
Analiza uštede energije izborom dobijanja materijala tehnologijama reciklaže ELV-a
Authors: Tolmač Dragiša , Tolmač Jasna , Prvulović Slavica , Pavlović Milan , Hamuda Hosam Bayoumi
Published: June 2017

Reciklaža automobila podrazumeva različite procedure koje omogućavaju dobijanje proizvoda jednorodnih materijala (metali, plastika, guma, staklo), pogodna za proizvodnju novih materijalnih dobara. U radu je analiza reciklaže motornih vozila. Industrijska reciklaže vozila doprinosi održivosti i zaštiti životne sredine i uštedi energije. Korišćenjem recikliranih materijala štedi se energiju i prirodni resursi. Reciklaža troši manje vazduha i vode od primarne proizvodnje sirovina. Reciklaža štedi prostor za skladištenje, stvara nova radna mesta u preduzećima koja se bave sakupljanjem, proizvodnjom i distribucijom sirovina.