bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of Optimization Model of Haji Financial Investment Portfolio in BPKH RI (Haji Financial Management Agency of the Republic of Indonesia)
Authors: Setyawan Arif , Wibowo Hendro , Kamal Mustafa
Published: August 2020

Financial management board hajj is an institution in which manages investment funds haji who uses the shariah principle in Indonesia. This study aims to analyze the optimization of Indonesian BPKH investment in a period of the year 2017-2019 in diversified portfolios by adopting both Markowitz. The research data is historical data on investment is being done by BPKH in 2017-2019 which includes instruments, deposits sharia bonds, and a projection on the stocks, and the real sector accommodation. This study used a quantitative approach with the study descriptive. The technique of analysis that was used in this research is the solutions to the results of the portfolio equation optimal with the help of a computer program ms excel solver. The research results show the portfolio BPKH scenario of Indonesia concerning the period of 2017-2019 which showed the level of expected return and 3 on risk scenario investment composition. About the scenario conservative expected return 7,76 % and on the risk 1,09 % , scenario moderate expected return 14,70 % and on the risk 3,22 %, scenario aggressive expected return 26,62 % and on the risk 6,39 %.
The Effect of E-Marketing with the AISAS Model on Shariah Mutual Fund Investment Decisions at Bibit Mutual Fund Fintech
Authors: Nurjanah Iin Mega , Muhammad Iqbal Fadli , AB Muhammad Doddy
Published: August 2020

This study aims to examine the effect of E-marketing with the AISAS model on mutual fund investment decisions. This research using quantitative research. Data was obtained by distributing online questionnaires to 34 respondents who had or were investing in Bibit Mutual Fund Fintechs that had been registered in the OJK. The sampling technique in this study is purposive sampling, while the Structural Equation Modeling (SEM) with the Partial Least Square (PLS) approach is using a data analysis technique. Based on the results of data analysis,  Attention variable has a significant effect on Interest variable, Interest variable has a significant effect on Search variable, Search variable has a significant effect on Action variable, Action variable has a significant effect on Share variable, and Share variable has a significant effect on Investment Decisions.
The Effect of Career Development and Motivation of Employee Performance in Syariah Mandiri Bank Regional III Office Jakarta
Authors: Novitayanti Dita , AB Muhammad Doddy , Nasution Nursanita
Published: August 2020

This study aims to examine the effect of career development and motivation on employee performance. This research using quantitative research. Data were obtained by questionnaires to 37 respondents who worked at BSM Region III Office in 2020. The sampling technique in this study is non-probability sampling, with the Partial Least Square (PLS) approach is using a data analysis technique. Based on the results of data analysis,  career development has a significant effect on employee performance and motivation has a significant effect on employee performance. Therefore, by providing career development opportunities and motivation for employees will improve employee performance. Keywords: Career Development; Motivation; Employee Performance
THE EFFECT OF THE PERCEPTION OF ELECTRONIC MONEY ON CONSUMPTIVE BEHAVIOR OF STEI SEBI STUDENTS
Authors: Fauziah Nailah , Nurhasanah Nining
Published: August 2020

In the era of industrial revolution 4.0, technological developments made changes in the lifestyle of the modern generation. The purpose of this study was to analyze the perception of the use of electronic money, whether it supports the consumptive research of STEI SEBI students. The electronic money acceptance model in this study uses the Technology Acceptance Model (TAM), and the indicators used to measure the consumptive level of STEI SEBI students are indicators of consumptive behavior. The research used descriptive-quantitative. The data used are primary data sent from questionnaires distributed to STEI SEBI students. The method of analysis in this study uses a simple regression analysis. The results of this study indicate that electronic money has a positive and significant influence on the consumptive students of STEI SEBI, users using high electronic money than making consumptive STEI SEBI students will also increase.
XXVII JORNADAS DEL COMITÉ DE GRADUADOS: "ACTIVIDAD FÍSICA Y DIABETES"
Authors: Gómez Martín Carolina , Muratore Carolina
Published: August 2020

El cuerpo humano está diseñado para estar en movimiento y la actividad física forma parte fundamental de un estilo de vida saludable. Sus beneficios son múltiples: mejora la calidad de vida y ayuda a prevenir el sobrepeso, la obesidad, entre muchas otras enfermedades crónicas.
MESA 1: ACTIVIDAD FÍSICA Y DIABETES MELLITUS. ASPECTOS GENERALES
Authors: De Roia Gabriela , Florio Andrés , Garrido Santos Natalia , Maraschio Martín , Blanco Debat Natalia Mabel , Cuzziol Gabriela Edith , De Loredo Santiago , De Marco Rubén , Forlino Mariano Adrián , Maldini Alejandra Carolina , Mengoni Karina Elizabeth , Pogio Lucía Fiorella
Published: August 2020

Se define como actividad física (AF) a cualquier movimiento corporal que realice el músculo esquelético y que resulte en gasto energético superior al basal. El ejercicio es una subcategoría de AF planeada, estructurada y repetitiva, y tiene como objetivo mejorar o mantener la aptitud física. El ejercicio crónico genera adaptaciones metabólicas favorables para el tratamiento de la diabetes, mejorando la función mitocondrial e incrementando la expresión de los GLUT-4. A su vez, la AF ayuda al control del perfil lipídico y la presión arterial y puede mejorar el bienestar psicológico, la calidad de vida y la depresión en individuos con diabetes mellitus tipo 2 (DM2).La condición o aptitud física es el conjunto de atributos que le permiten a una persona realizar actividad física en forma eficiente. La condición física cardiorrespiratoria (CCR) se define como la capacidad de los sistemas circulatorio, respiratorio y vascular de suministrar oxígeno a los músculos durante una actividad física sostenida. El entrenamiento intervalado de alta intensidad (HIIT) mejoraría la CCR de forma superior al ejercicio aeróbico tradicional. Por otro lado, la termogénesis de la actividad no ejercicio (NEAT) se refiere a todo gasto de energía que se produce por actividades distintas al ejercicio, como cocinar. Pequeñas ráfagas de NEAT mejoran el manejo de la insulina y la lipólisis.
MESA 3: DIABETES MELLITUS TIPO 2 Y ACTIVIDAD FÍSICA
Authors: Buso Carlos Javier , Avila Pablo Javier , Bertollo Natalia , Gómez Martín Carolina , De Dios Alejandro , Fabregues Sofía , González Lázaro , Lobbe Velia , Mumbach Giselle , Retamosa José , Retamosa Pablo , Schindler Ana , Sobol Dana
Published: August 2020

La prevalencia de diabetes mellitus (DM) actividad física es cada vez mayor asociada a bajos niveles de actividad física (AF) y aumento de sobrepeso-obesidad.Los beneficios de la AF incluyen la prevención de la DM, reducción de hemoglobina glicosilada y glucemia postprandial, mejoría del perfil cardiovascular (descenso Presión arterial y triglicéridos, aumento de colesterol HDL), descenso significativo de biomarcadores proinflamatorios. Además, la AF mejora la disfunción sexual, la función endotelial, el óxido nítrico biodisponible y la insulinosensibilad, incrementa la testosterona, mejora el humor y la autoestima, la ansiedad y la depresión.El ejercicio incrementa la producción de glucosa, la secreción de insulina compensatoria está alterada y se exacerba por una mayor secreción de catecolaminas. Las personas con insulinopenia marcada tienen riesgo de cetosis. El aumento de hipoglucemias está dado por una mayor captación de glucosa.  La AF mejora la polineuropatía y la neuropatía autonómica cardíaca, previene la enfermad renal crónica y se asocia a menores niveles de retinopatía diabética. En pacientes con retinopatía preproliferativa y proliferativa o degradación macular, se desaconsejan las actividades que aumentan considerablemente la presión intraocular. Está contraindicado el ejercicio en caso de hemorragia vítrea.El requerimiento energético depende del tipo, intensidad y duración del ejercicio. Se debe considerar el cuidado del pie. Las recomendaciones son disminuir el tiempo sedentario, ejercicio aeróbico al menos 150 min/semana y ejercicio de resistencia.Al aumentar la intensidad o ante riesgo elevado se debe realizar chequeo que incluya electrocardiograma y test de esfuerzo. Considerar ecocardiograma bidimensional y doppler.
DISRUPTORES ENDOCRINOS, OBESIDAD Y DIABETES MELLITUS
Authors: Arias Pablo
Published: August 2020

Si bien la visión actual de las causas de esta epidemia de obesidad reside en un desequilibrio entre la ingesta calórica y el gasto de energía, desde el punto de vista endocrino puede considerarse a la obesidad como un trastorno en el que se alteran numerosos sistemas de control hormonal que relacionan el tracto gastrointestinal, el páncreas, los músculos, el tejido adiposo, el hígado y el cerebro, y que involucra una interacción entre factores genéticos y ambientales.
MICROBIOTA
Authors: Frechtel Gustavo
Published: August 2020

La microbiota intestinal se considera un órgano que posee un importante impacto en la salud del huésped, cuya formación en los dos y tres primeros años de vida es clave en el futuro desarrollo de la salud/enfermedad del individuo.
CÓMO VIVEN Y QUÉ VIENEN A BUSCAR NUESTROS PACIENTES TRANS
Authors: Nagelberg Alberto
Published: August 2020

Una persona transgénero es aquella que presenta un conflicto entre su identidad de género y su sexo biológico. En la actualidad recurren a la consulta médica en busca de opciones terapéuticas que les permitan adecuar su cuerpo al género autopercibido y, entre ellas, el tratamiento hormonal cruzado y las cirugías de reafirmación genital, torácica y facial ocupan un rol preponderante.
PREVENCIÓN Y PREDICCIÓN EN DIABETES MELLITUS TIPO 1
Authors: De Dios Alejandro
Published: August 2020

La diabetes mellitus tipo 1 (DM1) es una enfermedad que se caracteriza por la destrucción autoinmune de la célula beta mediada por el ataque de los linfocitos T citotóxicos y en la cual los autoanticuerpos (GADA, IAA, AI2A y ZnT8A) son marcadores de la misma. Dado que esta enfermedad tiene bases poligénicas, el riesgo de desarrollar DM1 es más frecuente en los familiares de primer grado que en la población general.
FÁRMACOS NO INSULÍNICOS EN DIABETES MELLITUS TIPO 1 (METFORMINA, IDPP-4, PRAMLINTIDA, AGLP-1, ISGLT-2)
Authors: Litwak León
Published: August 2020

Existen aproximadamente 25 millones de pacientes con diabetes mellitus tipo 1 (DM1) en el mundo, cifra que se triplicaría en el año 2050. Si bien lo óptimo es alcanzar niveles de A1c <7% para evitar y/o enlentecer la aparición/evolución de las complicaciones crónicas, sólo el 30% de los pacientes lo logra. Más aún, el conteo de hidratos de carbono (HD) sin una educación alimentaria general adecuada, asociado a la insulinoterapia intensi cada (IT), se vincula hoy en día a una mayor incidencia de hipoglucemias, obesidad y otros factores de riesgo como dislipidemia (DSL), hipertensión (HTA), obesidad (O) y obesidad abdominal (OA) en esta población, lo que genera un fenotipo muy frecuente de pacientes con DM1 asociado al síndrome metabólico (SM).
RELACIONES Y VÍNCULOS ENTRE PÁNCREAS EXOCRINO Y ENDOCRINO
Authors: Grosembacher Luis
Published: August 2020

El páncreas endocrino y exocrino provienen del mismo botón embrionario y conviven en un mismo órgano: el páncreas. Sin embargo es habitual que en la práctica enfoquemos las enfermedades endocri- nas, como diabetes mellitus, y las exocrinas, como pancreatitis, de una manera completamente inde- pendientes entre sí. No obstante, en la actualidad se identi caron numerosos mecanismos siológicos y siopatogénicos que relacionan el páncreas endocrino con el exocrino y que permiten alcanzar una mayor comprensión del vínculo que une a las enfermedades de ambos.
MANEJO DE LA DIABETES EN SITUACIONES EXTREMAS: CATÁSTROFES NATURALES, SITUACIONES DE ENCIERRO
Authors: Gómez Martín Carolina
Published: August 2020

La catástrofe es un evento natural (sequía, inundación, huracán, terremoto) o humano (conflicto armado, accidente nuclear) que actúa como detonante de una crisis. El desastre consiste en el impacto de esa crisis y sus consecuencias humanas, sociales y económicas. Una catástrofe desencadena un desastre al actuar sobre una situación de vulnerabilidad preexistente, cuando la comunidad afectada no dispone de las capacidades necesarias para ejecutar las estrategias de afrontamiento con las cuales resistir a tal proceso.
IMPACTO DE LA CIRUGÍA BARIÁTRICA EN PACIENTES CON OBESIDAD Y DIABETES MELLITUS TIPO 1
Authors: Polo Paola , Álvarez María Graciela , Babor Eduardo , Herrero Maia , González Sandra , Yuma María , Sinay Isaac , Litwak León , Gutt Susana , Fuentes Susana , Musso Carla , Aguirre Ackermann Marianela
Published: August 2020

Introducción: la obesidad es un problema médico serio y en crecimiento en los pacientes con diabetes mellitus tipo 1 (DM1). El tratamiento de reemplazo con insulina es la única terapia disponible y los principales efectos adversos asociados son la hipoglucemia y la ganancia de peso. La cirugía bariátrica (CB) mostró mejoría en el control glucémico en los pacientes con DM2 pero se han reportados pocos casos en DM1.Objetivos: evaluar los cambios en los parámetros metabólicos en pacientes con obesidad y DM1 a quienes se les realizó una CB.
Universal Neonatal Hearing Screening - a Necessity and not a Choice
Authors: Samaddar Saikat , Banerjee Swagatam , Ghosh Sanjoy Kumar , Bhattacharya Subhra , Mukherjee Diptanshu , Dutta Sirshak
Published: August 2020

INTRODUCTION

Congenital deafness in a child is often missed. Several distraction tests have evolved over time to diagnose congenital deafness. These are of limited value in the era of Evoked response audiometry. Evoked responses, such as Oto-acoustic emission (OAE) and Brainstem Evoked Response Audiometry (BERA) have played a significant role in early diagnosis of congenital hearing impairment. The study was conducted to compare the result of neonatal hearing screening in high risk and non high risk neonates.

 

MATERIALS AND METHODS

A study was conducted over a time period of three months at a tertiary care institute to screen all live neonates for congenital hearing impairment using OAE and BERA.

 

RESULT

1182 neonates were screened for hearing impairment. 336 were in High risk group and rest in Non high risk group. Nine neonates turned out to have abnormal BERA result (absence of wave V). Six of them were high risk babies and rest 3 were non high risk.

 

DISCUSSION

33.33% of congenital deaf population detected by UNHS belong to the Non High Risk group. Studies across the world suggest at least 50% chance of missing out a congenital deaf child if Universal Neonatal Hearing Screening is not practiced.

 

CONCLUSION

In order to ensure that early detection and effective intervention are made on all newborns with hearing impairment, UNHS should be performed. Three stage UNHS protocol using TEOAEs and BERA showed that the implementation of UNHS for congenital childhood hearing loss among all newborns in India feasible and effective.
Adult retropharyngeal abscess
Authors: Bandopadhyay Saumendra Nath , Mukherjee Dwaipayan , Mukherjee Diptanshu , Banerjee Swagatam , Sen Shubhra Kanti
Published: August 2020

ABSTRACTIntroductionThe proportion of adults suffering from retropharyngeal abscess (RPA) has increased in comparison to children.Materials and methodsEight cases of adult retropharyngeal abscess were reviewed. The diagnostic criteria were radiological evidence of widening of pre-vertebral soft tissue shadow and presence of pus in the swelling.ResultsSore throat, fever, muffled speech, painful swallow and stiffness of the neck were common presenting symptoms. Lateral X-ray of the neck was diagnostic. Commonest organism isolated was Streptococcus pyogenes. Airway obstruction was the commonest complication.DiscussionMost of the patients had history of trauma prior to the development of RPA. CT scan has an important role in planning the management in addition to lateral X-ray of the neck. Transoral surgical drainage in association with antibiotics is the treatment of choice in abscesses confined to the retropharyngeal space.ConclusionTuberculosis is no longer the commonest cause of adult retropharyngeal abscess. Sore throat or dysphagia, disproportionate to clinical findings in the throat should arouse suspicion of RPA. Early intervention with antibiotics reduces the chances of the development of complications.
Addressing Quality of Life Issues in Long Term Survivors of Head & Neck Cancer treated with Radiation Therapy
Authors: Basu Bishan
Published: August 2020

The rapid advancement of curative treatment modalities has resulted in improvement of cure rates of head neck cancer leaving us with a larger number of long term survivors from the disease. Unfortunately, long term complications of therapy continue to hurt patients even after cure, compromising their quality of life. This is particularly true for the patients treated with primary radiation/chemo-radiation therapy, where so called organ preservation does not necessarily translate into preservation of organ function. Long term sequelae of treatment, particularly xerostomia and swallowing difficulties compromise the survivors’ quality of life. More studies, particularly suited to our clinical scenario, are warranted to address the quality of life issues in these patients, so that better evidence-based guidelines may be developed for their benefit.
Rhinosporidiosis: Various Presentations and Different Sites
Authors: Bandopadhyay Saumendra Nath , Jana Utpal , Bandopadhyay Gautam , Majhi Tapas Kumar , Sen Shubhrakanti , Das Soumyarup , Mandal Ipsita
Published: August 2020

IntroductionRhinosporidiosis commonly affects nasal mucosa but may have varied presentations depending upon the site of involvement.

Materials and Methods119 patients of rhinosporidiosis, attending the two medical colleges of West Bengal over a period of two years were reviewed.

ResultsGranulomatous lesion in the nose and nasopharynx was the commonest presentation. The most common symptoms were nasal obstruction, bleeding from the nose and nasal discharge. The less commonly involved sites were the eye, penis, skin, subcutaneous tissue, muscle and bone.

DiscussionMost of the extranasal rhinosporisdiosis were secondary to nasal disease. Extranasal lesions do not have the typical granular polypoid appearance of the nasal and nasopharyngeal rhinosporidiosis. Extranasal rhinosporidiosis could be excised with minimal operative bleeding.

ConclusionRhinosporidiosis has nasal and extranasal presentations. This chronic disease may also present acutely with respiratory distress or haemorrhage. A high degree of suspicion helps the diagnosis of extranasal rhinosporidiosis. FNAC helps in the diagnosis. Histopathology is confirmatory.
Reliability of Free Radial Forearm Flap for Tongue Reconstruction Following Oncosurgical Resection
Authors: Chaudhuri Gaurab Ranjan
Published: August 2020

Introduction

Primary closure following oncosurgical resection of carcinoma tongue has been found to compromise tongue function in regards to speech and swallowing very badly. In contrast, reconstruction of tongue with free radial forearm flap following oncosurgical resection has shown promising functional outcome.

Materials and Methods

Thirteen patients (ten male and three female) with squamous cell carcinoma involving anterior 2/3rd of tongue had undergone either hemiglossectomy or subtotal glossectomy. Reconstruction was done with free radial forearm flap following oncosurgical resection and neck dissection. All of them received postoperative radiotherapy. Follow-up ranged from 2 months to 2 years. The age of the patients ranged between 32 and 65 years. Flap dimension ranged from 7x6 cm to 10x8 cm. Vascular anastomosis performed in an end-to-end manner with 8-0 Ethilon® under loupe magnifiacation.

Results

Venous congestion occurred in one patient after 48 hours postoperatively and the flap underwent complete necrosis on postoperative day 5. Postoperative hematoma was found in one patient within first 24 hours of reconstruction. Re-exploration was done immediately, blood clots were removed. No fresh bleeding point was seen and the flap survived. In this series, 12 out of 13 flaps survived completely (92%).

Conclusion

The free radial forearm flap has become a workhorse flap in head and reconstruction due to its lack of extra bulk, relative ease of dissection, long vascular pedicle, good calibre vessels, malleability and minimal donor site morbidity. Furthermore its low flap loss and complication rate offer the best choice for tongue reconstruction.
Endoscopic Cauterization of Sphenopalatine Artery in Posterior Epistaxis- Our Experience
Authors: Singh Mukesh Kumar , Das Chiranjib , Mukherjee Dwaipayan , Majumder Anirudhha , Hazra Tapan Kanti
Published: August 2020

IntroductionEpistaxis is one of the commonest emergencies in Otorhinolaryngology. The management of intractable posterior epistaxis sometime becomes challenging to ENT surgeons. Over the last decade endoscopic cauterization of sphenopalatine artery has emerged as a viable and minimally invasive alternative.

Materials and MethodsThirty four patients with intractable posterior epistaxis were treated by endoscopic sphenopalatine artery cauterization between March 2010 & February 2013.

ResultsThere was no recurrence of epistaxis with an average follow-up of 12 months in 30 out of 34 patients. Only 4 patients had anterior epistaxis in follow up period, which were managed with anterior nasal packing. The success rate of endoscopic sphenopalatine artery cauterization, in this study was 88%.

ConclusionEndoscopic sphenopalatine artery cauterization is a safe & efficient method of controlling persistent posterior epistaxis with minimal complication.
Surgical approach to Parapharyngeal Tumours - Our Experience
Authors: Ghosh Shrestha Devjani , Majumdar Kinjal Shankar , Samanta Nirmalya , Jana Utpal
Published: August 2020

IntroductionThe complex anatomy of the parapharyngeal space, the surrounding vital structures and late presentation of the tumours affecting this space pose difficult surgical challenge to every otolaryngologist. The study gives an overview of the experience in managing parapharyngeal tumours in a tertiary care setting.

Materials And MethodsFifteen patients with parapharyngeal tumours were treated surgically in a medical college hospital in Kolkata in the three year study period. Surgical approaches were chosen, considering the size, site, extent and histology of the tumours.

ResultsMost of the patients (33.33%) were from 20-30 years age group. 60% were females. The most common presenting feature was neck swelling. 80% of the cases were benign.The most common histologic variant was Schwannoma. The tumours were accessed through Trans-cervical, Trans-cervical Trans-parotid or Trans-cervical with Midline Mandibulotomy approaches. The most common post-operative complication was wound dehiscence.

DiscussionThe most common presentation of a parapharyngeal mass was neck swelling mainly behind the angle of mandible (86.67%). Younger patients in their third decade of life were found to be affected more. Gadolinium enhanced MRI was found to be the most important investigation in parapharyngeal tumours. Complications were minimal.

ConclusionA conservative trans-cervical approach was found to be feasible and effective in majority of the cases over radical ones, which may be required in malignancies and skull-base involvement.
Occult Foreign Bodies in ENT
Authors: Adhikary Bijan Kumar , Biswas Subhra Deb , Das Avick , Ghosh Swapan Kumar
Published: August 2020

IntroductionForeign bodies are common ENT emergencies. Histories are usually forthcoming from the patient himself or the relatives . Three occult foreign bodies are reported here, which were missed even by treating doctors, with discussion about steps to avoid such errors in future.

Case SeriesCase 1: Though the history was apparent, the foreign body was removed only after 13 years from the Zygomatic region.Case 2: The parents were aware of the foreign body but inadequate investigations led to a delayed diagnosis.Case 3: The history clinched the diagnosis. Pre operative localization and separate incision to remove the foreign body saved the vital structures.

DiscussionA high index of suspicion, meticulous history and proper investigation like x-ray or CT scan or MRI of the diseased area may help in locating the hidden foreign bodies in the ENT region.
Migration of Ingested Fish Bone from Upper Aerodigestive Tract to the Skin of the Neck
Authors: Saha Mukulika , Chakrabarti Amit , Maity Amit Bikram , Mandal Satadal
Published: August 2020

IntroductionIngested foreign bodies commonly get impacted in the upper aero digestive tract, but only a few of these foreign bodies have perforated the oesophagus and an even smaller number of these have migrated extraluminally.

Case reportA 43 year old male patient presented with history of accidental ingestion of fish bone (F.B) 3 weeks back. On examination a sharp pointed swelling was seen over right side of neck and on palpation a pointed object was felt beneath the intact skin. Digital X-ray, ultrasonography of the neck and CT scan neck showed a linear obliquely placed foreign body on right side of neck at the level of thyroid gland. The foreign body was easily removed by an incision over the skin and was confirmed to be a fish bone.

DiscussionHorizontally oriented foreign bodies are more likely to penetrate the lumen of a hollow viscus. The muscular contraction of the neck might account for this unusual event to some extent, one possible factor being that the presence of the foreign body in the soft tissue might have led to inflammation and oedema, which made the texture of the surrounding tissue loose and lax ; a sort of gel-sol interconversion.
Temporomandibular Joint Disorders – A Few Interesting Experiences to Share
Authors: Chattopadhyay Sumit , Bose Majumdar Aloke
Published: August 2020

Temporomandibular joint disorders rarely present in a very direct way. Often, the complaints are far away from the joint itself, making the diagnosis difficult. But a high index of suspicion and a good clinical idea often clinches the diagnosis in many cases of otalgia with apparently no definitive finding.
Hyperbaric Oxygen Therapy in the Treatment of Idiopathic Sudden Sensorineural Hearing Loss
Authors: Guha Debashish , Sanyal Shaoni , Bhattacharya Chayan , Santra Abhijit , Banerjee Swagatam
Published: August 2020

Backgrounds and objectivesIdiopathic sudden sensorineural hearing loss (ISSNHL) is an entity whose diagnosis and treatment remain controversial to date. Various modalities of treatment have been tried with varying degrees of success. Hyperbaric oxygen therapy (HBOT) is a recent modality of treatment for this condition which acts by improving cochlear microcirculation. The objective of this study was to evaluate the effect of HBOT in improving hearing loss and secondary symptoms patients with ISSNHL.MethodsThis prospective study was undertaken over a 6 month period from the Department of Otorhinolaryngology in a tertiary referral hospital in eastern India. 48 consecutive newly diagnosed ISSNHL patients were included in this study. The patients were subjected to HBOT at 2 A.T.A (Atmosphere Absolute) for an hour over 45 days. Hearing status and secondary symptoms as assessed by clinical tests, pure tone audiogram were analysed before and after HBOT.ResultsMales comprised 62.5% (30/48) of our study population, mean age of the population was 49.3 ± 13.4 years. 45/48 patients (93.7%) had unilateral ISSNHL, while 3 (6.3%) had bilateral ISSNHL. Average hearing loss in the affected ear before and after treatment was 79.96dBHL and 62.27dBHL respectively. The most common secondary clinical feature was tinnitus (27/48, 56.3%), followed by vertigo (24/48, 50%), aural fullness (15/48, 31.25%) and nystagmus (5/48, 10.41%). After treatment tinnitus and vertigo were showed marked improvement; (22/27, 81.48%) and (18/24, 75%). 5 out of 15 (33.34%) patients showed reduced aural fullness. There was no improvement in patients suffering from nystagmus.
Revisiting the Operating Room Basics
Authors: Chakravorty Tushar
Published: August 2020

Young doctors walking into the operating room are eager to develop their skills to become efficient and knowledgeable professionals in future. But precious little is done to actively develop the basic practical skills of the budding doctors. They remain unaware about the layout of the operating room, the OR etiquette and often do not have sound scientific understanding and importance of meticulous execution of the basic operating room protocols.

This article stresses the need to develop the basics of OR protocol and to improve the confidence of the young doctor by strengthening his foundation by showing him that attention to the basics of medical care and empathy for the patient can really make a difference to the outcome of a treatment.
Idiopathic sialectasia of Stensen’s duct treated by marsupialisation of ectatic segment
Authors: Pal Indranil , Kumar Saumitra , Sinhababu Anindita , Chatterjee Kushal
Published: August 2020

Introduction:Sialectasis of parotid duct is an uncommon condition characterised by abnormal dilatation of a part or whole of the Stensen's duct. It may lead to recurrent parotid infections as well as a cause of concern for the patient. Superficial parotidectomy is the accepted surgical treatment for this condition.

Case Report: A case of idiopathic dilatation of parotid duct is presented. It was treated by marsupialisation of the sialectatic segment.This procedure proved to be much simpler and safer than superficial parotidectomy whilst being equally effective.

Conclusion: In cases of Stensen's duct sialectasis without any abnormality of the parotid gland, marsupialisation of the ectatic segment should be the treatment of choice.
Effect of Canalplasty on Outcome of Results in Type I Tympanoplasty
Authors: Mallick Ajay , Bhalla Vijay , Roy Ravi
Published: August 2020

Background: The aim of  the surgical procedure of tympanoplasty is to strive to achieve an intact neo tympanum with normal hearing acuity. Widening of the external auditory canal, called canalplasty,  helps in better visualization and hence better placement of the tympanic membrane graft. Aim of this study was to compare effect of canalplasty on the outcome of results of type I tympanoplasty. 

Methods: 50 cases of patients diagnosed with chronic otitis media mucosal disease with a central dry perforation involving two or more quadrants of the tympanic membrane were included in the study. One group of 25 cases underwent tympanoplasty with canalplasty and was grouped under Group I while the other group of 25 cases underwent tympanoplasty without canalplasty and was called group II. 

Results: Analysis was done for graft uptake, hearing improvement and time taken for the surgery. Group I achieved a success rate of 92% graft uptake as compared to group II, which achieved 84%. There was statistically significant improvement in post-operative hearing in cases with canalplasty. Time taken was between the two groups were not statistically significant.

Conclusion: Anatomical and technical factors diversely affect the functional outcome of tympanoplasties. Canalplasty helps in better visualization and placement of the graft. Time spent on drilling in canalplasty is compensated by the time gained in grafting of the neo tympanum. The procedure prevents lateralization of the graft due to the accurate exposure of the annulus. Post operative care is also easier in cases of tympanoplasty with canalplasty.
Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry
Authors: K Sharath Babu , Prabakaran Jayagar , Radhakrishnan Shankar
Published: August 2020

Background : 

Otitis Media with Effusion(OME) also known as  Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy.

Aims and Objectives : 

To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion.

Materials and Methods: 

A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A), adenoidectomy with bilateral grommet insertion (Group B), bilateral grommet insertion (Group C),  bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D).

Result :

The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures.

 

Conclusion :

Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis Media with Effusion who is at risk for speech/language/hearing loss.
An Arrow Penetrating the Globe and the Sinonasal Complex
Authors: Narjinary Richard , Samaddar Saikat , Ghosh Sanjoy , Bandopadhyay Saumendra Nath
Published: August 2020

Introduction:

Foreign bodies represent on average 11% of all ENT emergencies. Associated eye trauma represents 5% of all cases of blindness in developing countries. Accidental and homicidal arrow injuries presenting to an otorhinolaryngologist are still a stark reality in this modern era.

Case report:

A 22 year-old female presented with an accidental arrow injury in her left eye; extending into the nose. On examination, she had no light perception in left eye and a penetrating injury of the sclera. CT scan showed extensive injury to ipsilateral nasal cavity, floor of left orbit and the maxillary sinus and anterior ethmoid cells. Multidisciplinary approach ensured removal of the unusual foreign body from the orbit, nose and paranasal sinuses.

Discussion:

Accidental injury in ear, nose or throat with sharp projectiles presents a challenge. Arrowhead may be poisoned and thus exploration is delayed until the systemic effect of the poisoned is reduced. An injury such as this involves a multidisciplinary approach. As ENT surgeons we must be aware such challenges and equip ourselves with the knowledge to tackle them.
Endoscopic Solution to Rhinogenic Contact Headaches
Authors: Segana Hasan Abdul Cader , Nair Reghunandanan , Ahmed Shah Fahim
Published: August 2020

Introduction

Headache is a common complaint that brings patients to multidisciplinary clinics. It is utmost important to have meticulous clinical diagnosis of patients with rhinogenic and non sinusogenic headaches. The diagnosis has become easier with the advent of modern endoscopy and endoscopic sinus surgical techniques. This study aims to investigate the role of some anatomical nasal abnormalities in rhinogenic contact headache and to evaluate response to endoscopic surgery.

 

Materials and Method

A prospective study was conducted at a secondary level regional referral Hospital in the Sultanate of Oman. Patients with long-lasting, frequent, severe headaches not amenable to medical treatment, above 20 years of age were taken into consideration. Routine nasal endoscopy, Computerized tomography scan of the paranasal sinuses, Nasal decongestion and various surgical techniques to correct the anatomical abnormalities were included in our study and results were correlated statistically.

 

Result

There was a male predominance in our study with duration of headache ranging from 2 weeks to 5 years. There was a preponderance of headache in frontal region in our study group. Diagnostic nasal endoscopy and CT scan of PNS revealed Deviated nasal septum / septal spur, concha bullosa, Haller cell, pneumatised uncinate process and agar nasi cells. The overall success rate of the surgery in relieving headaches, measured by the MIDAS- VAS score, was approximately 75 %. The non-parametric Wilcoxon signed rank test, Chi square and paired T tests shows that the following study has rejected the null hypothesis as statistically significant where the P value <0.05.

 

Discussion

Researchers have examined the contact points as a source of rhinogenic / contact headache. Intranasal mucosal contact released substance P, causing pain and headache, Substance P has a potent vasodilator effect. Vasodilatation and perivascular inflammation are the final common pathways in pain. Surgical treatment for contact point-induced headaches has had good success.

 

Conclusion

The etiology of rhinogenic headache is multifactorial. Complete history taking, scrupulous preoperative evaluations, multidisciplinary consultations, Initial medical controls, long observation, and diligent postoperative follow-ups are mandatory for not only accurate diagnosis but also for promising surgical outcomes of non-sinusitis related rhinogenic headache. Our experience reveals that patients with rhinogenic contact headaches can benefit significantly from meticulous endoscopic decompression
A Comparative Study on Laryngeal Aerodynamics in Dysarthrophonic versus Normophonic Male Subjects
Authors: Chatterjee Indranil , Dhara Sovon , Chatterjee Somsubhra , Chaterjee Shahi Arpita
Published: August 2020

Introduction

Dysarthria is a motor speech disorder.  It occurs due to paralysis, weakness, or incoordination of the speech musculature. The authors with this study want to enrich clinical understanding of the difference of the aerodynamic characteristics in normophonic and dysarthric population.

Materials and method

The aerodynamic characteristics in normophonics and in dysarthric population were compared and documented using Voice Function Analyzer (Aerophone II®). Forty male individuals within the age range of thirty five to fifty five years participated in this study. The control group   had twenty normophonic cases with no history of neurological disorder. The second group had twenty cases with dysarthria.

Result

Significant difference was found between the two groups in peak flow, forced volume and duration, vital capacity and fast adduction-abduction measurements.

Discussion

The difference in results from both the groups and their implications are discussed based on these findings.

Conclusion

The present study has assessed the parameters of speech and voice disorder in male dysarthric individuals. It suggests inclusion of aerodynamic measurement in test protocol and for evidence based research and prognosis documentation. Measurement of laryngeal or vocal tract resistance may be useful in documenting a variety of the perceptual voice characteristics.
Clinicopathological Study of Thyroid Swellings with Some Emphasis on Geographical and Community Distribution: A Hospital Based Analysis
Authors: Borsaikia Kusum , Patar Mukul
Published: August 2020

Introduction: Thyroid swellings/goiter are still prevalent in north east part of India. Apart from its sub-Himalayan location the areas along the river Brahmaputra suffer from flooding every year and there is also frequent changing of river course, thought to be another reason for iodine depletion in soil of this region(3).

      Aim: To determine the incidence of thyroid swellings and distribution among different sections of society and geographical areas, and to evaluate the role of FNAC in the diagnosis and management and find out its accuracy by comparing with histopathology.

    Materials and methods: In the present study, total 212 patients with thyroid swellings attending department of ENT of a state medical college during the period from January 2013 to December 2015 and undergone FNAC at department of Pathology were taken into consideration.

    Results: Out of 212 cases major fraction (52.83%) were hailed from areas along the Brahmaputra river followed by patients (33.96%) from tea gardens and adjacent areas. Patients belonging to tribal communities constituted 45.28%, whereas patients from tea workers section of society formed the second majority (34.9%). Female male ratio of cases was 5:1. Majority of patients were from 21-40 years age group with mean age of 37.2 years.  Cytology results of 212 cases showed colloid goiter 73.58%, adenomatous goiter 8.49%, thyroiditis 9.9%, hurthle cell neoplasm 1.41%, follicular neoplasm 4.24%, papillary carcinoma 1.41%, papillary carcinoma of follicular variant 0.47% and medullary carcinoma in 0.47% cases. Histopathology was possible in 65 cases and compared with FNAC results with accuracy rate of 89.23%.

    Conclusion: Frequent flooding and changes of river course may be one of the reasons for high prevalence of thyroid swellings and goiter along the Brahmaputra valley apart from its sub-Himalayan location. Consumption polluted drinking water and goitergenous food stuffs may be another reason of high incidence. FNAC is an easy, rapid, reliable, less invasive, low cost technique for diagnosis of thyroid swellings.
Intratemporal Facial Nerve Paralysis- A Three Year Study
Authors: Ghosh Anirban , Bera Sankar Prasad , Saha Somnath
Published: August 2020

Introduction

This study on intratemporal facial paralysis is an attempt to understand the aetiology of facial nerve paralysis, effect of different management protocols and the outcome after long-term follow-up.

Materials and Methods

A prospective longitudinal study was conducted from September 2005 to August 2008 at the Department of Otorhinolaryngology of a medical college in Kolkata comprising 50 patients of intratemporal facial palsy. All cases were periodically followed up for at least 6 months and their prognostic outcome along with different treatment options were analyzed.

Result

Among different causes of facial palsy, Bell’s palsy is the commonest cause; whereas cholesteatoma and granulation were common findings in otogenic facial palsy. Traumatic facial palsies were exclusively due to longitudinal fracture of temporal bone running through geniculate ganglion. Herpes zoster oticus and neoplasia related facial palsies had significantly poorer outcome.

Discussion

Otogenic facial palsy showed excellent outcome after mastoid exploration and facial decompression. Transcanal decompression was performed in traumatic facial palsies showing inadequate recovery. Complete removal of cholesteatoma over dehiscent facial nerve gave better postoperative recovery.

Conclusion

The stapedial reflex test is the most objective and reproducible of all topodiagnostic tests. Return of the stapedial reflex within 3 weeks of injury indicates good prognosis. Bell’s palsy responded well to conservative measures. All traumatic facial palsies were due to longitudinal fracture and 2/3rd of these patients showed favourable outcome with medical therapy.
Unilateral Acquired Posterior Maxillary Mandibular Syngnathia
Authors: Sahu Abhishek Vijay , Roy Kamalika Purkayastha , Kashyap Niva
Published: August 2020

Introduction: Congenital bony fusion of the maxilla and mandible, especially as an isolated occurrence, is a rare condition while acquired fusion being even rarer.

Case report: A rare case of a 32 year old female patient with acquired unilateral bony fusion between the zygomatic arch of maxilla and ramus of mandible is reported.

Discussion: Forty one cases of syngnathia has been reported in the international literature from 1936 to 2009, of which 39 cases are congenital and two were acquired, case 1 probably as a result of a fibrotic tubed pedicle and in case 2 from myositis ossificans. According to several case series, bony ankylosis of the mandible and maxilla has also been found to occur in 30%-43% of cases of NOMA.
The Efficacy of Local Application of Mitomycin C in Reducing Recurrence Rate of Keloid after Surgery
Authors: Sengupta Anindita , Das Arindam , Ghosh Debasish , Dhara Subhadip , Ghosh Soumyendu , Sengupta Arunabha , Bhattacharya Subhendu
Published: August 2020

Introduction 

Keloid is a hyperproliferative response of the fibroelastic connective tissue to dermal trauma, appearing predominantly in areas of high skin tension. Surgical excision produces immediate cosmetic correction, but recurrence rates after surgical treatment alone are high and post excision adjunct therapies should be considered. Topical application of Mitomycin C has shown to suppress cell division, fibroblast proliferation, protein and collagen synthesis and angiogenesis. In our study we applied it locally after surgical excision of keloid of auricle and compared the outcome with post-surgical perilesional Triamcinolone acetonide injection to reduce recurrence.

Materials and Method

Fifty cases with primary or recurrent keloid over auricle were studied from February 2015 to January 2016. They are divided into two groups; Group 1 received local Mitomycin C application after keloid excision while Group 2 had perilesional injection of Triamcinolone acetonide after surgical excision of keloid. The results were compared 6 months after the initial treatment.

Result 

There was no statistical difference in the baseline characteristics like age, sex, type of symptoms and previous history of recurrence between the two groups. Most of the patients in both the groups were aged between 14 and 30 years. The study population constituted predominantly of females. At the end of 6 months follow up, the recurrences noted were 5 and 6 respectively in Group 1 and 2 out of 25 patients in each group.

Conclusion

After surgical excision of keloid, topical application of Mitomycin C is as effective as intralesional Triamcinolone acetonide injection in terms of recurrence of the keloids affecting the auricle.