bluuebunny/crossref_metadata_2025 huggingface dataset:
Unusual metastatic sex cord stromal tumor - staging and response assessment
Authors: Agrawal Namita , Jain Tarun Kumar , Singh Guman , Malhotra Hemant , Yadav Ajay
Published: June 2020

Metastatic sex cord stromal tumor (SCST) is rare and contributing <1% of ovarian tumors. A 42-year-old female presented with lower abdominal pain for 2 months. Ultrasonography revealed masses in the abdominal and pelvic. USG guided biopsy from the pelvic mass revealed SCST. For staging, whole body F-18 fluorodeoxyglucose positron emission tomography-computed tomography was performed and revealed heterogenous mildly FDG avid retroperitoneal and bilateral pelvic masses with lung nodules. To confirm the nature of the lung nodule; PET-CT guided biopsy performed and revealed metastatic SCST. After three cycle of chemotherapy, clinical, biochemical and imaging show partial response to treatment.
Collision tumor of ovary: a case report on bilateral dermoid cyst with co-existing unilateral mucinous cystadenoma
Authors: Maddipati Sowmya Sampurna , P. Sudha C. , K. Sowmya
Published: June 2020

A collision tumor is the coexistence of two adjacent, but histologically distinct tumors without histological admixture in the same tissue or organ. Such tumors have often been reported in various organs, but location in the ovary is rare. The juxtaposition with dermoid cysts has been reported as comprising approximately 5% of benign mucinous ovarian tumors and rare examples of proliferating mucinous tumors. Authors are reporting a case of collision tumor which included benign mucinous cystadenoma and benign cystic teratoma. The gynecologists and pathologists should be aware of such combination of tumors. The case was diagnosed post-operatively. It is important to correctly diagnose the component of tumor for further management and favourable prognosis. Frozen section intra-operatively plays an important role in diagnosing such tumors.
Vesicouterine fistula: a case report
Authors: Singh Swati , Sangwan Vijayata , Singh Kulvinder , Khandelwal Atul
Published: June 2020

Vesicouterine fistula represents a rare urogenital fistula, accounting for approximately 1-4% of genitourinary fistulas. Iatrogenic reasons have been shown to be most common cause. Surgical excision is the mainstay of treatment. Less than 5% patients respond to conservative management. Authors report a case of successful conservative management of vesicouterine fistula.
Myomectomy during cesarean section: is it a contraindication these days?
Authors: Gupta Amit , Vij Anju , Verma Tanu , . Molly , Kumar Rajender , Gupta Bharti
Published: June 2020

Myomectomy during the cesarean section is a debatable procedure because of raised risk of associated uncontrollable hemorrhage and postoperative morbidity. 38 years, elderly primigravida, who conceived after primary infertility with large leiomyoma in the lower uterine segment, underwent myomectomy during the cesarean section. Her intra-operative hemorrhage was within normal limits and post-partum period was uneventful. Conclusion of this study is Safety and feasibility of myomectomy along with cesarean largely depends upon the case selection, experience of the obstetrician and backup ICU and transfusion facilities.
Hysteroscopic polypectomy versus expectant management in endometrial polyps in asymptomatic infertile women: a meta-analysis
Authors: Modesto Tauane Bahia , Dias Amanda Tamiris Barbosa , De Oliveira Sofia Andrade
Published: June 2020

Background: Endometrial polyp is a hyperplastic structural abnormality of the uterine cavity and is one of the most commonly found intrauterine abnormalities. The endometrial polyp is mostly asymptomatic and sometimes diagnosed only during infertility investigation. The influence of endometrial polyps on female infertility is not completely understood, however, due to the possibility of endometrial polyps influencing fertility, their removal is usually performed in women undergoing infertility treatment.Methods: This meta-analysis was performed through an electronic search using MEDLINE, PubMed in October 2017, bringing together the terms of interest in order to select studies that would compare polypectomy and expectant management for endometrial polyps in sub fertile women. Four articles were selected according to the inclusion and non-inclusion criteria.Results: Five variables were collected from the selected articles to be compiled and analyzed (rate of live births per transferred embryo, chemical pregnancy rate, spontaneous abortion rate, implantation rate and clinical pregnancy rate), none of which showed any difference statistically significant in conduct.Conclusions: The data concluded that there is no statistical significance between expectant management and polypectomy.
Fertility department’s response and experience to the global coronavirus COVID-19 pandemic
Authors: Al Jaroudi Dania H. , Al Dossary Mona
Published: June 2020

WHO has asked countries to activate and scale up their emergency response mechanisms, communicate with the people to inform them about the risks and how they can protect themselves. They have encouraged find, isolate, test and treat every case and trace every contact, protect and train their health workers. Therefore, in alliance with the global response to limit the spread of the transmission of COVID-19 and in the pact of KFMC’s mission, which is its dedication to provide highly specialized, evidence-based and safe health care, enhanced by education, training and research, our fertility department had taken all the measures to keep the hospital patients and staff safe from acquiring the COVID-19 by closing down its assisted reproductive services. This article will highlight the strategy taken to comply with WHO’s call and highlight a fertility department’s actions taken to handle patients coming for assisted reproductive treatment. This hopefully will stipulate ideas for future research and policy making.
Evaluation of Alvarado scoring system (Mandrels scoring) as a diagnostic aid in preoperative diagnosis of acute appendicitis at Nalanda Medical College and Hospital, Patna
Authors: Shekhar Raj , Gupta V. K.
Published: June 2020

Background: Acute appendicitis is one of the commonest surgical emergencies. The rate of negative appendicectomy has been reported to be between 20-30%. The aim of this study is to evaluate the efficacy of Alvarado scoring system in cutting down the rate of negative appendicectomy without increasing morbidity and mortality.Methods: A study of 100 patients presenting with pain abdomen and diagnosed provisionally as acute appendicitis, was undertaken. Depending on individual presentation, a score was calculated for each case, based on Alvarado scoring system. Operative and conservative intervention was undertaken in patients with scores between 5 and 10 and <5 respectively. The results of Alvarado scoring system, on table operative findings and HPE, were reviewed.Results: A total of 94 patients with score of 7-10 and 5-6 were operated. Among males with score of 7-10, 33 patients were operated and 31 were found to have inflamed appendix. Among females with score of 7-10, 33 patients were operated and 28 were found to have inflamed appendix. The sensitivity of Alvarado scoring system in males with score of 7-10 was found to be 81.57% and among females with score of 7-10 was found to be 75.67%.Conclusions: The Alvarado scoring system is a fast, simple, reliable, non-invasive, repeatable and safe diagnostic modality without extra expense and complications.
Clinicopathological evaluation of thyroid swelling in patient attending Hamidia Hospital Bhopal
Authors: Shukla Samir , Tiwari Shashi kant
Published: June 2020

Background: The prevalence of thyroid nodule ranges from 4-10% in general population. Its treatment includes either conservative management or surgical excision of gland. Fine needle aspiration cytology (FNAC) has emerged as most accepted, accurate diagnostic procedure and considered the gold standard diagnostic test in evaluation of thyroid nodule, other tests like ultrasound, nuclear scan used in conjunction with FNAC. The aim of study was to study the spectrum of diseases in thyroid swelling and accuracy of FNAC in the diagnosis.Methods: A prospective study, with total 50 patients, was conducted during period from 2017-2019 in department of surgery, Gandhi Medical College Bhopal. All patients who underwent thyroid surgeries were selected for study. All patients underwent detailed history, clinical examination, routine investigations, thyroid function test, FNAC, ultrasonography neck and histopathological examination.Results: Of 50 cases female to male ratio was 9.2:1, with median age group was 38.6 years. Among all, 42 (84%) were benign, 3 (6%) malignant and 5 (10%) suspicious. Of 5 suspicious lesions, only 1 (5%) case found malignant. Hemi thyroidectomy was common surgery performed, followed by subtotal/near total and total thyroidectomy.Conclusions: Thyroid swellings are common in females occur in 3rd and 4th decade most commonly. FNAC is very useful and indispensable in the diagnosis. Most common non neoplastic and neoplastic lesion was solitary thyroid nodule and papillary carcinoma respectively.
Functional and aesthetic outcomes of first dorsal metacarpal artery flap for thumb reconstruction: a prospective study
Authors: Ravada Sujana , Mahipathy Surya Rao Venkata , Durairaj Alagar Raja , Sundaramurthy Narayanamurthy , Jayachandiran Anand Prasath
Published: June 2020

Background: Reconstruction of soft tissue defects of the thumb, with exposure of tendon, joint or bone, has been a challenging problem. Surgical options include local, regional or free flaps. Here, we have evaluated the functional and aesthetic outcomes of first dorsal metacarpal artery (FDMA) island flap in reconstruction of various soft tissue defects of the thumb.Methods: Between January 2018 and January 2019, twenty patients with post-traumatic and post-infective thumb defects underwent FDMA flaps. Sensory function was evaluated with static 2 point discrimination and mobility of the thumb was tested by the Kapandji score. The aesthetic outcome was also assessed.Results: The mean defect size was 39.9×19.95 mm. Eighteen flaps survived completely and one had distal flap necrosis and one had superficial epidermal peeling which was treated conservatively. The mean static two-point discrimination was 9.3 mm. Cortical reorientation was complete in 45%. The average Kapandji score was 7.9. The aesthetic outcome was excellent in ten, good in eight and poor in two subjects. After a mean follow up period of 11.85 months, most patients regained all functions of the thumb and index finger and were pleased with the cosmetic appearance of the flap and donor site.Conclusions: FDMA flap offers a good quality skin cover for small to moderate sized thumb defects. It is a reliable and versatile flap which is sensate and pliable. It gives excellent functional and aesthetic outcomes with minimal or no donor site morbidity.
Management of infections with Mycobacterium other than tuberculosis as a complication of surgical procedures
Authors: Naskar Bikash , Bakshi Sabyasachi , Mandal Tapas
Published: June 2020

Background: Atypical Mycobacterium other than tuberculosis (MOTT) have emerged as significant human pathogens, causing post-surgical wound infections. The aim of this study is to assess the causative organisms of such infection and their treatment response.Methods: After matching the criteria, 28 cases, were taken for this prospective, single center, observational study. The diagnosis was confirmed by bacterial culture.Results: Among 28 patients, 16 were females (median age of 45.5 year). Patients had undergone laparoscopic cholecystectomy (n=13), laparoscopic appendicectomy (n=3), laparoscopic hernioplasty (n=2), open appendicectomy (n=2), open mesh hernioplasty (n=7), exploratory laparotomy (n=1). No major comorbidities or immunosuppression was identified. All patients were initially treated with repeated incision and drainage and started conventional antibiotics until culture and sensitivity report was available. All except one patient had culture confirmed MOTT infection. Combination antibiotics (clarithromycin, linezolid and ofloxacin) given for initial 3 months. 12 well responded within 3 months. 9 required additional few months to get complete cure. 4 patients cured after 6 months of treatment and 3 patients did not come for follow up.Conclusions: Delayed onset chronic wound infection by atypical mycobacteria is preventable. These organisms are not responsive to conventional antitubercular drugs but to specific drug regimens.
Common bile duct stones: its different aspects of presentation and management
Authors: Kumar Nishant
Published: June 2020

Background: Common bile duct (CBD) stone management is a commonly occurring potential challenge for surgeons.Methods: A total of 38 patients who was admitted in admitted in surgery Department of Sri Ram Institute of Medical Sciences, Bareilly UP during the period of March 2019 to September 2019 were studied. The diagnosis was made using USG MRCP, relevant blood investigations. Patients were managed based on radiological findings by the best possible way and expertise available.Results: Out of the 38 patients, 14 (37.14%) were male and 24 (62.85%) were female. The mean age for male was 50.92 years and for female, it was 51.74 yrs. Most of the patients had pain abdomen and /or jaundice with a mean total bilirubin of 3 mg/dl. Patients are managed either by ERCP or by surgery (open/laparoscopic). Mortality is nil but morbidity is more for open procedures.Conclusions: There can be no definite algorithm for the management of CBD stones as the patients’ age, underlying general condition being the only standardizable factor with facilities for endoscopic, laparoscopic management being variably available from institution to institution and hence, necessitating tailoring the management of CBD stones depending upon the Institution’s resources.
Role of laparoscopic appendicectomy in management of early appendicular mass
Authors: Ramesh Kota , Janapareddy Khyati Kiran
Published: June 2020

Background: Appendicular mass consists of matted loops of bowel and omentum adherent to the adjacent inflamed appendix. Laparoscopic approach adds diagnostic value and allows visualization of entire abdominal viscera facilitating better and safer dissection.Methods: This is an observational prospective study done in patients presenting to Gandhi Hospital’s surgical department with incidentally detected appendicular mass on laparoscopy from August 2016 to August 2018.Results: Maximum cases belong to adolescent age group (13 out of 30). Majority of cases are male patients (24 out of 30). Each surgery took around 1 hour. No intraoperative complications occurred in 23 patients. Difficult adhesiolysis experienced in 5 patients. Serosal bowel injury occurred in 1 patient. Orals were delayed where intraoperative dissection was prolonged or difficult. Majority of patients were discharged after 3 days.Conclusions: With immediate operative management of appendicular mass presenting in early stages of inflammation, dissection can be safely proceeded with and appendicectomy can be safely performed eliminating the need for second hospitalization and risk of recurrence. The incidence of intra-operative and post-operative complications is low making laparoscopic appendicectomy in early appendicular mass a safe and feasible treatment option.
A case series of adult intussusception diagnosed by ultrasound in South India: an uncommon notion
Authors: Vinoth D. , Rajeshkumar S. , Abu Sali Sheik Asik
Published: June 2020

Intussusception is the telescoping of one segment of the gastrointestinal tract into an adjacent one. Adult intussusception is less than 0.1% of all hospital admissions. Non-specific symptoms often delay the diagnosis with most cases diagnosed only after emergency laparotomy, hence the need for imaging as a screening investigation. The gold standard is computed tomography with the limitations of cost, radiation and contrast hazards. Our suggested initial screening tool is ultrasound. the aim of this study was to evaluate the sensitivity of ultrasound in diagnosing this rare entity. Thirteen patients (2013 to 2019) in a single tertiary care hospital diagnosed as “intussusception” were analysed. They were initially diagnosed by ultrasound and confirmed by CT or intra-op as needed. There were no exclusion criteria. The mean age was 50. There were 6 males and 7 females. Ultrasound sensitivity was 72%. Symptoms were variable. 100% had abdominal pain (1 day to 2 years duration). 69% had Intestinal obstruction. The most common type of adult intussusception observed was ileo-ileal (39%). The least common noted was gastro-jejunal (8%). The most common treatment was resection and anastomosis (77%). 3 cases were managed conservatively successfully. The biopsy was mostly benign (54%), 3 were malignant (23%) and 3 were unknown as they were not operated (23%). Our suggested initial screening is ultrasound with a fairly good sensitivity (72%). The upcoming improvement in technology can raise this sensitivity even further. The management protocols, biopsy findings, and clinical findings are however subjected to discretion.
A rare presentation of aorto-bronchial fistula and the relevance of open repair in endovascular era
Authors: Zulkifli M. Faizal Effendi , Marican M. Azri , Radzif Abdul Rashid M. , Azmi Muhammad Ibrahim , Muhammad Mohamad Arif , Jasid Abdul Muiz , Kamarulzaman M. Hamzah
Published: June 2020

Aorto-bronchial fistula is a rare but potentially fatal condition due to torrential bleeding from erosion of aneurysmal wall into bronchial wall or lung parenchyma. It is usually associated with infection, lung transplantation, pulmonary malignancies, atherosclerotic and mycotic aneurysms, and anastomotic pseudoaneurysms after open or endovascular surgery. The typical presentation usually manifested by haemoptysis, but rarely the patient also can be presented with hematemesis and this will delay the definitive treatment. Surgical or endovascular repair is mandatory because non-operative management will lead to a poor prognosis due to massive bleeding from the fistula.  We would like to present a unique case of an elderly man presented with intermittent haematemesis, in which he later developed profound haemoptysis and diagnosed with ABF. Although in the era of endovascular, the ABF was successfully treated via open thoracotomy, resection of thoracic aorta aneurysm, left lower lobe lobectomy, and completed with aortic repair using Gelweave aortic graft.
Lumbar spine metastasis in a breast cancer survivor after twelve years of disease-free survival
Authors: Okwunodulu Okwuoma , Inojie Moses O. , Campbell Francis C. , Ndubuisi Chika A. , Ohaegbulam Samuel C.
Published: June 2020

Spine metastasis is a common occurrence in breast cancer. The median time of spine metastasis from the diagnosis of breast cancer is approximately 3 years. In this case report, a 55 years old woman presented with insidious onset and progressively worsening severe low back pain. Spine MRI revealed L4-S1 heterogeneous marrow signal changes with L5 vertebral body collapse. She had undergone surgery, radiation, and chemotherapy for breast cancer 12 years prior. Although she had not received any anticancer treatment for 12 years, but she has been on regular follow up with the oncology team with no clinical evidence of local tumour recurrence. She had laminectomy and biopsy and the histological diagnosis was metastatic adenocarcinoma from breast cancer. She had palliative external beam radiation therapy and systemic chemotherapy with improvement in Karnofsky performance. We present a case of dormant micro metastasis re-activated 12 years after perceived cure for breast cancer.
Right para duodenal hernia presenting as small bowel obstruction: a rare case report
Authors: Kakkar Dipanshu , Kochar Shubra , Prasad Sanjeev
Published: June 2020

Internal hernias are rare congenital anomalies. The most common internal hernias are para duodenal hernias (53%) followed by pericaecal hernias 13%. Para duodenal hernia, a rare congenital anomaly that arises from an error of rotation of the midgut, is the most common type of intra-abdominal hernia. There are two types, right and left para duodenal hernia, the right being less common.  Here we present a case of a 21 years old male presented in surgical emergency department non-passage of flatus and stools since, 5 days with associated nausea, vomiting and abdominal pain. Abdominal CT demonstrated signs of small bowel obstruction. A midline laparotomy was performed. Intra operative findings suggestive of right sided para duodenal hernia. Careful reduction of hernia and plication of sacs done with new D-J flexure formation. Para duodenal hernias are rare congenital entities. Left para duodenal hernia is more common than right. The right para duodenal hernia occurs when the pre arterial limb of the mid gut loop fails to rotate around the superior mesenteric artery. Symptoms may vary according to degree of obstruction or gut ischemia. Reduction of contents of the sac and plication of the sac to prevent further hernia formation and resection of small bowel in cases of gut gangrene remains the mainstay of the treatment.
Achondroplasia: a case report and the review of the basics
Authors: Agrawal Sujan Narayan
Published: June 2020

The achondroplasia is a variant of short-limbed dwarfism. The word achondroplasia literally means without cartilage formation. However, in achondroplasia the problem is not in formation of cartilage but, in its conversion to bone (i.e. ossification). This deficient ossification is particularly seen in the long bones of arm and leg. The characteristic external appearance of people born with achondroplasia is short stature. The average height of an adult male with achondroplasia is 131 centimetres (4 feet, 4 inches), and the average height for adult females is 124 centimetres (4 feet, 1 inch). The trunk is of average size but the leg and upper arm is of short length. It is because the femur and humerus are relatively shorter in length. The range of movement at elbow is limited. The head is enlarged called macrocephaly and is with a prominent forehead. People with Achondroplasia are generally of normal intelligence. They have bowed legs and abnormal curvature of spine giving rise to lordosis or kyphosis. They may develop spinal stenosis, which is associated with pain, tingling and weakness in leg. This may cause difficulty in walking. The other health problems associated with Achondroplasia are episodes of apnoea, obesity and recurrent ear infection. The purpose of this study is to evaluate the cardinal phenotypic features in patient of Achondroplasia. It is also to assess the body physique, anthropometric measurements and to study the typical radiological signs in such patients as the main tool of diagnosis.
A massive phylloides tumor in the breast: case report and literature review
Authors: Wilkinson T. Raju Vinay , Kashid Anupama Ashok , Sonarkar Rajiv Krishnarao
Published: June 2020

Phylloides tumor (PT) is a rare fibro epithelial neoplasm comprising <1% of all breast tumors. Clinical spectrum ranges from benign (B), borderline (BL), and locally recurrent to malignant (M) and metastatic type. Phylloides tumors originate from the connective tissue of the breast, so the malignant phylloides are histologically sarcomas. We are reporting a massive phylloides tumor in a 45 years old female. She presented with a huge breast mass occupying almost the whole of the right breast with two areas of pressure necrosis, on the overlying skin. She noticed a small lump 7 months ago in the right breast, which slowly grew to the current dimensions and areas of pressure necrosis appeared recently. FNAC was reported as a complex fibroadenoma; however due to strong suspicion, a core needle biopsy was done. The report came as a phylloides tumor. Simple mastectomy was done. The tumor specimen measured exactly 20×15×10 cm in size; the histopathology report came as benign phylloides tumor.
Epidydimal leiomyosarcoma: a rare case of scrotal swelling
Authors: Krishnan Sharath K. , Chirukandath Ravindran , Kunhikandilakath Safna , Vava Harikumar Kaniyamparambil , John Babu Pulluvelil
Published: June 2020

Sarcomas of the genitourinary tract are extremely uncommon and accounts for only 1-2% of genito urinary malignancies. Sarcomas of the para testicular region, comprising tissues such as the epididymis, spermatic cord, inguinal canal and testicular tunica are also extremely rare. epidydimal leiomyosarcoma accounted only for 4 percentage of all para testicular tumours and only 16 cases are reported so far in literature and they account 4% of all Para testicular sarcomas. We are presenting a 61-year-old patient presented with a hard welling of 1 year duration, with no other associated symptoms. On ultrasound evaluation, it was reported as extra testicular lesion, possibly from epididymal tail. We performed a high inguinal orchidectomy. Histopathological examination revealed a para testicular leiomyosarcoma arising from epididymis. This case has discussed because of the rarity of the disease and possible cure if diagnosed early and treated aggressively.
Dermatofibrosarcoma protuberance: a recrudescent dermal malignancy
Authors: Khan Nida , Mahadik Abhishek , Kumar Manish , Hitawala Rubina , Patel Khyati
Published: June 2020

Dermatofibrosarcoma protruberens is a rare soft tissue tumour of low malignant potential, commonly seen on the trunk and extremities. It is a slow growing sarcoma, with a tendency for recurrence. Rarely, it may be a high-grade tumour. It responds well to wide local excision. Radiotherapy is beneficial for margin positive and high-grade tumours. We present a case of a 22 years old male with a dermatofibrosarcoma protruberens presenting as a swelling over the left inguinal region since, 4 years, that was excised with a 2cm margin. Patient was followed up for six months without any recurrence.
Isolated renal mucormycosis: a rarity
Authors: Sandhu Arjun S. , Jha Aditya A.
Published: June 2020

Mucormycosis is a rare, opportunistic, highly aggressive, fungal infection primarily noted in immunocompromised individuals. Isolated involvement of any organ is rare in general. Isolated renal involvement is unusual, with only a few cases reported in literature to date. We present a rare case of isolated renal mucormycosis successfully managed with systemic anti-fungal therapy and nephron sparing surgery.
Morgagni-Larrey parasternal diaphragmatic hernia masquerading as pleural effusion: an interesting presentation with review of literature
Authors: Gupta Amit , Singh Sudhir Kumar , Darbari Anshuman , S. Durga Sowmya , Mani Rishit
Published: June 2020

Congenital diaphragmatic hernia (CDH) is a major malformation found in newborns and babies but rarely in adults. CDH is defined by the presence of a defect in the diaphragm, which permits the herniation of abdominal contents into the thorax. The diagnosis of CDH is based on clinical history, examinations and is confirmed by plain X-ray films and computed tomography scans. Here we report a case which was misdiagnosed at another centre as pleural effusion and managed by placement of intercostal tube drainage and later on diagnosed to be case of Morgnani-Larrey parasternal diaphragmatic hernia. Congenital diaphragmatic hernia (CDH) is a major malformation found in newborns and babies but rarely in adults. CDH is defined by the presence of a defect in the diaphragm, which permits the herniation of abdominal contents into the thorax. The diagnosis of CDH is based on clinical history, examinations and is confirmed by plain X-ray films and computed tomography scans. The purpose of reporting this case is to provide information on late-presenting CDH and to emphasize that a high index of suspicion is required for diagnosis and to avoid unwanted complications.
To lyse or not to lyse? Use of intrapleural tissue plasminogen activator and DNase in the management of parapneumonic effusions and empyema
Authors: Afolaranmi Oluwasegun , Arowojolu Oreoluwa
Published: June 2020

Despite a range of management options, pleural effusions and empyema continue to present therapeutic challenges in the clinical setting. With treatment options ranging from simple use of antibiotics to more complex surgical procedures, several important considerations need be made as to what type of treatment is best for each patient on a case by case basis. One treatment modality of increasing interest is the use of intrapleural fibrinolytics to facilitate drainage of effusions. This presents a viable option especially in patients in whom surgery is not preferred. But, as with many therapeutic approaches, the use of intrapleural fibrinolytics is laden with significant controversies and has been a subject of considerable debate over the last couple of years. With accruing evidence for and against this modality of treatment, the ensuing discussion has been whether or not it should be a routine treatment choice and which group of patients should this consideration be made for. This paper gives a background on the epidemiology and etiology of parapneumonic effusions and empyema and briefly outlines the available options of management. Furthermore, we extensively discuss available evidence on the use of intrapleural fibrinolytics as a management option for parapneumonic effusions and empyema, with particular emphasis on use of tissue plasminogen activator (tPA) and DNase.
The clinicopathological and radiological features of unilateral nasal mass in adults, a tertiary hospital experience
Authors: Aljafar Hadeel M. , Alenazi Eman R. , Alkhatib Abdulrahman M. , Alazzeh Ghaleb M. , Almomen Ali A.
Published: June 2020

Background: Aim and objectives of the study were to analyze and study the diverse presentations of unilateral nasal mass and to identify the suggestive features of neoplastic pathology in adult’s population at a tertiary referral hospital.

Methods: A retrospective analysis of 90 patients presented with unilateral sinonasal mass, reported to the Rhinology and Skull Base Clinic at the department of ENT in King Fahad Specialist Hospital, Dammam. The parameters include patient history, clinical assessments and histopathological examinations, which were supplemented with radiological investigations.In addition, demographic information and histopathological examinations for patients, who underwent surgical excision was analyzed for correlation with clinical diagnosis.  

Results: The reported cases are 55 males and 35 females with a median follow-up period of 12 months, ranging from 2-72 months. Nasal obstruction is the major symptom 34 (38%), 25 (27.8%) cases were reported with nasal mass and clinical diagnosis indicates 18 (20%) cases of malignancy. Type of disease and gender demonstrates low significance (p=0.023), whereas the diagnosis with age is highly significant (p=0.005).

Conclusions: Carcinoma, inflammatory polyposis, inverted papilloma and allergic fungal sinusitis were the highest histological diagnosis. The clinical diagnosis and the suggestive features of radiological findings mostly resembled the histological findings. In contrary to the resemblance, the histological finding reveals the general diagnosis of nasal mass to the precise diagnosis, especially the fatal conditions like carcinoma. The high rate of malignancy and its suggestive radiological findings indicates that the specialists should consider the cases with caution to carryout histological analysis to rule out the probability of neoplasm.
The effect of environmental noise on speech perception of individuals with sensorineural hearing loss: a prospective observational study
Authors: Sahoo Lokanath , Sahoo Krushnendu Sundar , Nayak Nitish Kumar
Published: June 2020

Background: This study was done to identify the effect that environmental noises have on speech perception of individual with sensorineural hearing loss. The objectives were to develop evidence-based approach to support the need for sophisticated technology and to choose the better one for daily listening purposes of Hearing-Impaired individual to obtain a speech perception score when environmental noises are used as competing signal.

Methods: The study was executed in three phases. In phase 1, developing a noise check list and recording the noise levels at different places by using sound level meter, in phase 2, analyzing the recorded noises into spectral and temporal distributions by using software and phase 3, testing the hearing loss individual’s syllables in the presence of recorded noises.  

Results: For 0 dB signal to noise ratio (SNR), the mean scores for white noise and temple noise were higher than for other noise types. The bus and auto noise conditions also showed significant difference in values between them. For +10 dB SNR, speech scores obtained for audiometry noise differed statistically from only restaurant and traffic noise. The traffic noise being the poorest differed statistically from all other noise types. On the other end of range, restaurant noise showed highest speech scores.

Conclusions: The overall the scores were a lot higher for only restaurant noise and noise of travel in auto. These showed effect of masking release and that hearing impaired are better able to understand conversations in these situations at least.
Endoscopic interlay tympanoplasty: our experience
Authors: K. Sajitha Bhaskaran , Kumar Naveen
Published: June 2020

Background: Chronic otitis media is treated conventionally by tympanoplasty using a temporalis fascia graft using a microscope, through a post aural approach. The present study comprises of 50 cases of chronic otitis media, which were treated by endoscopic interlay technique of tympanoplasty, combining two novel approaches in otological surgery.

Methods: Total of 50 patients were studied, with in a period of one year at our institution. All of them underwent type I endoscopic tympanoplasty by interlay method. All of whom were followed up for 6 months. Patients were evaluated in terms of graft uptake, improvement in hearing and rate of complications.  

Results: In the present study, we have recorded a graft uptake rate of 98%. The mean post operative air bone gap at the end of 6 months was 0.9 dB (p=0.001) which was statistically highly signiﬁcant.

Conclusions: Endoscopic interlay tympanoplasty is a novel and preferred technique, which could be implemented in all cases of dry chronic otitis media.
Clinico-pathological and radiological correlation of sino-nasal masses in a tertiary care center
Authors: Sahni Dimple , Kaur Gagandeep , Verma Peeyush , Kaur Rajwant , Singh Harpal
Published: June 2020

Background: The nasal masses are most commonly encountered condition in outpatient department of otorhinolaryngology. The purpose of this study was to show the clinical, radiological and histopathological correlation of sino nasal masses.

Methods: This study was conducted on 100 cases with sino nasal masses over a period of 2 years. A provisional diagnosis was made after clinical and radiological investigation which was confirmed with histopathological examination and the findings were correlated.  

Results: The number of non-neoplastic lesions were more than neoplastic lesions (75% vs 25%). Incidence was highest in the age group of 31-40 year (21%) with male to female ratio of 1.5:1. In our study among non-neoplastic lesion, inflammatory lesion had highest frequency (75%). We found clinical and histopathological correlation in 94.6% cases (p value 0.04). 93.33% cases correlated radiologically and histopathologically (p value 0.04).    

Conclusions: We concluded that for proper evaluation of sino nasal masses, clinical, radiological, histopathological evaluation should be carried out conjointly. Histopathologic evaluation remains the gold standard.
Laryngeal zoster: two esoteric cases
Authors: Bopanna Namrita , A. M. Anithakumari , Shree J. Nithya
Published: June 2020

Herpes zoster is a neurocutaneous disease resulting from the reactivation of varicella-zoster virus in dorsal sensory or cranial nerve ganglia. A thorough knowledge of laryngeal zoster is important to diagnose Zoster sine herpete. Case I shows polyneuritic involvement. Case II shows mononeuritic presentation. The clinical picture of laryngeal zoster varies from mucocutaneous lesions and paralysis to that mimicking malignancy leading to missed diagnoses.
Nasolabial hamartoma: a rare case report
Authors: Kannan D. Senthamarai , Rajan G. Soundara , Narendrakumar Veerasigamani , Sathiya V. K.
Published: June 2020

Nasolabial cysts are rare, nonodontogenic soft tissue developmental cysts occur in the maxillary lip and nasal alar regions. Patients usually presents with an asymptomatic soft swelling with obliteration of the nasolabial fold. Due to it's origin from entrapped epithelium in an embryonic fusion plane developmentally, this cyst is considered to be a Hamartoma. Hamartomas are non-neoplastic malformations, or inborn errors of tissue development. They are characterized by an abnormal mixture of tissues indigenous to that area of the body. Complete surgical excision is the accepted method of treatment. This report aimed to present a case of nasolabial cyst hamartoma, which is rare in presentation.
Pharmacotherapy for vertigo: a current perspective
Authors: Swain Santosh Kumar
Published: June 2020

Vertigo is a symptom often encountered in routine clinical practice. Pharmacotherapy plays a vital role for treating the vertigo. Vestibular sedatives and drugs controlling nausea and vomiting constitute the important part of the pharmacotherapy for vertigo. Although there are several drugs available for controlling the vertigo, there are no definitive and universally accepted drugs available for treatment of vertigo. On the basis of the etiology, drugs with specific mechanism of action may be used to control this disabling symptom. Symptomatic treatment is often priority by many clinicians during the treatment of the vertigo. The pharmacological treatment of the vertigo is often decided after correct etiological evaluation of the symptom. Common drugs which are beneficial for treating vertigo are anticholinergics, antihistamines, benzodiazepines, calcium channel blockers and dopamine receptor antagonists. This review article exclusively focuses on pharmacotherapy of vertigo.
Gasto fiscal e inversiones en mano de obra libre en Hispanoamérica. El caso de Cartagena de Indias (1750-1810)
Authors: Solano D Sergio Paolo
Published: June 2020

En el marco de los recientes debates sobre la naturaleza de la monarquía y del imperio español, el Estado fiscal militar y las características del gasto fiscal, este artículo presenta algunas ideas sobre la historiografía que se ha referido a algunos temas que de alguna forma tocan aspectos relacionados con las inversiones en las colonias y con la demanda de mano de obra por parte de las instituciones de la corona. Me interesa ver, por una parte, en qué medida esos estudios modifican una larga tradición historiográfica sobre las relaciones entre la corona española y sus posesiones en Hispanoamérica, y, por otro lado, como el caso de Cartagena de Indias se ubica en estos debates y cómo puede ayudar a comprender de mejor forma, y a nivel de una localidad, algunas consecuencias sociales de las reformas borbónicas.
ANALYSIS OF SHIFT FORM AND MEANING TRANSLATION OF POLITICAL NEWS IN INDONESIA ALYOUM.COM (SYSTEMATIC FUNCTIONAL LINGUISTIC APPROACH)
Authors: Alim Muhamad , Rafkahanum Rifa , Ma’mun Titin Nurhayati
Published: June 2020

Purpose: The purpose of this research is to analyze and describe the shift in form and meaning of the translation of political news, some aspect that affects the shift in form and meaning of the translated text from the source language, and recommends the news translation techniques that can be used as learning methods for Arabic-Indonesian or Indonesian-Arabic.

Methodology: This research uses identity and distributional methods and data presentation methods using qualitative descriptive analysis. The theory referred to the shifting of form theory and the shifting of meaning theory.

Main Findings: The results of this research identified that the shifting of form consisted 57 data of structure shift (64%), 18 data of class shift (20%), 14 data of unit shift (15%), 1 data of intrasystem shift (0,1%) and the shifting of meaning 16 data gain of information (27,5%), 26 data loss of information (45%), and 16 data skewing of information (27,5%). Translation techniques are identified as follows: structural shifts include passive into active, direct sentences into indirect sentences, explanation at the end into the explanation at the beginning, nominal sentences into verbal sentences and class shifts, for example, verb into a noun or adjective, and unit shift including the words into phrases and vice versa, phrase into clause and the change of the number of the sentence.

Implications/ Applications: The aspects that affect the shift in the form and meaning of the text translation from the source text are the aspects of transfer which include linguistic aspects (lexical, syntactic, and textual) and extralinguistic aspects (cultural, thematic, and encyclopedic).

Novelty/Originality of this study: The current study will analyse indonesiaalyoum.com to present ways of Introducing Arabic to Indonesia and the translation techniques to learn Arabic- Indonesian or Indonesian-Arabic. In addition, it will contribute to the existing literature by providing an overview regarding the forms and meaning of the translation of political news and aspects that affect the shift in meaning.
El Parlamento Abierto como mecanismo de rendición ético-social de cuentas en la discusión sobre la seguridad en México
Authors: Alonso Muñoz Roberto Ignacio
Published: June 2020

La idea de apertura que acompaña los propósitos del gobierno abierto alcanza otros espacios institucionales como el parlamento. Allí, en medio de una crisis de representatividad por los bajos niveles de confianza que genera esta institución, la noción de Parlamento Abierto se enfrenta al desafío de dar paso a esquemas deliberativos que permitan la cocreación con la sociedad. El Parlamento Abierto resulta un mecanismo de rendición social de cuentas al vehiculizar la incidencia de actores sociales. Pero por sí sola, la movilización social no garantiza desenlaces en los que se privilegie el bien común, siendo necesario un examen ético. Este artículo se pregunta bajo qué condiciones el Parlamento Abierto resulta un mecanismo efectivo de rendición ético-social de cuentas, analizando el papel del colectivo Seguridad Sin Guerra en la discusión sobre la seguridad en México, en cuyo caso pueden observarse consideraciones de sustrato ético como la responsabilidad, la representación y la deliberación.Recibido: 11 diciembre 2019Aceptado: 20 abril 2020Publicación en línea: 26 junio 2020
De la teoría a la práctica: evaluando las consultas sobre hidrocarburos en el Perú desde la perspectiva de los estándares internacionales de derechos humanos
Authors: Alva-Arévalo Amelia
Published: June 2020

Este artículo analiza las actas concernientes a los procesos de consulta previa sobre hidrocarburos, con el objetivo de determinar si el Estado peruano cumplió con las normas internacionales de derechos humanos o, por el contrario, si el derecho a la consulta previa se redujo a un proceso informativo que legitima al estado peruano para que proceda con la exploración o explotación de hidrocarburos en territorios indígenas. Las actas pertenecen a las etapas de Evaluación Interna y de Diálogo. En las Actas de Evaluación Interna están plasmadas la reflexión y deliberación de las comunidades indígenas sobre la medida propuesta. En las Actas de Consulta —denominadas así por ley— se plasman los acuerdos totales o parciales alcanzados durante el diálogo entre representantes de las comunidades indígenas, quienes transmiten el contenido de las Actas de la Evaluación Interna, y los representantes de la entidad que promueve la aprobación de la medida.Recibido: 06 marzo 2020Aceptado: 14 mayo 2020Publicación en línea: 26 junio 2020
Violación de los derechos humanos en Cuba: ¿Baja o alta intensidad?
Authors: Tedesco Laura , Diamint Rut
Published: June 2020

El artículo ofrece un análisis de la situación de los derechos humanos en Cuba teniendo en cuenta el marco legal vigente con la reciente aprobación de una nueva Constitución. Cuando Raúl Castro asumió la Presidencia, implementó cambios económicos que no se trasladaron en lo político. Por el contrario, las violaciones a los derechos humanos continuaron y en algunos casos se han incrementado. La investigación que se presenta en estas páginas está basada en entrevistas realizadas entre 2016 y 2019 en distintas ciudades de Cuba y en un seguimiento de las informaciones publicadas en distintos medios sobre las detenciones en la isla. La cuestión que se trata de responder refiere a la intensidad de las violaciones de derechos humanos que se registran en Cuba.Recibido: 31 octubre 2019Aceptado: 13 abril 2020Publicación en línea: 26 junio 2020
Kasey McCall-Smith, Jan Wouters and Felipe Gómez Isa (eds). 2019. The Faces of Human Rights, Oxford: Hart Publishing. 356 p.
Authors: López Belloso María
Published: June 2020

On the occasion of the 70th anniversary of the Universal Declaration of Human Rights, numerous initiatives were launched for its celebration, including events, conferences and publications, all seeking to commemorate its validity. Many of these publications, such as the one coordinated by Carol Proner, Héctor Olasolo, Carlos Villán Durán, Gisele Ricobom and Charlotth Back (2018), or the book directed by Carla Ferstman, addressed this tribute from the analysis of the evolution of the institutions and the normative body of the international system for the protection of human rights originating from the Declaration. However, among all of these, the publication coordinated by Kasey McCall, Jan Wouters and Felipe Gómez incorporates a different and necessary perspective. It reminds us that the milestone achieved with the Declaration was the result of the effort and struggle of many faces: men and women who, throughout history and from different parts of the world and backgrounds, made their contribution to the struggle for the freedom and dignity of people.Published online: 26 June 2020
Pandemic: the view of a clinical psychologist
Authors: Alekhin A. N. , Dubinina E. A.
Published: June 2020

Recent studies indicate that COVID-19 pandemic has significant negative consequences for the public mental health. These consequences should be assessed and analyzed in the future, but it is already clear, that mass surveys with the use of standard psychological instruments are not adequate for this purpose. The authors emphasize that all stress factors associated with the pandemic (virtual threat and informational stress, deprivation, socioeconomic stress) should be taken into account and qualitatively studied and expect an increase in the prevalence of stressrelated mental disorders and physical diseases.
Neurological and mental disorders associated with COVID-19
Authors: Novikova L. B. , Akopian A. P. , Sharapova K. M. , Latypova R. F.
Published: June 2020

The article presents a narrative review, clinical observations. Special attention is given to the pathogenesis, features of neurological manifestations and mental disorders, neurological complications in coronavirus infection, illustrated by clinical cases. Neurological disorders occur in approximately 36,4 % patients with COVID-19. Currently, severe viral hemorrhagic encephalitis, toxic encephalopathy, acute demyelinating lesions of the peripheral nervous system, stroke, behavioral and emotional disorders have been described. Despite numerous publications on the neurological pathology in COVID-19, pathogenesis, risk factors, and relation between neurological disorders and coronavirus infection remain unclear. There is a need for systematization of the accumulated data on the damage to the nervous system during the COVID-19 epidemic for clinical routine use, further development of the optimal treatment strategy and implementation of effective preventive measures.