bluuebunny/crossref_metadata_2025 huggingface dataset:
The pattern, management, and preventive protocols used for urological procedures during the pandemic of COVID-19: an experience of a tertiary care centre
Authors: Agrawal Mayank , Gite Venkat Arjun , Sankapal Prakash , Shaw Vivek
Published: October 2020

Background: During pandemic of coronavirus disease 2019 (COVID-19), there is a need for prioritization of the patients. Suspension of elective procedures avoids the load on already burdened medical facilities. Our aim was to highlight the pattern of urological procedures during the pandemic, preventive protocol used, and challenges faced in their management.Methods: This was a retrospective observational study of 152 patients who underwent urological procedures between March 22 and June 30, 2020, at a tertiary care centre. Outpatient department (OPD) consultation and elective urological procedures were suspended. Only emergency, semi-emergency, and OPD room procedures were performed. Procedures were classified into four categories i.e. emergency, semi-emergency, OPD room, and elective procedures. Patient demographics and operative details were assessed. Descriptive statistics were applied.Results: A total of 152 patients were included in the study. Majority of the patients were our follow up (70.4%) and rest were new patients (29.6%). Out of the total procedures done, 67.1% were emergency or semi-emergency and 32.9% were OPD room procedures. Local anaesthesia was the most used anaesthesia (69.1%). COVID-19 swab testing was done only for the inpatients (41) of which eight patients were tested positive. In the end, none of the health care workers had symptoms of COVID-19.Conclusions: The pattern of surgeries shows that most of the urological procedures performed during COVID-19 pandemic were for either emergency or semi-emergency urological conditions. Obstructive uropathy is one of the commonest indications for the urological procedures performed during this pandemic.
Laparoscopy superseding open appendectomy: a prospective view
Authors: Deshpande Amol , Khade Shardul
Published: October 2020

Background: Appendicitis is the most common surgical disease with appendectomy being the traditional treatment of choice. Different operative procedures exist for appendectomy. The objectives of the study were to compare the efficiency of laparoscopic versus open appendectomy and to compare post-operative complications between laparoscopic and open appendectomy.Methods: This is a longitudinal study done from January 2018 till January 2020 in a tertiary care hospital of central India. A total of 400 operative patients were randomly selected and analysed with acute appendicitis (AA) as diagnosis. Sample size was randomized into two groups. Data was analysed with of open Epi version 2.3 and p value <0.05 was considered significant.Results: Most common symptom was pain in right iliac fossa (94.63%). 18.18% had perforation while 26.38% had inflamed appendix. Histopathological assessment showed that 8.3% and 2.87% had suppurative and gangrenous appendicitis respectively. 23.82% of the open cases reported with surgical site infection (SSI). No SSI were reported in the laparoscopic group. Post-op duration for open and laparoscopic appendectomy was 4.91±0.86 and 2.98±0.76 (p value=0.04150) and was found to be statistically significant.Conclusions: Open appendectomy is considered safe and effective but associated with complications such as ileus, intestinal obstruction, and wound sepsis. Laparoscopic appendectomy with high accuracy and low complication rate has emerged as the modus operandi and has superseded the open approach for treatment of AA.
Study of the outcome on ureteroscopic lithotripsy in patients with upper ureteric calculi: a descriptive study
Authors: Babu Anu V. , Nair Arun B. , Paul Deepak , Shaji Devi V. , Christudas Ribin
Published: October 2020

Background: Ureteric calculi are one of the most common cause of abdominal pain in the emergency room. There are several options for the management of ureteric stones. Ureterorenoscopy and lithotripsy is the commonly used modality because it is less morbid and invasive, but the drawback is proximal stone migration which leads to persisting symptoms and increased costs. The aim of this study is to use an anti-retropulsion device to reduce the rate of proximal stone migration.Methods: This description study was conducted in Sree Gokulam Medical college from December 2014 to December 2015, on 75 consecutive patients who had ureteric stones, of ages 20-60 who were willing to give consent. All patients underwent ureteroscopy and lithotripsy and in those patients from who anti-retropulsion device could not be manipulated proximal to the stone lithotripsy alone was done. Both groups were compared for procedure time, post-operative symptoms and stone free rates.Results: The average time taken for the procedure with anti-retropulsion device was 45 minutes whereas in the other group was 72 minutes. 48 (96%) of patients using the device were symptom free and 48 (96%) patients had no symptoms after the procedure.Conclusions: The use of a anti retropulsion device can significantly reduce proximal stone migration, so thereby reducing further procedures and costs.
Management of common bile duct calculi in a tertiary care hospital in North East India
Authors: Hajong Ranendra , Newme Kewithinwangbo
Published: October 2020

Background: Common bile duct calculi are frequently encountered in patients with cholelithiasis. Treatment ranges from endoscopic retrograde cholangiopancreatography (ERCP) to various surgical treatment modalities done either by laparoscopic or open techniques.Methods: This was a retrospective cross-sectional study carried out in General Surgery department of NEIGRIHMS Hospital from April 2014 to March 2020. Patients attending the hospital with choledocholithiasis during the time period have been included in the study.Results: A total of 82 patients were included in the study. The prevalence of common bile duct (CBD) calculi in patients attending NEIGRIHMS Hospital with symptomatic gallstone diseases was 5.16%. Treatments ranged from primary CBD closure or T-tube drainage after CBD exploration either by laparoscopic techniques, choledocho-duodenostomy and ERCP. Bile peritonitis in 9 patients and retained stone were observed in some patients who were managed accordingly. No mortality was seen in any patient.Conclusions: The number of patients with CBD calculi and symptomatic gallstone disease attending NEIGRIHMS Hospital is less and standard of care is provided to the patients with acceptable morbidity and mortality.
Use of buccal fat pad flap for premalignant buccal mucosa defect reconstruction
Authors: Kshirsagar Pankaj , Nichkaode Prabhat B. , Reddy Saicharan , C. Manichandra Reddy
Published: October 2020

Premalignant lesions over buccal mucosa are very common in India, some of these lesions require excision leaving behind defects and various techniques can be used in reconstruction of these defects. Small palatal defect, oroantral fistulas have been successfully closed by buccal pad of fat flap. Aim of this study was to evaluate reconstruction of defects after excision of premalignant lesion over buccal mucosa using buccal pad of fat. 20 patients were selected for this study who presented with different premalignant lesions like erythroplakia, proliferative verrucous leukoplakia, chronic hyperplastic candidiasis, Oral submucous fibrosis over buccal mucosa in Dr. DY Patil medical college surgery unit 4 and 7. Excision of lesion followed by reconstruction with buccal pad of fat was done. Patients were followed up every 14 days for 14 weeks, and was evaluated for epithelisation of flap and post-operative complications like infection and flap necrosis and also the functionality of the flap. In this study we have observed complete epithelisation of the flap in most of our patients. Dehiscence of the wound was observed in 3 of the patients with large defects (>4×5 cm). No postoperative morbidity was in postoperative patients. Buccal pad of fat is an excellent technique for reconstruction of small defects of buccal mucosa. It is a reliable and a fast method which has easy accessibility less complications and minimal morbidity.
Expanded full thickness skin graft to repair scar and scar contractures: a descriptive case series
Authors: Ghag Nitin V. , Aggarwal Aditya , Singh Hardeep , Singh Sukhdeep , Mahendru Sanjay , Brajesh Vimalendu , Khazanchi Rakesh , Kothari Umang
Published: October 2020

Management of deep burns/trauma scars has always been a challenge. Seven patients with burn/trauma scar were treated with expanded full thickness grafts (EFTSGs). In stage one, tissue expanders were implanted at the donor sites and expansion with saline was done as an out-patient for 4-5 months. In stage two, the scar was excised and secondary wound was repaired with EFTSGs. Total of 8 EFTSGs were harvested from various donor sites. After stage one there was good blood supply noted in all the expanded skin flaps. After stage two, EFTSGs survived in all; except for partial skin necrosis in the leg of one patient. The graft take were excellent in color-match, texture and elasticity. There was a significant improvement in function and aesthetic aspect in all the cases. EFTSGs is an effective solution to repair effectively scar and scar contractures due to excellent cosmetic and functional recovery.
Imperforated hymen, a rare cause of acute urinary retention: a case report
Authors: Jha Aditya Abhishek , Saha Arunabha
Published: October 2020

A 12-year-old pre-menarchal girl presented to our emergency department with acute urinary retention for last eight hours. She admitted having difficulty in micturition for last one month. She denied any other significant past medical or surgical history. During per urethral catheterization a non-tender lump which used to increase on Valsalva manoeuvre was noted in the perineum. Abdominal ultrasonography and magnetic resonance imaging (MRI) showed a large haematocolpos compressing the urethra. She underwent hymenotomy with evacuation of collected menstrual blood. Post procedure recovery was uneventful and she was able to pass urine with normal stream subsequently.
Case report and operative management of obstructed epigastric hernia containing gall bladder: a rare entity
Authors: Thurwal Kartik , Kumari Seema
Published: October 2020

An obstructed epigastric hernia containing gall bladder is a very rare entity and there are only few cases described in literature previously. A 69 year old woman presented at the emergency department at 1.00 a.m. with complains of pain and swelling in upper abdomen and having recurrent vomiting. As patient was sick and there was no imaging facility available at that time, patient was taken to OT in view of obstructed epigastric hernia. When abdomen was opened hernia sac containing gall bladder was seen. Then cholecystectomy and repair of the abdominal wall defect were performed. The patient recovered very well and was discharged on day 7.
Dysgerminoma: diagnostic impasse
Authors: Anandakannan Indrajit , Swaminathan Shanthi Ponnandai , Kawarat Vikas , Mani Rajeshwari , R. Kannan
Published: October 2020

Dysgerminoma is a rare malignant ovarian tumour in women of reproductive age group, featuring lower abdominal pain and abdominal mass with elevated tumour markers. The tumour grows rapidly and diagnosed at an earlier stage. We present a short-statured 20 years girl with intermittent abdominal pain and distention for 4 months, on examination huge abdominal mass of size 20x15 cm, firm in consistency was palpable, lower limit not ascertained. Routine blood investigations normal, thyroid function test showed hypothyroidism. A plain abdominal radiograph shows a large homogenous mass fitting mid part of abdomen with displaced bowel loop. Contrast-enhanced computed tomography abdomen and pelvis show up 20x18.5x9.5 cm well defined heterogeneous mass, with areas of necrosis suggesting mesenchymal tumour or germ cell tumour. CA 125, alpha-fetoprotein, lactate dehydrogenase, beta human chorionic gonadotropin were raised. Magnetic resonance imaging abdomen and pelvis show 10x16x17cm hetero intense lesion, bilateral ovary normal. After tumour board discussion image-guided biopsy was done, suggestive of epithelioid gastrointestinal stromal tumour. Laparotomy displayed a large mass 22x16x10 cm arising from left ovary, no enlarged lymph node, completed with left salpingo-oophorectomy. Histopathology examination and immunohistochemistry definitive of dysgerminoma. In this clinical scenario, we narrate the importance of clinical examination and increased dependence on imaging modalities in diagnosing the patient. The treatment is based on the international federation of gynaecology and obstetrics staging with surgical treatment, adjuvant chemotherapy and radiotherapy.
Laparoscopic fenestration surgery of a large primary splenic cyst
Authors: Bhomaj Harsh , Padhy Aditya Prasad , Pujari Pran Singh
Published: October 2020

Splenomegaly is a major and perhaps the only concern pertaining to spleen for surgeons. Splenic cysts are rare presentations as splenomegaly, with about 800 cases reported so far. Presenting a case report of a 19 years old boy presented with a mass in the abdomen below the rib cage on the left side since 1 year. No other associated complaints. On clinical evaluation a soft cystic mass of size 10×10 cm approximately, was felt extending upto and just above the umbilicus, occupying the left hypochondrium, epigastrium, left lumbar and part of umbilical region. On contrast enhanced computed tomography (CECT) abdomen and pelvis, a well-defined, rounded cystic swelling arising from the spleen and abutting the surrounding structures was noted. Clinically diagnosing it as a primary splenic cyst and after thorough preoperative evaluation the patient was planned for laparoscopic fenestration surgery of the cyst. Surgery involved aspirating, deroofing of the cyst with omental packing of the cyst cavity. This surgery is a novel minimally invasive spleen preserving approach to such types of splenic cysts. This approach carries the least morbidity and recurrence rate among its other options.
A rare case: adenoma of the epididymis
Authors: Wadhwa Sheena , Kothudam Ashwini Rajareddy , Angani Sri Ram Varma , Khadri Syed Iqballulah Iqballula Sha
Published: October 2020

Adenomatoid tumour accounts for less than 1-2 % of all intrascrotal neoplasms which usually presents incidentally. It is a non-hormone dependent, uncommon benign mesothelial neoplasm, usually localized in the epididymis. Presenting a case of a 38 years old male requesting for consultation regarding a small lump that he palpated three years ago in his left hemiscrotum during self-examination. U/S examination of the scrotum with Doppler and cytopathology report revealed a benign adenomatoid tumour arising from the left epididymis. Surgical treatment was decided and a left scrotal exploration with excision of the mass was performed with annual follow up. We report here an interesting case of an adenomatoid tumour of the epididymis from our institution, owing to its sheer rarity, even today.
Cystic lymphangioma of the jejunal mesentery in a young adult: a rare case report
Authors: Rathod Jignesh , Patel Sujan , Upadhyay Henil M.
Published: October 2020

Lymphangioma is an uncommon congenital malformation of the lymphatic system that manifest as a benign tumor. They are most commonly seen in children and rarely in adults. Lymphangiomas in the peritoneal cavity are extremely rare in adults, comprising of less than 1% of all lymphangiomas. We report a case of 18-year-old healthy female who was diagnosed with cystic mesenteric lymphangioma of the small intestine on CT scan as a part of her routine health check-up. CT scan reported a large well-defined cystic mass in mesentery of the small intestine filled with a hyper dense fluid. The lesion had thin capsule and internal septa. Radiological diagnosis was confirmed intra-operatively on laparoscopy. The patient underwent laparotomy with resection of the cyst and the involved jejunum segment followed by end to end anastomosis. The specimen was sent for histo-pathological examination and the findings were consistent with the diagnosis of cystic lymphangioma of the jejunal mesentery. Cystic mesenteric lymphangiomas are rare entities in a clinical setting that can be easily missed on clinical examination or may present as asymptomatic disease. CT scan is the gold standard investigation for diagnosis of mesenteric lymphangiomas. The preferred surgical approach depends on the location of the lesion, the clinical features and the spread of the lesion to surrounding structures.
The role of long non-coding RNAs in human carcinoma
Authors: Zhou Qiang , Deng Minghua , Gong Jianping
Published: October 2020

Long non-coding RNAs (LncRNAs) are usually longer than 200 nucleotides in length, which have 4 functions including signal, decoy, guide and scaffold in cells. Many studies have shown that the expression of LncRNAs is differentially between normal tissues and cancers, including hepatocellular carcinoma (HCC), bladder cancer, epithelial ovarian cancer, gastric cancer and other cancers, which suggests that alterations in the expression of LncRNAs could promote or inhibit tumor growth. However, the exact mechanisms by which LncRNAs play their roles in the normal and tumor cells remain unclear. This article reviews the role of LncRNAs in some common human carcinomas especially in HCC.
Traumatic retained hemothorax: is it time for video assisted thoracoscopic surgery
Authors: Badkur Mayank , Baskaran Suruthi , Prakash Satya , Kishore Lalit , Lodha Mahendra , Rodha Mahaveer , Chaudhary Ramkaran , Puranik Ashok
Published: October 2020

Thoracic trauma is a significant cause of morbidity and mortality, if not treated promptly. 80% to 85% of chest injuries can be treated with chest tube insertion alone. However, in about four to 20% of population, there is incomplete clearance of hemothorax following tube insertion and can lead to a condition called retained hemothorax. The purpose of this review is to establish the role and effectiveness of Video assisted thoracoscopic surgery (VATS) in successful evacuation of retained hemothorax following blunt thoracic trauma. Relevant articles from databases like Pubmed, Google scholar, Medline and Cochrane library were included. A retained hemothorax is defined as the persistence of residual clots in the pleural cavity, which is radiologically evident, 72 hours following initial tube thoracostomy. The various options to manage this condition include observation, insertion of second thoracostomy tube, intrapleural fibrinolytic, VATS or thoracotomy. Based on review of existing studies, VATS evacuation was found to have shorter hospital stay, lesser costs and shorter duration of tube drainage. There was also lesser rate of conversion to thoracotomy as compared to other methods and fewer complications like fibrothorax and empyema. In hemodynamically unstable patients, which is a contraindication to VATS, use of intrapleural fibrinolytics like streptokinase may be considered as an alternative option to provide clearance of the retained hemothorax. Retained hemothorax, when encountered following thoracic trauma, can be effectively managed by VATS. The decision to use VATS for hemothorax evacuation should be made promptly for maximum results, especially within three to seven days following trauma.
Introduction of a safety checklist for gynecological laparoscopy
Authors: Silva Dhammike , Randombage Prabath , Gankanda Wedisha
Published: October 2020

This study focuses on the importance of a safety checklist for gynecological laparoscopic surgeries. There is no dedicated safety check list for gynecological laparoscopy although several general safety checklists are used in practice. (e.g. WHO safety check list). The aim was to introduce a safety check list dedicated to gynecological laparoscopy. This check list is based on our experience in performing gynecological laparoscopy in a tertiary care centre with a high workload.  This check list is introduced after studying the complications occurring in areas covered by the check list. Present data from 776 cases performed over 4 years at professorial unit in obstetrics and gynecology, university of Sri Jayewardenepura, Colombo South teaching hospital, Kalubowila, Sri Lanka. Mean surgical time and complications associated with patient positioning were assessed. Complications associated with the areas assessed were found to be low. However, it is belief that these can be further reduced by the introduction of a check list specifically designed for gynecological laparoscopy.
Study of vitamin C therapy in allergic rhinitis
Authors: Munjal Manish , Singh Atul , Khurana Ajit Singh , Bajwa Navjot , Munjal Shubham , Dhawan Neha , Waraich Gurkaran
Published: October 2020

Background: Vitamin C has a therapeutic role in allergic rhinitis by reduction of oxidative stress and inflammation. The present study has been undertaken to evaluate the improvement or otherwise in the clinical manifestations of allergic rhinitis, following supplementation of this vitamin.

Methods: 40 subjects of allergic rhinitis were selected from the allergy clinics of Dayanand medical college and hospital. The study period was one and a half year. Vitamin C in the dose of 1 gm per day was administered in the case group and in the placebo group a sugar tablet was administered by the oral route. Plasma levels of ascorbic acid and its effect on the symptoms and signs of rhinitis were recorded.

Results: The mean duration of illness in the patients with allergic rhinitis was 10.15±3.4 years, with 25 patients having duration of less than 10 years, 10 patients were with of illness between 10 to 20 years and 5 having duration more than 20 years. The most common complaint in patients with allergic rhinitis was of nasal obstruction (57.5%).

All the patients who showed improvement had increase in plasma ascorbic after the respective treatment but not all the patients showing increase in plasma ascorbic acid post-treatment showed improvement.

Conclusions: Vitamin C ameliorates the signs and symptoms of allergic rhinitis by raising the plasma ascorbic acid levels.
Endoscopic trans nasal intervention in cerebrospinal fluid rhinorrhea: a one and half-year pilot study
Authors: Munjal Manish , Kath Anmol R. , Kaushal Rakesh , Kaushal Arpit , Munjal Shubham , Kalra Shivam , Arora Anurima
Published: October 2020

Background: Cerebrospinal rhinorrhea from the anterior and middle skull base was repaired through the inferior intra-nasal corridor under high resolution endoscopic visualization. The sites, tissues utilized and the surgical outcome have been critically analyzed.  

Methods: 47 subjects of skull base lesions underwent surgical intervention jointly in the Departments of Otolaryngology and Neurosurgery, Dayanand Medical College and Hospital, Ludhiana during a period of 1.5 year.  

Results: Trans-nasal endoscopic intervention for cerebrospinal fluid rhinorrhea was undertaken in 1 male (14.3%) and 6 female (85.7%) patients. The minimum age in our study was 28 years and maximum 68 years with mean age 49.9 years. 6 (85.7%) patients had a history of spontaneous cerebrospinal fluid leak while 1 (14.3%) had a history of trauma prior to the leak. The body mass index (BMI) of 6 (85.7%) was in the range of 30.0–34.9.              Total 6 (85.7%) patients of cerebrospinal fluid leak presented with rhinorrhea or watery nasal discharge as the chief complaint. The cribriform plate, as seen in 5 (71.4%) patients, was the predominant site of cerebrospinal fluid rhinorrhea, followed by the sphenoid, 2 (28.6%) and the fovea ethmoidalis 1 (14.3%). The tissue utilized as graft were fascia lata (7 patients), nasoseptal flap also known as the Hadad-Bassagasteguy flap (5 patients) and middle turbinate mucosa                 (1 patient).  

Conclusions: Spontaneous leaks from the cribriform plate outnumbered traumatic leaks male to female ratio was higher 1:6 in the 5th decade. Hadad-Bassagasteguy flap (in isolation or with fascia lata graft) as reconstructive material is used more commonly as compared to fascia lata.  
Partial inferior turbinectomy versus submucosal diathermy in hypertrophied inferior turbinates
Authors: Gangaraj Smitha S. , Thomas Shilpa
Published: October 2020

Background: The study aims to compare the efficacy of submucosal diathermy and partial inferior turbinectomy in terms of improvement in nasal obstruction, pain, haemorrhage, crusting and wound healing.

Methods: A prospective sequentially randomized comparative study involving fifty patients, divided into two groups of 25 patients each. Group A consists of patients who underwent SMD and group B consists of patients who underwent PIT. Post-operative assessment was done at day 1, 2 weeks, 1 month, 3 months and 6 months.

Results: Post-operative improvement in nasal obstruction was seen in both groups. 80% showed significant improvement in SMD and 32% in PIT group at the end of second week. By sixth month, 40% in SMD group and 80% in PIT group showed significant improvement. Mild pain was observed in 12% of PIT group at 2 weeks. In SMD group, 8% developed reactionary haemorrhage. In PIT group, 24% developed minimal soakage and 12% developed moderate soakage. Severe nasal crusting was seen in 64% of the cases in PIT group and in 40% of the cases in SMD group at second week. By 1 month, 44% in PIT group and 12% in SMD group showed severe crusting.

Conclusions: Short term complications like pain, obstruction and haemorrhage was noted to be higher with PIT. On long term evaluation, PIT showed better results in terms of improvement in nasal obstruction scores.
Role of mitomycin-C in endoscopic dacryocystorhinostomy with lacrimal sac stenting
Authors: Singh Jogeshwar , Munjal Manish , Puri Sanjeev , Chopra Parth , Munjal Shubham , Garg Akshi , Chopra Hemant , Garg Dinesh
Published: October 2020

Background: This study critically evaluates the effectiveness of mitomycin-C in conventional endoscopic dacryocystorhinostomy (ENDODCR) that minimizes the reclosure of a neo-ostium by retaining an enlarged marsupialized lacrimal sac.

Methods: The combined retrospective and prospective study included 24 patients in the study group, who underwent endoscopic dacryocystorhinostomy in the Department of Otorhinolaryngology and Ophthalmology in a period of 1.5 years (June 2006 to January 2008).  

Results: An 83.33% primary success rate was observed, without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in 20.83% cases. Overall, the success rate of group I was 91.67% as compared to 75% in group II.

Conclusions: Intra operative mitomycin-C application is effective in increasing the success rate of DCR surgery in standard nasolacrimal duct obstruction, and no significant complications resulted from its use.
Correlation of ABO blood group phenotype with atrophic rhinitis: an observational study
Authors: Srivastava Abhinav , Bhadouriya Sunil K. S. , Sinha Omkar N.
Published: October 2020

Background: Atrophic rhinitis is very common in India. All etiological factors are yet unknown.  Many studies have been conducted to find the relationship between ABO blood group and various systemic diseases but limited number of studies has been conducted to determine the association of ABO blood group with atrophic rhinitis. The present study therefore was performed to see the association between atrophic rhinitis and ABO blood group.

Methods: 100 patients of both genders clinically diagnosed with atrophic rhinitis were included in this study. Patients with nasal obstruction, nasal discharge and foul smelling from causes other than the atrophic rhinitis were excluded from the study.  

Results: Maximum number of cases 27 (27%) were between 21-30 years of age. The most common presenting symptom in our study was foul smell from nose in 100 cases (100%). Foetors, crusts and roomy nasal cavity were seen in majority of cases. Commonest organism identified in this study was Pseudomonas aeruginosa 37% followed by Klebsiella (31%). Out of 100 patients, 42 patients belonged to group O, 40 patients belonged to group B, 14 patients belonged to group A and only 4 patients belonged to group AB. Control population with blood group B comprises the maximum number of cases followed by blood group O. Percentage of patients with blood group O is higher in atrophic rhinitis as compared with control and the percentage of patients with blood group B is slightly higher in atrophic rhinitis as compared with control.

Conclusions: Our study concluded that no correlation exists between the ABO blood group and atrophic rhinitis.
The surge of Bell’s palsy in COVID - pandemic era
Authors: Srinivas Champion Venkateshalu , Kauser Safina , Sangoli Bhavana
Published: October 2020

Background: COVID-19 is declared as a pandemic by WHO. Bell’s palsy is defined as isolated, sudden, peripheral facial paralysis of unknown etiology. Viral infections are capable of causing facial paralysis through infecting the motor neurons of brainstem, seventh nerve ganglia or through infections of supporting cells of the nerve, along with secondary inflammation and oedema, blocking the nerve function. Similarly, coronaviruses are known to have a neuroinvasive propensity.

Methods: Our study was aimed to report the increased number of cases of Bell’s palsy in the current COVID pandemic era and to hypothesize the probable role of coronavirus in the pathogenesis of Bell’s palsy. A total of 30 patients presenting with unilateral facial palsy in this COVID era were included in the study.  

Results: This prospective analysis of Bell’s palsy cases showed 30 cases in the COVID pandemic era, where the total number of OPD patients were 3720. This shows a percentage of Bell’s palsy cases as 0.8 % when compared to 0.05% in the pre-covid time.

Conclusions: This study shows that there might be an effect of COVID-19 virus on the immune status of the individuals along with stress induced reactivation of underlying viral infection.

 
Assessment of middle ear risk index in predicting the outcome of treatment of CSOM
Authors: Harugop Anil S. , Abhilasha Somashekhar , Desai Pratibha S.
Published: October 2020

Background: Chronic suppurative otitis media (CSOM) accounts for highly prevalent and serious health problems especially in developing countries. Even though there are good numbers of studies demonstrating the success rate of the procedures to treat CSOM, there is lack of uniformity in assessing the predictors for the outcome of the same. If we can predict the outcome of the surgical procedure depending upon the pathologic condition of the middle ear, the cost effectiveness of the surgery can be improved, and this will also improve the patient’s compliance. The objective of this study is to evaluate a group of patients who underwent surgical treatment for chronic CSOM with reference to the prognostic significance of Middle ear risk index (MERI).

Methods: It is a retrospective observational study of patients who underwent surgical treatment for CSOM from the year 2008 to 2020.

Results: Out of 1010 surgeries done, total of 287 cases were included in study. In our study the success rate in mild risk index was 76.9%, moderate was 62.2% and only 18% in severe risk index.

Conclusion: The outcome of surgery in the patients who undergo surgical treatment for CSOM can be predicted well using MERI. Presence of cholesteatoma and granulation tissue reduces the favourable outcome of surgery justifying the numerical value given in the score. However, presence of ear discharge and history of smoking doesn’t alter the outcome of surgery as long as complete clearance of disease is done.
Styloidectomy: our experience with intraoral approach
Authors: Maradesha Purigali S. , Chandrashekhar Subash , Jayaramaiah Samatha K.
Published: October 2020

Background: Eagle’s syndrome is a symptom complex arising due to elongated styloid process or calcification of stylohyoid ligament. Surgical treatment is regarded as the foremost option. The study aims to put forth our experience with intraoral approach to styloidectomy in 17 subjects.

Methods: A retrospective study was conducted between January 2017 to December 2019. The study included 17 subjects with a diagnosis of elongated styloid process. All the subjects underwent styloidectomy by intraoral approach and were followed up.

Results: In our study, the median age of the study group was 33.76 and out of 17 subjects 13 were female and 4 male. The procedure was done under local anesthesia in 13 subjects and under general anesthesia in 4 subjects. Styloidectomy by intraoral approach was done in all subjects among which 15 were bilateral and 2 unilateral. 88% of the subjects were symptom free by third week.

Conclusions: The study suggests that styloidectomy by intraoral approach is minimally invasive and can be done under local anesthesia with an added advantage of quick recovery.
A rare case of acrochordon of external auditory canal
Authors: Gowda Chandre Gowda Bendiganahalli Venkate , Kamath Rakshita R.
Published: October 2020

Independently arising acrochordon of the external auditory canal is a rare entity with only one reported case in literature. We present here the second such case. A 54-yr old lady presented to our outpatient department with complains of aural fullness and reduced hearing in right ear for 2 weeks. Clinical examination showed a pedunculated polypoidal growth in the external auditory canal. Excisional biopsy and histopathology revealed an acrochordon. Following the procedure, patient was free of symptoms and all structures of the right ear were normal. In the head and neck region, acrochordons have only but once been reported in the external auditory canal and hence should be considered as a differential diagnosis in the masses of this region. Resection must be done for confirmation of diagnosis, differentiation from neoplasia and alleviation of symptoms when associated.  
Non invasive assessment of the frontal sinus: a review
Authors: Munjal Manish , Puri Sanjeev , Soni Anshu , Kailey Vikramjit , Pooni Navreen , Munjal Shubham , Singh Angad Harshbir
Published: October 2020

The Frontal sinus with its peculiar mucociliary drainage affected by pathology at the frontal recess necessitates an intervention, medical or surgical. Current review elaborates upon the role of basic imaging in pre treatment evaluation. 
An unusual case of extensive chondrosarcoma of nasal septum
Authors: Jain Satish , B. Harikrishan
Published: October 2020

Chondrosarcoma is a very rare malignant tumour of nasal cavity. It is seen commonly in middle aged men. The definitive treatment is surgical resection with wide margins. Radiation and chemotherapy are reserved for residual or recurrent disease and as palliative treatment. Here we present a case of Grade II mesenchymal chondrosarcoma involving both nasal cavities extending into ethmoid, frontal and sphenoid sinuses with intracranial extension and also its surgical management.   
The physiological and pathophysiological aspects of the maxillary sinus
Authors: Munjal Manish , Gupta Ritu , Sidhu Joginder , Munjal Shubham , Ahluwalia Sahil , Bath Mehak , Singh Archit Pal
Published: October 2020

Among the paranasal sinuses the maxillary sinus with a bottle neck ventilatory and drainage pathway is the commonest sinus to be involved in inflammatory pathologies .With limited intervention at the osteo-meatal unit the disturbed intricate mucociliary physiology of the sinus tends to revert. The surgery being aptly captioned, the “functional endoscopic sinus surgery”. The unique physio-pathology of the maxillary sinus shall be elaborated.
Synthesis of Carbon Nanotubes from Benzene in a Fluidised Bed Reactor
Authors: Smagulova G.T. , Kaidar B.B. , Yesbolov N. , Prikhodko N.G. , Maxumzhanova N.R.
Published: October 2020

The paper presents the results of carbon nanotubes synthesis from benzene in fluidised bed reactor. Al2O3 spheres with iron and nickel nanoparticles coating were used as a catalyst for the synthesis of carbon nanotubes. To deposit nickel nanoparticles on the surface of Al2O3 spheres, the method of solution combustion was used. Optimum temperature conditions and gas flow rates were worked out for each of the catalysts. It was found that the best efficiency in the synthesis of carbon nanotubes from benzene is shown by catalysts based on aluminium oxide coated with iron. The obtained carbon nanotubes were studied by scanning electron microscopy and Raman spectroscopy. It was found that at temperatures above 850 °C from benzene on Al2O3 spheres with Ni/NiO, carbon frame structures are formed.
Herbicidal potential of Araucaria angustifolia (Bertoloni) Otto Kuntze in lettuce seedlings in vitro
Authors: Penha Nayara Clarete da , Botrel Priscila Pereira , Batista Jéssica Azevedo
Published: October 2020

Araucaria angustifolia (Bertoloni) Otto Kuntze plants are a viable source of potentially active secondary metabolites; however, deep studies and researches about the activity of these compounds are needed. The objective of this work was to assess the herbicidal activity of ethanolic extracts of plants of the species A. angustifolia in lettuce seedlings in vitro. Ethanolic extracts at different concentrations (0,0%, 12.5%, 25.0%, 50.0%, and 100.0%) were prepared using barks and leaves. A semisolid MS medium with pH adjusted to approximately 5.7 was prepared, solidified with 8g L-1 of agar, and autoclaved at 1.6atm for 20 minutes. The extracts were added to the culture medium during their preparation before the autoclaving, using an automatic pipette containing 0.1mL of A. angustifolia extract per lettuce seedling. The number of leaves per seedling, seedling height, chlorophyll content, root and shoot dry weights, and mortality percentage was determined at 20 days after inoculation. The results showed that the extract from leaves or barks of A. angustifolia plants has herbicidal activity in lettuce seedlings in vitro, and the extract concentration of 100% presented the best inhibitory results for the variables evaluated.
Susceptibility of four Ipomoea genus weed species to the herbicides saflufenacil or flumioxazin
Authors: Carvalho Saul Jorge Pinto de , Nery Leonardo Ferreira , Madeira Carlos Alberto Borges , Andrade Jeisiane de Fátima , Presoto Jéssica Cursino
Published: October 2020

Among weeds commonly found in Brazil that directly interfere on agriculture, those classified in Convolvulaceae Family may be highlighted, particularly Ipomoea L. genus, popularly known as morning glories. Flumioxazin and saflufenacil are herbicide molecules registered to control these weeds. In this context, this work was developed with the objective of evaluating the susceptibility of four Ipomoea genus weed species to the herbicides flumioxazin and saflufenacil. Two similar and independent experiments were performed in 2017, adopting completely randomized blocks and four replicates. Treatments were organized according to an 8x4 factorial scheme, which eight were the rates of each herbicide and four were the weed species of Ipomoea genus (I. hederifolia, I. nil, I. quamoclit and I. triloba). The following rates were adopted to saflufenacil (g ha-1): 0, 1.5, 3.0, 6.1, 12.3, 24.5, 49.0 and 98.0. The rates adopted to flumioxazin were (g ha-1): 0, 3.75, 7.5, 15.0, 30.0, 60.0, 120.0 and 480.0. Ipomoea genus weed species were completely controlled by the herbicides saflufenacil and flumioxazin, which may be considered excellent alternatives to control morning glories. I. triloba and I. nil were identified as the least sensible species to flumioxazin at the rate of 3.75 g ha-1; lower control of I. triloba was also identified with 7.5 g ha-1 of flumioxazin; rates equal to or higher than 15.0 g ha-1 promoted total control of weeds.
Production of Andropogon gayanus cv. Planaltina dry matter estimated through NDVI
Authors: Dias João Lucas Aires , Pereira Paulo Alexandre Rodrigues , Barros Izaías de Macedo , Barros Pedro Matheus Barboza , Silva Neto Sabino Pereira da
Published: October 2020

Pasture management studies seldom use remote sensing, especially for Andropogon gayanus cv. Planaltina. This work aimed to investigate whether a single-chip digital camera converted into multispectral equipment could measure and perceive differences in the normalized difference vegetation index (NDVI) in Andropogon gayanus cv. Planaltina grass subjected to different doses of nitrogen. In a greenhouse with a randomized block design, the research team subjected the cultivar to 5 different doses of nitrogen (treatments), with four replications. The group compared the NDVI measurements of canopies carried out with a GreenSeeker® HCS-100 active optical sensor and a Canon PowerShot A495 single-chip camera that was converted into a multispectral device by replacing the glass filter that blocks the passage of the infrared by a filter that allows the passage of the red and near infrared wavelengths. Both measurements were correlated with nitrogen doses, stem and leaf blades dry matter and dead material production, and cultivar height. The study concluded that the multispectral camera, as well as the active optical sensor, measured the NDVI and noticed differences in the production of stem, leaf blades and dead material dry matter, and Andropogon gayanus cv. Planaltina plant height when subjected to different doses of nitrogen.
The Role of Substance P in Neurodegenerative Diseases
Authors: Ghahremanloo Atefeh , Mohammadi Fariba , Hashemy Seyed Isaac
Published: October 2020

Abstract- Tachykinins (TKs) are a family of neuropeptides widely distributed in the human body, especially in the nervous system. TKs have exhibited both neuroprotective and neurodegenerative properties in the central nervous system (CNS) and spinal cord. Also, several studies have shown that substance P (SP), as a pioneering neuropeptide of the TK family, is engaged in the pathogenesis of neurodegenerative disorders (NDs), such as Alzheimer disease, Multiple Sclerosis, Parkinson’s disease, Huntington’s disease, and Amyotrophic lateral sclerosis. However, a huge body of information available about the level of SP in NDs demonstrates that SP and its receptors might be prognostic or diagnostic factors for NDs. The present review article summarizes the roles of TKs in common neurodegenerative disorders.
Prevalence of Helicobacter pylori vacA, cagA, cagE1, cagE2, dupA and oipA Genotypes in Patients With Gastrointestinal Diseases
Authors: Masoumi Asl Hossein , Badamchi Ali , Javadinia Shima , Khaleghi Siamak , Tehraninia Leila , Saedi Samaneh , Tabatabaei Azardokht
Published: October 2020

Helicobacter pylori (H. pylori) is a bacterium that resides in the human stomach, which is associated with gastroduodenal diseases. We investigate the prevalence of cagA, vacA, oipA, cagE1, cagE2 and dupA genotypes in H. pylori isolated from patients with Gastric ulcer, duodenal ulcer, and Gastric Cancer. Collected 74 samples from the Gastroenterology Unit of the Rasool Akram Hospital were included in this study. Gastric disorders were identified by endoscopy .gastric cancer was further confirmed by histopathology. H. pylori were detected by the urease test. Subsequently, DNA was extracted from gastric tissue of the subjects with the CLO-test yielded positive results. In general, 74 patients with a mean age of 53.45 years (Range 22 to 86-year-old), including 45 men and 29 women, were studied. Among 74 H. pylori-positive patients, 70 (94.5%) patients were positive for the cagA gene. About 95.8% (23/24) of the patients with gastric carcinoma were dupA positive and VacA gene (91.8%). The oipA genotype was detected in 71 (96%) of H.pylori positive samples. This gene was more common in patients with gastritis rather than cancer group. Also, 97.2% of 74 H. pylori isolates were cagE2-positive. In 25 patients with PUD, the occurrence percent of cagA+/VacA+, cagA+/Vac- , cagA- /VacA+ and cagA- /VaxA- genotypes were found 80%, 12%, 4.2% and 4.2 respectively. The results of the present study suggest that a high prevalence of virulent factors could contribute to the risk of developing gastroduodenal diseases.
Clinical and Histopathological Findings in Patients Who Underwent Splenectomy: A Ten-Year Study in Iran
Authors: Dehghan Arash , Eskandari Nika , Niknejad Nakisa
Published: October 2020

The description of histopathological features of spleen specimens in those are undergoing splenectomy is necessary and even vital for selecting the best patient's diagnostic and therapeutic management. However, in some cases, the histological findings of those with dramatic clinical presentation may be imperceptible and vice versa. What we did in the present study was to assess the clinical and histopathological findings as well as the main indications for splenectomy in a sample of Iranian affected population. This cross-sectional study was conducted on 616 spleen specimens following complete or partial splenectomy performed at pathology laboratory at Besat Hospital in Hamadan, Iran, between 2007 and 2017. Demographic characteristics, the main reasons for splenectomy, grading of trauma, and histopathological findings were retrospectively collected by reviewing the hospital recorded files and laboratory reports. The most common cause for splenectomy included trauma in 59.25%, followed by idiopathic thrombocytopenic purpura in 15.58% and symptomatic splenomegaly in 9.09%. The specimens were normal at 38.0%. Among those with lymphoma, the definitive diagnosis included diffused large B cell lymphoma in 42.85%, Hodgkin lymphoma in 42.85%, Follicular cell lymphoma in 9.52%, and Marginal cell lymphoma in 4.76%. Trauma and idiopathic thrombocytopenic purpura are the most common indications for splenectomy. Given the normality of the pathologic findings in more than one-third of patients undergoing splenectomy, closer attention to indications for this procedure through further evaluation of patients and predicting the outcome of the procedure is necessary.
Comparing the Effect of Simulated Patient and Lecture Training Methods in the Clinical Self-Efficacy of Nurses Caring for Patients With Acute Coronary Syndrome
Authors: Khalifehzadeh Asghar , Ranjbar Jahromi Hamid Reza , Karimyar Jahromi Mahdi
Published: October 2020

Various training methods can be used to enhance the clinical self-efficacy of nurses caring for patients with the acute coronary syndrome (ACS). The present study aimed at investigating and comparing the effect of simulated patient and lecture training methods in the self-efficacy of nurses' clinical performance caring for ACS patients in 2016. This was a quasi-experimental study. The population consisted of 62 nurses working in cardiac intensive care units (CICU) of associated hospitals with Jahrom University of Medical Sciences. Sampling was done with the conventional method and divided into two groups; "lecture" and "simulated patient" education through random assignment. Data was collected with the Self-efficacy of Nurses' Clinical Performance Questionnaire before and after the intervention. Data analysis was performed with SPSS v16.0 software and paired and independent t-tests. There was a significant difference between pre- and post-intervention self-efficacy mean scores in the two groups (P<0.05). In addition, there was no significant difference between pre-intervention self-efficacy mean scores in the two groups (P>0.05). The simulated patient training method was more effective in enhancing nurses' self-efficacy in caring for ACS patients than the lecture method.