bluuebunny/crossref_metadata_2025 huggingface dataset:
Preserving Transparency and Integrity of Elections Utilising Blockchain Technology
Authors: Al-Zoubi Abdallah , Aldmour Mamoun , Aldmour Rakan
Published: December 2022

Digital voting is increasingly important in both established and emerging democracies. Some of the advantages of digital voting are faster vote count and tabulation; accurate results; increased voters’ participation and convenience; and effective handling of complex electoral system formats that require laborious counting procedures. However, transparency, credibility, and integrity concerns, as well as the limited possibility of recount, usually make traditional digital voting systems unpopular. Digital voting using blockchain technology, however, is safe, transparent, and immutable, which makes it a suitable choice for future decentralized voting systems. In particular, the Ethereum blockchain is proposed as an appropriate platform for the backbone of an e-voting system due to its widespread use, transparency, consistency and provision of smart contracts. Initial piloting on the implementation of a blockchain-based voting framework in Jordan shows promising results on its transparency and integrity by incorporating a space for representatives and observers to monitor the election procedure and results as an additional measure to ensure its efficiency and reliability. The uptake of the proposed system calls for further debate and dialogue amongst governments and people, especially in developing countries where democracy is still in its infancy.
David Piltz is Awarded the 2022 Charles Todd Medal
Authors: Gerrand Peter , Piltz David
Published: December 2022

On 21 October 2022, David Piltz was awarded TelSoc’s Charles Todd Medal for 2022, at TelSoc’s annual Charles Todd Oration in Sydney. This article provides Dr Peter Gerrand’s speech in presenting the medal on behalf of the TelSoc Board, and David Piltz’s speech in reply.
Towards an Australian Digital Communications Strategy
Authors: De Percy Michael Alexander , Campbell Leith , Reddy Nitya
Published: December 2022

In the early 21st century, governments developed national broadband plans to supply high-speed broadband networks for the emerging digital economy and to enable digital services delivery. Most national broadband plans are now focused on moving to ever faster networks, but there is a growing need to develop national digital communications strategies to focus on the demand-side of the broadband “eco-system”. In this paper, we outline the approaches adopted by the United States, Canada, the United Kingdom, Singapore, and Korea to assist in the development (or renewal) of Australia’s national broadband strategy, or, as we prefer, national digital communications strategy. The paper draws on the lessons learned from the case-study countries and the recent pandemic and considers some theoretical aspects of the broadband ecosystem. We conclude by suggesting a process to re-evaluate Australia’s national digital communications strategy as it rolls forward, and to incorporate recent international trends to develop demand-side policies to enable greater adoption and use of existing broadband infrastructure and digital services.
The Role of the Sarak Opat in Resolving Minor Crimes
Authors: Suhartini Suhartini , Surya Achmad
Published: December 2022

The Sarak Opat as one of the customary institutions in Aceh have been authorized to settle disputes of minor cases at the village level in Central Aceh, Aceh, Indonesia. This is guaranteed by the applicable  laws and regulations. However, the practice of resolving minor cases is currently delegated to the judiciary. Therefore, this study was a legal empirical or sociological research to analyze primary and secondary data in Central Aceh Regency. Data collection method employed were direct interviews with selected informants, and the collected data were processed in qualitative analysis method. The results showed that the role of the Sarak Opat customary institution in resolving minor cases in the Gayo community in Central Aceh has a strong legal basis as mandated by various national and regional legal policies. Subsequently, the customary institution has two considerations in delegating minor criminal cases to the judiciary. First, the litigants are dissatisfied with the sanctions decided by Sarak Opat. Second, the officials of Sarak Opat lack understanding of their authority as a customary justice institution.
Study of clinical profile and treatment of type 1 diabetes mellitus in pediatric patients at a tertiary care centre
Authors: Chauhan Anuya V. , Pathak Gargi , Khare Prarthana
Published: December 2022

Background: Type 1 diabetes mellitus (T1DM) is multifactorial autoimmune disease that leads to destruction of insulin-producing pancreatic β cells. Although exact etiology of T1DM is still unknown, researchers believe there is genetic predisposition, with strong link with specific HLA (DR and DQ2W) alleles. Treatment is directed at replacing missing hormone, insulin. After availability of more medical facilities, improvement in diagnosis and increasing awareness of diabetes, more cases of T1 DM have been diagnosed and treated. Aim of study were to study clinical profile of T1 DM in hospitalized children and to study effect of various insulin regimens in children with T1 DM.Methods: Study design was of prospective observational, carried out at paediatric ICU and pediatric wards of civil hospital Ahmedabad, conducted from 01 August 2017 to 31 July 2021 (4 years) and study population was 150.  Results: Maximum numbers of patients (50.0%) were diagnosed as T1 DM in the age group of 5‐10 years in the present study. Diabetic ketoacidosis was the most common cause of hospitalization in 111 patients (74.3%). Most common presenting symptom in present study was polyuria and polydipsia (81.4%). In the present study, 88.6% patients were discharged. With basal bolus regimen, better glycaemic control was achieved. Incidence of hypoglycaemic events was also lesser (37.5%) with basal bolus regimen compared to split mix regimen (62.5%).Conclusions: Diabetic ketoacidosis was the most common cause of hospitalisation. Better glycemic control was achieved through Basal Bolus Regimen.
White coat - is it safe?
Authors: Lokhande Amita A. , Behera Manas K. , Wankhede Sachin V.
Published: December 2022

Background: The transient contamination of medical professional’s attires including white coats is one of the major vehicles for the horizontal transmission of microorganisms in the hospital. In particular, white-coat cuffs had a higher bacterial load than the mouths of the pockets. The bacterial isolates were resistant to nearly all of the antibiotics tested. This study was conducted to determine the level and type of microbial contamination present on the white coats of medical students in order to assess the risk of transmission of pathogenic micro-organisms by this route in a hospital setting. This study was performed in tertiary care hospital to study the white coat as vehicle for bacterial dissemination and to know the way of handling, cleaning of white coat.Methods: It is observational prospective cross-sectional study conducted at tertiary care hospital. Nurses, interns, residents, technicians are included. Samples are taken from 3 sites of white coat pocket, lapel and collar.Results: We found that reason to wear white coat is dress code of the hospital. Most of the white coats were washed less than 3 days or less. Pocket was the most common site with MRCONS. Pocket (14%) is the most common contaminated site. Antibiotic sensitivity of organisms is mainly sensitive for ciprofloxacin and vancomycin.Conclusions: From the above study we confirm white coat carries microorganism hence it spreads nosocomial infection. Hand washing and multiple number white coat use should be encouraged.
Clinico-epidemiological study and laboratory profile of acute viral hepatitis in children of the age group 6 months to 12 years admitted in a tertiary care hospital
Authors: Khuntdar Bidyut K. , Gayen Biplab K. , Naik Surjit , Sau Manabendra , Patra Kajal K. , Nair Anupama , Madhwani Kishore P.
Published: December 2022

Background: Viral hepatitis is a major public health issue throughout the world affecting millions of children despite the availability of vaccines, prophylactic measures and improved sanitation. The objective of the study was to determine the etiological profile of acute viral hepatitis in patients admitted in a tertiary care hospital, West Bengal, India.Methods: This prospective hospital-based study was done in, Midnapore Medical College, Paschim Medinipur, West Bengal, India from February 2020 to July 2021. Children between 6 months to 12 years who presented with fever and prodromal symptoms, with or without jaundice, abdominal pain, high coloured urine, pale coloured stools with suspicion of acute viral hepatitis were included in the study. The data were statistically analysed using Microsoft excel and statistical package for the social sciences (SPSS) software.Results: Majority of the study subjects were from Lower middle class i.e. 59.6%. Only 34.6% regularly boiled water before consuming. Majority 44.2% of the subjects had history of practicing unhealthy eating practices which included not cleaning hands before eating. 66.7% subjects did not boiled water before consumption, 33.3% were involved in unhygienic food habits and 100% were using unhygienic sanitary practices. Prevalence of hepatitis A in our study was 96.2%. and hepatitis E was 5.8%. Prevalence of HAV IgM positive was 96.2%, prevalence of hepatitis A virus (HAV) and hepatitis E virus (HEV) positive was 1.9% and prevalence of HEV IgM positive was 5.8%.Conclusions: Prevalence of hepatitis A in our study was 96.2%. Hence, HAV was the most common etiological factor causing acute viral hepatitis in children. It’s important to create awareness in the society regarding preventive measures like hygienic food practices and improved sanitation which is of utmost importance in its prevention.
Adherence to the anti-epileptic drugs among children with epilepsy- a cross sectional study in a tertiary care hospital
Authors: Kaur Baljinder , Singla Anju , Kaur Amandeep , Kaur Surinder , Rai Kulwant
Published: December 2022

Background: Epilepsy is the commonest chronic and highly stigmatized neurological problem that affects many children. It is defined by two or more unprovoked seizures. The main stay of the epilepsy management is the anti-epileptic drugs and strict adherence to anti-epileptic drugs is the key to successful treatment. The 70% of children will become seizure free with appropriate anti-epileptic drug (AED) treatment. The goal of treatment of epilepsy includes minimizing the risk of recurrent seizures and side effects, and maintaining normal psychosocial and educational/vocational adjustment. Our study will assess the level of adherence to AEDs in children and factor associated with non-adherence.Methods: A cross-sectional prospective descriptive design study, conducted in Government medical college and Rajindra hospital, Patiala, Punjab from December 2021 to May 2021. 60 patients were included in this study who gave written consent and had been taking at least one AEDs for at least 6 months. Only those patients with normal neurological and cognitive development and no other severe comorbidities were included in this study. Patients and their parents were individually administered a structured questionnaire consisting of personal and demographic Information, self-prepared questionnaire to check compliance and validated questionnaire called Morisky medication adherence scale (MMAS-8). Data was analysed by using statistical package for social science software and p<0.05 considered as significant to see the association between factors and non-adherence.Results: The most common reason for non-compliance was problem in remembering that was seen in 41.8% of the patients. 21.8% of the patients had problems in sticking themselves and 18.6% had problems with buying the drugs. 60% patients are male.Conclusions: Poor adherence was seen in 50% of our study participants. In our study, patients were not stick to their therapy, buy the drugs or had problem to remember to take their medication.
Contributors and associated risk factors of neonatal mortality in a tertiary care hospital in the sub-Himalayan region of West Bengal
Authors: Bagchi Nilay Ranjan
Published: December 2022

Background: Lack of revision of knowledge on the magnitude of problem, cause and factors associated with neonatal mortality hampering early interventions and thus preventing reduction of neonatal mortality rate in India. Neonatal mortality statistics are sensitive indicators of the utility, convenience and effectiveness of maternal child health service in the community. This study was done to see the mortality pattern of neonates and contributing factors at the special newborn care unit (SNCU) and neonatal intensive care unit (NICU) of a rural tertiary care hospital so that special attention to those cause and factors can lead to favourable outcomes.Methods: This was a cross sectional retrospective study done in the SNCU and NICU of rural tertiary care centre of West Bengal for a period of three years with neonates admitted before 28 days of life. Data were collected in pre-designed proforma by analysing the case sheets from the records section of the hospital. Results were analysed by descriptive analytical method.Results:  Total 13738 babies were admitted in the study period (7143 inborn and 6595 outborn). Majority of the inborns (86.8%) and outborns (68.4%) were discharged during that period while 9.4% inborns and 19.5% outborns were expired and only those expired cases were included in this study. HIE/moderate-severe birth asphyxia (41.2%) was the major contributor of death in inborns but in outborns the most common contributor of death was sepsis/pneumonia/meningitis (34.8%). Prematurity and low birth weight were the most common associated risk factors in both the groups.Conclusions: This study delineating the mortality patterns and associated risk factors of neonates in a rural tertiary care hospital of West Bengal which is unique in its kind. Outcome analysis showed that neonatal mortality rate for outborn babies was higher than in relevant recent studies.
A rare case of progressive pseudorheumatoid dysplasia
Authors: Packia Stary R. B. Grashia , Siromony E. Nithin , Sylvia R. Karen
Published: December 2022

Progressive pseudorheumatoid dysplasia is a rare, autosomal recessive, noninflammatory musculoskeletal disorder caused by mutations occurring in the WNT1- protein present in 3 gene. Usual presentation is arthralgia, joint stiffness, contractures with primary involvement in joint cartilage. We present a 13-year-old female child presented with history of short stature, bowing of legs and curving of spine and inability to walk normally since the past two years. The symptoms have been progressively worsening for the past one year. Progressive pseudo rheumatoid dysplasia is a rare form of spondyloepimetaphyseal dysplasia and is clinically misdiagnosed as juvenile idiopathic arthritis. Any patient presenting with musculoskeletal symptoms should be evaluated appropriately to start appropriate therapy in time.
Avoiding granulations and accidental decannulation in paediatric tracheostomy
Authors: Munjal Manish , Munjal Shubham , Bhatt Deepak , Arora Vineeta , Sharma Salony , Talwar Shivam , Chawla Deeksha , Kaur Hardeep , Sandhu Lovleen , Arora Anurima , Bharadwaj Iti , Joshi Tanvi
Published: December 2022

Tracheal access, accidental deccannulation, peristomal granulation, stenosis and difficult weaning are the laryngologist’s dilemma, wherever tracheostomy has been resorted to, in the paediatric age group. These major problems necessitate a modification in the procedure of tracheostomy where ‘stay’ and ‘maturation’ sutures are utilized. The stay sutures facilitate a quick midline tracheotomy and the maturation ones minimise parastomal granulation and easy tracheal recannulation.
Cardiovascular accident unveiling rheumatic heart disease
Authors: B. E. Pavithra Shree , K. B. Namratha , N. Pradeep
Published: December 2022

Infection with group A Streptococci causes an autoimmune reaction known as acute rheumatic fever (ARF) which leads to chronic cardiac condition called rheumatic heart disease (RHD). Rheumatic involvement of the cardiac valves is one of the sequelae of ARF. The valvular lesions begin as verrucae along the borders of heart valves and tend to resolve leaving a scar once the inflammation subsides. Cardio embolism is seen as the main pathophysiological mechanism of ischemic stroke in RHD.
Novel gene mutation causing type 3 Von Willebrand disease: a case report and review of literature
Authors: Koneru Shree H. , Raman Shradha S. , Murugan Swathi P. , Suman Febe R. , Jayaraman Dhaarani
Published: December 2022

Von Willebrand disease (VWD) Type 3 is an uncommon bleeding disorder, resulting from the near absence of Von Willebrand factor (VWF) and extremely low factor-VIII levels. It is a close differential diagnosis of hemophilia. A wide heterogeneity of VWD mutations are reported in the literature. We report a 16-year-old girl with hemarthrosis, finally diagnosed with Type 3 VWD. Clinical exome sequencing confirmed the diagnosis, revealing a homozygous mutation c.4387G>T (p. Glu1463Ter) in exon 28 of the VWF gene, a unique mutation not yet reported in the literature.
Unusual suspect in a common diagnosis: think beyond ‘minimal’
Authors: Varghese Dhiya , Abraham Jacob , Cherian Carol S. , Kurien Jithu , Thomas Reji
Published: December 2022

Nephrotic syndrome is a glomerular disease commonly seen in paediatric population. The disease is characterized by a hypercoagulable state and risk of thromboembolic complications. Cerebral venous thrombosis (CVT) is a rare complication in children associated with nephrotic syndrome with an incidence of 0.67/100000 with very few case reports described. 12-year-old girl with steroid dependent nephrotic syndrome- minimal change disease, with a background of recent COVID-19 infection, presented with vomiting, headache, altered sensorium and an episode of generalized tonic clonic seizure. Diagnosis established by magnetic resonance imaging (MRI) brain and MR venogram which showed superior sagittal sinus thrombosis. Child was started on anticoagulant therapy, gradually recovered with no neurological sequelae. Thrombosis should be suspected in nephrotic syndrome with the added risk of hypercoagulable state associated with COVID-19 infection. Cortical vein thrombosis, even though rare, should be considered in any patient with nephrotic syndrome who presents with neurological signs or symptoms, especially in this era of COVID-19 pandemic. This highlights the importance of suspecting and recognizing post COVID hypercoagulability as a triggering factor for neurological complications associated with the same. Thromboembolic events are rare in paediatric patients with COVID-19 infection, but a high index of suspicion should be maintained in children, particularly those with comorbidities.
Study on the clinical and etiological profile of hepatocellular carcinoma in a tertiary care centre in south India: a prospective observational study
Authors: Marimuthu Revathy Shanmugam , Bavanandam Sumathi , Selvam Silambarasan
Published: December 2022

Background: Hepatocellular carcinoma (HCC) is the most common primary malignant tumour of the liver occurring in patients with underlying chronic liver disease with high morbidity and mortality with various clinical presentations. This study was conducted to analyse the clinical and etiological profiles of HCC patients in tertiary care liver transplant centre.Methods: This prospective cross-sectional study was conducted in the department of medical gastroenterology, government Stanley medical college, for one year, with a sample size of 75 patients. Clinical details, demography, laboratory parameters and imaging findings are entered in pre-structured proforma. Results: Among 75 patients, 69 were males (92%). The mean age of patients was 45.5±10 years. Abdominal pain in 56 (80%) and abdominal distension in 31 patients (44.2%%) was the most common symptom, with underlying cirrhosis in a majority (70.6%). The etiologies include hepatitis B in 25 (33.3%), ethanol in 20 (26.6%), hepatitis C in 8 (10.6%), NAFLD in 8 (10.6%) and cryptogenic in 11 (14.6%) patients. AFP levels >400 ng/ml were observed in 37 cases (49.3%) with a mean value of 6129 ng/ml with normal in 12 (16%) cases. On imaging, multifocal lesions were seen in 24(32%) patients and vascular invasion in 30 (40%) patients. Most of the patients belong to BCLC stage C (54.6%), followed by stage B (30.6%) and stage A (12%) and two patients (2.6%) in stage D. Patients were managed according to institutional protocol with either hepatectomy, TACE, systemic chemotherapy or combination of these modalities.Conclusions: In our study, HBV (33%) and alcohol (27%) were the most common etiologies, with the majority having underlying cirrhosis.
Homeopathic treatment of COVID-19 caused by novel coronavirus SARS CoV2-a real-world experience
Authors: Arora Geeta Rani , Indani Ashish , Goyal Arti , Bhutada Poonam
Published: December 2022

Background:  The unprecedented healthcare challenge of COVID-19 uncovered a new set of challenges for therapy and management of infective conditions. The aim of the study was to established efficacy and safety homoeopathic medicines, which works on principles of similar symptomatology of the disease and the drug, individualization of therapy and hyper-attenuated prescriptions.Methods: The present study was a single centre, OPD based, prospective real-world, all-comer study that included 94 patients of COVID-19, diagnosed based on criteria advised by the Ministry of AYUSH).Results: In all, 94 all-comer, real-world patients of COVID-19 were included in the study, diagnosed on this basis of the MoH guidance criteria. All patients were symptomatic. The overall age of the patients was 40.98 ±19.98 years. Few patients [n=21 (16.84)] had comorbidities while a majority of patients [n=79 (83.16%)] had no notable comorbidity. All the patients were relieved to be asymptomatic in maximum 6 days. In the reversed calculation of Cohen’s D, indicated that the effect of therapy was significantly large. However, pertaining to the data volume, the effect size was not statistically significant. Conclusions: Individualized homeopathic medicine were effective in treatment of COVID-19. However, Bryonia alba and arsenic album were most commonly indicated medicines p overall <0.0001 (Chi square for equal distribution of top 10). Another trend observation established that Bryonia alba was most commonly indicated and effective medicine; hence a potential homeopathic medicine for epidemic (genus: Epidemicus).
Cardiac function’s in patients with chronic kidney disease
Authors: Roy Rajesh , Solanki Bhagirath , Chawda Niraj , Jain Suresh , Sonkar Chetan , Patel Prashastee , Patel Jui , Pandit Heer , Vanpariya Nikunj , Radadiya Tejas , Bhattacharya Amal Kumar
Published: December 2022

Background: To assess the cardiac functions in patients with chronic kidney disease (CKD).Methods: 150 patients with CKD were randomly selected. 12 lead ECG were performed to detect CVD. All Patients were diagnosed with CKD. The left ventricular ejection fraction (LVEF) and fractional shortening (FS) were taken as measures of LV systolic function. Diastolic function was determined by measuring early to late peak velocities (E/A) ratio by spectral Doppler LV inflow velocity. Results: Male: female 95 and 55, hypertension 67% was leading cause of CKD. Diastolic dysfunction as denoted by E/A ratio of less than 0.75 or more than 1.8 was present in 64% of patients. Regional wall motion abnormality (RWMA) was present in 14%. LVH was present in 74%. Systolic dysfunction as measured by reduced fractional shortening (<25%) and decreased LVEF (<52%) was present in 8% and 12% respectively. PE was noted in 15% of patients. Valvular calcification in 8% of CKD patients. Mean LV internal diameter in diastole was 41±6 mm. Mean Interventricular septum diameters in systole was11.9±1.21 mm. Mean LA diameter was 29±4 mm. Statistically significant difference was noted in LVH and E/A ratio in hypertensive group as compared to normotensive group.Conclusions: LV diastolic dysfunction also happens in patients who having the early stage of CKD. Hypertensive patients along with CKD had found higher widespread presence of diastolic and systolic dysfunction as compared to normotensive.
A rare case of young multiple myeloma
Authors: Chinnasamy Vignesh , K. Mahendra Kumar , M. Jagadeesan , Karthik S. Prasanna
Published: December 2022

Multiple myeloma arises from a clonal population of plasma cells. It accounts for approximately 10% of all hematologic malignancies. It is a disease of the elderly and extremely rare in those under 50 years of age. Multiple myeloma is a malignancy of immune cells. The immune cells involved in tumorigenesis are especially plasma cells. The presentation may vary drastically in patients with this disease. The disease presentation ranges from an asymptomatic variant called Monoclonal gammopathy of unknown significance to a severe form of full-fledged multiple myeloma with systemic manifestations. The disease usually affects people aged more than 50. Here, we report a 40-year-old male who presented with anemia, and on further workup, he was diagnosed with multiple myeloma.
A case of stroke secondary to iron deficiency anemia in a young female patient
Authors: Anilkumar Devika , Periyasamy Manimekalai , Vinatha Mullangi Chenchu , Alex J.
Published: December 2022

In this article, we are reporting a case of acute stroke that occurred in a young patient with iron deficiency anaemia (IDA). There are only a few cases where the association between IDA and stroke has been established. The possible mechanisms behind the relation between IDA and stroke are anaemic hypoxia-induced to the brain, hypercoagulable state secondary to IDA and thrombocytosis secondary to IDA. In this patient, all causes of stroke were ruled out except Iron deficiency anaemia which came out to be the reason for the stroke. A decrease in the amount of haemoglobin in the blood results in decreased oxygen supply to the brain, causing hypoxia to the brain. This, in turn, leads to ischemic stroke. Therefore, diagnosing anaemia in patients and starting treatment as early as possible is important.
An interesting presentation of leptospirosis
Authors: A. Lokesh Kumar , S. Devipriya , M. Jagadeesan
Published: December 2022

Leptospirosis is a zoonotic infection more common in south India. Most of the cases are asymptomatic but rarely patient can develop complications like renal failure, acute liver failure, pancreatitis, ARDS and bleeding diathesis. Haemorrhage has been reported in multiple sites, of which the most common is pulmonary haemorrhage. Here we report a case of 53-year-old male presenting with acute febrile illness and seizures. CT brain revealed subdural hemorrhage (SDH). He also had thrombocytopenia with elevated liver and renal parameters and elevated Lipase levels. CT abdomen revealed features of acute pancreatitis. Here we encounter a rare case of leptospirosis presenting with subdural haemorrhage and pancreatitis.
Hepato-pancreatic fat-fetuin A based axis in context of diabetes and its reversal
Authors: B. Jayakrishnan
Published: December 2022

Recent research has focused on reversing type 2 diabetes mellitus (T2DM) via lifestyle-related approaches, including low-calorie diets. Metabolic parameters such as fat accumulation in the liver and pancreas have garnered much attention in this context. Pancreatic fat has been linked with adverse metabolic consequences including T2DM and metabolic syndrome. Obesity is the primary factor leading to ectopic fat in organs such as the liver and pancreas. This review examines the potential role of pancreatic fat in the pathogenesis of T2DM and whether it can be a potential target in reversing this chronic condition.
Prospective study on the functional outcome of septoplasty
Authors: Varghese Kulina A. , Alex Benjamin
Published: December 2022

Background: A thorough assessment of nasal obstruction remains a matter of debate with no accepted subjective and objective measurement tools. The purpose of this study was to use a cost-effective tool for objective assessment of nasal obstruction and compare it with subjective scores.

Methods: This was a longitudinal, prospective study conducted at a tertiary care center on patients undergoing septoplasty for deviated nasal septum (DNS) from March 2016 to August 2017. All patients were assessed pre- and post-operatively at 3 months with nasal peak inspiratory flow, sino-nasal outcome test (SNOT-22) and nasal obstruction symptom evaluation (NOSE) questionnaire to determine post-operative improvement and correlation between objective and subjective scores.  

Results: 64 patients were included in the study with 16 females and 48 males. Male patients had higher peak nasal inspiratory flow (PNIF) score post-operatively. Younger patients (less than 25 years) showed significant subjective improvement compared to older patients post-operatively using NOSE questionnaire. Significant improvement in PNIF, SNOT-22 and NOSE scores post-operatively using paired student-t test. There was moderate correlation between PNIF values and subjective scores before surgery and excellent correlation between the subjective SNOT-22 and NOSE scores before and after surgery.

Conclusions: PNIF is a cheap, portable, and convenient method for assessing nasal patency. Subjective and objective scores have good correlation, with improvement in all scores post-surgery. Men may show more objective improvement and early intervention at younger age may provide more subjective improvement.
Esophageal foreign bodies: our experience
Authors: Muzaffar Rahil , Malik Altaf , Khurshid Sumat Ul
Published: December 2022

Background: The objective of this prospective study was to report our experience of presentation and management of esophageal foreign bodies at GMC Doda.

Methods: This prospective study was conducted in the department of ENT at GMC Doda from January 2019 to October 2022. During this time period 43 patients of foreign body ingestion were admitted in the department of ENT. Of the 43 patients 27 were male and 16 were female patients. 34 were children and 9 patients were adults. After doing through examination, plain radiograph was done on admission in all patients. Age appropiate rigid endoscope was used for foreign body extraction under general anaesthesia.

Results: In children the coin was the most common type of foreign body (28 patients, 82.3%), with about 39% managed conservatively after overnight observation,as the coin passed on spontaneously. In adults chicken bone was the most common type of foreign body (5 patients, 55%). Upper esophagus (cricopharynx) was the most common site of foreign body impaction in both adults and pediatric patients. Rigid endoscope was used in all patients requiring intervention.

Conclusions: Our study suggests that pediatric patients have higher incidence of foreign body ingestion as compared to adults. Management depends on the type of foreign body ingested as many can pass on spontaneously without requiring any invasive intervention. Also the rigid endoscope is a safe, effective and cheaper instrument that is used for removal of foreign body from esophagus.
Clinicopathological profile and outcomes of treatment of head and neck cancer patients in a tertiary care center: a hospital-based prospective study
Authors: Puthukudy Preetham A. , Feshan Musarrat , Satheesh Radhika
Published: December 2022

Background: Globally head and neck cancers constitute among the 10 most common cancers. The study's main purpose was to study the epidemiological and demographic factors and outcomes of treatment of head and neck cancer patients in a tertiary centre. A Chi-square test was used to analyse the association of various factors. Statistical package for the social sciences (SPSS) version 20 was used for statistical analysis.

Methods: In this prospective observational study, 52 patients with head and neck cancers were evaluated and data regarding age, gender, risk factors, clinical features, grading, staging, and treatment modality received were taken. Presenting symptoms of patients at the 1st follow-up (at 1 month), 2nd follow-up (at 2 months), and 3rd follow-up (at 6 months) were statistically analysed.  

Results: Results showed that the mean age group was between 61 to 70 years. Gender distribution showed that 75% were males and 25% were females. The most common site of malignancy was the oropharynx (23.08%). The majority of the tumors were squamous cell carcinoma (88.46%) and are of moderately differentiated type (53.85%). Majority of the tumors (42.31%) presented with stage III lesions. Most of the patients 35 (67.31%) received concurrent chemoradiation (CT-RT). The most common complaint in the first and second follow-up was mucositis.

Conclusions: The majority of the tumors are squamous cell carcinoma and are moderately differentiated. Most of the tumors were in stage III, and most received chemoradiation (CT-RT) for treatment.
Prospective study on the outcomes of harmonic scalpel assisted thyroidectomy in a tertiary care centre in South Kerala
Authors: Sasindran Vivek , John Mithra S. , B. Arunkrishna , B. Harikrishan
Published: December 2022

Background: To estimate the outcomes of thyroidectomy using harmonic scalpel in terms of intra-operative and post-operative blood loss, operating time, incidence of post-operative hypocalcaemia, incidence of recurrent laryngeal nerve and superior laryngeal nerve palsy and post-operative pain.

Methods: The patients are selected consecutively as and when they were presented during the study period. The study involved 23 patients out of which 17 underwent total thyroidectomy and 6 underwent hemithyroidectomy, all using harmonic scalpel. A complete history, physical examination and appropriate investigations were done to arrive at the correct diagnosis. Surgery was done and all the parameters were accurately assessed.  

Results: The mean intra-operative and post-operative blood loss in thyroidectomy by harmonic scalpel was 92.2 ml and 20.6 ml respectively. The mean operative time for thyroidectomy using harmonic scalpel was 58.2 minutes that includes 38 minutes for hemi thyroidectomy and 65.3 minutes for total thyroidectomy. Out of 23 patients, only 1 patient (4.3%) had transient hypocalcaemia in the post operative period. Three patients (13%) had transient unilateral recurrent laryngeal nerve palsy and none had superior laryngeal nerve palsy. The pain assessment by visual analog scale (VAS) score at 24 hours and 48 hours after harmonic scalpel assisted thyroidectomy were 3.87±0.97 and 2.35±1.30 respectively.

Conclusions: Harmonic scalpel gives effective and reliable hemostasis, shortens the operative time, reduces the complications and improved pain control and hence may be considered as an effective tool in thyroidectomy.
Incidentally detected retrosternal goitre with posterior mediastinal extension causing compression of airway: a case report
Authors: Paramasivam Praveen K. , Mohan Raj , Sahu P. K. , Keishing Chuimei , Yadav Mukesh K. , Varghese Jeenu
Published: December 2022

Retrosternal goitre (RG) is an enlarged thyroid gland which extends below the clavicle and sternum. Most patients have slow-growing enlargement without any symptoms but may develop symptoms related to compression of aerodigestive tract like dyspnoea, choking, sleep disturbance, dysphagia and hoarseness. Surgical removal is the treatment of choice either through a cervical approach or combination with sternotomy or thoracotomy. Here we present a case of a 51 years female without any symptoms, detected incidentally to have mediastinal mass on imaging during routine health checkup. On evaluation, she was found to have no significant neck swelling or any evidence of vascular obstruction or neurological compression. Contrast enhanced computed tomography showed large heterogeneous mass lesion extending from posteroinferior aspect of (right) thyroid lobe extending into mediastinum till tracheal bifurcation. Due to the mediastinal extension, multispecialty team approach involving oncosurgeon, ear nose and throat (ENT) surgeon and cardiothoracic surgeon was done. The patient underwent (R) hemithyroidectomy with excision of posterior mediastinal component through combined cervical and mediastinal approach under general anaesthesia. Histopathological examination revealed adenomatous goitre. Post operatively patient was symptom free and is on regular follow-up.
Kartagener’s syndrome: a rare case report
Authors: . Supreety , Singh T. Dinesh
Published: December 2022

Kartagener's syndrome is an autosomal recessive primary ciliary dyskinesia. It is due to ciliary dysfunction consisting of triad of situs inversus, bronchiectasis, chronic sinusitis. Normal ciliary function is critical for respiratory host defence, motility of sperm and ensures proper visceral orientation during embryogenesis. In Kartagener syndrome, the gene mutation is at DNAI1 and DNAH5 leading to pathophysiological changes like ciliary immobility causing accumulation of secretions and consequent recurrent sinusitis. The severity of symptoms and the age at which the condition is diagnosed is quite variable, even though the symptoms are present from birth. We are reporting a case of 12-year-old male who came to ear, nose and throat outpatient department (ENT OPD) with complaints of bilateral nasal obstruction for the past 6 years associated with bilateral mucopurulent nasal discharge, having pale, greyish white polyps filling bilateral nasal cavities. Clinical examination and imaging findings revealed ethmoidal polyposis with chronic sinusitis, bronchiectasis, and situs inversus totalis. Patient underwent revision endoscopic intranasal ethmoidectomy with functinal endoscopic sinus surgery.

 
An unusual case of angioleiomyoma of the vocal cord in a patient with oral cancer
Authors: Munnangi Ashwini , Buggaveeti Rahul , Budharapu Abhishek , Reddy Vinila Belum , Chennamchetty Vijay Kumar , Nayak Umanath K.
Published: December 2022

Angioleiomyomas, as the name suggests, are tumors arising from smooth muscle of vascular tissue. We report a case of angioleiomyoma arising from the right vocal cord in a 45-year-old male with a history of squamous cell carcinoma (SCC) of the oral cavity who had restricted mouth opening owing to previous surgery and adjuvant radiation therapy because of which accessing the vocal cord tumour was difficult by conventional laryngoscopy. Initial bronchoscopy guided excision of the tumour was done. After a month, an emergency tracheostomy had to be performed as he presented with stridor due to recurrence of tumour. Laryngofissure was performed and tumour was excised. The patient is on regular follow up with no recurrence of tumour. We present in this case report, the clinical presentation, diagnosis, management options, pathological features and outcomes of this rare entity known as laryngeal angioleiomyoma.

 
Crooked nose-extracorporeal septoplasty to the rescue: case report
Authors: Munjal Manish , Munjal Shubham , Talwar Shivam , Chawla Deeksha , Kaur Hardeep , Sandhu Loveleen , Arora Anurima , Bharadwaj Iti , . Abhiroop , Chahal Jasmeen , Gill Zoya , Joshi Tanvi
Published: December 2022

The nasal dorsum necessitates intervention at the level of its underlying septal support, in marked deformities, to achieve an acceptable outcome. Conventional intranasal septal access gives limited correction in severe deviations and often an extracorporeal approach is required. This technique, improves the individual’s nasal airway as well as the nasal aesthetics, even in the most advanced deformities. The extracorporeal procedure was undertaken in a robust gentleman with a gross internal and external deformity with a satisfactory result.
CLOTHES RATIONING DURING WORLD WAR II AND ITS IMPACT ON FASHION
Authors: Ermilova Daria , Lyakhova Nadezhda , Pustozerova Olesya , Tretyakova Svetlana , Firsova Yuliya
Published: December 2022

The article deals with rationing clothes during World War II. The hypothesis of the study: rationing is introduced to save resources and curb inflation and becomes a decisive factor shaping fashion along with shortage of goods. The subject of the study is fashion during World War II. The purpose of the study is to identify and compare the features of the rationing of clothing in different countries during the war. The objectives of the study are to consider how the normalized distribution influences the features of wartime fashion, which has been studied mainly on the example of the Soviet Union, Germany, Great Britain, the United States of America, and France. The authors utilize the socio-psychological approach that considers the features of human behavior in relation to apparel in specific historical conditions
DARNTON, BENEDICT E LEVI EM DESACORDO E A GRANDE DISCUSSÃO EM TORNO D´O GRANDE MASSACRE DE GATOS
Authors: Santos Rosenilson da Silva
Published: December 2022

Esse ensaio problematiza as repercussões que o livro de autoria do historiador estadunidense Robert Darnton, O Grande Massacre de Gatos, e outros episódios da história cultural francesa, desencadeou a partir de 1984, ano de sua publicação, entre o público não-especializado e em publicações específicas da área. Analisaremos textos assinados por dois historiadores: um americano, Philip Benedict e o outro, italiano, Giovanni Levi, que se posicionaram em um importante periódico internacional, uma revista da área de História, a italiana Quaderni Storici. Nosso objetivo é mapear como tal obra foi considerada na crítica dos dois autores supracitados e, para tanto, além de uma leitura atenta do próprio livro e dos textos em que ele é avaliado, cotejamos informações de cunho biográfico e intelectual de Darnton, especialmente a partir de entrevistas por ele concedidas e de obras com as quais ele dialoga.
TERESA DE JESUS E O SEU CASTELO INTERIOR:
Authors: De Sá Brandão Marcella
Published: December 2022

este artigo propõe duas linhas de reflexão: a primeira, pensar o contexto histórico-cultural no qual Madre Teresa de Jesus e sua obra Castillo Interior, o las Moradas estão inseridas analisando, desta forma, aspectos alegóricos presentes na obra; e a segunda reflexão, propõe uma discussão acerca do campo semântico fazendo uma aproximação interpretativa com base na perspectiva teórica sobre o dom e a noção de trocas em Ensaio sobre a Dádiva, de Marcel Mauss.
REFIGURAÇÕES, CONTIGUIDADES E SEGREDOS:
Authors: Alves Daniel Vecchio
Published: December 2022

Com base na noção de refiguração narrativa proposto por Paul Ricoeur (2010), neste artigo abordaremos sobre o histórico e o ficcional em suas peculiaridades configurativas e refigurativas, abordagem que vem desempenhando um papel ativo no processo de reestruturação heurística da narrativa ficcional contemporânea. Exemplo disso são as muitas representações literárias de Cristóvão Colombo que promovem uma releitura hermenêutica dos seus famosos diários, estratégia que permitiu a muitas narrativas hodiernas inferir sobre as diversas determinações históricas das quais possivelmente usufruiu a personalidade e o pensamento desse navegador. Como veremos, por meio de equívocos aparentemente intencionais, Colombo proliferou dúvidas geográficas, demonstrando indícios de que tentou enganar seus companheiros de viagem, assim como a realeza ibérica.
A systematic study on 3-D reconstruction computed tomography in cases of maxillofacial traumatic injuries
Authors: Raghu G.
Published: December 2022

The skeletal anatomy of maxillofacial region is the most complex in the body. Injuries of this region is classified from isolated injuries which involves osseous components to complex maxillofacial injuries involving the entire facial skeleton. The aim of any imaging technique for maxillofacial injury is to evaluate the positions of anatomic elements in precision for both hard and soft tissues in spatial planes. The oldest method of imaging Maxillofacial injuries was the classic x-rays. The challenge of the classical method was the inability to represent all the bone structures of facial skeleton precisely and the very difficulty to access the elements of the soft tissue of face in detailed form. Computed tomography have replaced conventional x-rays and is now a very important tool of imaging for very precise evaluation of maxillofacial trauma and it’s potency with the ability to detect the exact number and site along with the extent of fractures.

A systemic self-study was planned to analyze the best choice of imaging techniques for cases of maxillofacial traumatic injuries. With the application of electronic databases we searched PubMed, Google Scholar, Web of Science, Clinical Trial Gov, Medline Plus, health line, John Hopkins Medicine which were published in English language. This systemic self-study have reviewed the facts which were published earlier to determine the ideal choice of imaging techniques for any trauma to maxillofacial region. Vast analysis and along with proper examination of data to evaluate with final conclusion.

Based on our systemic self study we observed this fact that maxillofacial injuries are one of the most frequently encountered injuries which are very often admitted in emergency department. With the revolution of technology in healthcare, today 3D Computed tomography has become the ultimate and primary imaging method because of its significant technical improvement.

We concluded that 3D Computed Tomography imaging is very useful for assessing the severity of midface fracture and injury. The reason for 3D Computed Tomography being chosen as imaging choice is just because the 3D image displays the spatial relationships of fracture segments which are in dislocated form and assists surgeons with better graphic display of the actual anatomic presentation which further guides and asists in the management planning and surgical approach in operation Theatre. Hence 3D Computed tomography is the imaging method of choice for an accurate diagnosis which have totally replaced conventional radiography due to its inability to depict the complex anatomical structure of maxillofacial region. This is the reason 3D Computed Tomography is regarded as golden choice in cases of oro-maxillofacial trauma.
Different applications of platelet rich fibrin in dentistry: A review
Authors: Bashir Samah , Banoo Najma , Shah Ajaz Ahmad , Malik Safeer Ahmad
Published: December 2022

Platelet rich fibrin contains various growth factors with in it and it is composed of fibrin matrix. Platelet rich fibrin is a concentrate of platelets of the second generation. Platelet rich fibrin helps in reducing the process of inflammation and enhance the healing process. An ideal environment is provided by platelet rich fibrin for the process of wound healing as well as regeneration of the tissue, as they combine the properties of fibrant sealant along with the properties of the growth factors in it. Platelet rich plasma has some advantages as it is derived more easily and with economical method of preparation along with it, it also eliminates the requirement of any exogenous compound for e.g. bovine thrombin or calcium chloride during the process of fabrication.
A literature review on different diagnostic techniques used in oral and maxillofacial surgery
Authors: Bashir Samah , Habib Sheikh Tafazul , Ahmad Irshad , Malik Safeer Ahmad
Published: December 2022

Radiographs are one of the most important diagnostic tools in diagnosing and treatment planning of the patient along with the clinical examination of the patient for a dental disease. There are different imaging techniques used in oral and maxillofacial surgery which are having their own significance. Normal routine diagnostic approaches used in oral and maxillofacial surgery as well as in other specialty of the dentistry are normal intra oral peri apical radiography, OPG and radio visiography. Apart from these techniques some advanced techniques can also be employed in the diagnosis and treatment planning of the dental patient, techniques such as cone beam computed tomography, magnetic resonance imaging etc. All these techniques are having their own significance of use.