bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical outcome after surgical resection of small bowel cancer
Authors: Ali Mohamed Mahmoud , El-badry Ashraf Mohammad
Published: October 2020

Background: Small bowel cancer (SBC) is rare, however there is recent trend toward increased incidence.Methods: Retrospective evaluation of the clinical presentation, diagnosis, management and clinical outcome of adult patients with primary SBC who were admitted at Sohag University Hospital during 2014-2019.Results: Twenty-one patients with SBC were enrolled (14 males and 7 females) with median age of 56 (range 32-83) years. Small bowel mass was identified preoperatively in 13 patients (62%). Thirteen patients (62%) presented with abdominal emergencies after failure of prompt diagnosis of non-specific abdominal pain of variable durations (median: 4, range: 2-11 weeks). Apart from duodenal tumors, histopathological diagnosis for jejunal and ileal tumors was not achieved preoperatively. Tumor types were gastrointestinal stromal tumors, GISTs (9, 43%), lymphoma (8, 38%) and adenocarcinoma (4, 19%). Patients with jejunal and ileal masses were managed by resection and primary anastomosis. Duodenal tumors required local resection in 2 and pancreatico-duodenectomy in 4 patients. Increased risk of aggressive behavior in GISTs, advanced stage and incomplete resection in lymphomas and adenocarcinomas were associated with higher recurrence rates and diminished survival. Follow-up ranged from 5 to 48 months, with survival rate of 76% (16 patients alive).Conclusions: The diagnosis of SBC is difficult and delayed. Appropriate surgical management, even during emergency, could achieve prolonged survival.
Histopathological pattern of thyroid diseases and its correlation with post-thyroidectomy hypocalcemia: a prospective study in iodine-sufficient Southern India
Authors: Karunakaran Poongkodi , Devadas Geetha
Published: October 2020

Background: Increasing incidence of thyroid diseases requiring surgery and postoperative hypocalcemia after total thyroidectomy (TT) remains a concern. This prospective study evaluated the correlation between the histopathologic pattern of thyroid disease and the development of temporary and permanent hypocalcemia (>6 month) post-TT.Methods: Demographics and clinical profile of consecutive patients undergoing TT were documented. The final diagnosis was confirmed with histopathological examination (HPE) of thyroidectomy specimen. Serum corrected-calcium and intact parathormone was measured at baseline, 48-hour and 6-month post-TT.Results: Out of 328 subjects (mean age=35.5 year; M:F=65:263), 33.4% (n=109) and 7.6% (n=26) developed temporary and permanent hypocalcemia [calcium=8 mg/dl] post-TT. HPE comprised colloid goitre 33.2% (n=109), follicular adenoma 1.8% (n=6), Hashimoto’s/lymphocytic thyroiditis 16.8% (n=55), Graves’ disease 14% (n=46), adenomatous hyperplasia 19.8% (n=65), papillary thyroid carcinoma (PTC) 13.4% (n=44), follicular carcinoma 0.3% (n=1), medullary carcinoma 0.3% (n=1) and anaplastic carcinoma 0.3% (n=1). Multinomial regression analysis revealed that temporary hypocalcemia was associated with graves’ disease (Odds ratio: 11.6), PTC (10.3), follicular adenoma (16.7) and thyroiditis (17.5), while permanent hypocalcemia was associated only with thyroiditis (3.2), each p<0.01.Conclusions: Graves’ disease, thyroiditis and malignancy increased the risk of temporary post-thyroidectomy hypocalcemia by many-fold. Subjects with thyroiditis had 3.2-fold increased likelihood for developing permanent hypocalcemia. Hence thyroiditis, a benign pathology warrants high threshold for surgery with meticulous intraoperative dissection and in-situ preservation of parathyroid glands.
Pelvic exenteration for locally advanced and local recurrent primary rectal cancer: a 5 years Asian retrospective cohort study and lessons to learn
Authors: Leow Yeen Chin , Henry Fitjerald , Lee Fei Yee
Published: October 2020

Background: Locally advanced rectal cancer (LARC) and local recurrent rectal cancer (LRRC) were deemed incurable, but with surgical advancement, pelvic exenteration has emerged as a curative option. Although colorectal cancer cases are common, pelvic exenterations are limited to several centres in Malaysia. The study aimed to determine the outcomes of pelvic exenteration from the centre in terms of complete resection, local recurrence rate, mortality rate and complications rate.Methods: Retrospective data collection was done for pelvic exenteration surgeries of LARC and LRRC from year 2014 till 2018 in a Malaysian tertiary referral centre. Demographic data, types of pelvic exenteration, postoperative complications, postoperative histopathology for complete resection (R0) and local recurrence were collected from the hospital medical records.Results: From 2014 till 2018, 51 cases of pelvic exenteration were done, with a mean age of 55.8±12.4 years and predominance of male gender (55%). Thirty-four cases (66.7%) completed the exenteration. A mere 24 cases (47.1%) had complete preoperative imaging of computed tomography (CT scan), pelvic magnetic resonance imaging (MRI) and positron emission tomography-computed tomography (PET/CT) scan. R0 resection was achieved in 23 cases (67.6%). Complications were found in 44.8% of patients including anastomotic leak, collection, surgical site infection or cardiac/lung complications. The 30-days postoperative mortality rate is 3.9%. The six-months local recurrence rate was 5.8% and one-year local recurrence rate was 7.8%.Conclusion: Pelvic MRI and PET-CT scan is suggested to be compulsory for all pelvic exenteration candidates to ensure a good outcome. Multidisciplinary team approach is needed preoperatively to discuss the feasibility of pelvic exenteration to optimise the outcomes of this surgery.
Small bowel malignant tumor: a diagnostic dilemma, a case report and literature review
Authors: Makhdoomi Mahmood A. , Almotlaq Abdulaziz , Tawfiq Nader A.
Published: October 2020

A 47 years old Saudi male was admitted to king Khalid hospital with complaints of constipation and abdominal distension. Abdominal examination showed as a case of intestinal obstruction. He was fully evaluated and was treated first conservatively, until all investigative study confirmed as huge small bowel dilatation (mainly jejunum). Exploratory laparotomy confirmed small bowel tumor and on histology an adenocarcinoma. The introduction, history and research paper will also be discussed in this report.
A rare cause of mechanical obstruction: case report of cryptoorchidsm in adult
Authors: Hamdi Nik Hafinni Nik , Raj Kishen , Khairy Azuddin Mohd
Published: October 2020

Small bowel obstruction is common complication following abdominal surgery and other causes. However, cryptorchidism leading to intestinal obstruction with no previous abdominal surgery is extremely rare. We report a case of 22 year old man presented with small bowel intestinal obstruction due to cryptorchidism. Mechanical obstruction due to cryptorchidism were either from direct adhesion to gut loops or internal herniation or as complication of malignant transformation (torsion, mass effect, rupture or haemorrhage). It is important to keep in mind that undescended intra-abdominal testes may lead to acute life-threatening complication which should be considered in patient presented with acute abdomen and an empty scrotum. It is important to keep in mind that undescended intra-abdominal testes may lead to acute life-threatening complication which should be considered in patient presented with acute abdomen and an empty scrotum.
Spontaneous rupture of the pancreatic pseudocyst into the duodenum with massive upper gastrointestinal bleeding: case report and literature review
Authors: Sedik Alaa , Touheria Meriem , Fathi Ahmed , Ilyas Uzair , Wahdan Ahmed , Zarraouq Abdullah , Haraga Abdelhamid
Published: October 2020

Pancreatic pseudocyst is one of the common complications of both acute and chronic pancreatitis. While most pseudocysts resolve spontaneously with conservative treatment, larger pseudocysts are more likely to cause complications, such as, spontaneous rupture into the gastrointestinal tract and are usually associated with life-threatening bleeding, which is life threatening complication. Endoscopic or surgical drainage may be necessary for uncomplicated persistent large cysts. We present a case of 32 year old Indian male, admitted to our department, who was a known case of alcoholic acute pancreatitis treated conservatively and developed massive upper GI bleeding and shock. CT angiography and upper GI endoscopy failed so he was taken to theatre several time due to bleeding, recurrent bleeding and a major bile leak. Unfortunately, he was expired. Current study highlights this serious rare life-threatening complication.
A mega gallbladder removed by laparoscopic cholecystectomy: a case report
Authors: Bastidas Alexandra , Cuevas Liliana
Published: October 2020

Report the case of a giant gallbladder secondary to chronic cholecystitis treated with laparoscopic cholecystectomy with no complications. The patient was a 79-year-old woman who attended the emergency department because of a long-standing abdominal pain in the right hypochondrium exacerbated in the last 2 months. Physical exam revealed fever and a sensible mass in the right flank, laboratory tests shown leucocytosis, a mild indirect hyperbilirubinemia and elevated alkaline phosphatase. Images revealed an importantly distended gallbladder with sludge, stones and hydrops associated. Antibiotic therapy was started. She ultimately underwent laparoscopic cholecystectomy. A pathological examination evidenced cholelithiasis, acute and chronic cholecystitis. Only a few cases of surgical treatment of mega gallbladders are found in the literature. It is important to recognize them in the preoperative period for an adequate surgical planning. A laparoscopic approach was successful in our case.
A case of accidentally triggered shotgun injury in a hunter
Authors: Murugesan Ravi Kumar Sabu , Ross Kannan , Prabakar Joyce
Published: October 2020

The shotgun is used for bird hunting in rural areas of India. Its accuracy is usually 30 metres. Accidental injuries due to shotgun pellets are not very common. Shotgun has the tendency to disperse into pellets after hitting an object tangentially or after travelling a certain distance. These pellets are made of lead but steel, tungsten and bismuth pellets are also used.  There is no consensus in terms of removing or retaining foreign bodies such as the pellets. These pellets can travel to distant organs that are difficult to access by surgery. As a result surgical intervention in such patients can produce more harm than good. But leaving the pellets can lead to long term side effects like lead poisoning. In this report, we present a 32 years old male who suffered accidental shotgun injury from close range inspite of which the pellets got dispersed all over his body.
Case report of a rare isolated cysticercosis of the inguinal region
Authors: Suresh Sridhar
Published: October 2020

Cysticercosis, an infection with larval form of pork tape worm, Taenia solium, commonly presents with multiple muscular cysts or CNS involvement. Due to vague clinical presentation and unfamiliarity of clinicians with this entity, it is difficult to diagnose which seen as an isolated cyst. In this article presented a case of solitary inguinal region swelling in an 8-year-old boy which after diagnosis proved to be a solitary cysticercosis in the inguinal region which is very rare occurrence.
Intestinal liposarcoma: an unusual cause for peritonitis
Authors: Gowthaman Siddartha , Manickam Ramanathan
Published: October 2020

Liposarcoma is the commonest type of soft tissue sarcomas which can occur in any part of the body, most commonly involving the limbs and retroperitoneum but it rarely involves small bowel. Only very few cases had been reported of liposarcoma involving small intestine in the past. The clinical presentations of this type of tumour arising from small bowel are nonspecific mostly during the initial stages of the disease and because of this the disease is often diagnosed at advanced stage. We report a very rare case of primary small bowel liposarcoma of ileum which had spontaneously perforated leading to peritonitis in an elderly female who underwent laparotomy, the tumour mass is resected with adequate margins and primary bowel anastomosis was done. The patient was followed up for a year with no complication. Although the liposarcomas occurring in the gastrointestinal tract leading to intestinal perforation is extremely rare. This unique case represents an important learning point for all clinicians and pathologists.
Double magnets causing double perforations-a case report
Authors: Inugala Anusiri
Published: October 2020

Magnets are unusual gastrointestinal foreign bodies. Ingestion of multiple magnets may lead to serious complications including bowel perforation. Presenting the case of an 11-year-old girl who ingested 2 singing magnets. The patient presented with a history of pain abdomen and bilious vomiting and constipation of one day duration, 20 days after ingestion of the magnets. On examination there was distension of abdomen and severe tenderness all over the abdomen along with rigidity. Abdominal radiograph showed the presence of foreign bodies in the abdomen. In view of features of peritonitis, the patient was taken up for an exploratory laparotomy. Intraoperatively two perforations were found, one in the jejunum and the other in the ileum. The perforations were caused due to the pressure necrosis caused by the presence of magnets in different loops of the bowel. The perforations were closed. Post-operative period was uneventful. In conclusion, it is important to be aware of the problems that can be caused in cases of multiple magnet ingestion and to intervene at the earliest to prevent further complications.
Pneumomediastinum with COVID-19: a natural process or complication? A literature review
Authors: Kanani Elmutaz
Published: October 2020

COVID-19 pneumonia is a serious respiratory viral infection that recently spread all over the world. It carries a significant mortality risk. Little is known about the pathophysiology of the disease, being a newly mutated virus. Knowledge of the clinical disease manifestations kept evolving as unfamiliar findings and presentations are constantly reported. Pneumomediastinum had been frequently reported since the start of the pandemic, and its significance was questioned. The aim of this review is to analyze the reported cases of pneumomediastinum with coronavirus infection to look for its pathophysiology, prognostic value, and best treatment. A systematic literature search was conducted using free text search for pneumomediastinum with COVID-19 case reports and case series. PubMed and Google scholar data bases were searched. Twenty three articles were retrieved. All are case reports and case series, 39 cases of the reported cohort qualified for inclusion into analysis. Chronic respiratory conditions were found in 23% of the patients. There was about five folds risk of developing the condition with oxygen therapy (both through invasive and non-invasive means).  The best diagnostic modality was chest computed tomography scan (74.4%).  Management was conservative in 69%, while pleural drainage was necessary in 23% of the patients. Both treatment strategies were successful with no statistical difference (p value=0.327). It is not yet clear if pneumomediastinum is a pathological disease process or an interventional complication. Interventional and conservative treatment had similar outcomes depending on individual case merits. No prognostic value could be demonstrated.
Evaluation of knowledge and education of physicians to diabetic patients in primary care in Saudi Arabia
Authors: Hassan Khaled M. , Altooarki Eman A. , Alshomali Ahmad A. , Alhejeely Othman A. , Almutairi Mohammed A. , AlHarazi Ghassan K. , Aljawi Fahad W. , Alluqmani Maha F. , Tashkandi Abdulrahman M. , Almohussein Nasser S. , Albishri Abdulrahman T. , Kordi Dania M. , Sharaf Rodinah M. , Alzahrani Rami F. , Alzaher Ghadeer N. , Barakat Rayan A.
Published: October 2020

Background: Effective treatment of diabetes is not enough alone, there must be education and training from physicians and nurses to patients. To achieve education in correct manner there must be enough knowledge of physicians to apply care and teaching of these patients. The aim of the study was to evaluate the knowledge and education of physicians to diabetic patients in primary care in Saudi Arabia.Methods: Successive evaluation investigation through questionnaire. The work universe was made up of the 83 service areas of the 15 municipalities of Saudi Arabia, the sample of the total of the incorporated areas was initially made up of 625 health providers and 2,171 people with diabetes.Results: At the beginning of the study, the highest percentage of health providers surveyed declared that they did not know (78%) or that it was not defined (16.6) who should educate the person with diabetes, while the results at the end of the study show that 32% mentioned the doctor and the nurse and 62.7 the entire team of work (p=0.000) with a more adequate vision on the definition of responsibility for the fulfilment of this task and a generalized knowledge (97.5) of the existence of an education program in d diabetes that was useful for their compliance.Conclusions: Extension of the diabetes education program to Saudi Arabia achieved a significant change in the opinions of health providers on the health problem.
Combined conchal cartilage islet-periosteum and posterior based pedicled flap obliteration: a comparison with unobliterated mastoid cavities
Authors: Das Arindam , Mitra Sandipta , Hazra Sayan , Sengupta Arunabha
Published: October 2020

Background: Aim of the study was to compare the outcomes of a new technique of mastoid cavity obliteration with open mastoid cavity.

Methods: 90 patients diagnosed with chronic otitis media (active squamosal variety) and planned to undergo surgery between 2016-2018 were randomly assigned into two groups of 45 patients. One group underwent canal wall down matoidectomy followed by cavity obliteration with posteriorly based vascularised flap with mastoid cortex periosteum plus conchal cartilage composite graft and the other underwent the same surgery but without any obliteration. The two groups were compared in terms of cavity volume, discharge, epithelisation, wax formation, subjective sensation of vertigo and post-operative air-bone gap at 1 year.

Results: Cavity obliteration in post-canal wall down setting significantly reduced the post-operative cavity volume and need for cavity debridement with better epithelisation, less incidence of discharge, vertigo on caloric stimulation when compared to open cavity. The post-operative air-bone gap in obliterated cavities was better but not statistically significant.

Conclusion: Cavity obliteration has definite advantages over open cavity in terms of healing but no significant differences in long-term audiological outcomes.
Management of ear, nose, and throat out patient department in COVID-19 pandemic, experience: a descriptive study
Authors: Suligavi Shashidhar S. , Saiyad Saif N. , Doddamani Sangappa S. , Patil Mallikarjun , Mathri Archana , V. Divya K.
Published: October 2020

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19) has a predilection for infecting the mucosa of the upper and lower airways. Otolaryngologists and supporting health care workers (HCWs) are particularly at high risk of becoming infected while treating patients as many in-office procedures and Aerosol Generating Medical Procedures (AGMP). Based on a review of the literature and various guidelines, recommendations are made to mitigate the risk to health care workers from becoming infected with SARS-CoV-2 while providing clinical care. During the COVID-19 pandemic, all elective and non-time sensitive Otolaryngology procedures should be deferred to mitigate the risk of transmission of infection to HCWs. Objective of the study was to describe outpatient presentations requiring otolaryngology consultation and provide recommendations for protective measures based on the experience of ENT department in S Nijalingappa Medical College.

Methods: Personal protective equipment (PPE) use and infection control strategies implemented for ENT outpatients in S. N. Medical College, Bagalkot.

Results: After implementation of infection control strategies for outpatient clinics, no health care workers were infected in the ENT OPD.

Conclusion: Otolaryngologists play an indispensable role in the treatment of COVID-19 patients but, due to their work, are at high risk of exposure. Appropriate protective strategies can prevent infection to otolaryngologists.
Correlation between serum electrolyte levels and brain stem evoked response audiometry in chronic renal failure: a pilot study
Authors: Munjal Manish , Singh Karanpreet , Chopra Parth , Munjal Shubham , Chopra Hemant , Mathur Aditi , Grewal Mehtab
Published: October 2020

Background: The effect of electrolyte imbalance on hearing thresholds and its objective manifestation, as delayed latencies or inter-peak intervals in evoked response audiometry is studied.

Methods: The present prospective study was undertaken in a period of one and a half years, to analyze the audiological profile in patients of chronic renal failure and renal allograft recipients. 60 patients were randomly selected from the out- patient and indoor services of nephrology, urology and oto-rhino-laryngology, Dayanand Medical College and Hospital, Ludhiana. Brain stem evoked response audiometry was performed and the latencies were tabulated.  

Results: A significant delay in the absolute latency of wave V was noted in hyponatremic patients of CRF on comparison with patients of CRF having a normal serum Na+ levels. The I-V interpeak interval was also seen to be significantly delayed on comparison. A statistically significant delayed I-III inter-peak latency was also observed in hypernatremic patients in comparison to patients having a serum Na+ level in the normal range. No significance of serum creatinine levels and wave latencies was noted on comparison between the three categories of patients of CRF as categorized by their serum creatinine levels.

Conclusions: There is a definite deterioration of the audiological function in patients of chronic kidney disease, and some reversal of these abnormalities following a successful renal transplantation; indirectly pointing towards uremic milieu being the culprit.
Effect of canal widening (type I tympanoplasty) on hearing sensitivity
Authors: Kumaraswamy Prakash Tumkur , Shambulingegowda Abhilash , Neelanmegarajan Devi
Published: October 2020

Background: Chronic otitis media (COM) is a chronic inflammation of the middle ear cleft that is characterised by discharge from the middle ear through a perforated tympanic membrane for at least 6 weeks. The pattern and degree of hearing loss greatly vary in individuals with COM. Conductive hearing loss is the most common pattern. This could be managed conservatively or surgically. Mastoidectomy and/or tympanoplasty are frequently used management procedures for COM. The study aimed to investigate the efficacy of the type I tympanoplasty through a canal widening procedure on hearing sensitivity.

Methods: Two groups participated in the study. Group I included 25 participants who underwent type I tympanoplasty with canal widening procedure and group II included 25 participants who underwent type I tympanoplasty without canal widening procedure. The audiometric results of pre-operative condition and post-operative condition at 1 month and 3 months were documented for further analysis.  

Results: The mean difference of pre-post (1 month) air conduction threshold was 12.68 dB in group I and 5.5 dB in group II participants. The mean difference of pre-post (3 month) air conduction threshold was 18.86 dB in group I and 8.24 dB in group II participants. There was a significant difference in thresholds that was obtained between the two groups and across conditions.

Conclusions: The study provides clear evidence that Type I tympanoplasty with canal widening procedure provides a better improvement in hearing sensitivity for individuals with COM, where surgical procedure is an indication.
Air bone closure and graft uptake, vis a vis tympanic reconstitution
Authors: Munjal Manish , Mathur Nitin , Chopra Parth , Munjal Shubham , Chopra Hemant , Garg Ayushi , Arora Anurima
Published: October 2020

Background: Tympanoplasty involves reconstitution of the tympano-ossicular system with commonly. fascia of the temporalis muscle, situated in its proximity. The fascia is grafted on the residual tympanic membrane by placing it either over it or below it, after creating a raw surface. The former is the overlay and latter, the underlay technique. In this study on restitution of the ear drum utilizing the overlay and underlay techniques, an exhaustive analysis of the two modalities has been done, taking into consideration various variables individually. The surgical outcome wrt to graft uptake and hearing gain has been compared in "depth" with extensive studies undertaken in India and abroad. The unbiased tabulated comparison of each aspect is unique and would guide future researchers to opt the ideal modality.

Methods: Tympanoplasty was undertaken in chronic safe suppurative otitis media with the underlay and overlay techniques in a study group of 40 patients in this prospective study. The patients were randomly divided into equal groups for either procedure.  

Results: In the cohort of 40 subjects successful graft uptake was observed in 16 (80%) with overlay technique and 17 (85%) with underlay technique. Graft rejection was reported in 4 (20%) and 3 (15%) cases with overlay and underlay techniques respectively. Hearing improvement was 56.25% in 10-20 dB range in Overlay. Whereas, with underlay it was 47.05% in 10-2 dB.

Conclusions: Overlay technique is ideal for anterior and central perforations while underlay for subtotal and posterior perforations. In terms of hearing improvement, the fibrosis during graft uptake makes the results of either technique unpredictable.
Electronystagmographic analysis of peripheral vertigo
Authors: Suresh Abinayaah , Narendran Gitanjali
Published: October 2020

Background: Examination of the vestibulo-ocular reflex is still the investigation of choice for evaluating the vestibular function to rule out peripheral causes. Aim and objectives were to compare the electronystagmographic changes of all peripheral forms of vertigo and to highlight its significance in the diagnosis and management of the same.

Methods: This is a prospective study done after obtaining ethical committee approval in a total of 100 patients attending the ENT OPD at Sri Muthukumaran Medical College Hospital & Research Institute with chief complaints of vertigo. Patients diagnosed with chronic suppurative otitis media, hypertensive patients, h/o seizures, recent cardiac illness or patients on cardiac investigations, psychotic disorders, documented CNS lesions, cervical spondylitis, h/o recent eye/ ear surgery are excluded from this study. ENG analysis includes occulomotor testing, positional testing and caloric stimulation. Evaluation of gait and balance is done followed by maneuver induced vertigo testing (dix hallpike and fistula test) along with PTA. Statistical analysis was done using independent sample t test and chi square test to check the hypothesis using statistical package for social studies SPSS version 17.  

Results: The observations of ENG like spontaneous nystagmus and bi-thermal caloric test responses are represented on a claussens butterfly chart and the corresponding bar codes were obtained.  The inferences for different forms of vertigo were studied.

Conclusions: ENG is now an accepted routine and basic investigation in the management of all patients suffering from equilibrium disorders. Management consists of diagnosing the underlying pathology and treatment of the same.
Larygeotrache oseophageal cleft: a rare entity
Authors: Athawale Hemangi R. , Mane Shivaji B.
Published: October 2020

Larygeotrache oseophageal cleft is a rare anomaly in a newborn presenting with respiratory distress and choking with feeding symptoms identical with oesophageal atresia with or without tracheo-oesophageal fistula .It is an abnormal communication of the larynx and the trachea with the oesophagus occurring during fifth to seventh week of gestation as a result of circoid cartilage failing to fuse dorsally. LTOC varies greatly in anatomical extent and clinical severity; more severe forms in which the some or all of the tracheal cartilaginous rings are incomplete are fatal unless corrected surgically. LTOC occurs in less than 1/10,000 to 1/20,000 live births with slightly male predilection and has a autosomal dominant mode of inheritance. Routine chest X-rays and barium oesophagogram are usually not conclusive but bronchoscopy will delineate anatomy of cleft clearly. We present detailed case report of neonate with respiratory distress and choking on feeding and illustrating maneuvers at endoscopy and subsequent individualized surgical management of child.
Impact of turbinoplasty on over all results of indicated nasal surgeries with or without allergic rhinitis incidence
Authors: Kumar Singh Abhay , Srivastava Mohit , Singh Himani , Singh Harsimrat , Ahmad Waseem
Published: October 2020

Turbinoplasty is a procedure that aims to reduce the size of the inferior turbinate through exuberant bone removal with high mucosal preservation. The procedure is recommended for patients with or without allergic rhinitis and those showing irreversible hypertrophy of inferior turbinates.

To evaluate the efficacy of inferior turbinoplasty for obstructive and non-obstructive symptoms in patients with or without allergic rhinitis.

Prospective study with 57 patients who underwent inferior turbinoplasty. They were evaluated for nasal obstruction, snoring, facial pressure, smell alterations, sneezing, nasal itching and runny nose symptoms, surgery time, and intraoperative bleeding. The last evaluation took place three months after surgery.

Thirty-nine patients with allergic rhinitis and 18 without it were assessed. Ninety days after surgery, 94.7% of patients showed breathing improvement; 89.5% showed moderate or complete improvement in snoring; all patients showed smell improvement; 95.5% experienced complete facial pressure improvement; and 89.7% showed moderate to complete improvement in nasal itching and runny nose symptoms, as well as in sneezing.

The efficacy of inferior turbinoplasty was confirmed not only for obstructive symptoms, but also for non-obstructive symptoms in patients with and without allergic rhinitis.
Clinical study of benign tumours and tumour like lesions of oral cavity
Authors: Satyanarayana Handanakere Shruthi
Published: October 2020

The oral mucosa is constantly under the influence of various internal and external stimuli. It exhibits a range of developmental disorders, irritation, inflammation and neoplastic conditions. The oral cavity is the most common site for various tumours and tumour like lesions. Tumours may be benign or malignant. Various studies have been done for malignant tumours whereas very few studies have been done on benign tumours and tumour like lesions of oral cavity.

93 patients of either sex with oral cavity lesions diagnosed and confirmed histopathologically as benign tumours and tumour like lesions were studied for a period of one year.

48 cases of tumour like lesions like pyogenic granuloma, mucous retention cyst, fibrous epulis and 45 cases of lipoma, hemangioma, irritational fibroma, pleomorphic adenoma and leiomyoma were seen in our study.

Oral lesions are encountered by ENT surgeons, dentists and dermatologists. Hence knowledge of benign tumours and tumour like lesions in terms of incidence, presentation and histopathological features are beneficial for better diagnosis and treatment.
Unusual presentation of laryngotracheal injury due to electric burn
Authors: Gupta Vikasdeep , Salaria Neha , Sharma Naveen , Vandana  , Kaur Gagandeep
Published: October 2020

Laryngeal trauma is exceptionally rare due to the protective effect of the mandible and sternum and the laryngotracheal framework's elastic nature. Trauma to the larynx can be life-threatening and cause not only mortality but longterm upper aerodigestive morbidity.

Here is a case of a 37 year-old male with electric burn of laryngotracheal region.
Real Time Stabilization of Lipschitz Nonlinear Systems with Nonlinear Output
Authors: Thabet Assem , Frej Ghazi Bel Haj , Gasmi Noussaiba , Metoui Brahim
Published: October 2020

This brief discusses a simple stabilization strategy for a class of Lipschitz nonlinear systems based on the transformation of nonlinear function to Linear Parameter Varying system. Due to the introduction of the Differential Mean Value Theorem (DMVT), the dynamic and output nonlinear functions are transformed into Linear Parameter Varying (LPV) functions. This allows to increase the number of decision variables in the constraint to be resolved and, then, get less conservative and more general Linear Matrix Inequality (LMI) conditions. The established sufficient stability conditions are in the form of LMI with the introduction of a cost control to ensure closed-loop stability. Finally, Real Time Implementation (RTI) using a DSP device (ARDUINO UNO R3) to a typical robot is given to illustrate the performances of the proposed method with a comparison to some existing results.
Design of Two-Dimensional Recursive Digital Filter Using Multi Particle Swarm Optimization Algorithm
Authors: Kaddouri Lakhdar , Adamou-Mitiche Amel B.H. , Mitiche Lahcene
Published: October 2020

Particle Swarm Optimization (PSO) is an evolutionary algorithm widely used in optimization problems. It is characterized by a fast convergence, which can lead the algorithm to stagnate in local optima. In the present paper, a new Multi-PSO algorithm for the design of two-dimensional infinite impulse response (IIR) filters is built. It is based on the standard PSO and uses a new initialization strategy. This strategy is relayed to two types of swarms: a principal and auxiliaries. To improve the performance of the algorithm, the search space is divided into several areas, which allows a best covering and leading to a better exploration in each zone separately. This solved the problem of fast convergence in standard PSO. The results obtained demonstrate the effectiveness of the Multi-PSO algorithm in the filter coefficients optimization.
A Novel Approach to Control the Sidelobe Levels in Orthogonal Frequency Division Multiplexing Radar Waveform Design Using Broyden-Fletcher-Goldfarb-Shanno Algorithm
Authors: Gopalkrishna Raghavendra C. , Kumar Harish , Choudapur Manohara
Published: October 2020

Employing orthogonal frequency division multiplexing (OFDM) for radar applications has attracted many researchers in recent days. In OFDM systems the reduction of out-of-band (OOB) radiations is one of the most discussed and researched topics. To successfully design an OFDM based overlay system, it is necessary to reduce the sidelobe levels in OFDM signals. In this paper a novel technique for reducing the sidelobe in OFDM radar signals is projected and examined. Subcarrier weighting technique is the method used to scale down the sidelobe heights by multiplying real valued weighting coefficients with the used subcarriers. In order to obtain optimal subcarrier weights a numerical optimization technique called Broyden-Fletcher-Goldfarb-Shanno (BFGS) is utilized. The proposed scheme applies BFGS method to enhance the performance of OFDM radar signal. The reduction in sidelobe levels thus obtained from the proposed method shows the superiority in functioning (small sidelobe crest and good resolution) shown with extensive simulation results.
A Numerical Study of Fluid Flow in the Porous Structure of Biological Scaffolds
Authors: Daulbayev Ch. , Mansurov Z. , Sultanov F. , Shams M. , Umirzakov A. , Serovajsky S.
Published: October 2020

Tissue engineering (TE) is one of the promising areas that aims to address the global problem of organ and tissue shortages. The successful development of TE, particularly in bone tissue engineering, consists of the use of modern methods that allow the creation of scaffolds, the physicochemical, mechanical, and structural parameters of which will allow achieving the desired clinical results. The vast possibilities of the rapidly developing technology of three-dimensional (3D) printing, which allows the creation of individual scaffolds with high precision, has led to various developments in bone tissue TE. In this work, for the successful use of three-dimensional printing in TE to ensure the diffusion of nutrients during cell cultivation throughout the entire structure of the scaffold, a model of a rotating scaffold is proposed, and the movement of the diffusion flow of nutrient fluid is calculated based on Darcy’s law, which regulates the flow of fluids through porous media. The conducted studies of the rate of diffusion flow of nutrients based on glucose in the porous structure of scaffolds with a 10% content of calcium hydroxyapatite demonstrated the promise of using a model of a rotating composite scaffold in TE of bone tissue. The results show that at a scaffold rotation speed of 12 rpm, the diffusion flow rate of nutrients in the composite scaffolds porous structure is practically not affected by their geometric shape.
Acid Modification of Diatomite-Based Sorbents
Authors: Nurgain A. , Nazhipkyzy M. , Zhaparova A.A. , Issanbekova A.T. , Alfe M. , Musina A.S.
Published: October 2020

In this work, the effect of acid pre-treatment (hydrochloric acid, HCl) and calcination of diatomite, a silicon dioxide-material from natural sources, was studied with the aim to obtain diatomite-based sorbents with specific physicochemical properties. For this, acid pre-treatments with HCl at different calcination conditions, namely HCl concentration (0.5, 1 M) and calcination temperatures (from 600 to 900 °C) were studied. Morphological features different from those of natural diatomite were obtained. It has been found that treatment of diatomite with 0.5 M HCl at 800 °C showed a specific pore volume of 0.008 cm3/g, and a specific surface area of 19.26 m2/g, while the treatment of diatomite with 1.0 M HCl showed a specific pore volume of 0.011cm3/g, and a specific surface area of 25.57 m2/g. The performance of the acid pretreatment of diatomite for adsorption of Pb ions from water was also studied.
Comparative Analysis of Physicochemical Properties of Rutile TiO2
with Hierarchical 3D Architecture Prepared by Liquid Hydrolysis
of TiCl4 and Hydrothermal Method
Authors: Shikina N.V. , Yashnik S.A. , Toktarev A.V. , Ishchenko A.V. , Ushakov V.A. , Mel’gunov M.S. , Mansurov Z.A. , Ismagilov Z.R.
Published: October 2020

TiO2 (rutile) samples with a hierarchical 3D nanostructure of the particles were synthesized by two methods: liquid hydrolysis of TiCl4 at 90 °С and atmospheric pressure; hydrothermal synthesis from TiCl4 at 160 °С and different [H2O]/[Ti] ratios. The effect exerted by conditions of the synthesis and post-treatments on the crystallite size, morphology, electronic properties and pore structure of the rutile samples was investigated. It was shown that severe hydrothermal conditions with the ratio [H2O]/[Ti] = 20 provide the formation of a more perfect crystal structure of rutile with a smaller band gap energy (3.00 eV against 3.06 eV for the rutile obtained by liquid hydrolysis at atmospheric pressure). The study revealed the stabilizing effect of cerium cations on the pore structure of rutile, which changes upon thermal treatment.
Synthesis of Nanomaterials in a Coaxial Flame
Authors: Lesbayev B.Т.
Published: October 2020

The paper presents the results of experimental studies of the synthesis of fullerenes C60 in a coaxial flame of benzene and acetylene at low pressures; of the synthesis of graphene in a coaxial flame of ethanol and propane, benzene, and acetylene; of the soot formation process in the coaxial flame of propane and ethanol. It has been established that the optimum temperature of a coaxial flame for the formation of fullerenes C60 is 970‒1000 °C with the carbon to oxygen ratio in the internal benzene-oxygen flame C/O ≈ 0.9 ÷ 1. The C/O ratio in an external acetylene-oxygen flame was maintained at a stoichiometric ratio. It was found that the preliminary (before feeding into the burner) treatment of the benzene-oxygen mixture using ultraviolet (UV) radiation with a wavelength of 254 nm promotes an increase in the yield of fullerenes. The synthesis conditions were optimized for: 5‒10 layers graphene in a coaxial flame of acetylene and ethanol; graphene containing more than 10 layers in a coaxial flame of propane and ethanol; one and two-layer graphene in a coaxial flame of ethanol and benzene. The possibility of a significant reduction of the formation of soot particles in the diffusion flame of propane by organizing its coaxial combustion with ethanol is shown.
The Flouting Maxim on Twitter Influencers’ Tweets
Authors: Hassani Nibros
Published: October 2020

This study aims to discover the use of maxim principles on the tweets that made by certain of Indonesian social-media influencers which the method is conducted qualitatively. The data is taken from Twitter.com and Twitter App, where the researcher captured the tweets randomly and analyzed it by using maxim relevance principle as the tool of analysis. The result shows vary: most of the conversations were not obeying the maxim of relevance principles, or in other words do not imply maxim of relevance principle. Moreover, the intentions are to make jokes, and to run the conversation smoothly while doing the flouting.Keywords: maxim of relevance, twitter, social media influencer
La experiencia del riesgo de deserción como oportunidad y camino de formación en los estudiantes universitarios
Authors: Barrero Rivera Floralba
Published: October 2020

En este artículo se realiza un acercamiento teórico al concepto de deserción estudiantil universitaria, a partir de las narrativas experienciales del riesgo de deserción estudiantil (que surgen de las vivencias de los estudiantes), las cuales son analizadas y comprendidas desde su significado. Se propone explicar cómo estas narrativas pueden ser analizadas desde la hermenéutica y su dimensión ontológica, subjetiva e intersubjetiva. Lo anterior orienta el camino para convertir los escenarios de riesgo de deserción estudiantil en una propuesta de comprensión personal, que se traduzca en una búsqueda de la equidad educativa desde el desarrollo en lectura y escritura como fundamento de la propia comprensión de la experiencia de riesgo de deserción referenciada en el desarrollo de las potencialidades del estudiante como ser humano.
Multivariate analysis of bathymetry in the evaluation of reservoirs in Serra Talhada, Pernambuco, Brazil
Authors: Bezerra Alan Cézar , Shinozaki-Mendes Renata Akemi , Moura Geber Barbosa de Albuquerque
Published: October 2020

The constant demand for water resources has increased the need for research and adoption of new water use and management practices. In this sense, this work utilizes multivariate cluster analysis to identify the correlation of respective depths of bodies of water in Serra Talhada city, over different periods of rainfall. In order to achieve this, four bathymetric surveys were carried out during one year for three reservoirs within the municipality of Serra Talhada, then cluster analysis and multiple modeling were used to identify the most influential variables on reservoir depth. Based on our results, the multivariate grouping technique can be used to define periods of higher and lower water storage, through bathymetric data, as well as to understand the effects of regional precipitation variability on the water levels of reservoirs. In addition, the generated model indicated a clear influence of the previous month’s precipitation on the bathymetry of the reservoirs.
Seeder-fertilizer performance with two furrowing mechanisms and sowing speed
Authors: Viegas Neto Antonio Luiz , Souza Cristiano Márcio Alves de , Arcoverde Sálvio Napoleão Soares , Lima Junior Izidro dos Santos de , Piletti Lígia Maria Maraschi da Silva
Published: October 2020

The displacement velocity of the tractor-seeder set, associated with the furrowing mechanism, influences the plant distribution and the establishment of a correct plant stand in the field. The objective of this study was to evaluate the operational performance of a seeder-fertilizer in the non-tillage sunflower crop, according to sowing speeds and furrow mechanisms. The experimental design used was the randomized blocks, with treatments arranged in a split-plot scheme, where the plots were the furrowing mechanisms (chisel openers and double disk) and the subplots were the sowing speeds (3.2; 4.6; 6.2 and 7.0km h-1), with three replicates. The following were determined in this study: the emergence speed index, the emergence in the field, the average distance between the plants, plant height, plant population and the longitudinal distribution of plants. Sunflower sowing using a chisel openers provides greater emergence in the field, emergence speed index and, consequently, greater plant population. Sowing speed ranging from 3.2 to 7.0km h-1 do not influence field emergence, emergence speed index, height and population of sunflower plants.
Pig manure in the production of banana seedlings
Authors: Torsian Waleska Silva , Almeida Leandro da Silva , Silva Nara Cristina de Lima , Nascimento Marcely Ferreira , Caron Vanessa Cristina
Published: October 2020

Pig breeding generates waste that, if not handled correctly, can cause serious environmental problems. The application of these residues in the soil appears as a sustainable alternative, since the manure, being rich in organic matter and mineral nutrients, promotes the improvement of the physical, chemical and biological quality of the soil avoiding the contamination of natural resources if it is released in the water or directly on the ground without proper treatment. The objective of this study was to  evaluate the development of banana seedlings fertigated with pig slurry (PS) analyzing its efficiency compared to conventional treatment (chemical). The experiment was carried out in a completely randomized design with six treatments and six replications (3 seedlings per repetition), the doses being defined based on the fertilizer recommendation for the production of banana seedlings and the nutrient in greater concentration in the manure, which, in this case, was nitrogen, considered as the dose limiter. The results showed that PS was efficient in supplying nutrients to the banana seedlings and it can be used as a substitute for chemical fertilizer. The treatment with manure corresponding to 25.0% of the nitrogen recommended to produce banana seedlings provided the greatest development.
Efficient Microorganisms in lettuce cultivation
Authors: Sousa Westefann dos Santos , Pontes José Roberto Verginio de , Melo Osmanny Francisco Pereira de
Published: October 2020

Efficient Microorganisms are shown to be an effective, alternative, sustainable, safe, and low-cost technique to increase the productivity of organic foods, and their use is a good option for agroecological management. Based on this context, this work had as main objective to evaluate the efficiency of the application of a biological cocktail from Efficient Microorganisms in the cultivation of lettuce. In the capture of the Efficient Microorganisms and the manufacture of the biological cocktail, a methodology proposal in the agroecology used by Brazilian Ministry of Agriculture, Cattle and Supplying (MAPA, in Portuguese, Ministério da Agricultura, Pecuária e Abastecimento). The adopted experimental design was randomized blocks containing 8 blocks and 3 treatments. The T1 treatment, application of the Efficient Microorganisms, obtained a greater fresh mass of the aerial part of the plants sampled in the two cycles, resulting in a higher productivity in tons/hectare. The results proved to be advantageous for the productivity of the lettuce that received application of the biological cocktail from Efficient Microorganisms, when the biomass parameters were analyzed.