bluuebunny/crossref_metadata_2025 huggingface dataset:
Study of negative pressure wound therapy in management of abdominal wound dehiscence
Authors: Tirpude Bhupesh , Borkar Mrinalini M. , Lokhande Nilesh N.
Published: June 2020

Background: Postlaparotomy Abdominal wound dehiscence (AWD) occurs in 0.25% to3%. Many technique are being used to manage AWD like surgical revision with open dressing/closed irrigation, temporary covering with ‘Bagota bag’, saline soak gause dressing, absorbable/permanent mesh. Negative-pressure wound therapy (NPWT) is a recent modality of treatment of wound. It involves controlled application of sub atmospheric pressure to local wound environment, using sealed wound dressing connected to vacuum pump. This study aimed at finding the effectiveness of negative pressure wound therapy in management of abdominal wound dehiscence over conventional methods of wound management.Methods: This was hospital based non randomised comparative prospective interventional study carried between July 2017 to November 2019, includes all patients admitted in GMCH, Nagpur Hospital having post laparotomy AWD, excluding the patients having enter ocutaneous fistula and patient not giving consent for VAC application. Total n=60 cases were included in study. Out of 60, 30 were taken as cases in whom intervention was done by applying vaccum assisted closure (VAC) therapy and 30 were control.Results: All 60 patients had undergone laparotomy of this patients 30 patients was applied NPWT and efficacy plotted on the parameter of, wound sepsis, wound contraction, length of hospital stay and extension of time therapy. It was found that 90% patients had negative c/s post VAC dressing, compared to 26% in post ns dressing, there was MWC of 0.86 cm in post VAC patients compared to 0.14 cm in post NS dressing, MHS was 18.9 days in cases and was 28 days in controls,13 patients had complete fascial closure in cases whereas none in controls.Conclusions: NPWT significantly reduces the hospital stay of patients, it causes faster and higher degree of wound contraction, reduces wound sepsis thereby reducing morbidity of patients.
Laparoscopic versus open appendectomy in children with complicated appendicitis in a tertiary teaching hospital
Authors: Sreekantamurthy Pramod , Chinmayee Bhavana , . Sharath
Published: June 2020

Background: Acute appendicitis in children is the most common surgical emergency. Good outcomes have been reported with laparoscopic appendectomy (LA) in children for uncomplicated appendicitis. But the use of laparoscopy for complicated appendicitis in children is more controversial. Higher incidences of postoperative abdominal and wound infections have been reported. The purpose of this study was to retrospectively compare LA and open appendectomy (OA) for complicated appendicitis in children.Methods: The outcome of 73 patients with complicated appendicitis was retrospectively analyzed. There were 36 children in the LA group and 37 in the OA group. Data collection included demographics, duration of symptoms, type of complicated appendicitis, operative time, resumption of diet, early and late complication, length of hospitalization and duration of antibiotic use.Results: No significant difference was found with respect to age, duration of symptoms and total leucocyte count between two groups.  The operative time for LA (55.83±4.81 minutes for LA versus 67.16±4.27 minutes for OA; p=0.0001) was shorter. Patients in the LA group returned to oral intake earlier (2.83±0.31 days for LA versus 3.84±0.33 days for OA; p=0.001) and had a shorter length of hospital stay (5.11±0.55 days for LA versus 7.92±1.06 days for OA; p=0.0001).  The incidence of wound infection in group LA was 5.5% compared to 18.9% in OA group.Conclusions: The laparoscopic technique for complicated appendicitis in children is feasible, safe. Laparoscopic appendectomy should be the initial procedure of choice for most cases of complicated appendicitis in children.
Role of seton versus conventional techniques in the management of anorectal fistulas
Authors: Akhtar Mohammad Sadik , Alim Sheikh Saif , Raza Mohammad Habib , Ali Wasif Mohammad
Published: June 2020

Background: This study was conducted to compare the use of different setons with conventional management like fistulotomy and fistulectomy in terms of healing (after 1 and 3 months), recurrence and incontinence.Methods: This was a retrospective non-randomized study conducted at JNMCH, Aligarh from January 2018 to June 2019. Patients included- patients (males and females) of age group 18-70 years, patients giving consent. Patients excluded- fistula secondary to- Crohn’s disease, tuberculosis, malignancy, recurrent fistula, pregnant females, immuno-suppressed patients.Results: After 1 month, 17 out of 24 patients (70.8%) of fistulotomy, 48 out of 68 patients (70.6%) of seton group and 21 out of 32 patients (65.6%) of fistulectomy group had their wounds healed (p=0.8693). After 3 months, 19 out of 24 (79.2%) patients of fistulotomy, 61 out of 68 (89.7%) of seton, and 24 out of 32 patients (75%) with fistulectomy had their wound healed (p=0.1374). Recurrence was observed in 5 out of 24 patients of fistulotomy, 10 out of 68 patients of seton use and 5 out of 32 patients with fistulectomy (p=0.7788). 6 out of 24 patients (25%) had incontinence after fistulotomy, 7 out of 68 (10.3%) of seton group and 8 out of 24 (25%) after fistulectomy (p=0.0944). Healing was higher in patients of non-cutting setons as compared to cutting seton (p=0.0252). After 3 months, no difference was observed (p=0.1245). Recurrence higher in cutting setons as compared to non-cutting setons (p=0.0187).Conclusions: Setons are safe, low-cost, less invasive, precise, and cost-effective option for treating simple and complex fistula-in-ano.
Prevalence of surgical site infections and their sensitivity patterns in elective abdominal surgeries in King George Hospital, Visakhapatnam
Authors: Ramani Pratha Anantha , Kiran Simhadri Uday , Deevi Murali Manohar , Reddy Ginni Vijay Sainath , Saichand Ginjupalli , Yeeli Sivaram Shashank , Reddy Potireddy Yaswanth
Published: June 2020

Background: Surgical site infections are one of the most common complications in the postoperative period leading to increased morbidity, prolonged hospital stay and reduced quality of life. The present study aims to identify the incidence of surgical site infection (SSI), risk factors, causative organisms, and their sensitivity patterns in patients who have undergone elective abdominal surgeries.Methods: A prospective study containing 200 patients who have undergone elective abdominal surgeries from May 2018 to January 2020 were evaluated. A thorough history was taken in all the patients. A detailed clinical examination and routine investigations were done. Parameters such as body mass index (BMI), diabetic status, type of surgery, wound grading, culture, and sensitivity patterns were considered. The patients underwent treatment based on their investigatory reports.Results: In the present study, 54 patients developed surgical site infection, and among them, 22 are diabetics. Only ten patients with normal BMI developed SSI, whereas the other 44 patients who developed SSI had abnormal BMI. The incidence of SSI was higher in clean-contaminated surgeries comprising up to 89% of cases. Staphylococcus aureus was the most commonly isolated organism, and cefoperazone plus sulbactam was the most sensitive on antibiogram.Conclusions: The surgical site infections are on rising trend due to the emergence of antibiotic-resistant microorganisms. Treatment of the underlying risk factors, regular wound dressings, and antibiotics, according to sensitivity patterns, are the mainstay.
Neutrophil-lymphocyte and hematocrit scoring in acute pancreatitis as an early predictor of severity and outcome
Authors: R. Satish Kumar , A. Sharath , K. Prajwal R. , K. Supreeth
Published: June 2020

Background: The management of acute pancreatitis (AP) is determined by an accurate assessment of severity of disease. Numerous severity indicators have been described till date, most of which require reassessment after admission and resuscitation. Authors propose a novel indicator, the neutrophil-lymphocyte and hematocrit (NLH) scoring as a predictor of acute pancreatitis at the initial time of diagnosis. NLH may have a role in predicting the length of hospital stay and intensive care unit admission and also to predict adverse manifestations of severe acute pancreatitis (SAP).Methods: A retrospective analysis of 107 patients done who diagnosed with acute pancreatitis based on Atlanta 2012 definitions, who were admitted and treated between August 2018 and November 2019. NLH score calculated by adding NLR (neutrophil lymphocyte ratio) and Ht (hematocrit) i.e., NLH=NLR+Ht. NLH was also compared with APACHE II score as a standard predictor of prognosis in acute pancreatitis.Results: Median NLH score among the severe group is significantly higher compared to mild and moderate group. NLH score significantly correlated with length of hospital stay and also had a statistically significant correlation with ICU stay. NLH scoring is comparable with APACHE II scoring system in predicting prognosis in acute pancreatitis.Conclusions: NLH score can be used as a predictor of severity of acute pancreatitis, right at the time of initial diagnosis. Further it may predict adverse outcomes, need for ICU care as well as the length of hospital stay. NLH score can be used as a tool to refer at risk patients to tertiary center needing ICU admission.
Functional and radiological assessment of displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured locking compression plates
Authors: Kakkar Rohil Singh , Mehta Deepak , Sisodia Ankit
Published: June 2020

Background: Fractures of the clavicle constitute approximately 2.6% of all the fractures and nearly 44-66% of fractures around shoulder.Methods: This particular study is intended to assess the functional and radiological outcomes in a series of 32 patients with closed displaced midshaft clavicle fractures treated through open reduction and internal fixation surgery using pre-contoured clavicle locking compression plates.Results: All 32 patients achieved fracture union within 6 months follow up period. As per Constant-Murley scoring, 56.25% cases had excellent results, 34.37% cases had good, 6.25% cases had fair and 3.12% of the cases had poor results respectively.Conclusions: Open reduction and internal fixation surgery with pre-contoured locking compression plates in the displaced midshaft clavicle fractures restores the anatomy, biomechanics and contact loading characteristics of the clavicle and significantly reduces the incidence of non-union with improved functional outcomes resulting in better patient satisfaction.
A clinical study on reconstruction of small and medium sized defects of tendo Achilles and heel regions with fascio cutaneous flaps
Authors: Gopalakrishnan Ravikumar , Rajalingam Manoharan , Rajagunasekaran Balamuralee , Esakimuthu Ramya
Published: June 2020

Background: Soft tissue defects of tendo Achillis and heel regions are difficult to reconstruct because of less vascularity and limited mobility of the skin. Most of these defects result from trauma, infection and excision of malignancy. Well vascularized tissues with sensation are needed to cover these defects as these regions are more prone for repeated friction and weight bearing. Aim was to study the versatility and applications of various flaps in the reconstruction of soft tissue defects of tendo Achillis and heel regionsMethods: This retrospective study was conducted in the Department of Plastic and Reconstructive Surgery, Thanjavur Medical College, Tamil Nadu, India from 2015-2019. About 22 patients with soft tissue defects of tendo Achillis and heel regions were studied. The aetiology of the defect, size of the defect and the outcome of treatment with various flaps were evaluated.Results: Of the 22 patients 20 patients were males and 2 patients were females. The age group ranged from 12 years to 68 years. Most of the defects were due to road traffic accidents. The soft tissue defects were classified into small, medium and large sized defects based on the area of the defects. Reverse sural artery flap extended lateral calcaneal artery flap, posterior tibial artery perforator flap and lateral supra malleolar flap were the various flaps used to cover these defects.Conclusions: Fascio cutaneous flaps play a major role in the reconstruction of tendo Achillis exposed defects and heel defects. Long term follow-up with physiotherapy is essential to achieve excellent function of tendo Achillis.
Study of the association of serum procalcitonin with leukocytosis in predicting complicated acute appendicitis
Authors: Patel Thana Ram , Jain Amit , Agarwal Lakshman , Choudhary Vakta Ram , Bijarniya Dinesh
Published: June 2020

Background: Delay in the diagnosis of complicated appendicitis and its treatment results in an increased rate of postoperative morbidity, mortality and hospital stay. The diagnosis of appendicitis rests on a combination of signs of inflammation such as fever, pain and tenderness; leukocytosis, and elevated C-reactive protein levels, interleukin-6 (IL6) and procalcitonin. Raised level of serum procalcitonin in bacterial infection has been used to further improve the diagnosis of complicated AA.Methods: One-hundred ten patients of appendicitis confirmed by intra-operative findings and final pathologist report, who underwent appendectomy consisting 25 women (22.73%) and 85 men (77.27%) with a mean age of 25 years (age range 15-55 years) were included in this study. Serum procalcitonin value was measured by chemi E411 Cobas method (chemilumiscent immunoassay system) using the B.R.A.H.M.S PCT kit. Serum PCT level >0.5 ng/ml was consider as risk for progression to severe systemic disease.Results: At a 0.5 ng/dl cut-off value of PCT, the sensitivity and specificity of PCT level measurement for acute complicated appendicitis prediction was 90% and 97.14% respectively. Association between WBC count and PCT value shows the sensitivity and specificity in 40 case of acute complicated appendicitis prediction was 86% and 75% respectively.Conclusions: Both the higher PCT values and leukocytosis correlates well with  infectious post-operative complications for acute appendicitis and it can help to carry out timely surgical intervention which is highly recommended in complicated appendicitis(correlates PCT >0.5 ng/dl).
A clinical study to evaluate platelet count and serum albumin as independent prognostic factors in predicting the outcome in burn patients in a tertiary care hospital
Authors: Balachandran Kavitha Jayanthi , Mohammed Serbin
Published: June 2020

Background: Burns can affect the population of all age groups and regions. There has been a reduction in the mortality and morbidity of burn patients due to improvements in standards of medical care. Several laboratory values were proposed to indicate the prognosis of burns patients. Of these, the oldest is abbreviated burn severity index (ABSI), which includes variables such as sex, age, total burned body surface area (BSA), full-thickness injuries, and burns attributable to inhalation. Later the acute physiology and chronic health evaluation (APACHE) II and APACHE III scales which incorporates biochemical markers to improve predictive power evolved.Methods: In this study, in a tertiary care government institution, we attempt to assess platelet count and serum albumin independently in the prognosis of burns patient, in a background of sepsis.Results: For analysis, patients were divided into two groups- survivors and non-survivors as sepsis development and mortality was observed. There was a progressive decline in the platelet count in non-survivors, while the initial fall improved in those who survived. There was only a marginal difference between the two groups in serum albumin levels.Conclusions: A serial fall in platelet count is a predictor of sepsis and mortality in burn patients. It is an indicator of bone marrow depression and correlation with leucocyte count needs to be evaluated. In those patients where the initial fall in platelet count improved, survival rates were high. As a biochemical marker, serum albumin was not a reliable marker in predicting sepsis and mortality.
A comparative clinicopathological study between ultrasonography, mammography, fine needle aspiration cytology and core needle biopsy of breast lump
Authors: Mandal Arnab , Jana Pradipta , Bakshi Sabyasachi , Mandal Ram Krishna
Published: June 2020

Background: Early presentation and prompt diagnosis is the essential key in treatment of different variety of neoplastic as well as non-neoplastic breast disease. In this study usefulness of high-resolution ultrasonography (HRUSG), mammography, fine needle aspiration cytology (FNAC) and core needle biopsy in correlation with histopathological pattern, was assessed.Methods: After matching the criteria, 212 cases, were taken for this prospective, single center, observational study.Results: Out of 212 cases, 163 (76.88%) were benign lesions, 49 (23.11%) were malignant and 1 (0.47%) were of inflammatory pathology. Benign to malignant breast disease ratio was 3.3:1. Out of 49 malignant cases, 45 (91.83%) were ductal cell carcinoma and 4 (8.16%) was apocrine carcinoma. Maximum numbers of cancer patients were found in the 51-60-year age groups. The sensitivity, specificity, positive predictive value and negative predictive value of mammography in detecting carcinoma breast were 87.76%, 64.71%, 87.76% and 64.71% respectively. The sensitivity, specificity, positive predictive value and negative predictive value of HRUSG in detecting carcinoma breast were 85.71%, 90.18%, 72.41% and 95.45% respectively. Among benign lesions, 47 (28.83%) were diagnosed by mammography and 147 (90.18%) were diagnosed by HRUSG. When these modalities were combined, >95% of the lesions was diagnosed accurately.Conclusions: Ultra sound used liberally as an adjunct to mammography, increase the cancer detection rate. Core needle biopsy is found more accurate but FNAC have limited value in evaluation of benign breast lump. This study also proves that preoperative categorization of breast lesions is utmost important for management of the patient and this will help to avoid unnecessary surgical treatment.
Studying the impact of the cost-effective Suvidha off-loading dressing in healing neuropathic ulcers in diabetic foot: a case series of 83 cases from South India
Authors: Bhat Sunay N. , Vinoth D.
Published: June 2020

Neuropathic ulcers pose a global burden carrying a risk of amputation of 15-46 times especially in developing countries. These ulcers are mainly managed with offloading techniques. In this study we share our experience of using an easy to use, cost effective method the Suvidha offloading dressings in terms of its acceptability and effectiveness in managing these cases. A prospective case series of 83 patients with mean age 58 years, managed with Suvidha offloading dressing in our institution from 2016 till 2019, excluding patients with ABI less than 0.4 and Wagner 4 and 5. They were reviewed after 6 months/SOS. Ulcer measured 1×1 to 4×4 cm, was present most commonly in the mid foot and least commonly in the lateral aspect of the foot. 53 cases were Wagner grade 2 and 9 cases Wagner grade 3. Forty cases were initially infected, 29 cases had a deformed foot, 5 cases needed interval wound debridement. The duration of ulcer healing was 2 weeks for 1×1 cm great toe ulcer, to 12 weeks for the 4×4 cm mid foot ulcer. All 83 patients were followed up for 6 months. 5 ulcers recurred. The patient satisfaction was measured by a 5-points Likert scale with a mean value of 17.4 out of 20. The Suvidha offloading footwear is a cost effective, easily replicable and efficient dressing requiring only the readily available dressing materials, with good healing rates, good patient satisfaction and adapted for developing countries. The results are comparable with other methods of offloading practiced worldwide.
You are not yourself when you are hungry: a rare case of malignant insulinoma
Authors: Amaral Maria Joao , Alexandrino Henrique , Meireles Daniela , Oliveira Rui Caetano , Serodio Marco , Tralhao Jose Guilherme
Published: June 2020

We present a rare case of high-grade functional neuroendocrine carcinoma of the pancreas secreting insulin. Our patient, an 80 years old woman, presented with neuropsychiatric symptoms consistent with hypoglycaemia that regressed with food intake and dextrose administration. Abdominal imaging showed a pancreatic tumour with invasion of the spleen and lymph node metastasis, highly suggestive of an insulinoma as the cause of the hypoglycaemia. The patient underwent left pancreatectomy with splenectomy and atypical gastric resection. The postoperative course of our patient was uneventful, with complete remission of the hypoglycaemic episodes, and the definitive histological examination showed three poorly differentiated large cell neuroendocrine carcinomas of the pancreas.
Torsion of caecal appendices epiploicae: mimicking acute appendicitis
Authors: Roshini A. P. , Samant Dattaprasad , Noronha F. P.
Published: June 2020

Acute appendicitis is a common cause for pain in the right iliac fossa, which requires urgent surgical intervention. However, at the time of surgery, if the appendix is normal, the surgeon has to search for other causes of acute abdominal pain including rare etiologies, such as torsion of appendices epiploicae and subsequently its gangrene. We report the case of a 45 years old female who presented with right lower abdominal pain, rebound tenderness and guarding in right iliac fosse, with regular menstrual cycles and no urinary complaints. Investigation revealed leucocytosis and ultra-sonography abdomen was suggestive of an inflamed appendix in the right iliac fossa with free fluid. Intra-operatively, we found a normal appendix with gangrene of the appendices epiploicae which had undergone torsion. She underwent excision off appendices epiploicae with appendicectomy with uneventful post-operative period. Histopathology of the appendices was suggestive of congestion.  Preoperative diagnosis of this condition is rarely made.
Large non-functional adrenocortical oncocytoma with uncertain malignant potential: case report and review of literature
Authors: Yadav Praveen Kumar , Hasan Arshad , Singh Anunay , Kundu Gaurab , Haque M. Faizul , Swain Samir , Hota Datteswar
Published: June 2020

Adrenocortical oncocytomas are a very rare group of adrenal tumors. Unless functional, these tumors are incidentally diagnosed for clinical manifestations that are unrelated to the adrenal gland. The majority of these oncocytomas are benign and nonfunctional. Very few cases of uncertain malignant potential are reported. Here we present such a rare case of a 60 years old man presenting with voiding lower urinary tract symptoms but on contrast enhanced computed tomography (CECT) abdomen and pelvis a fairly large well defined heterogeneously enhancing retroperitoneal mass lesion with calcifications in the left anterior pararenal space (measuring 10.8×9.7×9 cm) was detected. On excision a well encapsulated solid mass of size approximately 12×10×9 cm was present in left suprarenal region. Histopathological examination confirmed the diagnosis of adrenocortical oncocytoma with uncertain malignant potential. As the incidence of adrenal oncocytoma is less, the knowledge regarding its clinical pattern, confirmatory imaging or histopathological diagnostic tools and chances of recurrence or turning malignant is limited.
A case of recurrent porocarcinoma of the scalp requiring scalp reconstruction
Authors: Puri Gopal , Kataria Kamal , Ranjan Piyush , Dhar Anita , Srivastava Anurag
Published: June 2020

Eccrine porocarcinoma (EPC) is a rare malignant tumour, first reported by Pinkus and Mehregan in 1963. It can develop from the eccrine duct epithelial component or transform from an underlying eccrine poroma. The tumor usually presents as an exophytic growth and has a female predilection. Rarely it can occur in scalp, face, ear, genitalia and eye lids. Treatment modalities have included standard excision, Mohs micrographic surgery, chemotherapy, and radiation therapy. Therapy of choice is surgical excision with clear margins with 70-80% cure rates. Chemotherapy is of no known significance and radiation might help in selective cases. Majority of cases are managed with excision and closure of defects but in selective cases there may be need to reconstruct the scalp defects. The methods of reconstruction may be local flaps, free tissue transfer and partial/full thickness skin grafts. Regional flaps are very useful in patients requiring cover of large defects.
The cadaveric human skin allograft as a paradigm shift for the management of a large wound of necrotizing soft tissue infection: an interesting case report
Authors: Gupta Madhusoodan , Varshney Deepti , Brajesh Vimalendu , Aggarwal Aditya , Biswkarma Vishal K.
Published: June 2020

Necrotizing soft tissue infection (NSTI) is an uncommon but fatal and rapidly progressing disease which requires emergent recognition and prompt treatment. Patients of NSTI frequently suffer from large soft tissue defects, which require coverage of these defects by auto-skin graft or flap cover. It becomes a challenge to cover the soft tissue defects in an already sick patient. The patient of NSTI has a restricted skin graft donor site and a poor skin grafting bed. Here authors report a case of 50 years old female, known case of type 2 diabetes mellitus, who suffered from NSTI post intramuscular injection of the left gluteal region. Her left thigh, left gluteal region, lower back, pubic and perineal region were involved. She underwent multiple radical debridement’s followed by the use of Cadaveric human skin allografts to cover the raw area temporarily. Meanwhile, authors optimized the patient nutrition state and controlled the infections. Finally, raw areas were covered with an autologous skin graft, and the patient discharged in stable condition.
A clinicopathological study of the lesions of paranasal sinuses causing proptosis
Authors: Anchery Vineeth Abraham , Kavathur Viswanathan
Published: June 2020

Background: The orbit and its contents lie in close proximity to the paranasal sinuses. The aim of the study was to analyse the lesions of paranasal sinuses causing proptosis.

Methods: All patients with proptosis secondary to paranasal sinus disease were taken up for a systematic otolaryngological and ophthalmological clinical evaluation and investigation using a standard proforma. Incidence of various disease of paranasal sinuses causing proptosis, age and sex distribution, incidence of different symptoms and signs and its association with proptosis were estimated. The reversible and irreversible nature of the proptosis in relation to the degree of proptosis and the histopathological nature of the disease were studied.  

Results: Malignant diseases were found to be the commonest lesion that caused proptosis. Squamous cell carcinoma was the most common histopathological type. Invasive fungal sinusitis among inflammatory and inverted papilloma among benign tumours were the commonest lesions that cause proptosis. Male preponderance was seen in the inflammatory and malignant lesions and the commonest symptoms were headache and nasal obstruction. Malignancies caused faster proptosis than benign and inflammatory lesions. Analysis of X-ray and computed tomography (CT) findings were also done.

Conclusions: Malignant lesions are the most common para nasal sinus disease that cause proptosis. Duration of illness and degree of proptosis varied with the underlying disease process. With inflammatory proptosis some underlying sinus pathology in addition to the sinusitis is found in all cases. CT is a better modality to identify underlying pathology.
A comparative study of preoperative and postoperative hearing after type I tympanoplasty using temporalis fascia graft at Dr. B. R. Ambedkar Medical College, Bengaluru
Authors: M. Muniraju , Hegde Smita
Published: June 2020

Background: The objective of the study was to identify the factors which significantly influence type 1 tympanoplasty success.

Methods: A prospective study was performed on 30 patients who underwent type 1 tympanoplasty via underlay technique using temporalis fascia graft from December 2017 to September 2019 in a teaching hospital. Outcome measures were graft uptake rate and hearing gain. The factors assessed were the age and sex, preoperative condition of the ipsilateral and contralateral ears, perforation size, presence of tympanosclerosis, and whether simultaneous cortical mastoidectomy was performed.  

Results: None of the factors proved to have a significant influence on tympanic membrane closure or hearing gain.

Conclusions: The success rate of a type 1 tympanoplasty is dependent on the skills of the surgeon and the type of graft used. Age, sex, laterality of the disease, duration of dry ear, size of the perforation, presence of tympanosclerosis and simultaneous cortical mastoidectomy have no bearing on hearing gain.
Congenital anomalies in childhood encountered during clinical practice by an otorhinolaryngologist
Authors: Goswami Abhilasha , Sharma Kalpana , Biswas A. K.
Published: June 2020

Background: The otorhinolaryngological developmental anomalies are predisposed by a number of factors like genetic factors, intrauterine infection and maternal nutritional deficiencies. The otorhinolaryngological anomalies may be associated with other systemic maldevelopments.

Methods: A total of 134 cases of congenital otorhinolaryngological childhood anomalies, fulfilling the inclusion criteria, who presented to the out-patient department were examined for a period of one year from January 2019, and were included in the study. They were thoroughly evaluated by undertaking a detailed history and clinical examination. Whenever required, additional investigations were performed. After carrying out the necessary investigations, the cases were either managed surgically or conservatively. Data was evaluated using proper statistical tools.  

Results: Out of the 134 cases, 64.9% were male and 35.1% were female. In our study, 116 cases presented in the first decade of life and 18 cases presented in the second decade of life, up to 18 years of age. The most common childhood congenital anomaly was congenital deafness, which accounted for 44% of all cases.

Conclusions: Encountering cases of congenital anomalies in childhood is quite common during practice of otorhinolaryngology. Parents of the suspected children should be counselled properly to investigate other systemic anomalies. Medical and surgical management of the condition should be undertaken hand in hand with adequate counselling.
Anterior nasal packing: does it affect middle ear pressure?
Authors: Pragadeeswaran K. , Yadavkrishnan Raj Prakash , Raja Roopak Visakan
Published: June 2020

Background: Eustachian tube maintains middle ear pressure equal to that of atmosphere. Its function may be deranged due to variety of factors like adenoids, cleft palate, nasogastric tubes, allergy, nasopharyngeal intubations and also by nasal packing following septal surgery. Our aim was to evaluate the effect of anterior nasal packing protocol, on eustachian tube function, followed in our ENT Department for nasal surgeries.

Methods: A descriptive study was done on 60 patients undergoing nasal surgery from March to November 2018 was done in the ENT Department of a tertiary care hospital. All patients underwent pre-operative otoscopic examination followed by tympanometry. Tympanometry was repeated following nasal surgery with nasal pack in situ and again 24 hours after removal of pack. The results of all these 3 impedance audiometries were tabulated and analysed.  

Results: Pre-operatively both ears in all the patients showed type a tympanometry, which implied normal eustachian tube function. Out of 60 patients who underwent nasal surgeries, 40 had abnormal impedance tympanograms immediately after surgery. 26 patients had abnormal impedance tympanogram after pack removal. These patients were treated with nasal decongestants and antibiotics which were routinely prescribed as a post-operative prophylaxis. These patients 1 week after pack removal recorded a normal tympanogram.

Conclusions: Changes in middle ear pressure following nasal packing associated with most nasal surgeries were transient but not severe. Hence, we conclude that anterior nasal packing for 24 hours is considered safe, if no other co-morbid factors for altering middle ear pressures are present.
Various spectrum of lesion in palatine tonsil underwent for tonsillectomy in tertiary care center: a two years retrospective study
Authors: Kumar Gaurav , Sharma Ritu , Pal Desh , . Geeta
Published: June 2020

Background: Palatine tonsils are paired masses of lymphoid tissue which act as immunologic barrier against the entry of pathogenic organism into the respiratory and digestive tracts. Despite their protective function, tonsils are prone to infection. Chronic tonsillitis is a disease with repeated attacks of acute tonsillitis or a sub-clinic form of a resistant or poorly treated infection. Objective of the study was to know the various clinico-pathological finding in palatine tonsil underwent for tonsillectomy.

Methods: This was a retrospective study where 105 cases (unilateral-15, bilateral-86 and tonsillar biopsy in 04) of histopathologically identified tonsillectomy specimens were included. The available data for all the patients as regards to age, sex and clinical symptoms was collected. Representative bits were taken from formalin fixed tonsillectomy specimens in which hematoxylin and eosin (H and E) staining was done.  

Results: Amongst the cases, 79 cases showed chronic tonsillitis. Other lesions were chronic tonsillitis with actinomycosis in 11 cases, acute on chronic tonsillitis in 07 cases, granulomatous tonsillitis in 03 cases, Acute ulcerative tonsillitis with micro abscesses in 01 case and Reactive lymphoid hyperplasia in 02 case. Two malignancies were observed - one case of poorly differentiated carcinoma and another case of lymphoma.

Conclusions: This study showed that chronic tonsillitis is a common problem facing in all age groups and histopathology play a key role in diagnosing both benign and malignant lesion of tonsil therefore deciding the proper management.
Rapid control of thyrotoxicosis for urgent thyroidectomy
Authors: Kreze Alexander , Podlesak Tomas , Roulova Jana , Koskuba Jiri
Published: June 2020

Surgery for Grave’s disease is one possible option for definitive treatment. Thyroidectomy is performed after achieving a euthyroid state. Pre-operative preparation of the hyperthyroid patient is essential to avoid peri- and post-operative serious complications due to thyrotoxicosis mainly thyrotoxic crisis and death. The mainstay of preparation is the administration of anti-thyroid drugs. Occasionally rapid pre-operative optimization is required for special reasons (intolerance or side effects to anti-thyroid drugs or an aggravated serious disease with thyrotoxicosis). Various regimens for this aim were suggested with protocols composing various combination iodine (as a Lugol’s solution, or iopanoic acid, or ipodat sodium), steroids, usually dexamethasone and beta blockers, alternatively other options are plasmapheresis, lithium and exchange ionic resin. The restoration of hyperthyroid Grave’s disease to euthyroidism in our patient was rapidly accomplished with iodine, dexamethasone and beta blockers (at seventh day without complications). We propose a possible treatment protocol for these cases.
Optic nerve decompression - role in preventing traumatic ischaemic optic neuropathy: case report
Authors: Munjal Manish , Kaur Japneet , Rishi Porshia , Tuli Nitika , Bharadwaj Iti , Munjal Shubham
Published: June 2020

Traumatic optic neuropathy is a complication that arises due to head injury, high velocity road traffic accidents causing maxillofacial trauma. Due to involvement of optic nerve which endangers vision, there is a race against to save the vision. Endoscopic optic nerve decompression is a useful procedure for optic nerve decompression. We report a case of ischaemic optic neuropathy following road traffic accident, who underwent endoscopic optic nerve decompression within 6 hours of injury.
A study of respiratory system involvement in autoimmune connective tissue diseases: a marker of morbidity
Authors: Solanki Neha T. , Raju Sahana P. , Budhrani Deepmala , Patel Bharti K.
Published: June 2020

Background: The auto-immune connective tissue diseases (AICTD) are polygenic clinical disorders having heterogeneous overlapping clinical features. Certain features like autoimmunity, vascular abnormalities, arthritis/arthralgia and cutaneous manifestations are common to them. Lung involvement can present in AICTDs in form of: pleurisy, acute/ chronic pneumonitis, pulmonary artery hypertension (PAH), shrinking lung syndrome, diffuse alveolar damage, pulmonary embolism (PE), bronchiolitis obliterans organizing pneumonia, pulmonary infections, cardiogenic pulmonary edema, etc. High-resolution computed tomography (HRCT) plays an important role in identifying patients with respiratory involvement. Pulmonary function tests are a sensitive tool detecting interstitial lung disease.

Methods: The present study is an observational study carried out on 170 patients of AICTD in department of Dermatology, Venereology and Leprosy at a tertiary care centre during a period of 2 years from October 2017 to August 2019. Detailed history, examination and relevant investigations like chest X-ray, pulmonary function test (PFT), HRCT thorax were done as indicated.

Results: The overall incidence of respiratory involvement was 56.7% with maximum involvement in systemic sclerosis cases (82.8% of cases). 45.7% of patients of systemic lupus erythematosus had respiratory involvement, most common being pleural effusion in 11.5%. Impaired PFT’s were seen in 82.8% cases of systemic sclerosis (SSc)  and all cases of UCTD. Interstitial lung disease was seen in 34.7% and 25% cases of SSc and DM respectively. PAH was found in 15.2% cases of SSc and 9.8% cases of mixed connective tissue diseases.

Conclusions: AICTD are multisystem disorders in which pulmonary involvement can be an important cause of morbidity to the patient and early detection is necessary for prevention of long-term respiratory complications.
Clinico-epidemiological study of melasma in tertiary care centre
Authors: Patel Nishtha H. , Gangaiah Narendra , Thimappa Veena , Gundappa Pavithra
Published: June 2020

Background: Melasma is common pigmentary disorder and affect patient quality of life due to its presentation over the face. It mostly affects sun exposed area and present as grey-brown pigmentation over the face.

Methods: In this observational or descriptive study, total 110 patients were enrolled which was carried out in the Department of Dermatology from February 2019 to January 2020 at Sri Siddhartha Medical College and Sciences, Tumkur, Karnataka.

Results: Mean age group affected was 31-40 years of age (41.8%). Out of 110 patients 18 patients were male and 92 patients were females. Total 15 patients had positive family history (13.6%). 30 patients had history of taking oral contraceptive pills (27.3%). 22 patients had sun exposure history (20%). 59 patients had epidermal pigmentation (53.6%) and 62 patients had malar region distribution (56.4%).

Conclusions: During third decade of life, females were more commonly affected. Pathogenesis of melasma is multifactorial. In our study, we found that oral contraceptive pills and sun exposure may predispose or trigger the melasma. Most common area affected was malar. Epidermal pigmentation was more common.
Boosting effect of cyclosporine on corticosteroids in the acute management of toxic epidermal necrolysis
Authors: Sidhabathuni Nageswaramma , Tadi Sahitya , Darla Rakesh , Gomukonda Premsagar
Published: June 2020

Toxic epidermal necrolysis (TEN) is a life-threatening dermatological emergencies. It is a rare, acute mucocutaneous disorder that usually occur secondarily as an idiosyncratic reaction to certain drugs. Prompt identification and discontinuation of the causative drug is mandatory along with adequate supportive care like proper hydration, minimize the number of skin manipulation, prevention of secondary infections. Many immunosuppressive modalities have been tried with variable results. In this manuscript, we reported 12 consecutive cases of TEN presented to our hospital over a period of 2 years from 2017 to 2019. All the cases presented with varying percentage of skin blistering and mucosal involvement secondary to an offending drug. The incriminated drug was discontinued, supportive care was initiated along with combination therapy of cyclosporine and corticosteroids as immunosuppressants. The clinical presentation, etiological drugs and treatment protocol followed and its efficacy will be described in details.
“En una ciudad gris y silenciosa”: la migración francesa en Bogotá (1900-1920)
Authors: Figueroa Salamanca Helwar , Corredor  Espitia Julián  David
Published: June 2020

A pesar de la pequeña cantidad de franceses llegados a Colombia, es posible analizar cómo en Bogotá lograron tener una presencia destacada por medio de sus actividades comerciales e influencia cultural. Para dar cuenta de este proceso se ubicó a los franceses llegados a Bogotá, a comienzos del siglo XX, identificando sus oficios y aportes materiales, e influencia en la vida cotidiana de la ciudad. Un análisis basado en los censos poblacionales, pasaportes y correspondencia existente en el Archivo General de la Nacional; información contrastada con la prensa de la época y la historiografía sobre la inmigración en Colombia. En conclusión, se evidencia que la colonia francesa en Bogotá fue la más numerosa y que sus labores estuvieron asociadas al comercio, las profesiones liberales y artesanales.
Manuel Serrano Blanco y el cambio político en Colombia. Periodismo, literatura y raza (1897-1953)
Authors: Acevedo  Tarazona Álvaro , Villabona Ardila Juliana
Published: June 2020

El propósito de este artículo es analizar la trayectoria de una nueva generación de políticos e intelectuales que surgieron en las primeras décadas del siglo XX, a partir del itinerario política y periodístico de Manuel Serrano Blanco, líder del Partido Conservador en el departamento de Santander. A través del texto se podrá reconocer aún más a esta generación, denominada Los Nuevos, jóvenes conservadores y liberales con un marcado partidismo quienes se consolidaron en la vida pública hacía la década de 1920 y desarrollaron, en algunos casos, discursos y posiciones raciales que marcaron el devenir del país. Se analiza la obra periodística y literaria de este autor poco trabajada, teniendo en cuenta un contexto local y nacional de creciente polarización marcada en parte por discursos agresivos y beligerantes relacionados con la violencia y la raza.
ADDRESSING THE NOTION OF SOCIO-CULTURAL CONTINUUM SEEN THROUGH THE CHORAL ART AS IT DEVELOPED THROUGHOUT INDEPENDENCE OF UKRAINE: LITERATURE REVIEW
Authors: M. Marach Oleksandr , L. Panasyuk Svitlana , I. Shurdak Mariia , A. Krivitska Tatyana , R. Kinder Karyna
Published: June 2020

Purpose of the study: The purpose of the present study is to specify the notion of socio-cultural continuum seen through the choral art as it developed throughout independence in Ukraine and to identify its main tendencies as drivers of choral art development. In this regard, the research tasks are to investigate the meaning of the concepts of “continuum”, “socio-cultural continuum,” and to identify the main socio-cultural tendencies that, in our opinion, have the most significant influence on the development of choral art.

Methodology: This study used a meta-analysis approach to solve the issues raised in the research. Reference sources, peer-reviewed databases like Education Resources Information Centre (ERIC), Scopus, Arts & Humanities Database, the Choral Scholar (online journal), Google Scholar, together with open-source-published researches and books (published either in Ukrainian or English) were used to obtain the relevant information.

Main findings: It was found, that the socio-cultural continuum in Ukraine of the period of independence emerges as a complex hierarchical system of phenomena characterized by an inextricable link between the Spatio-temporal parameters of human beings, society, and culture.

Applications of this study: Interpreting this concept in relation to the development of choral art as an imaginary model of a single socio-cultural space-time in Ukraine (region) occurring throughout the independence period in all the continuous hierarchical multiplicity of its phenomena related to the functioning of choral art identified several major trends that, in our opinion, were influenced by the intensity and nature of such development. This period, as a transition period characterized by a change in outlook, the revival of previously forbidden traditions, and the emergence of new socio-cultural trends not only intensified the development but also caused several challenges that Ukrainian society faced.

Novelty/Originality of this study: This scientific exploration was an attempt to understand the theoretical essence of this continuum and its tendencies, which in the future will allow knowing more about their positive and negative orientations and ways.
THE EXISTENCE OF ARABIC LANGUAGE IN INDONESIAN SOURCE TEXT AND ENGLISH TARGET TEXT
Authors: Zulkifli Mahmud Erlina , Bayusena Bima , Erika Mawarrani Ratna
Published: June 2020

Purpose: To study the existence of the Arabic language in the Indonesian language mostly limited to terms used in Islam religion.

Methodology: This article discusses the existence of Arabic literature in the Indonesian source text, a novel with the life in a pesantren as the setting, where the author of the source text needs to translate the Arabic expressions used in the story into Indonesian. Then from the Indonesian source text, the novel is translated into English. The method used in this research is the descriptive comparative method. The leading theory used for this research is the strategies of Translation by Vinay and Darbelnet (1995), what Arabic linguistic units involved in the Indonesian source text, and what strategy of conversion used by the author and the translator become the objectives of this research.

Principal Findings: The results show that the Arabic linguistic units found are ranging from a word into a clause or sentence, and the strategies of Translation used in the target text do not always deal with one single procedure; sometimes, it involves a combination of some procedures.

Applications of this study: The translation work may lead to similar as well as a contrastive linguistic phenomenon. People can learn more about languages involving in a translation, particularly when the structures of the source and target language are compared linguistically.

Novelty/Originality of this study: This study covers the gap left in the previous research carried out by the same team entitled “Translation Equivalences of Islamic Terms in the Novel (The Land of Five Towers ‘Negeri Lima Menara’). This previous research used the same data source, Arabic expressions, in the novel. It focused more on the Arabic feelings relating to Islamic terms, such as names of five obligational prayers, names of optional prayers, activities in shalat, or praying. The rest of the Arabic phrases which are not used in this previous research are left unstudied.