bluuebunny/crossref_metadata_2025_split huggingface dataset:
Chronic rhinosinusitis with nasal polyps: predictive factors for recurrence and revision surgery
Authors: Salvador Pedro , Lombo Catarina , Silva Francisco Moreira da , Fonseca Rui 
Published: November 2020

<p class="abstract"><strong>Background:</strong> Chronic rhinosinusitis with nasal polyps (CRSwNP) is an inflammatory condition which may have a significant impact on quality of life. Endoscopic sinus surgery (ESS) is indicated for patients refractory to maximal medical treatment and presents high recurrence and revision surgery rates. Aim of the study was to evaluate ESS outcome in CRSwNP management and to assess independent predictive factors for recurrence and revision surgery.</p><p class="abstract"><strong>Methods:</strong> Retrospective medical chart review of patients who underwent ESS for recalcitrant CRSwNP, from January 2013 to December 2017, with a minimum follow-up time of 12 months. </p><p class="abstract"><strong>Results:</strong> This study enrolled 132 patients, 62.1% of whom were males, with a mean age of 43.4±11.5 years. Asthma was the most common comorbidity (39.4%, n=52) and aspirin exacerbated respiratory disease (AERD) was present in 9.8% (n=12) of the study population. We found a recurrence rate of 34.1% (n=45) and 9% (n=12) of patients required revision surgery. Multivariate analysis identified as independent variables of recurrence (95% CI): a history of asthma (OR=8.81, CI 3.87-20.03; p&lt;0.001) and a severe Lund-Mackay score (17-24) (OR=5.85, CI 2.73-12.51; p=0.001). Revision surgery was related to a severe endoscopic Lund-Kennedy score at presentation (OR=4.05, CI 1.91-8.01, p=0.001).</p><p class="abstract"><strong>Conclusions:</strong> CRSwNP presents a high tendency to recur after ESS. Asthma, severe sinus opacification and severe endoscopic score are poor prognostic factors that hallmark a more aggressive disease. A more extensive surgical procedure and/or middle turbinate resection with a rigorous postoperative compliance should be considered to improve long term results.</p>
Physicians perception in the management of allergic rhinitis: a Pan-India survey
Authors: Bhagat Sagar , Patil Saiprasad , Panchal Sagar , Barkate Hanmant 
Published: November 2020

<p class="abstract"><strong>Background: </strong>Allergic rhinitis (AR) affects a wide proportion of the population across all age groups. There are several guidelines and consensus statements in AR management, the effect of this is implicit from a physician's perspective. The present cross-sectional survey was conducted to understand physicians approach to the management algorithm in the treatment of allergic rhinitis and medication choice.</p><p class="abstract"><strong>Methods:</strong> Physicians from diverse specialties such as pulmonologists, consultant physician, paediatricians, Allergists, ENT specialists and general practitioners were invited to participate in the survey, which focused on recognizing the burden of disease, clinical presentation, and management methods.</p><p class="abstract"><strong>Results:</strong> 1,261 Physicians participated in this survey, belonging to different specialties. Oral H1 antihistamine was favoured as a first-line therapy, followed by the combination of oral H1 histamine and leukotriene receptor antagonist. Fexofenadine was the most frequently prescribed. Majority believed, bilastine as antihistamine with the least sedative potential and was identified as the most effective treatment. Bilastine was preferred in patients with mild- moderate hepatic/renal impairment and in patients with persistent allergic rhinitis. Most physicians prefer bilastine in all AR clinical profiles. Aside from AR, bilastine is also use in management of upper respiratory tract infections and urticaria respectively.</p><p class="abstract"><strong>Conclusions: </strong>AR is still a growing challenge in India with majority of physician preferring oral antihistamine either as monotherapy or in combination. Bilastine is a preferred choice in patients with impaired liver and renal function and was also referred as least sedative antihistamine by majority of physicians across India. </p>
A polydrug regime for treatment of sudden sensorineural hearing loss
Authors: M. Muniraju , Killera Shambulinga , Kauser Safina 
Published: November 2020

<p>Sudden sensorineural hearing loss (SSNHL) is a very frightening and incapacitating event and it impairs the patient's quality of life. Steroids are considered the first line of treatment. Intratympanic dexamethasone produces a significantly higher perilymph concentration of steroids. The aim of our study was to assess the efficacy of multi-drug regimen in the management of SSNHL, to analyse the recovery and to assess use of intratympanic steroid injections (ITSI) as a primary treatment. This is a prospective study presenting as a case series of 5 cases of SSNHL. Our treatment included intratympanic steroids, oral steroids, antiplatelet drugs, rheological-agents and neuro vitamins. Complete recovery was seen in 2 (40%), partial recovery in 2 (40%), 1 patient was lost to follow up. In the patient with bilateral SSNHL, the ITSI was administered in the right ear only; which showed a significant improvement. SSNHL is described as a decline in hearing of 30 dB or more, on 3 or more frequencies over 3 days or less, with tinnitus and ear fullness. Early presentation and intervention within 72 hours is the ideal treatment. Since viral infections and vascular compromise are considered as probable theories for SSNHL, steroids, with anticoagulants, antiplatelet and rheological-agents are used as an effective therapy. Our study shows that a multi-drug treatment of SSNHL can be much more effective than a single drug treatment. We also conclude that using intratympanic steroid injections have a greater improvement as seen in the case of bilateral SSNHL.</p><p> </p>
Q-tip ear injury with stapes luxation into the vestibule-a case report
Authors: Lame Cheikh Ahmedou , Ndiaye Cheikhna Ba , Loum Birame , Fall Amat , Goumba Alice , Diallo Thierno Boubacar 
Published: November 2020

<p>Stapediovestibular luxation by Q-tip ear injury is a rare occurrence. The traumatic context associated with cochleovestibular symptoms should lead to a high index of suspiscion. Temporal bone CT scan confirms the diagnosis. The authors report a case of stapediovestibular luxation and discuss the management of this condition. An 8-year-old boy presented to our department for otalgia, hearing loss, and dizziness. The history revealed a penetrating right ear injury by Q-tip, which had occurred 5 days previously. ENT examination found a right peripheral vestibular syndrome with ipsilateral tympanic perforation. Tonal audiometry noted right cophosis. Temporal bone CT scan showed right side internal stapediovestibular dislocation. Middle ear inspection with oval window fistula repair and tympanic closure were performed. Postoperative outcomes showed complete resolution of vestibular symptoms without improvement of sensorineural hearing loss thresholds. Traumatic stapediovestibular dislocation by Q-tip ear injury is unusual. Early diagnosis, with precise lesion assessment and appropriate management resolve vestibular symptoms, prevent infectious complications. But, hearing outcomes are variable.</p><p> </p>
Fluorodeoxyglucose positron emission tomography-computed tomography base response assessment in primary thyroid lymphoma
Authors: Jain Tarun Kumar , Punia Anushree , Dhal Shikha , Singh Guman , Malhotra Hemant , Punia Ankur , Gupta Naveen 
Published: November 2020

<p class="abstract">Isolated primary thyroid lymphoma and lesion in the thyroid gland presenting as a lymphoma, both are uncommon entities. This subgroup of thyroid malignancies is managed in different ways as compared to common thyroid malignancies. A 63-year-old male diagnosed as non-Hodgkin’s lymphoma of the thyroid gland underwent for F-18 fluorodeoxyglucose positron emission tomography-computed tomography (FDG PET-CT). It revealed isolated FDG avid soft tissue mass in left lobe of thyroid gland. After two and six cycles of chemotherapy, PET-CT was perfomed and response assessed in Deauville scores. </p>
Bimodal intervention in cystic lesions of the maxillary antrum
Authors: Munjal Manish , Tilavat Venus , Rishi Porshia , Munjal Shubham , Sidhu Harjinder , Sharma Salony , Dosanjh Jigisha 
Published: November 2020

<p class="abstract">Intrinsic or extrinsic cysts are common maxillary antral lesions as there is close proximity between the maxillary antrum and maxillary teeth. Main stay of treatment is complete surgical excision. Endoscopic trans nasal middle meatus corridor and the canine fossa approach facilitate 360-degree access, resection and removal of cystic lesions of the maxillary antrum. Bimodal technique to treat maxillary cysts that have expanded into the maxillary sinus is discussed here. </p>
To evaluate the efficacy between 0.15mg/Kg and 0.25mg/Kg of iv labetalol in the suppression of haemodynamic response to extubation
Authors: S Sindhu , Srinivas V Y 
Published: November 2020

Tracheal extubation process evokes stress response which causes autonomic variations such as tachycardia, rise in systolic arterial blood pressure and diastolic arterial blood pressure which is potentially lethal in high risk patients.Thus this study is conducted to compare the efficacy between 0.15mg/kg and 0.25mg/kg of iv Labetalol in the suppression of haemodynamic response to Extubation. 60 participants aged between 18-55 yrs belonging to ASA 1 or 2 were randomly allocated into 2 groups. Group Lb received injection Labetalol 0.15mg/kg and Group Lt received injection Labetalol 0.25mg/kg. Heart rate, systolic arterial blood pressure and diastolic arterial blood pressure were recorded at basal, two, five, eight minutes after drug infusion, at extubation and one, three, five, eight, ten and fifteen minutes post extubation. Group Lt showed a better lowering values in heart rate, systolic arterial blood pressure and diastolic arterial blood pressure after drug infusion, at Extubation, and fifteen minutes post Extubation compared to Group Lb. Injection Labetalol 0.25mg/kg showed a effective suppression of haemodynamic response to Extubation compared to injection Labetalol 0.15mg/kg.
Comparison of the efficacy of ultrasound guided adductor canal block versus intra-articular infiltration in providing post-operative analgesia after arthroscopic anterior cruciate ligament repair surgery
Authors: Bangal Kedar , Ghodki Poonam 
Published: November 2020

Ultrasound guided adductor canal block (ACB) is a modality for providing analgesia after arthroscopic anterior cruciate ligament repair surgery. Intra-articular infiltration of analgesics in the knee joint acts on the free nerve endings at the operative site and provides analgesia. We aim to compare the analgesic efficacy and opioid consumption between these two modalities.Sixty patients were randomized to receive either ACB under ultrasound guidance (group A) or intra-articular infiltration (group B). Post-operatively time of rescue analgesia and opioid consumption were noted. Quality of analgesia was assessed every 2 hours until 6 hours, then every 6 hours until 24 hour post-operative period between the two groups. Data was analysed statistically and P value &#60; 0.05 was considered significant.: Time of rescue analgesia was comparable in both the groups (p value 0.4317). NRS scores in ACB group and intra-articular infiltration group were comparable till first 6 hours (p value 0.4519) but increased in intra-articular infiltration group at 12 hour (p value &#60;0.0001) and 18 hour (p value &#60;0.0117) as compared to group receiving ACB. The opioid consumption was more in intra-articular infiltration group than ACB group although not statistically significant (p value 0.6319).ACB is a better modality for postoperative analgesia after arthroscopic anterior cruciate ligament repair surgery as analgesia of intra-articular infiltration wears off in 12-24 hour period which is crucial for early ambulation and from rehabilitation point of view.
Effect of 2% dextrose in ringer lactate on incidence of nausea and vomiting in laparoscopic cholecystectomy-Prospective randomized control study
Authors: Singh Yashpal , Verma Surabhi , Singh A P , Bhartiya S K 
Published: November 2020

Post-operative nausea and vomiting (PONV) is the distressing situation for patients & caregivers. Various groups of pharmalogical agents are used for prophylaxis in high risk patients for PONV but they have their own advantage and disadvantages. Recent metaanalysis on intravenous use of 5% dextrose showed conflicting results with risk of hyperglycemis. So in this study we plan to use intravenous 2% dextrose in ringer lactate for prevention of PONV in laparoscopic cholecystectomy patients.This prospective randomized double-blind controlled study was conducted in 60 American Society of Anaesthesiologist 1 & 11 patients, age 20-55 years undergoing elective laparoscopic cholecystectomy under general anaesthesia. Patients were randomly divided into two groups: group DRL received 2% dextrose in ringer lactate and group RL received ringer lactate. Allocate fluid was started at induction of anaesthesia and continued post-operatively up to 6hr. Incidence and severity of PONV was measured as a primary outcome. Secondary outcome includes comparison of blood sugar level, requirement of rescue antiemetic, time of oral acceptance of food & time of discharge between two groups. Mean between two groups were compared with student t test. The critical value of ‘p’ indicating the probability of significant difference was taken as&#60;0.05 for comparison.Incidence and severity of PONV was less in group DRL than group RL. Blood sugar level was higher in group DRL but within the normal range. Time of oral feed and time to discharge was early in group DRL.Intravenous 2% dextrose in ringer lactate reduces the incidence and severity of PONV in laparoscopic cholecystectomy patients.
Supraclavicular brachial plexus block with and without dexamethasone as an adjuvant to local anesthetics - An observational study
Authors: Marathe Radhika M , Shende Sunita Y , Khairmode Ujwala B , Gorgile Rupali N 
Published: November 2020

Brachial plexus block with bupivacaine provides very effective intraoperative anaesthesia and also analgesia. It was found that when dexamethasone was added as an additive to bupivacaine, it increases the duration of anaesthesia and also the duration of analgesia. This study was carried out to compare onset and duration of sensory and motor blockade and duration of postoperative analgesia on addition of dexamethasone to local anestheic and local anesthetic alone in supraclavicular brachial plexus block.After obtaining the approval from the Institutional Ethical committee and written informed consent from the patients, 60 patients were included in our study.We included 60 ASA I & II patients who were aged between 18 years & 60 years, underwent elective upper limb surgeries. They were divided into two equal groups.Group 1 (cases) who received 15 milliliter of 2% lignocaine with adrenaline and 15 milliliter of 0.5% bupivacaine + dexamethasone 8mg(2ml).Group 2 (controls) who received 15 milliliter of 2% lignocaine with adrenaline and 15 milliliter of 0.5% bupivacaine + 0.9% normal saline(2ml).We observed the Onset of sensory and motor blockade, duration of sensory and motor blockade and postoperative analgesia between the two groups.The onset of sensory blockade was within 7.3 min in group 1. In group 2 the onset of sensory blockade was 13.66 minutes.The onset of motor blockade was within 3.93 min in group 1. In group 2 the onset of motor blockade was 18.66 min.The duration of intra operative analgesia was 654.33 minutes in group 1. In group 2 the duration of intra operative analgesia was 292.6 minutes.The duration of post operative analgesia was 815±13.57 minutes in group 1. The duration of post operative analgesia in group 2 was 393.8±42.88 minutes.There were no complications in both the groups in intra operative period and post operative period.Dexamethasone, when added to 15 millilitre of 0.5% bupivacaine and 15 millilitre of 2% lignocaine plus adrenaline, very effectively enhances the onset of sensory and motor blockade. It dramatically prolongs the duration of sensory and motor blockade and duration of analgesia. There were no untoward side effects with the use of dexamethasone as an additive in the brachial plexus block.
Patient-reported outcomes after femoral nerve block versus periarticular injections in patients undergoing total knee arthroplasty: A randomized controlled study
Authors: Ismail Tarek I , Elshafie Mohamed H 
Published: November 2020

Total Knee Arthroplasty (TKA) is one of the most advanced surgical solutions for pain relief and mobility improvement in patients with end stage osteoarthritis. TKA patients experience severe postoperative pain. Recently, peripheral nerve blockade and Peri or intra-articular injections have been used successfully with fewer side effects when compared to the conventional analgesic techniques. Measuring quality of recovery (QoR) using QoR-15 scale is considered as an accepted and efficient scale for clarification the success of surgery and anaesthesia. One hundred and thirty adult patients scheduled for TKA were randomized into 2 groups: Femoral nerve block (FNB) group and periarticular injections (PAI) group. All patients completed the QoR before or on the day of surgery and at the end of the first post-operative day. Postoperative pain scores, opiod consumption and adverse effects of the drugs and techniques were also measured. Periarticular injectionsresulted in better analgesia at rest and on movement and less postoperative morphine consumption during the first 24 h postoperatively when compared to femoral nerve block. Global QoR-15 score was significantly higher in PAI when compared to FNB group. Periarticular injection of local anesthetics provides better quality of recovery and sufficient level of analgesia than does single shot femoral nerve block for patients undergoing total knee arthroplasty in early postoperative period.
Daya Saing Bawang Merah di Provinsi Maluku dan Upaya Peningkatannya
Authors: Santoso Agung Budi , Nurdin Maryam , Hidayah Ismatul 
Published: November 2020

Shallot is one of horticultural commodities with a high demand. Majority of shallots in Maluku are bought from Surabaya and Makasar. However, the government continuously does horticultural development in the center of shallot production. The objective of this study was to analize the competitiveness and comparativeness of farming between shallots which are cultivated by local farmer and shallots which are imported. There were three locations of research i.e., Maluku Tenggara, Seram Bagian Barat, and Maluku Tengah. Primary data were collected by quessioner and used purposive sampling method. Primary data were analyzed using policy analysis matrix. The results showed that shallot farming in Maluku has comparative and competitive advantages compared with imported shallots. Agricultural government policy effectively increases local farmer insentive. However, it shows a decreasing trend while increasing productivity of shallot. Shallot farming having production higher than 8 ton/ha need output subsidy to give price guarantee. Effort to increase shallot competitiveness is conducted by increasing productivity and developing a farmer institution to make a sustainable agricultural development. Keywords: shallot, competitiveness, competitive and comparative
The Relationship of Headache with Inflammatory Serum Parameters and Disease Severity in COVID-19 Patients
Authors: BİLGE Nuray , KESMEZ CAN Fatma , ALAY Handan 
Published: November 2020

Aim: Most of the coronavirus disease 2019 (COVID-19) patients have respiratory symptoms; however, various neurological symptoms, such as headache, can be seen. The pathophysiological mechanism of headache in COVID-19 is unknown completely. In our study, we aimed to investigate the relationship between headache and inflammatory markers and disease severity in COVID-19 patients.
Material and Methods: Two hundred and three hospitalized patients with a polymerase chain reaction (PCR)-confirmed COVID-19 diagnosis between 15 March and 01 June 2020 were retrospectively investigated. A total of 62 patients with headache symptoms (n=31) and without headache symptoms (n=31), who were age and gender-matched, were included in the study. The demographic characteristics, inflammatory serum parameters, neutrophil/lymphocyte ratio (NLR), C-reactive protein (CRP)/albumin ratio (CAR), hospitalization times, and disease severity were determined.
Results: Of the 203 COVID-19 patients, 36 (17.7%) had a headache, and it was the fourth most common symptom. Headache accompanied other symptoms in all patients. Of the patients with headache, 14 (45.2%) were female, 17 (54.8%) were male, and the mean age was 37.74±16.65 years. In our COVID-19 patients, the neutrophil count, NLR, CRP, CAR were significantly higher, and hospital stay was longer in patients with headache than those without headache (p=0.023, p=0.041, p=0.034, p=0,048 and p=0.049, respectively).
Conclusion: As a result, the increased inflammatory response may play a role in the pathogenesis of headache in COVID-19 patients. Our study is the first study that evaluated the relationship between headache symptom and inflammation in COVID-19 patients. Further research is needed on this subject.
Evaluation of COVID-19 Thorax Computed Tomography Findings in Hemodialysis Patients
Authors: ATEŞ Ömer Faruk , ARIK Erbil , TAYDAŞ Ogün , DHEİR Hamad , GÜNEYSU Fatih 
Published: November 2020

Aim: Coronavirus disease 2019 (COVID-19) is an unprecedented cause of pandemics affecting all segments of society. It is not known whether hemodialysis patients form a different patient group in terms of susceptibility to COVID-19 infection or severe disease. In this study, thorax computed tomography (CT) findings were evaluated in hemodialysis patients diagnosed with COVID-19 infection during the pandemic period.
Material and Methods: CT findings of 32 hemodialysis patients diagnosed with COVID-19 with real-time polymerase chain reaction or thorax CT examination were evaluated retrospectively. Radiological findings were classified as ground glass, consolidation, mixed type involvement (ground glass and consolidation), crazy paving appearance, interlobular septal thickening, nodule, halo-reverse halo finding, air bronchogram finding, subpleural curvilinear opacities and tree-in-bud views.
Results: A total of 32 patients were included in the study. Twenty-one (65.6%) of the patients were male and 11 (34.4%) were female. The mean age was 67.5±8.5 years. All patients had chronic kidney failure. Thorax CT examination revealed ground-glass opacities in 14 (43.8%) patients, consolidation in 3 (9.4%) patients, and mixed type involvement (ground-glass opacities and consolidation) in 15 (46.9%) patients. The accompanying CT findings were pleural effusion in 23 (71.9%) patients, subpleural curvilinear opacities in 13 (40.6%) patients, bronchial wall thickening in 11 (34.4%) patients, lymphadenopathy in 7 (21.9%) patients, bronchiectasis in 4 (12.5%) patients and pleural thickening in 4 (12.5%) patients.
Conclusion: When hemodialysis patients are infected with COVID-19 infection, they differ significantly from other COVID-19 patients in terms of symptoms, clinical course, and prognosis, as well as imaging findings.