bluuebunny/crossref_metadata_2025_split huggingface dataset:
Primary Laryngeal Aspergillosis in an Immunocompetent Host
Authors: Biswas Kaustuv Das , Choudhary Ankit , Ghosh Swapan Kumar , Biswas Subhradev 
Published: August 2020

Introduction
Aspergillosis of Larynx is very rare and may present with symptoms suspicious of malignancy. Prevention of dissemination warrants early diagnosis. It is found mainly in Immunocompromised patients and is usually necrotizing, invasive with disseminated systemic infection, associated with poor prognosis. In Immunocompetent patients it is extremely rare and may present as colonization associated with excellent prognosis.
Case Report
A 43 year old male patient presented with hoarseness of voice for about 3 months with whitish irregular lesion that involved the anterior 1/3 of both the vocal cords. A cheesy material was found covering indurated lesion of both the vocal cords, intraoperatively. Stripping of mucosa over vocal cords was done and cheesy material collected and sent for HPE which revealed Aspergillus hyphae overlying Mild dysplastic changes. Following diagnosis the patient was followed up with oral dosages of Itraconazole.
Discussion
The primary Aspergillosis of larynx is extremely rare. Involvement is always secondary to immunocompromised states like AIDS, malignancy, Diabetes, etc. This was a rare case in Immunocompetent patient.
Management constitute removal of the vocal cord lesions during biopsy. Amphotericin B is first-line agent for this infection, however aerosolised and liposomal amphotericin B offer effective dosing with less toxicity. Newer antifungal Itraconazole may produce more reliable results.
Effect of Topical Nasal Decongestants on Nasal Peak Flow Rates in Adults Suffering from Acute Sinusitis
Authors: Rajamani Santhosh Kumar 
Published: August 2020

INTRODUCTION
In this research we study the effect of Nasal decongestant Xylometazoline 0.1% solution on Serial measurements of Nasal peak flow rates in a cohort of patients who were suffering from Acute Sinusitis.
CASE SERIES
A population of 90 patients were chosen from our regular Out-patient clinics who were suffering from Acute Sinusitis based on a Clinical diagnostic criterion. A baseline Nasal peak Flowmetry was done before and this was followed by common Decongestant Xylometazoline 0.1% solution spray application, followed by serial readings of Nasal peak Flowmetry done after 10 minutes, 25 minutes, 60 minutes, 120 minutes,240 minutes and 360 was taken then plotted and analysed.
DISCUSSION
From the A.U.C Curves it can be inferred that Maximum decongestant action of Xylometazoline 0.1% solution is seen 1 hour after application and the raise in decongestant reaches a plateau by 2 hours. Readings remain elevated from baseline well 6 hours post decongestion.
CONCLUSION
Patients who are prescribed Xylometazoline 0.1% solution are advised that maximum relief from congestion would be obtained around 1 to 2 hours after application and hence effect would decrease. Surgeons who use Xylometazoline 0.1% solution for nasal packing must proceed with the Surgery within 1 hour of application of the pack to obtain maximum hemostatic and decongestant benefit of this drug.
The Contralateral Ear in Unilateral Chronic Otitis Media - Does it Need Reckoning ?
Authors: Narayanaswamy Ramakrishnan , Awasthi Gaurav 
Published: August 2020

Introduction
This comparative study aims to analyze findings and their significance in the contralateral ears of patients with unilateral Chronic Otitis Media (COM) and compare it with a control group of healthy subjects.
Materials and Methods
One hundred patients of unilateral COM and 100 healthy individuals were included in this study from Jan 2015 to July 2016. The findings were noted in the contralateral ears of patients with unilateral COM and 100 control subjects. The changes found in the contralateral ears were assessed statistically for significance.
Results
In 100 cases of unilateral COM, 58 patients had some abnormality in the contralateral ear. Myringosclerosis patches being the most common finding were seen in 29 patients followed by TM retractions seen in 28 patients. Prevalence of abnormal findings was found to be significantly higher in the squamous group as compared to the mucosal group. In 100 ears in the control group, only 11 % had positive findings. TM retractions were seen in 5 subjects (3 Attic and 2 Pars tensa retractions).
Conclusion
It can be statistically concluded that the disease of COM in one ear affects the contralateral ear slowly and silently. Hence both ears are affected as pairs and a slow pathological process continues behind an intact TM and kept hidden from the view unless it is actively sought for. Contralateral ears should also be actively followed up, in cases of unilateral COM in order to pick up disease harboring silently.
Epidemiological Profile of Foreign Body in Upper Aero-digestive Tract in a Peripheral Tertiary-Care Hospital
Authors: Maiti Amit Bikram , Hembrom Rabi , Sinha Rupam , Mandal Satadal , Nair Mayur M , Patra Somnath 
Published: August 2020

Introduction
Foreign body in upper aero-digestive tract leads to many complications including life-threatening ones to the patients. Its management depends upon type of foreign body and site of lodgement.
Materials and Methods
A descriptive study was conducted from March 2013 to February 2017 to determine the different components of the epidemiological profile of the cases of Foreign body in upper Aero-digestive Tract (UADT) and its management principle. Total 192 patients were selected for this study. These patients underwent different procedures for foreign body removal and post-operative notes were taken for data analysis to note the epidemiological pattern.
Results
A total of 192 patients were included in the study. Epidemiological data were derived and analyzed comprehensively to present the different profiles.
Conclusion
Fish bone was found to be the commonest foreign body in upper aero-digestive tract, followed by coin and meat bone. Foreign bodies are commonly removed by Tilley's forceps followed by Hypopharyngoscopy.
Assessment of the Utilization Pattern and Related Knowledge about Topical Nasal Decongestants among the Users
Authors: Rajasekaran Valli , Ghosh Puja 
Published: August 2020

Introduction
Nasal decongestants are one of the drugs commonly prescribed by otorhinolaryngologists in their day to day practice. The excessive or inappropriate use of nasal decongestant due to rapid symptomatic relief leads to drug misuse or abuse. Inadequate knowledge about the drug usage leads to inappropriate drug usage.
Materials and Methods
A cross sectional study was done among 90 patients who were using topical nasal decongestants. A pre tested, pre validated questionnaire was used to assess the patient’s knowledge, the utilization pattern and the attitude towards the drug usage.
Results
The mean age of presentation in our study was 38.4 years. Only 14.4% of the people knew the appropriate duration of drug usage. Only 33.3% knew about the probable side effects of prolonged drug usage. There was a significant correlation between knowledge and utilisation pattern of topical nasal decongestants usage and the literacy level. Though most of the people (46.7%) started using the drug after being prescribed by a doctor, only 14.3% among them strictly adhered to doctor’s instructions.82% of the users were not much worried about the prolonged usage as 73.3% believed that prolonged use may or will surely improve their symptoms. Though 66.7% users wanted to stop prolonged usage of the drug, 76.9% had varying difficulties in stopping the drug.

Conclusion
The knowledge and the utilization pattern regarding the drug usage were very low. The same was found to be better with increase in literacy level. Health professionals should play a major role in establishing a rational drug usage.
A Study on Hospital Acquired Infections among Patients in a Tertiary Care Hospital of Darjeeling District, West Bengal
Authors: De Maumita , Mukherjee Diptanshu 
Published: August 2020

Introduction
Hospital Acquired Infections (HAI), also called ‘Nosocomial Infections’ are identified at least 48-72 hours following admission to health institution. In many hospitals, HAI appears to be a hidden, cross-cutting problem. Thus a continuous surveillance is imperative for determining the extent of the problem and its effective prevention and control. Present study determines the incidence and different types of hospital acquired infections and the bacterial pathogens responsible for those.
Materials and Methods
An observational longitudinal study was undertaken during January to June 2014, among 107 patients admitted in ENT wards of North Bengal Medical College and Hospital (NBMCH), selected by consecutive inclusion technique. Information was taken using a predesigned, pretested semi-structured schedule. The collected data were analyzed as frequencies, percentages and means ± standard deviations.
Results
The present study found incidence rate of hospital acquired infections as 19.6% and incidence density as 26.35 per 1000 patient days. Surgical site infection was commonest type (57.2%) followed by urinary tract infection (23.8%) and blood stream infection (19.0%) respectively. 15.4% of blood cultures, 100.0% of surgical wound swab cultures and 21.7% of urine cultures were positive and gram negative bacteria were most frequently occurring organisms. Most commonly found bacteria were Pseudomonas and Klebsiella.
Discussion
Background characteristics of the study population; incidence rate, the different types of hospital acquired infections among those admitted patients and the bacterial pathogens responsible for those infections have been discussed along with review of literature.
Conclusion
Even if in a tertiary health care facility, hospital acquired infection rate could not be brought down into <10%. So implementation of stringent guidelines on prevention of HAI and continuous surveillance and monitoring system can help to diminish this problem in future.
Chondroid Syringoma of Dorsum of the Nose
Authors: Pathak Netra Aniruddha , Rokade Vidya Vasant , Shinde Kiran Jayawant 
Published: August 2020

IntroductionChondroid syrigomas are rare, usually benign tumors occurring predominantly in the head and neck area. These are also known as mixed tumors of skin. Preoperative diagnosis is difficult and generally histopathology examination confirms the diagnosis. The usual presentation is that of a slowly growing mass.Case ReportA rare case of chondroid syringoma on dorsum of external nose in 30 year old female patient is presented.DiscussionChondroid syringoma presents as slow‐growing, painless, subcutaneous or intracutaneous nodule in middle‐aged adult males. The tumor is often initially confused with more common dermatologic skin disorders such as sebaceous cysts, dermoid cysts, neurofibromas, dermatofibromas, basal cell carcinoma, histiocytoma and seborrheic keratosis. The treatment of choice is surgical excision with negative margins with follow-up to detect recurrences.
An Interesting Case of a Butcher Who Attempted to Cut His Neck
Authors: Ankale N R , Mudhol R S , Havaldar Rajesh Radhakrishna , Singh Anju 
Published: August 2020

Introduction
Cut throat injuries are well recognized in homicide but less recognized in suicides. The incidence of suicide is increasing worldwide owing to the more stressful strenuous lifestyle and other risk factors like substance abuse. Suicide by incising one’s own throat is associated with hesitation marks whereas homicidal wounds are not.
Case Report
We present an interesting case of a suicidal cut throat of the victim being a butcher who was on alcohol abstinence since 3 days with severe injuries of supraglottic larynx and cricopharynx, surprisingly without any evidence of hesitation marks. He underwent immediate neck exploration and suturing of the injured structures without the need of a tracheostomy.
Discussion
A multidisciplinary approach by Otolaryngologists, Psychiatrists, Intensivists, and Anaesthetists is required in the effective management of these victims. A thorough proper early assessment can totally avoid the need of tracheostomy which is recommended in practice, hence preventing complications arising out of this unnecessary but advocated procedure.
Myxoid Chondrosarcoma of the Hyoid Bone
Authors: Majumdar Kinjal , Samanta Nirmalya , Shrestha Devjani Ghosh , Mondal Kasturi , Jana Utpal 
Published: August 2020

Introduction
Chondrosarcoma of hyoid bone is very rare with only 19 cases still reported. We, therefore, present this case report for the interest of medical literature to make clinicians aware of the disease.
Case Report
They usually present as a slow growing upper neck mass. Computed tomography (CT) and magnetic resonance imaging (MRI) are useful radiologic investigations. The tumour was resected through a trans-cervical approach. Definite diagnosis was made by postoperative histopathology and immunohistochemistry.
Discussion
Surgical excision is the treatment of choice for local control. Incomplete removal is a risk factor for recurrence and possible dedifferentiation. Long term follow up is necessary.
Isolated Sphenoid Sinus Disease- A Unique Case of Sphenoidal Mucocoele
Authors: Ghosh Tushar Kanti , Gupta Srijoy , Devineni Pradeep 
Published: August 2020

Introduction
Isolated Sphenoid Sinusitis and sinus lesions is a rare entity accounting for just 1-3% of all Sinus afflictions. Most have occurred in men between the ages of 30 and 40 years.
Case Report
A case of right sphenoid sinus mucocele is reported in a male patient aged 68 years, with size of the lesion (35 x 34 mm) detected by CT & MRI scans. The patient presented with a 3 weeks history of unilateral ptosis, diplopia, and photophobia. He also complained of bilateral nasal obstruction, nasal stuffiness, and a mucoid nasal discharge. Endoscopic decompression of the right sphenoid sinus was performed, and approximately 160 ml of thick, sterile mucoid secretion was aspirated. Despite the size of the mucocele, no significant destruction of the sphenoid walls was evident. Postoperatively within 15 days the patient's symptoms improved significantly.
Conclusion
The Nasal Endoscope has revolutionised sphenoid sinus mucocele treatment. An adequate sphenoidotomy and drainage give excellent results.
Radiological Analysis of Frontal Cells and its Association with Frontal Sinus Mucosal Disease: A Tertiary Care Hospital Based Study
Authors: Shrestha Bikash Lal , Karmacharya Sameer 
Published: August 2020

Introduction
The frontal sinus and frontal recess both have complex anatomy causing difficulty during endoscopic sinus surgeries. The term frontal cells is currently used to describe a group of anterior ethmoidal cells classified by Kuhn et al into 4 types. Though there are precise descriptions, the frequency of frontal sinus cells (FSCs) varies widely in the literature. The presence of FSCs is responsible for a narrowing of the frontal sinus outflow tract which subsequently causes a partial obstruction of drainage and aeration of the frontal sinus. Our main aim is to the see the distribution of different frontal cells in Nepali population and relation with frontal sinus mucosal disease.

Materials and Methods
This prospective, longitudinal study performed in 110 consecutive patients who underwent CT scan of nose and paranasal sinuses. The frontal cells and agger nasi cells were identified and association between the frontal cells and agger nasi cells with frontal sinus mucosal disease was analyzed with chi square test.

Results
The agger nasi was present in 83.63% CT scans whereas frontal cells were distributed in 61.82% CT (computed tomogram) scans. There was not statistical significance and any association between the frontal cells and agger nasi cells with frontal sinus mucosal disease.

Conclusion
The frontal cells and agger nasi cells distribution in Nepalese population, even though in small sample size, is similar with other studies in the literature. There is also non association of either frontal cells or agger nasi cells with frontal sinus mucosal disease.
A Study of Aetiological Profile of Unilateral Sensorineural Hearing Loss
Authors: Gangopadhyay Prasenjit , Prasad Bipin Kishore 
Published: August 2020

Introduction: It is necessary to identify the aetiology of sudden sensorineural hearing loss for proper management. Despite advancement in the field of diagnostic radiology, immunochemistry and genetic studies, there are still many cases of USNHL where a definite cause cannot be identified. In this study, an attempt has been made to identify the aetiological factors responsible for unilateral sensorineural hearing loss (USNHL)..
Materials and Methods: Seventyfive patients with acquired unilateral sensorineural hearing loss without chronic otitis media were included in the study. Hearing was assessed by tuning fork test and pure tone audiometry. Special tests were done to differentiate between cochlear and retrocochlear pathology, to objectively assess hearing loss and to diagnose nonorganic hearing loss. Radio-imaging was done to diagnose skull bone fractures, space occupying lesions in internal auditory meatus and cerebellopontine angle or intracranial pathologies. Biochemical analysis of blood, immunoglobulin and serological assay were done to rule out specific causes.
Results: Majority of patients were within 21-30 years of age. 37 patients presented with sudden and remaining with progressive hearing loss. Majority (57.3%) were found to have idiopathic cochlear pathology. Amongst the remaining, there were 8 cases of acoustic trauma, 4 each of Meniere’s disease and cerebellopontine angle tumour and 3 each of Noise-induced hearing loss, labyrinthitis and Non-organic hearing loss. There were 2 cases of meningitis and 1 each of barotrauma, connective tissue disorder, iatrogenic trauma, fracture of petrous bone and cerebrovascular accident.
Conclusion: Most of the studies have been done on sudden sensorineural hearing loss. Current study, including sudden and progressive cases, is hence an attempt to ascertain aetiological profile of unilateral SNHL.
Demographic Profile of Hearing Deficiency in a peripheral referral hospital- A Five Year Study
Authors: Chakrabarti Amit , Sen Indranil , Sinha Rupam , Kumar Manish , Hembrom Rabi , Mandal Satadal , Maiti Amit Bikram 
Published: August 2020

Introduction: This present study is an attempt to study the demographic characteristics of individuals presenting with hearing loss in a peripheral tertiary care hospital using the available database of pure tone audiometry results.
Materials and methods: A retrospective, observational, descriptive study was conducted over a period of 5 years in the Department of ENT of a peripheral tertiary care hospital wherein all subjects having a pure tone audiometry were included in the study. The records of PTA done were analyzed followed by systematic analysis.
Results: A total of 9790 individuals inclusive of 5566 males and 4224 females were studied. Maximum no of individuals belonged to the age group of 21-30 years. Nearly 63% of total subjects suffered from Bilateral hearing loss. Sensorineural hearing loss was most prevalent type of loss. Mild degree of loss was most prevalent. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent.
Conclusion: This study emphasized the ‘Composite parameter distribution’ in addition to the classical single parameter demographic profile of deafness in a remote tertiary care hospital. Adolescents and young adults comprised the bulk of the study population. Sensorineural hearing is the most common type. Bilateral hearing loss is more frequent. Mild degree of loss is most frequent.
Clinical Study to Determine Occult Vestibular Dysfunction in Patients of Chronic Otitis Media using Computerized Static Posturography
Authors: Singh D K , Gupta Salil Kumar , Bhalla Vijay , Raina Sheetal , Kumari Abha 
Published: August 2020

Introduction
Various studies have shown high incidence of subjective vestibular dysfunction in cases of chronic otitis media (COM). Evaluation of vestibular dysfunction in chronic otitis media patients is becoming an integral part of comprehensive management of COM. In our study, we have evaluated vestibular dysfunction in patients with COM, using computerized static posturography, an objective technique in contrast to other subjective tests of vestibular dysfunction.
Materials and Methods
In this prospective case control study done over a period of 1.5 years, 50 cases of COM and 50 healthy controls were included and they underwent Computerized Static Posturography. Parameters taken were Somaesthetic, visual and vestibular scores in both antero-posterior (AP) and medio-lateral (ML) axis; and in combined axis (Antero-posterior +Medio-lateral) and these scores were compared with those of healthy controls.
Results
Total 50 cases of COM (average disease period - 5.7 years), of both sexes, with age range of 15-60 years and mean age of 31.58 years were taken. On analyzing above mentioned parameters using SPSS software, we found no significant difference in vestibular function in cases of COM as compared with healthy individuals.
Discussion
The outcome of computerized static posturography can be quantified with respect to changes in center-of-force sway amplitude, distance, or velocity, which, by virtue of not being burdened by subjective interpretation, its results can be, documented both graphically and numerically.
Conclusion
This study, further solidified with objective evidence, raises a question on COM without complications being directly responsible for vestibular dysfunction.
Maxillary Dentigerous Cyst Associated With Supernumerary Tooth
Authors: Nanwani Prashant 
Published: August 2020

Introduction
Dentigerous cysts are caused by a developmental abnormality derived from the reduced enamel epithelium of the tooth-forming organ. Dentigerous cyst rarely involve impacted supernumerary tooth in anterior maxilla while commonly involve third molar tooth.
Case Report
A case of dentigerous cyst in association with supernumerary tooth in a 15-year-old male patient is reported causing right nasal cavity obstruction. The present case report describes the management of a dentigerous cyst by surgical enucleation.
Fibrolipoma of the Hypopharynx
Authors: Bhutia Kunzang Doma , Bose Anandabrata , Debnath Anjon 
Published: August 2020

Introduction: Hypopharyngeal lipomas are rare tumors of head and neck which present with vague symptoms like dysphagia, foreign body sensation in throat, feeling of something coming to the throat or mouth, choking sensations or with symptoms of obstructive sleep apnea. These tumors can cause upper airway obstruction and even asphyxial deaths presenting as medical emergency.
Case report: We report one such case of a 38 year old female with hypopharyngeal lipoma who had presented to us with symptoms of dysphagia, choking episodes and foreign body sensation in throat.
Discussion: Laryngoscopic examination in these cases is diagnostic to assess its size and site of attachment. Imaging studies like CT scan or MRI help in diagnosis.