bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality challenges to the universities for contributing to the development of the smart cities and communities
Authors: Anttila Juhani , Jussila Kari 
Published: August 2020

Universities have had a diverse influence on the development of the society as a whole and also today on the smart city and community projects. Successful collaboration with the many different involved societal parties, however, sets requirements forquality in all of the main activity sectors of the universities including higher education, research and participation and influence in regional development. In practice, this is ensured through organizational learning towards excellence in the overall performance of the university that implies professional quality management principles, innovations in processes and practices aligned with the other organizations of the society.
Smart cities and communities bring together city planning, industry, universities and citizens to improve urban life of individuals and organizations and ultimately to enhance quality of society and reinforcing sustainable development. Smart city also is a manifestation of the 4th industrial revolution and industry 4.0, which are the subjects of considerable discourse today widely. These emerging phenomena imply innovations, better planning, a more participatory approach, higher energy efficiency, better transport solutions, intelligent use of information and communication technologies. However, it is essential that people are at the center.
This article brings up conceptual bases, practical solutions and examples especially from the viewpoint of professional quality management in the universities.
HEALTH-RELATED QUALITY OF LIFE IN THAI CHILDREN WITH THALASSEMIA AS EVALUATED BY PEDSQL AND EQ-5D-Y: A SINGLE CENTER EXPERIENCE
Authors: Surapolchai Pacharapan , Sinlapamongkolkul Phakatip 
Published: August 2020

Background: Thalassemia remains a chronic challenging disease in Thailand, but national prenatal screening along with better treatment and management may have improved health-related quality of life (HRQoL) for pediatric patients. We aimed to measure the HRQoL of transfusion dependent (TDT) and non-transfusion dependent (NTDT) of these pediatric patients at our institute.
Methods: We included all patients 2 – 18 years old, with TDT and NTDT, using the Pediatric Quality of Life Inventory 4.0 Generic Core Scales (PedsQL) and the EuroQol Group’s Five Dimensions for Youth (EQ-5D-Y) instruments. Patients and caregivers responded as appropriate for age.
Results: Mean PedsQL total summary scores (TSS) (SD) of child self-reports and parent proxy-reports were 81.00 (10.94) and 78.84 (16.72) from 150 participants. Mean EQ-5D-Y VAS (SD) for children was 89.27 (11.56) and 86.72 (10.62) for parent proxies. The most problematic EQ-5D-Y dimension was “having pain or discomfort”. These scores had significant correlations between child and parental proxy perspectives, as well as between the PedsQL and EQ-5D-Y. An age of 8 - 12 years and oral chelation therapy predicted lower self-reported PedsQL TSS. Parental proxy-report predictors for reduced PedsQL TSS and EQ-5D-Y VAS were primary school education for children, parental proxy secondary school education, Universal Coverage insurance, and TDT.
Conclusion: HRQoL scores of our pediatric thalassemia patients had improved from the previous decade, and these findings may represent our better standard of care. Some sociodemographic and clinical characteristics may present negative impacts on HRQoL.
Association of VDBP rs4701 variant, but not VDR/RXR-α over-expression with bone mineral density in pediatric β-Thalassemia patients
Authors: Sahmoud Shaimaa , Ibrahim Mostafa , Toraih Eman , Kamel Noha , Fawzy Manal , Elfiky Samar 
Published: August 2020

Introduction: The reduced rate of bone formation despite the availability of vitamin D has been reported in β-thalassemia. This suggests genetic factors together with environmental one can be implicated in this condition. Since vitamin D binding protein (VDBP) maintains bioavailability of vitamin D which binds to vitamin D receptor (VDR)-retinoid X receptor alpha (RXRA) heterodimer to exert its molecular actions, we speculated that vitamin D metabolic-axis expression signature and variants could be potential molecular candidates for bone turnover/disease in thalassemia. To this end, this study aims to analyze VDR/RXRA expression signature, and two VDBP variants in a pilot sample of Egyptian β-thalassemia children in correlation with bone mineral density (BMD).
Patients and methods: Forty-four β-thalassemia children and 40 unrelated controls were enrolled. The serum bone chemistry profile was measured. Peripheral blood mononuclear cells (PBMN) VDR/RXRA expression levels were quantified by Real-Time quantitative reverse transcription-polymerase chain reaction (qRT-PCR). VDBP rs7041 and rs4588 variants were identified by Real-Time allelic discrimination assay. All patients were subjected to lumbar-spine Dual-energy X-ray absorptiometry (DEXA).
Results: VDR/RXRA expressions were significantly higher in β-thalassemia children compared to controls (P = 0.001 and <0.001, respectively) and showed higher values in β-thalassemia major relative to β-thalassemia intermedia. Expression levels of both genes were not associated with sex or BMD. However, VDBP rs4701 genotyping revealed lower BMD-L4 and a higher frequency of osteoporosis.
Conclusions: β-Thalassemia children had higher expression levels of PBMN VDR/RXRA. VDBP rs4701 variant was associated with osteoporosis in our β-thalassemia patients on vitamin D supplementation. Further large-scale studies in other ethnic populations are warranted.
A SEROPREVALENCE OF HBV, HCV AND HIV-1 AND CORRELATION WITH MOLECULAR MARKERS AMONG MULTI-TRANSFUSED THALASSEMIA PATIENTS IN WESTERN INDIA
Authors: Mishra Kanchan , Shah Avani , Patel Krima , Ghosh Kanjaksha , Bharadva Sumit 
Published: August 2020

Background: Blood transfusion is a lifesaving therapy for patients with hemoglobinopathies. However, the need of frequent transfusion carries the risk of transfusion-transmitted infections (TTIs). This study was aimed to determine the seroprevalence of Hep-B, Hep-C and HIV-1infections among the multi-transfused Beta-thalassemic patients and correlate the same with NAT testing.
Methods: Total 196 patients with Beta-thalassemia were included in the study. Patients were screened for the presence of viral markers by third generation ELISA test as well as for viral DNA/RNA by NAT.
Results: Among these 196 multi-transfused Beta-thalassemia patients, 32.1% were females and 67.8% were males. A total of 100 (51.1%) patients were found to be anti-HCV antibody reactive, while HCV-RNA was positive in 66 (33.7 %) of the 196 patients tested. There were 6 (3.1%) patients reactive for anti-HIV-1 antibody, while 8 (4.1%) were positive for HIV-RNA. There were only 3 (1.5%) patients that were found to be reactive for HBsAg, however 5 (2.5%) were positive for HBV-DNA. Two (1%) patients had co-infection of anti-HCV antibody and HBsAg,whereas 6 patients were found co-infected by NAT testing, in-which 3 (1.5%) were positive for HBV-DNA and HCV-RNA, 1 (0.5%) was positive for HIV-RNA and HBV-DNA, and 2 (1%) had co-infection of HIV-RNA and HCV RNA.
Conclusion: Prevalence of HCV among multi-transfused Beta-thalassemia patients is significantly higher than the normal population. On the other hand, the study showed low prevalence of HBV. Therefore, a follow-up schedule and administration of booster dose of HBV vaccine is strongly recommended for thalassemia patients. To the best of our knowledge, this is the foremost work that shows prevalence of HIV, HBV and HCV in thalassemia patients using both serology and molecular markers in Western India.
Impressive continuous complete response after mogamulizumab in a heavily pre-treated Sézary syndrome patient
Authors: Zinzani Pier Luigi , Lolli Ginevra , Casadei Beatrice , Argnani Lisa , Nanni Laura , Cavo Michele 
Published: August 2020

Background: Sézary syndrome (SS) is a rare lymphoproliferative neoplasm, almost incurable outside the setting of allogeneic transplantable patients. Prognosis for relapse/refractory patient remains poor, as the available drugs confer short lasting remission. In this setting, the anti-chemokine receptor type 4 (CCR4) monoclonal antibody mogamulizumab demonstrated efficacy in an international, open label, randomized controlled phase 3 trial (MAVORIC) versus vorinostat.
Case description: A heavily pretreated 57-year-old SS woman (stage IVA) was randomized in the mogamulizumab arm of MAVORIC at our Institution. She quickly achieved a response but after 30 cycles she was discontinued from therapy due to cutaneous toxicity. Nevertheless, she is still in complete response (CR).
Conclusions: mogamulizumab is an anti-CCR4 monoclonal antibody that can induce long lasting response also in very heavily pre-treated patients not responding to any previous treatment. The extraordinary characteristic of our patient is that she is still in CR after 2.5 years since treatment discontinuation.
A Few Unusual Cases of Benign Laryngeal Lesions - Our Experience
Authors: Halder Sebananda , Ghosh Debangshu , Saha Jayanta , Basu Sumit Kumar 
Published: August 2020

Introduction: Benign laryngeal lesions may have some uncommon presentations.
Aims: The aim was to identify unusual benign vocal cord lesions and review their management and follow up.
Material and methods: The records of the patients presenting with different benign vocal cord lesions were reviewed retrospectively. Confirmed cases of vocal cord paralysis and malignancy were excluded from the study. Nine cases were imcluded in this study. Clinical findings, investigation reports, treatment and outcome were analysed.
Results: Most of the patients were from 18 years to 52 years (66%). Most common presenting feature was hoarseness of voice (89%) followed by respiratory distress (33%) . Microlaryngeal surgeries were done in 7 patients (78%) and 2 patients (22%) were managed conservatively.
Conclusion: Diagnosis of benign vocal cord lesions may sometimes be difficult. Careful history, attention to the anatomy and the probable variations in presentation of the benign lesions of larynx, thorough clinical examination and different diagnostic tools are essential for satisfactory management.
A Complicated Case of Foreign Body Oesophagus in an Infant
Authors: Verma Arvind Kumar , Guha Ruma , Das Chiranjib , Bandopadhyay Saumendra Nath 
Published: August 2020

Ingestion of foreign bodies is common primarily in children, psychiatric patients, alcoholics and elderly people who use dentures. Selivanov et al. reported that, in most cases of foreign body ingestion, the most common foreign bodies ingested were coins, bones, food debris, safety pins and razor blades. Rarity, technical difficulty in removing the foreign body, complications associated with the delay in diagnosis and treatment, migration of the foreign body extraluminally, site, shape and position of the sharp end of a safety pin makes this case interesting and worth reporting. We are reporting a case of a one year child presenting to us with accidental ingestion of a safety pin. The case was difficult because the protected end of the safety pin was broken which made both the ends of the foreign body sharp. Also, the ends of safety pin were wide apart and pointing upwards.
Negotiating the Learning Curve in Endoscopic Skull Base Surgery: A Local ENT Perspective
Authors: Raychowdhury Ranjan , Chaterjee Sandip 
Published: August 2020

IntroductionSkull base surgery, although recognised as an interdisciplinary specialty involving both Neurosurgery and Otolaryngology in the West, has been the domain of the Neurosurgeon in West Bengal. Several superspecialty healthcare facilities in the state are now actively promoting endoscopic skull base surgery.
Structured trainingThe Pittsburgh group has published a systematic training programme for skull base surgery.
Paradigm shiftFollowing the work of several groups, most notably the Pittsburgh group in the USA, a paradigm shift from open to endoscopic anterior skull base surgery has occurred.
Learning curveThis paper discusses how the ENT surgeon may negotiate the learning curve in endoscopic skull base surgery in the context of the local resources available.
Three Years’ Experience of Management of Different Types of Rhinosporidiosis in Rural Part of Western West Bengal
Authors: Chakraborty Debdulal , Das Chiranjib , Hansda Rajesh 
Published: August 2020

Introduction: The incidence of different types of rhinosporidiosis is very high in the rural western part of West Bengal. The treatment of choice is surgical excision and cauterization of the base. The recurrence rate is very high.
Aims and objectives: The objectives of this study were to assess the distribution of rhinosporidiosis according to age, sex, presenting features, site of origin, recurrence rate and compare them with literature; and describe the surgical technique to reduce recurrence of the disease.
Materials and methods: This prospective case study was done in the department of Otorhinolaryngology in a tertiary care hospital in the western part of West Bengal from April 2012 to March 2015. Wide local excision of rhinosporidiosis along with electrocautery of the base was done. We took the help of endoscope and microscope whenever needed. Regular follow up with endoscope was done in postoperative period.
Results: Out of total 112 patients 62 were male and 50 were female. Commonest age group affected was 2nd decade. There was no recurrence in patients undergoing operation for the first time. Recurrence was noted in nasopharynx of 3 patients undergoing revision surgery.
Conclusion: Complete removal of rhinosporidiosis from the base is the basic criterion to reduce recurrence. It is possible by using meticulous technique along with the guidance of endoscope or microscope whenever needed. Regular postoperative follow up with endoscope is must to detect and treat early recurrence.
Acetic Acid Instillation after Canal Wall Down Mastoidectomy
Authors: Shetty Hamsa , K S Gangadhara 
Published: August 2020

Introduction:
Persistent otorrhoea and granulation tissue in the mastoid cavity are common post-operative complications of Canal Wall Down Mastoidectomy. In order to avoid the same and to achieve a dry cavity instillation of acetic acid into the mastoid cavity during the post operative period is common practice.
Materials and Methods
In this study we assessed the results of 4% acetic acid instillation in varying quantity and frequency, in the ears after modified radical mastoidectomy.
40 Patients of chronic suppurative otitis media (atticoantral) / cholesteatoma, who underwent modified radical mastoidectomy during one and a half year period, were included in the study. The patients were divided into two groups; Group A with 30 patients and Group B with 10 patients, by simple randomization method. Group A patients were asked to instill 4% acetic acid approximately 10 to 12 drops (generously) into the mastoid cavity thrice a day for 8 weeks and were followed up every week. 10 patients of Group B were asked to instill the same preparation only once weekly and followed up for the next 12 weeks.
Results:
In Group A, dry mastoid cavity was achieved remarkably faster within six to eight weeks and in all the 30 patients. In Group B the results were delayed by up to 4 to 6 weeks in comparison to the Group A patients.
Conclusion:
Though acetic acid instillation is known to help in achieving a dry cavity but a slightly higher concentration (4% acetic acid) used more frequently is highly effective in rendering dry cavity much earlier without proliferation of granulation tissue.
OSSICULAR STATUS IN CHOLESTEATOMA : A DEPARTMENTAL EXPERIENCE IN A STATE MEDICAL COLLEGE OF WESTBENGAL.
Authors: Mozumder Somesh , Sengupta Arunabha , Mondal Alok Ranjan , Basu Soumik 
Published: August 2020

Introduction: Chronic otitis media is a long standing infection of part or whole of middle ear cleft. Its active squamosal variant (cholesteatoma) is most dangerous due to its bone eroding property.
Aims & Objective: Background knowledge of ossicular status in cholesteatoma will help us in determining the type of reconstruction needed during the surgery.
Material & methods: 60 cases of cholesteama, irrespective of age and sex [diagnosed on the basis of clinical examination , audiological and radiological evaluation] were selected during the study period of two years and their ossicular status were recorded intra-operatively.
Results & analysis: Ossicles and their parts getting involved in cholesteatoma cases , in decreasing order are :
Lenticular process (in total 50 cases)>Long process of incus (in total 49 cases) > stapes super-structure(in total 29 cases) > body of incus(in total 26 cases)> head of malleus(in total 23 cases)> handle of malleus(in total 10 cases).
Ossicular chain defeact in decreasing order are : M-I-S- > M+I-S- > M-I-S+ > M+I-S+.
Conclusion: In our study it was found that incus is the most vulnerable ossicle to get involved in cases of active squamosal variety of chronic otitis media where as malleus appeared to be the least susceptible one.
A RARE CASE OF A GIANT HEMANGIOENDOTHELIOMA OF NECK
Authors: Banerjee Swagatam , Chakravarty Sharmistha , Sarkar Saurav , Bera Sankar Prasad 
Published: August 2020

Introduction
Hemangioendothelioma is a rare variety of vascular soft tissue neoplasm, classified as a borderline tumour with diverse modality of clinical presentation. It is seen mostly at sites like the liver, lungs and bones while very few head and neck cases have been reported.
Case Report
A rare case of an unusually large tumour mass presenting as an anterolateral neck mass with extensions to right parapharyngeal space, posterior triangle and prevertebral space is presented here. The entire tumour was removed en-masse surgically. Histopathological examination confirmed the mass to be an epitheloid hemangioendothelioma, the enormous size of which in the neck makes it unique and unusual.
A CASE OF ORAL MUCOSAL MALIGNANT MELANOMA IN DISGUISE OF CERVICAL METASTATIC LYPMHADENOPATHY WITH APPARENTLY UNKNOWN PRIMARY.
Authors: Mozumder Somesh , Dubey Shirish , Dam Aniruddha , Bhowmick Anup Kumar 
Published: August 2020

Introduction: Primary malignant melanoma of the oral cavity is a rare neoplasm. The tumors tend to metastasize or locally invade tissue more readily than other malignant tumors in the oral region.
Case Report: A 55 year old male presented with left sided hard cervical lymphadenopathy with unknown primary with cytology of malignant melanoma. 18FDG-PET-C.T scan helped identification of the primary.
Discussion: The survival of patients with mucosal melanomas is less than for those with cutaneous melanomas. Tumor size and metastases are related to the prognosis of the disease. Early oral malignant melanomas can be clinically very difficult to distinguish from other benign oral pigmented lesions.
Conclusion: Any case presenting with cervical lymphadenopathy with a cytological diagnosis of Malignant Melanoma and without clinically identifiable primary, early detection using whole body 18FDG-PET CT is utmost important.
Recurrent Acute Tonsillitis, The 'Core' Issue
Authors: Samaddar Saikat , Mukherjee Dipanshu , Nandi (Mitra) Anita , Mandal Shyam Sundar , Roy Nirmalya , Sanyal Shaoni , Banerjee Swagatam , Bandyopadhyay Saumendra Nath 
Published: August 2020

Introduction:
Today bacteriological and patho-anatomical considerations too are taken into account while treating a case of tonsillitis. Past decade has seen the rise of resistance amongst the common pathogens, as well as rise in the number of unusual offenders. Determination of the true offending organism and prescribing an antibiotic as per the sensitivity pattern is of utmost importance.
Materials and Method:
A prospective longitudinal study was conducted in a tertiary care hospital in Kolkata. The study population consisted of patients presenting with recurrent attacks of acute tonsillitis. Determination of throat swab micro flora, ASO titre and core tissue microflora was done and correlated statistically.
Result:
There was poor correlation between throat swab and core tissue microflora. Positive predictive value of throat swab was 10%. Pseudomonas is the predominant flora harbouring tonsillar core in our study population. Amoxicillin the most commonly prescribed antibiotic stands out to be the most resistant one. No statistical significance could be reached comparing streptococcal tonsillitis with ASO titre.
Discussion:
The real pathology within the tonsil core is not always reflected in routine throat swab and bacteriology of recurrent tonsillitis may differ in different regions. ASO titre estimation adds up to the economic burden if rheumatic fever is not suspected. Judicious use of antibiotics based on true sensitivity pattern is encouraged. In the era of antibiotics Tonsillectomy still holds an important position in the management of recurrent attacks.
Conclusion:
Pseudomonas was found to be the most common pathogen in recurrent acute tonsillitis. Core tissue study remains the Gold standard in identifying the pathogenic organism. Oral third generation Cephalosporin was the most efficacious antibiotic for recurrent tonsillitis in our study population.
Vertigo, can it be redefined?
Authors: Choudhury Bhabani Kumar 
Published: August 2020

Background & Objectives-
Vertigo, a clinical symptom complex is not infrequent in our patients. Its diagnosis too is controversial. Majority of these cases run from hospital to clinics, some times to Otolaryngologists to get rid of this bizarre experience. Sometimes they get benefit but otherwise they experience a destitute life.
Our aim was to treat them by Physical Therapy in the light of Cervical Spondylosis that is commonly associated with vertigo.
Material & Methods-
This is a prospective case study done in PMR department (OPD) of a teaching institute over a period of 6 months time period. 20 OPD patients of both sexes (14 ladies and 6 gents) with definite Cervical Spondylosis along with complain of vertigo or dizziness, pain at cervical spine were accounted for the study. Only extreme aged persons or patients with other major co-morbidity were excluded. These 20 patients were treated with conventional Physical Therapy for CS. Medications were prescribed as and when required.
Results-
After Physical Therapy, that included lifestyle modification, isometric cervical exercise, intermittent cervical traction, application of Therapeutic Ultrasound (UST) to cervical region and proper posture care of cervical spine along with use of cervical orthosis (where needed), majority of the patients become symptom free.
Conclusion-
Physical Therapy may be considered as an alternative method of treatment of Vertigo patients, who are otherwise not responding satisfactorily to pharmaceutical agents.
Large Neurilemmoma of Buccal Mucosa in a Child – A Rare Entity
Authors: Dutta Sirshak , Aggarwal Neeraj , Choudhury Avijit , Sinha Ramanuj 
Published: August 2020

Introduction: Neurilemmoma or Schwannomas are benign tumour arising from the nerve sheath of myelinated nerve. Head neck neurilemmomas are not uncommon but intraoral region is very uncommon for this type of tumour.
Case Report: A very rare case of buccal neurilemmoma in an eleven year old child, but much larger than other reported case is reported in the present article with review of literature.
Discussion: Among the intraoral subsites, very few cases of neurilemmoma are reported to be situated in the buccal mucosa. Diagnostic dilemmas due to Fine needle aspiration cytology with features often resembling that of pleomorphic salivary adenomas are reported. The size of the tumour was larger than the cases reported in literature till date. The age of the patient was also much younger than the other reported cases, which made the present case unique.