bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinico-etiological Profile of Vocal Cord Paralysis
Authors: Senniappan Shivakumar , Gopalakrishnan Govind Krishnan , Kumar Chinnu Sudha , Panicker Anjali Mahendra , Nair Visakh Kookkal , Radhakrishnan Shankar 
Published: August 2020

Introduction
Vocal Cord Paralysis may be of central or peripheral origin based on the underlying pathology. Central Causes contribute about 10% while peripheral causes about 90% and the current study evaluated the clinical profile of vocal cord paralysis.
Materials and Methods
A cross-sectional observational study was conducted in the department of ENT for a period of one year. Patients with complaints of hoarseness or aspiration who on laryngoscopy examination with 45° telescope have been diagnosed to have vocal cord paralysis were included for the study. A total of 83 patients were included in our study.
Results
Vocal cord palsy was found most commonly after thyroidectomy (20.4%) followed by the idiopathic cause (19.2%). Certain cancers like lung cancer and neck cancers (hypopharyngeal, laryngeal and thyroid) carcinoma had also contributed significantly in the development of vocal cord palsy. Left sided vocal cord palsy (65%) was found to be the commonest side affected followed by bilateral vocal cord palsy.
Conclusion
A proper protocol is necessary for identifying the factors responsible for vocal fold paralysis which would help in managing the condition more effectively. Before making a diagnosis as idiopathic vocal cord paralysis, detailed investigations should be carried out to rule out the possibilities of cancer, causing vocal cord paralysis.
Managing Rhino-cerebral Mucormycosis: Institutional Experience
Authors: Patel Kalpesh , Gugliani Abhishek , Mehta Dhwani 
Published: August 2020

Introduction
Rhinocerebral mucormycosis is a rapidly progressive life threatening opportunistic fungal disease and usually occurs in individuals with weakened immune system. It is caused by filamentous fungi of Mucorales from class Mucormycotina. After nasal inoculation, it usually spreads to orbit and brain. The common presenting complaints are purulent sinusitis, facial swelling, headache, complaints of vision or palatal ulceration. Despite the many recent advances in the diagnosis and management of mucormycosis, it still carries a high mortality rate.

Materials and methods
Here we present our experience in managing 30 such cases of mucormycosis that presented to our department between June 2016 to June 2018.

Results
All these patients were started on systemic antifungals with or without surgical debridement. The patients were followed up with repeated nasal endoscopies and imaging studies.

Conclusion
Successful treatment of mucormycosis consists of aggressive repeated surgical debridement of necrotic tissue, systemic antifungal therapy and immediate control of underlying systemic diseases. Since there are no clear-cut guidelines, the treatment needs to be individualized on a case to case basis.
Sinonasal Polyps: A Diagnostic Challenge
Authors: Sarkar Sucharita , Saha Rama , Das Mou , Sardar Samares 
Published: August 2020

Introduction
Sinonasal polyps, presenting as mass lesion of nose and paranasal sinuses ranges pathologic entity including infective diseases to malignant lesions. 80% are non-neoplastic lesions and less than 1% are malignant. They all present with symptoms of nasal stuffiness or obstruction and mass lesion, producing significant diagnostic challenges as they possess extremely varied clinical behaviour, etiopathogenesis, treatment protocol as well as prognosis.

Case Series
During period of one year (March 2017 to February 2018), we had six patients presenting with nasal polyp having special features that need attention. After proper investigation each case was operated and gross examination followed by histopathology was done. They revealed six different diagnoses e.g., Olfactory neuroblastoma, Adenoid Cystic Carcinoma, Basal Cell Adenocarcinoma, Sinonasal Mucosal Melanoma, Primitive Neuroectodermal Tumour (PNET) and Aspergilloma.
Discussion
Clinicians’ attention is drawn to the fact that, similar presentation may have varied differential diagnoses, some of which may be very rare and histopathology is essential for coming to definitive diagnosis.
Human Bite on Nose
Authors: Biswas Prasit , Sinha Shriyash , Saha Somnath 
Published: August 2020

Introduction
Human bites are notorious due to chance of infection by direct inoculation of pathogens from saliva and must be managed properly. Human bite injuries cause dilemma to the treating doctor regarding its way of management. The options of management are primary closure, delayed closure with skin/tissue grafting and conservative.
Case Report
A 43 year old male patient with a human bite injury with tissue loss on the tip of nose was admitted in hemodynamically stable condition. He was given tetanus toxoid and anti-rabies vaccination as per current guidelines. Delayed wound closure was done in 2 steps with forehead flap, in 3 weeks interval. Patient was discharged after suture removal. There was good color matching and no complications.
Discussion
Human bite injuries are mostly due to inter personal violence, alcohol intoxication and psychiatric illnesses. Multiple instances of such bite injuries have been reported. Delayed closure of bite injuries with forehead flap provides good colour and texture match as well as good flap survival due to rich vascularity.
Laryngopharyngeal Reflux: Inter-rater Reliability of Reflux Finding Score in Clinical Practice
Authors: Keshavamurthy Venkatesha Belur , Sadashivappa Yogeesha Beesanahalli , Harsham Nithin K 
Published: August 2020

Introduction
Laryngopharyngeal reflux (LPR) is a clinical entity, caused due to retrograde flow of gastric content into the larynx. It imposes great diagnostic challenge to clinicians because of lack of specific symptoms, signs and validated tool. Reflux Finding Score (RFS) has been proposed for clinical diagnosis of LPR. Inter observer reliability of RFS tool was found out using two independent observers
Materials and Methods
In this Cross sectional study, ninety LPR subjects were subjected to 90° rigid endoscopic examination of larynx and RFS scores were calculated by two observers. Inter observer reliability of RFS was calculated using Kappa value.
Results
Most commonly observed laryngeal findings were erythema/hyperemia, posterior commissure hypertrophy, and vocal fold edema. Subglottic edema, thick endolaryngeal mucus and erythema had fair agreement.
Conclusion
There was a poor agreement between observers for total RFS score. The variables like subglottic edema, erythema/hyperemia, and thick endolaryngeal mucus showed fair agreement between the raters. The findings of diffuse laryngeal edema and posterior commissure hypertrophy showed poor inter rater reliability.
Impact of Intravenous Tranexamic Acid on Intraoperative Bleeding during Endoscopic Sinus Surgery
Authors: Padhy Pawan Kumar , Narayanaswamy Ramakrishnan 
Published: August 2020

Introduction
Bleeding during surgery is one of the most important concerns in endoscopic sinus surgery (ESS). The study conducted was aimed at assessing the efficacy of tranexamic acid on bleeding during endoscopic sinus surgeries.
Materials and Methods
A total of 30 patients were enrolled for the study. Lund and Mackay symptom score and radiological staging was used to compare clinical profile. The surgical field was assessed by the surgeon who was blinded, i.e., was not aware of which set of patients were receiving the drug. Boezaart and van de Merwe grading scale was used to assess the intraoperative surgical field. Both groups were selected so as to comprise of patients having similar clinical profile in terms of symptom score and radiological staging.
Results
In the arm receiving tranexamic acid, blood loss was found to be less and statistically significant (p=0.0157). The surgical field in endoscopic sinus surgery is more important factor in determining the completion and satisfactory outcomes of the surgery. Significantly high percentage (80%) of patients who were given the drug had a grade 2 scale when compared to (26.7%) in patients not receiving the drug. The difference in score in surgical field grading scale was also statistically significant (p=0.0034). The reported side effects of tranexamic acid mainly include nausea, vomiting, and possibly arterial or venous thrombosis, however none of the patients in our study had any side effects of the drug. Post-operative stay in the hospital was uneventful.
Conclusion
Intravenous Tranexamic acid reduced the intraoperative bleeding significantly and was useful in providing a better operative field.
Third Party Disability among Spouses of People with Hearing Loss
Authors: Rajasekaran Valli , Rajasekaran Preeti 
Published: August 2020

Introduction
With increasing life expectancy globally, hearing loss has become a major issue of concern. In addition to the negative implications on the people with hearing loss, it is also found to have a significant negative impact on the communication partners especially the spouse. Understanding the impact of hearing loss on their partners can aid us in addressing these issues during rehabilitation.
Materials and Methods
A cross sectional study was conducted among 60 people who presented with hearing loss and were living with their spouse. The hearing loss was assessed using pure tone audiometry. The third party disability among the spouses was assessed by using HII-SOP questionnaire. The disability scores were calculated and correlated with the severity of hearing loss using chi square test.
Results
The hearing loss was associated with some degree of third party disability (58.3%). The degree and duration of hearing loss did not correlate with the degree of third party disability. Female significant others had more difficulty than the male significant others. However, increasing age of the spouse, longer duration of married life and presence of chronic illness in the spouse were associated with more third party disability.
Conclusion
Hearing loss causes third party disability among spouses. In addition to treating hearing loss, the health care professionals should involve the spouses in treatment and rehabilitation. This highlights the need for family centred policies in treatment of hearing loss.
Efficacy and Safety of Microdebrider Assisted Adenoidectomy over Conventional Adenoidectomy
Authors: Harugop Anil S , Soni Samanvaya , S Tejaswini J 
Published: August 2020

Introduction
Adenoidectomy has conventionally been performed by curetting the adenoid tissue blindly with St. Clair Thompson curette leading to inadequate removal of tissue. Here the use of endoscopic guided adenoidectomy with microdebrider has been employed to compare the two methods.

Materials and Methods
It is a one-year randomized control trial conducted from January 2018 to December 2018. Patients were allocated into 2 groups i.e. conventional adenoidectomy and microdebrider adenoidectomy group. Pre and post-operative endoscopic grading of adenoid was compared and intraoperative blood loss and operative time were studied.

Results
Total 45 patients included 25 in conventional and 20 in microdebrider group. Following adenoidectomy operation the percentage of reduction of adenoid grading in microdebrider group was 63.79 % whereas 30.29% in conventional group, the average time taken by microdebrider assisted surgery was 16.45 mins as compared to 13.28 mins in conventional curettage. The average amount of blood loss in conventional group was 44.76 ml whereas in microdebrider group was 77.30 ml.

Conclusion
Microdebrider assisted adenoidectomy has proven to deliver completeness of clearance at the expense of slight increase in bleeding and the operative time.
Sure Shot Technique for Management of Ranula
Authors: Das Chiranjib , Chatterjee Pritam 
Published: August 2020

Introduction
Ranula is a pseudocyst in the floor of the mouth originating from the sublingual salivary gland.A variety of surgical procedures have been quoted in the literature. But the main concern is high rate of recurrence. Aim of the present study is to describe a definitive technique for managing ranula and compare the result with review of literature.
Materials and Methods
A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from 1st April, 2014 to 31st March, 2019. Patients presenting with ranula irrespective of age and sex; size of the mass; whether primary or recurrent case were included in the study. Patients presenting with congenital and plunging ranula were excluded. Patients were treated with total excision of ranula along with sublingual salivary gland. Patients were followed up regularly for at least one year post-operatively.
Results
We treated thirteen primary and four recurrent cases of ranula. Among them eight were male and nine were female. Patients were from seven to thirty three years of age with most being in the second decade of life. There was no injury to lingual nerve or submandibular duct in any patient. We did not observe any recurrence till date.
Conclusion
Successful management of a ranula includes identification of the extent of the cyst and removal of the cyst along with the sublingual salivary gland. When done meticulously, this technique gives 100% success without any complication.
Feasibility of Transoral Thyroidectomy by Vestibular Approach
Authors: Shah Kshitij , Patekar Shivali , Patel Tejal , Bradoo Renuka 
Published: August 2020

Introduction
An open approach to thyroidectomies through neck provides good exposure and safe dissection however, the patient still has a scar. Endoscopic thyroid surgery has been practised since the late 90s. The latest addition is the transoral endoscopic thyroidectomy by vestibular approach.
Materials and Methods
We at our centre performed this surgery on 3 patients. Here we present our initial experience of transoral endoscopic thyroidectomy by vestibular approach (TOETVA).
Results
Two of the three patients did not have any complication. Diffuse bleeding was encountered during one instance and decision was taken to convert it into an open procedure.
Conclusion
The preliminary experience of transoral thyroidectomy by vestibular approach shows it to be a feasible and promising ‘scarless’ and ‘minimally invasive’ surgery.
Endoscopic Excision of Juvenile Nasopharyngeal Angiofibroma: Case Series of 20 Patients
Authors: Parsana Monil , Patel Kalpesh , Gugliani Abhishek 
Published: August 2020

Introduction
Juvenile Nasopharyngeal Angiofibroma (JNA) is a highly vascular, benign, locally aggressive tumour of the nasopharynx. Endoscopic approach is the current accepted modality for the excision of Juvenile Nasopharyngeal Angiofibroma. The current study was undertaken to assess the outcome of this procedure at our institute.
Materials and Methods
A total of 20 patients of JNA at a medical college in Ahmedabad between the period of July 2015 to July 2017 were included. The tumour was staged according to Fisch system and clinical presentation, local examination, nasal endoscopy findings, radiological findings, approach of surgical resection, complications and recurrence were noted.
Results
We found that endoscopic approach for the excision of juvenile nasopharyngeal angiofibroma is safe and effective technique associated with reduced post operative morbidity and low recurrence rates.
Conclusions
JNA is a rare but a potentially life-threatening disease. All young males presenting with profuse, spontaneous and recurrent epistaxis should be evaluated for JNA. Endoscopic approaches have become the procedure of choice for resection of these tumours.
Epidemiological Analysis of Maxillofacial Injuries in Road Traffic Accidents: A Peripheral Hospital Based Study
Authors: Mondal Satadal , Sen Indranil , Hembrom Rabi , Roy Swagato , Sinha Rupam , Nair Mayur , Mahato Tapas Kumar 
Published: August 2020

Introduction
The aetiology of maxillofacial fractures is greatly influenced by geographic location, socioeconomic status of the cohort, and the period of investigation. The aim of this study is to analyze and identify characteristics of maxillo-facial fractures that took place in and around Midnapore- Kharagpore city of West Bengal and who presented to a peripheral medical college hospital during a period of 1 year.
Materials and Methods
A detailed database analysis was performed based on data collected from the patients of Road Traffic Accidents (RTA) with sustained facial trauma admitted to General Surgery and Otorhinolaryngology ward of a peripheral medical college hospital. Detailed clinical examination as well as radiological data was collected.
Results
The highest frequency of maxillo-facial injury due to RTA was among the young adults 18-40 years. Most common type of injury encountered is abrasion (44%) followed by bruise and closed fracture. Mandible is the most common bone to get fractured and most common type of Le fort type is Type II. Significant number of patients having RTA were young adults under the influence of alcohol riding in two-wheeler .
ConclusionWith the increasing incidence of RTA awareness must be created concerning safety rules and more policies need to be addressed.
A Clinical Study of Serum Vitamin D Levels in Chronic Tonsillitis among Paediatric Age Group
Authors: M.S. Sudhakar Rao , Karade Deepak 
Published: August 2020

Introduction
Infectious diseases of the faucial tonsils are most frequently encountered by Oto-rhino-laryngologists. Vitamin D has got an important role in the production of surface Anti-microbial peptides (AMPs). Overall, the active form of vitamin D plays a vital role in maintaining the immune system of the body. This study aims to evaluate the association of vitamin D deficiency in chronic tonsillitis among paediatric age group.
Materials and Methods
It is a clinical study carried out in the Department of Oto-rhino-laryngology and Head and Neck surgery at a medical college in Ballari, Karnataka, India from January 2018 to January 2019 for the time period of 12 months. Patients were evaluated with the relevant investigations and digital X-ray nasopharynx along with serum Vitamin D level assessment.
Results
A total of 60 children with chronic tonsillitis were enrolled in this study. There were 26(43.3%) male children and 34(56.7%) females, ranging in age group from 5 to15 years, mean age is 9.82. The common clinical presentation was recurrent episodes of throat pain seen in all the patients (100%). On serum 25-hydroxyvitamin D assessment, 40(66.7%) patients were found to have deficiency and 20(33.3%) patients were having insufficiency. Mean is 17.99ng/ml and ranging from 9.13-28.58ng/ml.

Conclusion
The study concludes that, the serum vitamin D levels in chronic tonsillitis among the paediatric age groups is found to be below normal levels and is unrelated to the socio demographic factors.
Influence of Khasi Language on Nasal and Oral Passages in English: A Nasometric Study
Authors: Chatterjee Indranil , Bhatt Shubhangi Shree , Kumari Kavita , Raj Divya , Saxena Vidushi 
Published: August 2020

Introduction
Speech is a overlaid function of respiratory, phonatory, resonatory, articulatory systems . Nasalance can be defined as the relative amounts of oral and nasal acoustic energy in speech done by modification of oral and nasal cativities that is complex activity of the resonator system. Nasometer was developed by Samuel Fletcher, Larry Adams, and Martin McCutcheon at the University is a computer based instrument facilitating accurate analysis of signal yielding nasalance scores. There is no report regarding nasalence score variance in khasi language speakers speaking English.
Materials and Methods
The study aims at analysing and measuring nasalence score in Khasi speakers reading English passages. A total of 5 female subjects were chosen who were native speakers of khasi language and who had exposure of English language since childhoods were selected. Nasometer II Model 6400 (Software version 2.6) of Key Elemetrics Corporation was used. Three standardized passages (Zoo passage, Rainbow passage and nasal sentences) were used for the study.
Results
The mean nasalance scores obtained for zoo, rainbow and nasal sentences in female were 19.39± 12.21 SD, 38.13 ± 14.83 SD, 68.33 ± 15.29 SD and 18.26 ± 3.53 SD, 33.13 ± 1.68 SD, 63.20 ± 88 SD respectively. Standard norms show significant differences in nasalance scores obtained for Zoo, Rainbow and Nasal Sentences. Paired t-test was used for comparison among the sentences and computation of data show more significant differences for nasal sentences as compared to zoo and rainbow sentences, that is significant (p>0.05). Rainbow sentences revealed more nasalance scores than zoo sentences (p>0.05) i.e. level of significance.
Conclusion
The reported normative Nasalance data can be used by several voice clinicians for assessing resonance quantitively for khasi speakers using austrioasiatic language.
Varied Presentations of Non-Hodgkin Lymphoma in Head and Neck Region
Authors: Das Chiranjib , Chatterjee Pritam 
Published: August 2020

Introduction
Majority of lymphomas involving the head and neck are Non-Hodgkin lymphoma (NHL). Most of them present as cervical lymphadenopathy. The objectives of this study are to present the problems encountered in the diagnosis of extra-nodal NHL in head and neck region and show the importance of thorough clinical examination and proper investigation.
Materials and Methods
A prospective study was done in the department of ENT in a tertiary care hospital of West Bengal from July 2015 to June 2018. Patients diagnosed as NHL on the basis of histopathology and immunohistochemistry were included in this study. Patients who were lost in follow up were excluded from the study. Patients were treated with chemotherapy and radiotherapy by Oncologist. All patients were followed up routinely both by Otorhinolaryngologist and Oncologist.
Results
There were 26 male and 11 female patients in this study. Patients were between 22 years to 76 years of age with highest incidence in 6th decade of life. Patients presented with only cervical lymphadenopathy; asymmetrical tonsillar enlargement with cervical lymphadenopathy; unilateral tonsillar enlargement only; huge inta-oral mass with stridor; parotid gland swelling; thyroid swelling with multiple cervical lymphadenopathy; epistaxis, palatal ulcer and cheek swelling; severe trismus with inconspicuous retro-mandibular mass. Majority of patients did well with chemoradiotherapy. Two patients succumbed to death, one with huge intra-oral NHL and another with nasal T/NK-cell lymphoma.
Conclusion
Good knowledge of the clinical characteristics of extra-nodal NHL and the methods to establish the diagnosis are essential for a correct and timely therapy of the disease.
Building Legislative Frameworks
Authors: Mokgothu Tshepo 
Published: August 2020

Building Legislative Frameworks: Domestication of the Financial Action Task Force Recommendations
As the international financial framework develops it has brought with it dynamic national legislative reforms. The article establishes how the domestication of the Financial Action Task Force (FATF) Recommendations directly affects national legislative processes as the FATF mandate does not have due regard to national legislative drafting processes when setting up obligations for domestication. The article tests the FATF Recommendations against conventional legislative drafting processes and identifies that, the proposed structures created by the FAFT do not conform to traditional legislative drafting processes. Due regard to functionality and efficacy is foregone for compliance. It presents the experience of three countries which have domesticated the FATF Recommendations and proves that the speed at which compliance is required leads to entropic legislative drafting practices which affects harmonisation of national legislation.