bluuebunny/crossref_metadata_2025_split huggingface dataset:
Combined hysteroscopy and laparoscopy in evaluation of female infertility
Authors: Gandotra Nikita , Rizvi Syed Masuma , Sharma Preeti 
Published: December 2018

Background: Infertility has always been one of the most elusive symptom complexes that perplex the best gynecologists and affects about 10-15% of reproductive age couples.Methods: This descriptive study was conducted in the Postgraduate Department of Obstetrics and Gynaecology at Government Medical College, Jammu for a period of 18 months in which 100 infertile females attending OPD for infertility workup were subjected to detailed relevant history taking followed by physical examination. Diagnostic hysteroscopy and laparoscopy along with laparoscopic chromopertubation was carried out after written informed consent including minimal therapeutic interventions if required.Results: Out of 100 patients included in the study, 67 (67%) presented with primary infertility and 33 (33%) presented with secondary infertility. Combined laparoscopy and hysteroscopy was normal in 13% (13) of cases. Out of 100 patients, abnormal laparoscopic findings were noted in 73% of patients: Endometriosis ( 13%),Polycystic ovaries (12%), Unilateral tubal block (11%), Pelvic inflammatory disease (9%).Abnormal hysteroscopic findings were noted in 47% of patients: Submucous myoma (8%),unilateral ostial block (8%),Endometrial polyp (7%), Hyperplasic endometrium (7%), Cervical stenois (6%).Most common cause of infertility in present study on Combined hysteroscopy and laparoscopy was Endometriosis (13%) followed by Polycystic ovaries (12%),Uterine myoma (12%) out of which 5% myomas were diagnosed on laparoscopy and 8% on hysteroscopy and 1% had myoma diagnosed on both hysteroscopy and laparoscopy. In the primary infertility group most, common finding was Polycystic ovaries (16.4%) followed by Endometriosis (14.9%) and uterine myoma (14.9%) while in patients suffering from secondary infertility, most patients had Bilateral tubal block (18.2%), Pelvic inflammatory disease (12.1%), Unilateral tubal block (12.1%), intrauterine adhesions (12.1%).Conclusions: Combined Hysteroscopy and Laparoscopy is a quintessential tool that provides cost-effective, comprehensive and single set-up diagnostic aid in infertile patients.
Maternal outcome following uterine rupture and its associated factors among mothers who delivered at Felege-Hiwot referral hospital, Amhara-Ethiopia
Authors: Wesson Alemtsehay , Assefa Enyew 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Ruptured uterus is one of the major causes of maternal and prenatal morbidities and mortalities in developing countries, particularly in Africa. Ethiopia is one of developing countries where maternal and prenatal mortalities are still high. The major objective of this study was to determine maternal outcomes of uterine rupture and its associated factors.</p><p class="abstract"><strong>Methods:</strong> The study design was facility based retrospective cross-sectional study from all mothers who visit from 01 September 2011 to 31 August 2015 at Felege-Hiwot referral hospital delivery room for delivery service with ruptured uterus was conducted in the study. A total of 312 cases were enrolled in the study<em>. </em>The table, graph and binary logistic regression was found to be more appropriate for analyzing the data. </p><p class="abstract"><strong>Results:</strong> More than<em> </em>39% mothers had severe complication. The common complication was severe anemia 24.4% followed by severe shock 14.7%. There were also 2.7% maternal deaths. The binary logistic regression model showed that incidence and its complication of uterine rupture in this study were remarkably high. Antenatal care visit, duration of labor and admission to laparotomy time and hospital stay had strong association with maternal outcome.</p><p class="abstract"><strong>Conclusions:</strong> Improving access to antenatal care, proper monitoring of labor and early referral of high risk patients will contribute to the reduction of unfavorable maternal outcome.</p>
Analysis of hearing improvement following fat graft myringoplasty
Authors: Panchal Ajay J. , Kumar Rakesh , Desai Megha 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Fat graft myringoplasty (FGM) is a procedure with a short learning curve, cost effective, with minimal morbidity in properly selected patients. It is useful to relieve the patient of annoyance caused by a small perforation in terms of ear discharge and hearing loss. The aim was to assess postoperative hearing improvement and investigate influence of factors like age, gender and location of perforation on audiological outcomes.</p><p class="abstract"><strong>Methods:</strong> This study was a prospective study done on 25 patients at a tertiary care hospital who underwent FGM. All patients had small dry central perforation. Air and Bone conduction (AC/BC) thresholds and air-bone gap (ABG) were evaluated both preoperatively and postoperatively. </p><p class="abstract"><strong>Results:</strong> Mean hearing improvement was 14.4762 dB in &lt;40 yrs age group whereas it was 11.2500 dB in &gt;40 yrs age group. Mean hearing improvement in females was 13.75 dB whereas it was 14.154 dB in males. Mean hearing improvement was 15 dB in posterior, 14.7 dB in inferior and 14.46 dB in anteriorly located perforation.</p><p class="abstract"><strong>Conclusions:</strong> FGM is effective in improving postoperative hearing thresholds hence it can be used in small dry central perforations of tympanic membrane in patients irrespective of patient variables such as age, gender, and location of perforation. As no significant statistical difference was observed in terms of gender, location or aetiology of perforation, we consider it a procedure to be recommended across all spectrums of patients.</p>
Benign lesions of the nose: a comprehensive study
Authors: Khot Sunil N. , Priyadarshini G. , Patil Prajakta 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Benign lesions of the nasal cavity represent a diverse group of pathologies. Furthermore, each of these disorders may present differently in any given patient as pain and discomfort, epistaxis, headaches, vision changes, or nasal obstruction.</p><p class="abstract"><strong>Methods:</strong> This study was carried out in a tertiary care center in India from October 2016 to March 2018. A total of 80 patients of age 10 years to 80 years were included. Detailed history and complete ENT examination including radiological studies was done. Patients were subjected to diagnostic nasal endoscopy and biopsy followed by histopathological examination. Depending on the diagnosis, medical or surgical treatment or combination of both was administered. </p><p class="abstract"><strong>Results:</strong> In present study the commonest presenting complaint was found to be nasal blockage found in 76% of cases, followed by rhinorrhea in 40%, nasal mass in 30%, epistaxis in 16%, cheek swelling in 5%. Out of 80 benign lesions, polyp was noted in 65 cases, hemangioma in 8 and inverted papilloma in 3 cases. Out of 65 cases of polyps, 52 were antrochoanal, 10 ethmoidal and 3 maxillary. Medical treatment was given in ethmoidal polyp cases, out of which 5 were cured. Most common surgery was polypectomy. Lateral rhinotomy was done in 6 cases</p><p class="abstract"><strong>Conclusions:</strong> Patients with benign lesions of the nose commonly presented in the second and third decade with slight male preponderance.Antrochoanal polyps are most common. Medical treatment works to a certain extent in patients with ethmoidal polyposis and surgery is the mainstay of treatment in the benign lesions of the nose.</p>
Traumatic perforations of tympanic membrane: our experience
Authors: Bhargava Anuja , Faiz Syed M. , Shakeel Mohammad , Singh Nafas J. , Gaurav Kumar 
Published: December 2018

<p class="abstract"><strong>Background:</strong> The aim of the study was to evaluate various etiological factors, clinical presentation in patients presenting with Traumatic ear perforations.</p><p class="abstract"><strong>Methods:</strong> 27 patients were taken in our study who reported within two weeks of history of trauma with no previous history of middle ear pathology. Data was collected and patients were treated. </p><p class="abstract"><strong>Results:</strong> 27 patients were studied (11 males and 16 females); age ranging from 15 years to 56 years. Laterality of trauma was found to be more in left ear. Aural Fullness &amp; pain in ear were the most common presenting complaints. Most common etiology was found to be assault and poster inferior quadrant was found to be most commonly involved.</p><p class="abstract"><strong>Conclusions:</strong> Traumatic perforations have a very good prognosis if they are treated at the right time. We would also like to stress on the fact that domestic violence is still prevalent in our society leading to patients of traumatic perforation.</p><p class="abstract"> </p>
Clinico-microbial profile in chronic suppurative otitis media and its management in tertiary care centre
Authors: Ramashesh Rashmi , Wajid Samira Abdul , Chandra Smitha 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Chronic suppurative otitis media (CSOM) is an ever growing concern of preventable hearing loss and is a major health concern especially in tropical countries. Lack of cleanliness, overcrowding, poverty, malnutrition and medical ignorance are few of the contributing factors. The microbiological flora is constantly changing due to indiscriminate use of antibiotics with rapid change in the antibiotic sensitivity patterns. Hence, this study was undertaken to determine the epidemiological profile, bacteriological profile and the antibiotic sensitivity pattern which would help in establishing a protocol in management of CSOM patients in the hospital.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients of CSOM attending the ENT Outpatient Department of The Oxford medical College, Hospital and Research Centre were included in the study. The samples were immediately sent to the Microbiology laboratory for further processing according to standard procedure. </p><p class="abstract"><strong>Results:</strong> Out of 100 cases, 74 were active mucosal type and 26 were active squamous, with Pseudomonas species (33.6%) being the predominant organism. <em>Staphylococcus aureus</em> was the next common organism with MSSA (16.3%) and MRSA (12.5%), CONS were 6.7%. Among the 28 gram-negative bacilli, <em>Klebsiella pneumoniae</em> (7.7%), was followed by <em>Escherichia coli</em> (5.7%), and <em>Proteus mirabilis</em> (4.8%).</p><p class="abstract"><strong>Conclusions:</strong> Pseudomonas species and <em>Staphylococcus aureus</em> are the commonest organisms of CSOM. Ciprofloxacin can be used as a topical agent for treating gram-negative bacilli. Among systemic antibiotics- Linezolid, Amikacin and Imepenam remains the drug of choice.</p><p><br /><br /></p>
Allergic fungal rhinosinusitis: a clinical study in Srikakulam
Authors: Jeevan Pradep K. , Ramesh S. , . Hareesh 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Allergic fungal rhinosinusitis is one of the differential diagnoses for chronic bacterial rhinosinusitis. Recognition and understanding of this unique disease will lead to efficient diagnosis and treatment of this curable process. India being a tropical country, provides an apt environment for fungal growth, the clinical diagnosis of Allergic fungal rhinosinusitis should not be missed and should be thoroughly investigated and managed to prevent recurrence. The objective of the study was to verify the management protocol for allergic fungal rhinosinusitis, after surgical clearance with functional endoscopic sinus surgery and postoperative histopathological examination and to see the efficacy of steroid and antifungal treatment</p><p class="abstract"><strong>Methods:</strong> A one year prospective study was considered with 28 patients from July 2016 to July 2017. Clinically suspected cases of rhinosinusitis depending upon their clinical presentation were subjected to nasal endoscopy, radiological examination and functional endoscopic sinus surgery. Postoperative histopathological examination was performed. Patients were followed up after giving steroid and antifungal treatment. </p><p class="abstract"><strong>Results:</strong> 28 cases were non-invasive. <em>Aspergillus</em> was found to be the most common isolate. The criteria responsible for good prognosis of allergic fungal rhinosinusitis management were mainly found to be functional endoscopic sinus surgery followed by topical corticosteroid therapy.</p><p class="abstract"><strong>Conclusions:</strong> Allergic fungal rhinosinusitis is a disease entity on the rise. Prompt diagnosis and intervention prevents recurrence and complications.</p>
Comparison between microdebrider assisted surgery and the conventional methods in the surgical treatment of nasal polyps
Authors: Bellad Shama A. , Manjunath N. , Ravi Shilpa 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Microdebrider is emerging as a convenient tool for various ENT surgeries that helps in easier disease clearance and reduced morbidity. Though it requires some surgical expertise initially to master the skill of handling it, it is worth procuring and using in endoscopic sinus surgery. The present study was conducted to compare the microdebrider assisted endoscopic surgery and conventional methods using sinus endoscopes in the surgical management of nasal polyps.</p><p class="abstract"><strong>Methods:</strong> 30 patients diagnosed with nasal polyposis between the age group of 5 to 60 were equally randomized into 2 surgical groups- powered endoscopic sinus surgery group and conventional endoscopic sinus surgery group with 15 patients in each group. The study aimed at comparing the intra operative (blood loss, duration of surgery) and post operative results (crusting, scarring, discharge, symptoms, recurrence) between the two groups using Lund–Mackay scoring system and visual analogue scale. The data was statistically analysed. </p><p class="abstract"><strong>Results:</strong> A significant statistical evidence for a shorter operative time, dryness of the field, better surgical conditions and improved VAS scoring at 3 and 6 months postoperatively was observed in the powered endoscopy group than using conventional techniques.</p><p class="abstract"><strong>Conclusions:</strong> The use of microdebrider in endoscopic sinus surgery has the advantage of complete clearance of disease, smoother intra operative course and better post operative healing when compared to conventional instruments in the treatment of nasal polyps.</p><p> </p>
Correlation between histological grading, LVI and PNI of carcinoma oral tongue to lymph node metastasis
Authors: C. Viswanatha Sumana , Hedne Naveen , Hasan Suhel 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Squamous cell carcinoma (SCC) of oral tongue has a higher predisposition to lymph node metastasis which reduces survival by 50%. In clinical practice, TNM classification is used for treatment planning which does not provide information on the biological characteristics of the tumor.</p><p class="abstract"><strong>Methods:</strong> This prospective cross sectional observational study included 30 patients with T1 to T3, N0/+ oral tongue SCC from 1<sup>st</sup> March 2014 to 30<sup>th</sup> April 2015. Incisional biopsy was taken from the primary tumour, pathological evaluation for differentiation of the tumour and assessment of lymphovascular (LVI) and perineural invasion(PNI) was carried out. Post operative histopathological examination included differentiation, LVI and PNI. The pathological findings were correlated using chi square test. </p><p class="abstract"><strong>Results:</strong> Majority presented with T2 stage. 27% had nodal metastasis. There was higher incidence of lymph node metastasis in moderately differentiated (MD) and poorly differentiated (PD) SCC which was not statistically significant. Significant correlation was seen between LVI and PNI to lymph node metastasis (p≤0.001).</p><p class="abstract"><strong>Conclusions:</strong> There is a higher incidence of lymph node metastasis seen in moderately and poorly differentiated SCC of oral tongue, which can be assessed on the preoperative biopsy, guiding us to be more aggressive in the management of cervical nodes in early tongue cancer.<strong> </strong>LVI and PNI are good predictors of nodal metastasis, help in assessing aggressiveness and prognosis of the disease, and are soft indicators for considering adjuvant / concurrent RT.</p>
A study of head and neck space infections and their sensitivity pattern at tertiary care hospital
Authors: Jindal Simmi , Parmar Suchina , Davessar Jailal , Bawa A. G. S. , Singh Gurbax , Prinja Sumit , Bali Alisha 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Head and neck space infections including submandibular, buccal, diffuse neck space, peritonsillar, parapharyngeal, parotid, submental, retropharyngeal, result in frequent hospital visits. Infection can be mild or severe life threatening infection.</p><p class="abstract"><strong>Methods:</strong> 40 patients with head and neck space infections were considered. Pus samples were collected with aseptic precautions and sent to department of microbiology for culture and antibiotic sensitivity. </p><p class="abstract"><strong>Results:</strong> The most common head and neck space infections are submandibular followed by buccal, diffuse neck abscess, peritonsillar, parapharyngeal, parotid, submental and retropharyngeal. Incidence of aerobic growth is 60%, fungal 10%, anaerobic 7.5%, tubercular 7.5% and no growth 15%. Predominant aerobes are <em>Staphylococcus aureus</em>, <em>Pseudomonas aeruginosa</em>, Methicillin Resistant<em> Staphlococcus aureus</em>, <em>Klebsiella</em> species and anaerobes are Peptostreptococcus and bacteroides and fungal species is <em>Candida</em>. Aerobic organism showed maximum sensitivity to Amikacin, Vancomycin, Linezolid, Piperacillin+Tazobactum, Clindamycin, Erythromycin, Cefoperazone, Ceftriaxone and maximum resistant to Levofloxacin, Cefoperazone, Ceftriaxone, Meropenem. Anaerobic bacteria showed sensitivity to Clindamycin, Metronidazole and Colistin and resistance to Vancomycin.</p><p class="abstract"><strong>Conclusions:</strong> Bacteriological examination and culture of head and neck abscesses helps to identify causative organisms. It helps to isolate even rarest of organisms and by knowing their sensitivity pattern we can detect specific therapy against them. Thus it helps in more effective treatment and fast recovery.</p>
Pilomatricoma in the pinna: a case report
Authors: Timna C. J. , Chandrika D. 
Published: December 2018

<p class="abstract">Benign calcifying epithelioma of Malherbe or pilomatricoma is rare benign skin tumours, typically seen in head and neck region. This is supposed to arise from hair follicle matrix cells. Though head and neck is the commonest area involved by this tumour, only 4.5% cases have been reported in the pinna. Neck is most commonly involved followed by cheek, scalp, pre auricular and peri orbital areas. Here we report a case of pilomatricoma over medial surface of pinna in a 20 years old female. She had the swelling which was gradually increasing for the past 5 years. Histopathological examination following excision biopsy confirmed the diagnosis.</p><p class="abstract"> </p>
Evaluation of correction of kyphotic deformity in dorso-lumbar spinal injuries by posterior stabilization with pedicular screw rod fixation
Authors: Srinivasan N. , Prabhakar Y. V. S. 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Acute injury to dorso-lumbar spine is the second most frequent site after cervical spine in adults. The injury, although not associated with high mortality, causes severe morbidity. The management of the traumatic dorso-lumbar spine injuries has improved considerably in the last few years. The objective of the study was to evaluate correction of kyphotic deformity in dorso-lumbar spinal injuries by posterior stabilization with pedicular screw rod fixation.</p><p class="abstract"><strong>Methods:</strong> The study includes 52 patients with dorso-lumbar spinal injuries with or without neurological deficit treated between 2006 and 2014. Pre and postoperative kyphosis was measured by Cobb’s method on plain radiographs. Pre and postoperative neurological status was evaluated based on Frankel’s classification. All un-stable dorso-lumbar spine injuries where two or more columns are involved on X-ray and CT scan were included in the present study.<strong></strong></p><p class="abstract"><strong>Results:</strong> Majority of the patients were in the age group of 20-30 years (38.5%) followed by 31-40 years (30.8%). Males were more than females. The most common mode of injury was road traffic injury in 71.2% of the cases. The most common level of injury was at L1 in 28.8% of the cases followed by at level D12 in 25% of the cases. In all the groups the mean kyphosis angle is reduced significantly. Overall the improvement rate was 94.2% and failure rate was only 5.8%.</p><p><strong>Conclusions:</strong> In conclusion the posterior reduction and internal fixation is a useful procedure in the treatment of the acute injuries of the dorsolumbar spine. </p>
Trousseau’s sign in orthopedic: a rare sequelae of inadequate postoperative pain management
Authors: Acharya Hriday P. , Patel Zulfikar M. , Mungalpara Nirav K. , Mehta Meet S. 
Published: December 2018

<p class="abstract"><strong>Background:</strong> Pain management in orthopedic is very crucial matter to handle, which is many a times not managed properly and that leads to various medical complications to the patients. Trousseau sign of latent tetany is a medical sign observed in patients with low calcium. This is the first and one of a kind case series describing the development and pathogenesis of Trousseau sign in orthopedics.</p><p class="abstract"><strong>Methods:</strong> This is a case series of 5 patients with lower limb fractures who underwent surgery. All these patients developed Trousseau's sign in immediate postoperative period. All the patients were investigated and were diagnosed with respiratory alkalosis. They were managed with closed bag ventilation which relieved the symptoms.<strong></strong></p><p class="abstract"><strong>Results:</strong> Here we put forward a direct physiological and psychological relation between a low pain threshold and associated hyperventilation with lead to development of Trousseau's sign in our patients. So, next time in postoperative round, if we see patient hyperventilating and complaining about fixed hand’s position, do not start calcium gluconate drip immediately, it may be due to respiratory alkalosis, then closed bag ventilation would be suffice.</p><p class="abstract"><strong>Conclusions:</strong> Trousseau’s sign seen postoperatively in Orthopedics may be commonly due to inadequate pain management rather than altered calcium metabolism.</p><p class="abstract"> </p>