bluuebunny/crossref_metadata_2025_split huggingface dataset:
Indian clinical practice consensus guidelines for the management of nasopharyngeal cancer - Update 2023
Authors: Darling HS , Noronha Vanita , Babu K Govind , Chaturvedi Pankaj , Kuriakose Moni , Birur Praveen , Kaushal Ashish , Singhal Manish , Gairola Munish , Goyal Sumit , Mahajan Abhishek , Patil M Vijay , Rao Vishal , Rath Goura Kishore , Kumar Prabhash 
Published: November 2024

ABSTRACT
Nasopharyngeal carcinoma (NPC) is a rare malignancy that poses significant treatment challenges, particularly in the context of curative intent. This updated guideline consolidates contemporary evidence and clinical practices tailored to the Indian healthcare landscape. It emphasizes a multidisciplinary approach to diagnosis and treatment, incorporating advances in chemotherapy, radiotherapy, and supportive care. Key recommendations include the use of induction chemotherapy for locoregionally advanced cases, detailed risk stratification, and specific management strategies for recurrent and metastatic disease, all aimed at improving patient outcomes.
Study and Comparison of the ph of the External Auditory Canal in Patients with Otitis Externa and Healthy Individuals
Authors: Yadav Krutika Vinay , Chethana R. , Gowda Vishwanath M. , Ghoshal Anuja 
Published: November 2024

Abstract

Context:
Otitis externa is the infection of epithelial lining of the external auditory canal (EAC). Cerumen has an acidic potential of hydrogen (pH) which accounts for its bactericidal and fungicidal property. The acidity of the EAC decreases due to high humidity, bathing, swimming, and frequent ear cleansing, which can lead to otitis externa.

Aims:
To study and compare the pH of EAC in patients with otitis externa and healthy individuals.

Settings and Design:
Tertiary care center and prospective, observational, and comparative study.

Methods:
This study includes 60 subjects with 30 diagnosed with otitis externa in diseased group and 30 in nondiseased group. pH of the EAC was evaluated by placing pH strips in outer one-third of EAC for 1 min.

Statistical Analysis Used:
Independent sample t-test was calculated using the Statistical Package for the Social Sciences version 24.0, IBM Corporation, USA for MS Windows.

Results:
Of the 60 subjects, 24 out of 30 subjects in diseased group had pH more than 5.6 and no subjects had pH more than 5.6 in nondiseased group. The average pH in diseased group was 8.73 ± 1.57 and nondiseased group was 5.13 ± 0.43.

Conclusion:
A change toward alkalinity of EAC is an important factor for the pathogenesis of otitis externa. Treatment of otitis externa should include acidification of the EAC with treatment with antibiotics and antifungals.
Mastoid Mucocele with Intracranial Complication Presenting as Acute Otomastoiditis
Authors: Aziz Nabilah Abd , Zainon Izny Hafiz , Johari Hafiza Husna , Othman Nik Adilah Nik 
Published: November 2024

Abstract
Mucocele is a benign epithelial-lined mucoid-filled sac that may sound harmless but has the potential of expanding at the expense of its surrounding bony architecture. The incidence of its emergence from the mastoid bone is relatively rare, whereas one that results in intracranial complications is almost unheard of. We present the case of a patient presenting with the symptoms of a middle ear infection, which was initially treated as refractory acute otitis media with intracranial complication. However, intraoperative findings revealed an infected mucocele within the mastoid bone.
Predictive Accuracy of Middle Ear Risk Index in Terms of Hearing Outcomes in Middle Ear Surgery
Authors: Ayushree Ayushree , Richa Richa , Prasad Raj Kumar , Sharma Satyendra 
Published: November 2024

Abstract

Introduction:
Chronic otitis media (COM), affecting millions globally, remains a significant health concern despite antibiotic advancements. Evolving otological approaches focus on both dry ear attainment and hearing restoration. Grading systems such as middle ear risk index (MERI) can aid in stratifying disease severity and predicting surgical outcomes for effective patient management.

Aims and Objectives:
The study aimed to assess MERI scores in tympanomastoid surgery patients to categorize disease severity and evaluate its correlation with postoperative hearing improvement.

Materials and Methods:
A prospective study was conducted over 2 years on 50 patients of COM. Patients were categorized into three groups based on MERI scores developed by Becvarovski and Kartush. A preoperative audiometry was obtained. The type of middle ear surgery required for each patient was decided intraoperatively as per the findings. Patients were followed up for a 6-month period, and hearing improvement was assessed in terms of closure of air-bone gap in the postoperative audiogram. Statistical analysis was performed using SPSS v23 software for Windows, and P < 0.05 was considered statistically significant.

Results:
In our study, significant associations (P < 0.05) were observed between the “MERI category” and variables such as otorrhea, cholesteatoma, ossicular status, previous surgery, middle ear granulation/effusion, smoker, total MERI score, and surgery performed. MERI was found to be negatively associated with hearing improvement, the higher the score lesser the improvement in hearing, and vice versa.

Conclusion:
The incorporation of MERI scoring into the surgical evaluation of COM cases holds promise for improving patient care and treatment strategies.
Study Protocol for Assessing Serum Superoxide Dismutase Response to a Novel Head Rotation Maneuver in Posterior Canal Benign Paroxysmal Positional Vertigo Treatment
Authors: Dhiman Neetu Rani , Gyanpuri Vyom , Joshi Deepika 
Published: November 2024

Abstract

Background:
Benign paroxysmal positional vertigo (BPPV) is a condition with sudden onset which causes short episodes of severe vertigo on altering the position of the head. Superoxide dismutases (SODs) are antioxidant proteins that regulate oxidative stress response in the body. Through this study, we evaluate the role of SOD in causing BPPV and effect of a new alternating maneuver, head rotation maneuver, for the treatment of BPPV of the posterior canal in reducing oxidative stress levels.

Methodology:
For investigating the role of serum SOD in the occurrence of BPPV Posterior canal, 60 BPPV and 60 healthy controls will be recruited. Their serum samples will be collected and SOD levels will be evaluated through colorimetry. For evaluating the effectiveness of head rotation maneuver in reducing the oxidative stress, patients with posterior canal BPPV (PC-BPPV) will be enrolled and divided into two groups through random allocation. Both the groups will be treated with head rotation and Epley maneuvers, respectively, by two separate therapists. Post-therapy SOD level will also be assessed.

Results:
Two-way repeated measures analysis of variance will be used to compare the groups’ improvement; treatment measures will be referred to as intergroup variables. Binary logistic regression analysis will be used to determine how SOD levels affect BPPV and recurrent BPPV. Pre- and postmaneuver SOD level will also be compared.

Conclusion:
SOD can be established as a reliable and strong biomarker for the occurrence of BPPV. Moreover, head rotation maneuver which is easy to perform can be used for managing PC-BPPV if the results show promising outcomes.
Efficacy of Adjuvant Yoga Therapy for Cognition in Schizophrenia: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Pattanashetty Daiveek G. , Varambally Shivarama , Bhargav Hemant 
Published: November 2024

Background:
It is well-known that negative and cognitive symptoms in schizophrenia are challenging to treat with conventional psychotropics. Hence, various mind–body interventions like yoga have been brought into the modern scientific realm to investigate for possible benefits. Although several studies have been done using yoga as an intervention for cognition in schizophrenia, the results have been inconclusive. In this study, we systematically reviewed and performed meta-analyses of the eligible studies to investigate the efficacy of yoga as adjuvant therapy for cognition in the schizophrenia population.

Methodology:
After registration of the protocol in PROSPERO (CRD42024504319), electronic databases such as PubMed, MEDLINE, PsycINFO, Scopus, Cochrane Library, ClinicalTrials.gov, and gray literature were searched for randomized controlled trials from their date of inception till March 2024, with appropriate search terms. Covidence and Microsoft Excel for data extraction, Cochrane tool for risk of bias assessment version 2, and RevMan version 5.4.1 for data analysis were used.

Results:
Of 182 studies found through database search, five articles were included for systematic review and two for the meta-analysis, with a pooled sample size of 76 patients. A systematic review of five articles showed high risk in two articles and low risk in three articles. Meta-analysis showed no significant effect of yoga on cognition (standardized mean difference 0.17, 95% confidence interval: −0.28 to 0.63, P = 0.46).

Conclusion:
The results of the meta-analysis should be interpreted with caution owing to the low power, small sample size, methodological limitations in the included studies, and hence high likelihood of type II error. There is a need for more studies with rigorous methodology involving yoga for cognition in schizophrenia.
Optimizing Laundry Service Outsourcing in the Hospital Sector: A Cost–benefit and Quality Analysis
Authors: Ashika D. , Prabhu G. Vaman , Parameshwari Vijaya , Marla Amitha P. 
Published: November 2024

Abstract

Introduction:
The decision to outsource laundry services within multispecialty hospitals involves numerous considerations, including financial implications and service quality. This study investigates the feasibility and consequences of outsourcing in-house laundry services in a multispecialty hospital context. The research aims to assess the cost–benefit dynamics and quality implications of such a strategic shift by employing a mixed-method approach, combining both quantitative and qualitative analyses.

Aim and Objectives:
The primary objective of this study is to evaluate the financial and operational aspects of outsourcing laundry services, as well as its impact on service quality in multispecialty hospitals. The objectives are to identify the processes and costs involved in laundry services, analyze variable and fixed costs along with monthly and annual consumption, and evaluate annual maintenance contracts on equipment to determine per-visit spending. In addition, the study aims to assess the cost efficiency of outsourcing laundry services and examine the qualitative aspects of service quality as perceived by hospital management.

Methodology:
This study employs a mixed-method approach, incorporating retrospective and prospective analyses. Quantitative data on process costs and financial implications were gathered through financial records and budgetary documents. Qualitative data regarding service quality perceptions were obtained through interviews and surveys with laundry staff. The analysis includes a comparative examination of in-house versus outsourced laundry services, considering factors such as cost-effectiveness and quality assurance.

Observations and Results:
The findings reveal significant cost savings potential associated with outsourcing laundry services in multispecialty hospitals. Objective data indicate that outsourcing can reduce the cost per kg of linen from ₹46.20 to ₹40.00, leading to a reduction in annual expenses from ₹10,533,600 to ₹9,120,000. This translates to an annual savings of ₹1,413,600. In addition, outsourcing results in a reduction in monthly costs of ₹117,800. The qualitative findings from expert interviews provide additional context to the cost analysis, highlighting both the challenges and benefits of outsourcing laundry services.

Conclusions:
The study concludes that outsourcing laundry services in multispecialty hospitals can provide tangible benefits in terms of cost savings and service quality enhancement. By strategically reallocating resources and leveraging external expertise, hospitals can optimize their laundry operations and focus on delivering high-quality patient care. This study underscores the importance of careful consideration and strategic planning in outsourcing decisions within the health-care sector, offering valuable insights for hospital administrators and service providers alike.
Hub-and-Spoke Model for Quality Improvement in Oncology Outcomes
Authors: Sinha Issac , Rapheal Jomon , Bishnoi Neeraj , Sharma Ankit , Pai Siddharth , Anand G , Choudhary Shovan 
Published: November 2024

Abstract
The hub-and-spoke model in oncology is a strategic approach designed to decentralize cancer care in India. In this model, a central, highly specialized cancer center (the “hub”) is connected to smaller, regional hospitals (the “spokes”). The hub provides advanced diagnostic and treatment facilities, while the spokes handle more common and less complex cases. This model aims to improve accessibility and quality of cancer care across the country. By distributing services, it reduces the burden on central hospitals and ensures that patients in remote areas receive timely and effective treatment. For instance, Tata Memorial Center has been a pioneer in implementing this model, proposing the development of 30–40 hub centers across India, each serving a population of 5–7 crores.
Traitement non opératoire des traumatismes abdominaux chez l’adulte au Centre Hospitalier Régional de Sokodé (Togo)
Authors: Foadey M.K.S. , Dossouvi T. , Kanassoua K. , Kassegne I. 
Published: November 2024

Objectif : Montrer qu’il est possible d’instituer un traitement non opératoire (TNO) aux traumatismes abdominaux en pays médicalement sous équipés.
Méthode: Il s’est agi d’une étude transversale et descriptive sur 5ans, nous avons étudié les dossiers médicaux de patients hospitalisés dans les services de Chirurgie Digestive et Générale du CHR Sokodé pour contusion abdominale avec hémopéritoine et/ou lésion viscérale à l’échographie ou au scanner, ou pour plaie pénétrante de l’abdomen, chez qui un traitement non opératoire a été institué.
Résultats: Nous avons retenu vingt dossiers de patients qui se répartissaient en 17 hommes et 3 femmes avec un sex-ratio de 5,6. La moyenne d’âge était de 30±7 ans avec des extrêmes de 20 ans et 55 ans. La tranche d’âge la plus touchée était comprise entre 26 ans et 35 ans. Il y avait 15 cas de contusions et 5 cas de plaies de l’abdomen dont 2 éviscérations avec issue d’épiploon. Une instabilité hémodynamique a été retrouvée à l’admission chez sept patients contus de l’abdomen. Une laparotomie secondaire a été réalisée chez 2 patients contus de l’abdomen. Aucun décès n’a été noté. Le taux de réussite du TNO était de 90%.
Conclusion: Le traitement non opératoire est possible en milieu sous équipé, à condition d’instituer une surveillance clinique et paraclinique rigoureuse et rapprochée et une prise en charge pluridisciplinaire. Le malade et son entourage doivent être informés de la procédure instituée et de ses modalités évolutives.
Technique et résultats de cure d’éventration à l’Hôpital National de Niamey (Niger)
Authors: Boka Tounga Y. , James Didier L. , Ide K. , Zabeirou Abdoul A. , Saidou A. , Chaibou M.S. , Sani R. 
Published: November 2024

Introduction : Les éventrations abdominales constituent une complication postopératoire courante après toute laparotomie. Le but de notre travail était est de rapporter les techniques des cures d’éventration à l’hôpital national de Niamey (HNN).
Méthodologie : C’était une étude transversale et descriptive sur une période de 6 ans et 3 mois (1er Août 2015 et 31 décembre 2021) conduite dans le service de chirurgie viscérale de l’Hôpital National de Niamey. Les données de 297 patients admis pour éventration de la paroi abdominale ont été collectées et analysées.
Résultats : Les éventrations postopératoires ont représenté 4 ,55 % des activités du service. On notait une prédominance féminine avec un sex-ratio F/H de 0,39. La tranche d’âge de 40-49 ans était la plus représentée dans 31,99% des cas. Un antécédent de laparotomie était retrouvé chez 49,83% des patients. Le facteur de risque prédominant serait la laparotomie en urgence suivie suppuration pariétale, du diabète et de la surcharge pondérale. Les techniques chirurgicales utilisées ont été la raphie, et la pariétoplastie prothétique. Au total 150 patients ont été opérés par Hernioraphie et 147 patients par prothèse. La durée moyenne d’hospitalisation était de 3 jours. Nous avons eu 11 patients qui ont présenté des complications à court terme et 2 cas de décès.
Conclusion : Cette étude a permis d’évaluer les différentes techniques opératoires en cas d’éventration. La cure d’éventration par prothèse constitue la meilleure approche. Elle expose moins au risque de récidive.
Ética militar en el contexto de la guerra difusa
Authors: Alcántara Durán Alexander José , Dugarte Torres Carlos Daniel 
Published: November 2024

El objetivo general de esta investigación fue analizar los desafíos que generan las formas de ataque de la guerra no convencional a la ética militar frente a la defensa integral y la seguridad de la nación. Se apoyó en el enfoque cuantitativo de tipo documental. Las operaciones militares contemporáneas exigen altos estándares al liderazgo de los oficiales; en consecuencia, deben ser conscientes de impacto que frente a situaciones difíciles tienen en otras personas; por lo que su conducta debe estar en línea con sus roles, normas y valores éticos, el comportamiento ético frente la guerra difusa y el dominio cibernético han ganado importancia en las discusiones teóricas y doctrinarias en el ámbito militar. La utilización de la fuerza militar debe estar dentro de los límites de la norma, pero sobre todo debe ser ética, lo cual es una de las razones principales por las que existe la ética militar. Sin embargo, no hay leyes que regulen los conflictos cibernéticos ni se enmarca en los conceptos de la teoría de guerra tradicional. Entre las conclusiones resaltan que los ataques cibernéticos dirigidos a la FANB podrían ser considerados delitos de guerra. Las armas de guerra cibernéticas son costosas y su efectividad disminuye rápidamente después de su uso debido a la pérdida de su elemento sorpresa, lo que las hace poco rentables.
Influence of terrestrial and marine air mass on the constituents and intermixing of bioaerosols over a coastal atmosphere
Authors: He Qun , Wang Zhaowen , Liu Houfeng , Xu Pengju , Duan Rongbao , Xu Caihong , Chen Jianmin , Wei Min 
Published: November 2024

Abstract. Coastal environments provide an ideal setting for investigating the intermixing processes between terrestrial and marine aerosols. In this study, fine particulate matter (PM2.5) samples categorized into terrestrial, marine, and mixed air masses were collected from a coastal location in northern China. The chemical and biological constituents, including water-soluble ions (WSIs), metallic elements, and bacterial and fungal aerosols, were investigated from January to March 2018, encompassing both the winter heating and spring dust seasons. Terrestrial air masses constituted 59.94 % of the total air masses throughout the sampling period, with a significant increase during severe haze pollution (up to 90 %). These air masses exhibited a higher concentration of PM2.5 (240 µg m−3) and carried more water-soluble ions and metal elements. The terrestrial air mass also contained a larger number of animal parasites or symbionts, as well as human pathogens from anthropogenic emissions, such as Staphylococcus, Deinococcus, Sphingomonas, Lactobacillus, Cladosporium, and Malassezia. Conversely, a significant quantity of saprophytic bacteria such as hydrocarbon-degrading and gut bacteria from the genera Comamonas, Streptococcus, Novosphingobium, and Aerococcus and the saprophytic fungus Aspergillus were the most abundant species in the marine air mass samples. The mixed air mass elucidates the intermixing process of terrestrial and marine sources, a result of microorganisms originating from both anthropogenic and terrestrial emissions, which includes pathogenic microorganisms from hospitals and sewage treatment plants, and a multitude of soil bacteria. A stronger correlation was noted between microorganisms and continental elements in both terrestrial and mixed air mass samples, specifically K+, Mg2+, and Ca2+ derived from soil dust. Marine air masses exhibited a significant correlation with sea salt ions, specifically Na+. In the mixed air mass sample, a fusion of marine and terrestrial microorganisms is characterized by alterations in the ratio of pathogenic to saprophytic microorganisms when compared to samples derived from either terrestrial or marine sources. This study on the constituents and amalgamation of bioaerosols over the coastal atmosphere encompassing distinct air masses is crucial to understand the transport, intermixing processes, and health implications of terrestrial and marine air masses.
المختصر الكبير في سيرة الرسول ﷺاور اس كي تلخيصات كا تقابلي وتجزياتي مطالعه
Authors: Muhammad Aleem  , Tariq Ali 
Published: November 2024

Sirah of the Prophet Muhammad (SAW) is considered to be among the basic sources of Islamic Jurisprudence as well as a practical source of understanding Quranic Verses, Maqasid al Sharia and Dawah Strategies. Throughout Islamic history, considerable number of scholars have contributed through their writings in conveying and disseminating life , Akhlaq, Khasais, Shamail , Dalail and other topics related to the Sirah of Holy Prophet Muhammad (SAW). Family of Ibn-e-Jama’ah is one of them, which contributed through four books on Sirah. Three out of these books have been selected for a detailed review in this article. Abdul Aziz Bin Muhammad (767 AD) Wrote a comprehensive précis of life and belongings of the Holy Prophet(SAW) in the name of Al Mukhtasar al Kabir and then summarized as Al Mukhtasar al Saghir. His grand son Muhammad Bin Abu Bakar, Afterwards, summarized the both books in his book namely ”Al Ghurar wa al Durrar fi Sirat e Khair al Bashar “. This article elaborates bibliographic details, textual review and analytic comparison of the three afore mentioned books and methodology of worthy authors. Textual validity was confirmed through comparison of different prints and manuscripts of the book. Conclusions have also been drawn by careful comparative analysis of the three book. Detailed analysis suggests that the original books is more comprehensive and concise among short books on Sirah. The book has been authored with balanced arrangement of relevant material, derived through authentic and reliable sources. Both abridgements, however, lost comprehensiveness of the original work while first of the both is comparatively better for provision of basic information regarding Sirah of the Prophet (SAW).