bluuebunny/crossref_metadata_2025_split huggingface dataset:
Tokyo Declaration on Research Integrity and Ethical Publication in Science and Medicine in the Asia Pacific Region
Authors: WPRIM APAME IMSEAR 
Published: April 2019

We, the participants in the Joint Meeting of the Asia Pacific Association of Medical Journal Editors (APAME), the Index Medicus for the South-East Asian Region (IMSEAR), and the Western Pacific Region Index Medicus (WPRIM) held in Tokyo from 2 to 4 August 2013:

CONSIDERING
That overwhelming data in science and medicine may differ in their reliability and that quality control is important for compiling scientific and health information;
That equitable circulation of scientific and health information is facilitated by fair collaboration among policy makers, researchers, and industry sectors including pharmaceuticals and publishers;
That APAME, IMSEAR, and WPRIM are important collaborative initiatives that can implement global guidelines for publication and dissemination of scientific and medical knowledge in an equitable and ethical manner;

CONFIRM
Our commitment to endorse that scientific and medical knowledge is imperishable and should not be assessed or evaluated by only economic or temporal considerations;
Our commitment to improve quality and reliability of scientific and medical knowledge through the IMSEAR and WPRIM;
Our commitment to publish reliable and high-quality information by education of researchers, implementation of fair review processes, and organization of networks through APAME;
Our commitment to collaborate with publishers, academic or public libraries, and research bodies to achieve equitable and ethical publication and dissemination of scientific and medical knowledge;

COMMIT
Ourselves, to publishing reliable and high-quality information, thereby setting the ethical standard for our colleagues, editors, and librarians in the Region;
Our publishers, to disseminating scientific and medical knowledge fairly and impartially through digital library services including, but not limited to, IMSEAR, WPRIM, and the Global Health Library;
Our organization, APAME, to building further networks, convening conferences, and organizing events to educate and empower editors, peer reviewers, and authors to achieve internationally acceptable, but regionally realistic, scholarly standards.

4 August 2013, Tokyo

This declaration was adopted at the 2013 Convention of the Asia Pacific Association of Medical Journal Editors (APAME) held in Tokyo from 2 to 4 August 2013. It is concurrently published by Journals linked to APAME and listed in the Index Medicus for the South East Asian Region (IMSEAR) and the Western Pacific Region Index Medicus (WPRIM). Copyright © APAME. www.wpro.who.int/apame apame@wpro.who.int
Calcifying Cystic Odontogenic Tumor Associated with a Complex Odontoma
Authors: Atun Jenny Maureen L. , Carnate Jose M. 
Published: April 2019

We present a case of a 16-year-old lad with a one year history of gingival mass of the left maxillary alveolar ridge. Excision revealed a cystic mass with brown fluid and irregular calcified material within the cavity.
Histopathologic examination of the cyst lining shows a stratified cuboidal epithelium with palisading of the basal layer. The cells of the latter show reverse nuclear polarization reminiscent of ameloblastic epithelium. The superficial layers have a stellate reticulum-like appearance and contain large eosinophilic polygonal ghost cells. (Figure 1, 2) Some of the ghost cells show calcifications. (Figure 3) Sections from the hard, bony fragments show haphazard deposition of dentin and enamel-like material. (Figure 4) With these features, this case was called a calcifying cystic odontogenic tumour in association with a complex odontoma.
Calcifying cystic odontogenic tumor (CCOT) is a benign neoplasm characterized by an ameloblastoma-like epithelium with ghost cells that often show calcification.1 It comprises only 2% of all benign odontogenic neoplasms.2 There is equal distribution of involvement for the maxilla and mandible, no sex predilection, with most cases diagnosed at the 2nd to 3rd decade of life.1,2 The classic histologic findings are the presence of a stratified epithelium consisting of cuboidal to columnar cells with reverse polarization of the basal layer and the presence of ghost cells. A stellate reticulum-like appearance of epithelial cells is also seen. Ghost cells are the most characteristic feature of CCOT and this may represent an abnormal type of keratinization or the coagulative necrosis of the odontogenic epithelium. 3
CCOT may present alone or in association with other odontogenic tumours.2, 4 Association with an odontoma has been reported in 20% to 24% of cases of CCOT.5 Complex odontoma is a hamartomatous lesion characterized by haphazard arrangement of matrix-producing epithelium, enamel, dentin and cementum-like tissue, in contrast to the more regular structure of a compound odontoma.1
CCOT associated with odontoma (CCOTaO), in contrast to CCOT alone, has a slight female predominance (2:1), a younger age of presentation (mean 16 years) and a predilection to the maxilla (61.5 %).5 Sidana et al. postulated several possible pathogenesis of CCOTaO including the possibility that CCOT develops secondarily from the epithelium involved in the formation of odontoma or that the odontoma develops secondarily from the epithelium in CCOT.5 Enucleation is the treatment of choice and is curative.
A close histologic differential diagnosis is an acanthomatous ameloblastoma. Acanthomatous ameloblastoma contains distinct squamous epithelium within nests of ameloblastic epithelium, and ghost cells are absent.
Very rarely, transformation into its malignant counterpart, ghost cell odontogenic carcinoma (GCOC), has been reported in recurrent cases.6, 7 Infiltrative borders, nuclear atypia and increased mitotic activity indicate this change.6, 7
Effects of Type 3 Thyroplasty on Voice Quality Outcomes in Puberphonia
Authors: Chowdhury Kanishka , Saha Somnath , Pal Sudipta , Chatterjee Indranil 
Published: April 2019

Objective: To assess effects of type 3 thyroplasty on outcomes of voice quality in puberphonia.
Methods:
Design: Prospective Cohort
Setting: Tertiary Referral Hospital
Participants: 6 patients with puberphonia who failed voice therapy, aged 16-25 years, who consulted at the ENT Outpatient department between September 2010 and September 2012, underwent type 3 thyroplasty.
Pre-operative and 6-month post-operative voice analysis by voice recordings, Voice Handicap Index (VHI), GRBAS score and real time acoustic analysis (perturbation) using Dr Speech software (University version 4.0, Voice Tech Corporation, USA [Tiger Electronics]) using habitual fundamental frequency (F0), jitter % and shimmer % as parameters, were performed.

Results: Mean pre-operative VHI and GRBAS scores were 53 and 75.67 respectively whereas post-operative scores were 29 and 25.00 respectively. (P-value for VHI was 0.004 and that of GRBAS was 0.00). On acoustic analysis, mean pre-operative habitual fundamental frequency (F0), jitter % and shimmer % was 245.82 Hz, 0.21 and 2.34 respectively whereas post-operative mean was 140.78 Hz (P = 0.00), 0.19 (P = 0.04) and 1.52 (P = 0.00) respectively.

Conclusion: The mainstay of treatment of puberphonia is voice therapy. Thyroplasty provides a suitable management option in those cases who fail to respond by voice therapy.

Keywords: puberphonia, thyroplasty, laryngeal framework surgery, voice analysis
Drain verus No Drain After Thyroidectomy: A Preliminary Prospective Randomized Controlled Trial
Authors: Alamani Jefferson A. , Reala Elias T. , Castañeda Samantha S. , Chua Antonio H. 
Published: April 2019

Objective: To evaluate the necessity of placing a drain in post-thyroidectomy patients, we aimed to determine whether insertion of a passive drain, as compared to no drain, in post-thyroidectomy patients, would significantly affect hematoma formation, wound infection, wound dehiscence and length of hospital stay.
Methods:
Study Design: Prospective randomized controlled trial
Setting: Tertiary government training hospital
Subjects: Patients who underwent thyroidectomy for various thyroid pathologies were divided into two postoperative treatment arms: one group with insertion of a passive drain, and another group without a drain. Hematoma, wound infection, wound dehiscence, and length of hospital stay were the outcomes measured per treatment arm.

Results: A total of 66 patients were evaluated. There were 54 females (81.81%) and 12 males (18.18%). The mean age for the drain group was 44.88 years and 43.67 years for the no drain group. Four patients developed complications in the drain group and 2 developed complications in the no drain group. The rate of complications between both groups was not statistically significant. The mean hospital stay of the drain group was 3.15 days, which in the no drain group was 2.51 days. The difference in length of hospital stay was statistically significant.

Conclusion: There was no difference in the development of complications among the drain and no drain group. Thyroidectomy without surgical drains was associated with a significant reduction in hospital stay compared to thyroidectomy with routine placement of drains.

Keywords: Surgical drainage / methods, hematoma / prevention and control, postoperative complications / prevention and control, thyroid disease / surgery, thyroidectomy / methods
Auditory Steady State Response (ASSR) Frequency-Specific Thresholds with Absent Auditory Brainstem Response (click-ABR) Test Results among Filipino Children
Authors: Villarta Romeo L. , San Agustin Maria Luz M. 
Published: April 2019

Objective: Determine the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results.

Methods:
This is a cross-sectional study analyzing the frequency-specific thresholds of auditory steady state response (ASSR) of Filipino children with absent auditory brainstem response (click-ABR) results. The study population comprised of 99 pediatric patients referred for hearing assessment using electrophysiologic techniques at the Ear Unit of the Philippine General Hospital. The subjects underwent hearing threshold evaluation using both evoked-potential techniques (click ABR and ASSR) within a 1-month period from January 2009 to March 2014. The ASSR results of patients with absent click-ABR were collected and analyzed.
Results: There were 99 patients who underwent both ABR and ASSR. Of the 65 patients with absent ABR thresholds results, 13 patients had unilateral absent ABR while 52 had bilateral absent ABR results. The data of hearing tests from the combined 117 ears with absent ABR hearing tests were collected.
The proportion of children with ASSR thresholds with absent ABR per frequency were:

500 Hz - 45/117 (38.5 %);
1000 Hz - 76/117 (64.0 %);
2000 Hz - 63/117 (53.8 %); and
4000 Hz - 41/117 (35.0 %).

The proportion of children with ASSR thresholds with absent ABR per number of frequencies were:

4 frequencies - 19/117 (16.2 %);
3 frequencies - 32/117 (27.4 %);
2 frequencies - 22/117 (18.8 %); and
1 frequency - 44/117 (37.6%)

Conclusion: In the absence of click- ABR response, ASSR may provide information about the levels of severe to profound hearing loss among children. The criteria of selection of candidates for intervention (hearing aids or cochlear implantation) should include results from hearing evaluation not only from behavioral and ABR thresholds but also from ASSR thresholds. This may ensure that exclusion of some children with severe and profound hearing loss who may benefit from the intervention will be minimized.

Keywords: profound sensorineural deafness, evoked response audiometry, hearing thresholds
Response from the Authors
Authors: David Reylan B. , Lim William L. 
Published: April 2019

Dear Sir:
We would like to express appreciation for the comments given as well as for sharing your research findings in relation to the case.
We agree that a neurological problem must be properly ruled out most expecially when there is a delayed onset of neurological symptoms with progression over time.
Indeed, the presence of vocal fold dysfunction in children should make one consider CNS pathologies most common of which is the Arnold- Chiari Malformation.
However, the following are our reasons for concurring with the pediatric neurology service in not requesting imaging:

Aside from vocal fold paralysis, no other neurological symptom or finding was noted such as presence of swallowing and feeding difficulties, dizziness or uncoordination usually present in brainstem pathologies manifesting with vocal fold paralysis such as Chiari Type I1,2
Previous and subsequent neurological examinations showed a bilaterally intact gag reflex which somewhat made the possibility of a CNS lesion affecting the vagus unlikely. No findings indicative of cerebellar dysfunction (such as dysdiadokinesia) were noted

Thank you very much.

Reylan B. David, MD
reylandavid@gmail.com
William L. Lim, MD
The Use of a Soft Gel Capsule as a Medium for Modified Barium Esophagogram in Detecting Esophageal Foreign Body
Authors: Arenga Philip Jan P. , Villanueva Joebert M. 
Published: April 2019

Objective: To test a soft gel capsule with barium sulfate as a medium for modified barium esophagogram in detecting esophageal foreign body.
Methods:
Study Design: Preliminary Diagnostic Test Assessment;
Consecutive Convenience Sample
Setting: Tertiary Government Hospital
Participants, Patients or Population: Soft gel capsule with barium sulfate was pilot tested on patients with a history and diagnosis of radiolucent foreign body ingestion between June 1 and November 30, 2014.
Results: Seven patients (6 males, 1 female; aged 26 – 61 years) underwent the procedure. In all seven, the enhanced capsule immediately stopped above the level of the esophageal foreign body, easily identifying the exact location of the obstruction. Foreign bodies included 1 embryonated duck-egg white “balut”, 5 chunks of pork meat and 1 claspless denture. All were successfully marked by the capsule on fluoroscopy and documented on X-ray. Esophagoscopy under general anesthesia was successfully performed after fluoroscopy in all patients.
Conclusion: We were able to improvise a new medium for use in modified barium esophagograms that was easy to prepare and that rendered good radiographic imaging and localization of radiolucent foreign bodies. A randomized trial in comparison to the prevailing test may confirm our findings further. Meanwhile, we recommend exploring the procedure in other hospitals as an alternative to barium-soaked cotton in the diagnosis of radiolucent esophageal foreign bodies
Keywords: soft gel capsule, barium suphate, esophagogram, esophageal foreign body
Complications of Head and Neck Reconstructive Surgery Using Axial Pedicled Flap
Authors: Dy Alexander Edward S. , Alfanta Eduard M. , Chiong Armando M. 
Published: April 2019

Objectives: Axial flap surgery is associated with numerous complications. The purpose of this study is to determine the frequency of these complications, and identify possible factors contributory to their occurrence.

Methods:
Study design: Cross-sectional study

Setting: Tertiary public university hospital

Subjects: Records of all patients who underwent axial pedicled flap reconstruction at the otorhinolaryngology ward of our tertiary public university hospital from January 2013 to July 2015 were retrospectively reviewed, and data consisting of age, sex, diagnosis, disease stage, smoking history, alcohol intake, co-morbidities, past operations, pre-operative hemoglobin and albumin, total operative time, total blood loss, location and total area of the surgical defect, and length of hospitalization were tabulated. All complications were listed. Data were analyzed for any potential trends.

Results: A total of 38 patients underwent axial pedicled flap reconstruction in the study period. Nineteen out of 38 (50%) cases involved complications. The most common complication was infection. Most of the complications occurred in males with history of alcohol intake, advanced cancer stage, significant blood loss, recurrent tumors, low pre-operative hemoglobin and albumin levels, and a large area of surgical defect.

Conclusions: The complication rate for axial flap surgery in our series was significant at 50%. Potential risk factors identified were male gender, advanced cancer stage, tumor recurrence, alcohol intake, low pre-operative hemoglobin and albumin levels, significant blood loss, longer operative time, and a larger surgical defect.

Keywords: surgical flaps, myocutaneous flap, axial flap, complications, risk factors
Arnica Montana and Blood Loss, Surgical Field Bleeding and Operative Time in Endoscopic Sinus Surgery: A Randomized-Controlled Trial
Authors: Salinas Michael Luke T. , Bato Charmagne Ross E. 
Published: April 2019

OBJECTIVE: To determine the association of Arnica montana and blood loss, surgical field bleeding and operative time in endoscopic sinus surgery among adults with chronic rhinosinusitis with nasal polyposis.
METHODS:
STUDY DESIGN: Single-blinded Randomized Controlled Trial
SETTING: Tertiary government hospital
PARTICIPANTS: Forty-one (41) adults aged 19-76 years old with chronic rhinosinusitis with nasal polyposis and meeting inclusion criteria were randomly divided into two groups, Arnica and control. The former took 5 sublingual Boiron® Arnica montana 30C pellets, 12 hours then 1 hour prior to surgery; the latter did not. Both groups had routine oxymetazoline and lidocaine-epinephrine decongestion. Intraoperative blood loss, surgical field bleeding quality and operative time were assessed by blinded surgeons and anesthesiologists.
RESULTS: Mean estimated blood loss was 187ml (SD 100.14) for controls versus 72ml (SD 12.59) for the Arnica group; (p < 0.05). Mean operative time was 3.55 hours (SD 1.25) for controls and 3.44 hours (SD 1.57) for the Arnica group; (p=0.9). Surgical field bleeding was graded slight with 75% needing occasional suctioning (grade 2) and 25% needing frequent suctioning (grade 3) in the Arnica group, versus moderate bleeding with more frequent suctioning (grade 4) in 71% and slight bleeding but needing frequent suctioning (grade 3) in 29% of controls.
CONCLUSION: In this randomized clinical trial, Arnica montana was associated with less blood loss and less surgical field bleeding compared to controls, but there was no difference in mean operative times. Arnica montana may be effective in reducing blood loss and improving surgical field quality during endoscopic sinus surgery for chronic rhinosinusitis with nasal polyposis.
KEYWORDS: Arnica montana, hemostasis, surgical
Adult Acute Epiglottitis: An Eight - Year Experience in A Philippine Tertiary Government Hospital
Authors: Cruz Melanie Grace Y. , Almazan Natividad A. 
Published: April 2019

Objective: To review cases of adult acute epiglottitis in a tertiary government hospital and describe the clinical presentations, diagnostics performed, management and outcomes.
Methods:
Study Design: Retrospective Chart Review
Setting: Tertiary Government Hospital
Subjects: Records of patients admitted by or referred to the Department of Otolaryngology Head and Neck Surgery with a diagnosis of acute epiglottitis from January 2008 to August 2014 were identified from the department census and charts were retrieved from the Hospital Record Section and evaluated according to inclusion and exclusion criteria. Information regarding demographic data, clinical features, laboratory and other diagnostic examinations, medical management, and length of hospital stay were collected.
Results: There were 20 cases in seven years and eight months. Most were male, 18 to 37-years-old, presenting with dysphagia, odynophagia and a swollen epiglottis on laryngoscopy. Abnormal soft-tissue lateral radiographs of the neck and leukocytosis were seen in 73 % and 83% respectively. Intravenous antibiotics and corticosteroids were administered in all cases, and mean hospital stay was 11.2 days.
Conclusion: Adult acute epiglottitis should be highly suspected in patients presenting with dysphagia, odynophagia, and muffling of the voice even with a normal oropharyngeal examination. History of respiratory infection, co-morbidities, smoking and alcohol intake, concomitant laryngeal pathology and supraglottic structure insults contribute to development of the disease. Laryngoscopy is still the gold standard in diagnosis. Airway protection is mandatory but prophylactic intubation or tracheostomy are not advised. Intravenous antibiotics are necessary and corticosteroids may be of benefit.
Keywords: epiglottitis, supraglottitis, epiglottis, adult, Philippines
Motorcycle related cranio-maxillofacial injuries at a tertiary hospital in the Philippines
Authors: De la Cruz Rhodieleen Anne R. , Tuazon Rene S. 
Published: April 2019

OBJECTIVE: To describe the type and determine the number of motorcycle related cranio-maxillofacial injuries that were seen by the ORL service in the emergency room of a tertiary hospital from January 2013 to December 2013

METHODS
Study Design: Cross sectional retrospective chart review
Setting: Tertiary National University Hospital
Subjects: One hundred nine charts of patients seen at the emergency room from January 2013 to December 2013 were reviewed

RESULTS: Of the 109 charts of patients involved in vehicular accidents, there were 76 documented cases of motorcycle related accidents. Of these, 91% involved males and 9% involved females. Seventy one percent did not wear helmets, of whom 36% were young adult males between the ages of 18-30 years. Those that wore helmets had a total of 27 different facial fracture sites: 19% zygomatic tripod fractures, 15% temporal bone fractures and 11% with no fractures noted. Among those who did not wear helmets 75 fractures were noted. Twenty four percent were tripod fractures, 15% temporal bone fractures and 12% maxillary fractures. Only one did not incur any fractures.

CONCLUSION: Most cranio-maxillofacial fractures seen at the emergency room were from motorcycle related injuries (70%). Despite implementation of Republic Act 10054 (The Motorcycle Helmet Act of 2009) majority of motorcycle-related accidents are still incurred by riders without helmets.

Keywords: cranio-maxillofacial fractures, motorcycle accidents, helmet, tripod fracture, temporal bone fracture
Diagnostic-To-Treatment Interval and Disease Progression among Head and Neck Cancer Patients Undergoing Surgery
Authors: Lapiña Gerard F. , Castañeda Samantha S. 
Published: April 2019

Objectives: To determine whether the interval from pathological diagnosis to treatment is significantly delayed, and the presence or absence of disease progression occurring in those with, and without treatment delay, among head and neck cancer patients in our institution.
Methods:
Study Design: Retrospective Chart Review
Setting: Tertiary Government Hospital
Subjects: Medical records of 70 patients with newly diagnosed head and neck cancer who underwent primary surgery from January 2011 to December 2015 were retrieved and available data were extracted.
Results: A total of 28 patients were included in this study. Majority of the cancers were in the larynx (42.9%) and oral cavity (42.9%). The mean diagnostic-to-treatment interval (DTI) was 54 days, but 5(17.8%) out of the 28 had a DTI of more than 60 days. Four (80%) with a DTI more than 60 days had an upstage during surgery while 4 (17.4%) patients with DTI less than or equal to 60 days also had an upstage. 2 (60%) patients with treatment delay had tumor progression compared to 5 (21.7%) of those without treatment delay. Only 1 (20%) out of the 5 patients with treatment delay had increased nodal metastasis in contrast to 8 (34.8%) of those who did not have treatment delay.
Conclusion: A number of patients undergoing surgery in our institution experienced delay to initiate treatment of more than 60 days and majority of these patients were noted to have disease progression. However, even patients with treatment prior to 60 days had increases in tumor stage, which may suggest that the interval aimed for should be shorter than 60 days.
Keywords: head and neck cancer, treatment delay, diagnostic interval, tumor progression