bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Prospective Study of Spectrum of Depressed Fractures of Skull and its Surgical Outcome
Authors: Sidram Vishwanath , Kumar PC Chandra , Raghavendra Bellara 
Published: August 2016

ABSTRACT

Background
Depressed skull fracture is a very serious type of trauma occurring in 11% of severe head injuries, and there is a consistent association between the presence of cranial fracture and higher incidence of intracranial lesions, neurological deficit, and poor outcome. Depressed cranial fractures have to be treated aggressively because of their association with infection and late epilepsy.

Objectives
To study the clinical profile and surgical outcome of patients with depressed cranial fractures.

Materials and methods
A case series study of 44 patients with depressed fracture was conducted in a tertiary care hospital setting at the Department of Neurosurgery, Vijayanagara Institute of Medical Sciences, Bellary, Karnataka, during the period from June 2013 to January 2015. Among the selected patients, the clinical profile, radiological profile, and surgical interventions were undertaken and the outcomes were noted. Appropriate descriptive statistics were used to analyze the findings and to draw inferences.

Results
There were 30 males and 14 females. The mean age of the patients was 26.95 ± 14.87 years (6–65 years). The common cause of depressed fracture was road traffic accident (45%) and assault (40.9%); 63% of them had compound type and half of the fractures were located in the frontal region. Common associated injuries were extradural hematoma (50%) followed by dural tear (27.3%). Common complications were wound infection (9.1%) and cerebrospinal fluid leak (9.1%).

Conclusion
The management of depressed fractures should be individualized depending on factors like the degree of depression, communication with the exterior, neurological deficit and presence of associated injuries.

How to cite this article
Sidram V, Kumar PCC, Raghavendra B. A Prospective Study of Spectrum of Depressed Fractures
Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty
Authors: Devasamudra Chidananda Ramappa , Devasamudra Chidananda R 
Published: August 2016

ABSTRACTBackgroundA 25-year-old male patient came with a history of nasal obstruction on the left side. He was also concerned about his nasal framework deformities, such as gross deviation of the nose to left, hump over the nose, asymmetrical nostril, and overall bulky nose.Materials and methodsDetailed history was taken and examination done to rule out contraindication to septorhinoplasty. Expectations, requirements, and postoperative results of the patient were understood. Open approach reduction rhinoplasty was carried out. Unique techniques, such as intermediate and transverse osteotomies were done to achieve the required results.ResultsBulky deviated nose was reduced to an esthetically good-looking nose by humpectomy, four types of osteotomies, extended spreader grafts, columellar strut, and Tipplasty.ConclusionSurgical steps must be undertaken in order to achieve good esthetic results. Surgeries, such as humpectomy must be done before osteotomies, intermediate osteotomies must be done before lateral osteotomies, and Tipplasty must be done after osteotomies.How to cite this articleSagar NJ, Devasamudra CR. Intermediate Osteotomy and other Unique Techniques used in Reduction Rhinoplasty. Clin Rhinol An Int J 2016;9(1):6-12.
Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature
Authors: Chakraborty Priyanko , Jain Rajiv K , Joshi Purnima , Kumari Rakhi , Pradhan Sidharth 
Published: August 2016

ABSTRACTBackgroundChronic rhinosinusitis (CRS) refers to a group of disorders characterized by inflammation of the mucosa of the paranasal sinuses. Nasal endoscopy and computed tomography (CT) scans are successfully used as diagnostic modalities of nose and paranasal sinus diseases. There have been many studies regarding the anatomic variations leading to pathogenesis of paranasal sinus diseases. Considerable progress has been made in the medical and surgical control of these conditions; however, a large number of questions relating to the diagnosis, evaluation, and treatment of the diseases remain unanswered.Materials and methodsThe study included 82 clinically diagnosed cases of CRS who underwent CT scan and were advised to undergo diagnostic endoscopy. The anatomical findings of the nose were compared to see correlation between nasal endoscopy and CT scan.ResultsThe mean age (±standard error of the mean) of presentation was 34.11 (±1.42) years, while most patients were from the age group of 18 to 30 years. Males were predominating the study group with 62.2%, while 37.8% were females. The most common anatomic variation was deviated nasal septum with 92.68% CT reported patients. This was followed by inferior turbinate hypertrophy, septal spur, concha bullosa, and agger nasi cells.ConclusionComputed tomography scan is considered the gold standard for sinonasal imaging. Diagnostic endoscopy and CT scan are a must prior to any functional endoscopic sinus surgery. They help in assessing the extent of sinus disease and to know the variations and vital relations of the paranasal sinuses. Computed tomography scan assists the surgeon as a “road map” during endoscopic sinus surgery.How to cite this articleChakraborty P, Jain RK, Joshi P, Kumari R, Pradhan S. Anatomic Variations of the Nose in Chronic Rhinosinusitis: Correlation between Nasal Endoscopic and Computerized Tomography Scan Findings and a Review of Literature. Clin Rhinol An Int J 2016;9(1):13-17.
Epistaxis—Incidence, Etiology, and Management: A Hospital-based Study
Authors: Moran Niru , Das Debajit 
Published: August 2016

ABSTRACT
Epistaxis is defined as bleeding from the nose. Though it is not serious, it causes anxiety both to the sufferer and to the attending physician. The objective of this study was to review the incidence, common etiological factors, and management modalities of epistaxis. It is a prospective study of 288 patients seen with epistaxis over 1.5 years at Assam Medical College and Hospital from January 2014 to July 2015. The age of patients ranged between 4 and 80 years. An incidence of 7.5% (38,400) was recorded and slight male preponderance with a male:female ratio of 25:9. Trauma and local nasal factor were the main etiological factors identified, but over 5.90% had no discernable cause. About 65% presented with active bleeding and 50% required admission. Patients were managed according to their cause. About 10.41% required blood transfusion. Epistaxis is a common rhinological emergency that requires prompt intervention to reduce morbidity and prevent mortality.

How to cite this article
M oran N, D as D . E pistaxis—Incidence, Etiology, and Management: A Hospital-based Study. Clin Rhinol An Int J 2016;9(1):18-20.
A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis
Authors: Bist SS , Bhagat Sanjeev , Kala Himanshu 
Published: August 2016

ABSTRACT

Objectives
Although the association between obesity and bronchial asthma (BA) has been gaining more attention, few studies have been conducted concerning the relationship between body mass index (BMI) and other allergic diseases. The purpose of this study is to determine the relationship between allergic rhinitis (AR) and BMI.

Materials and methods
This was a retrospective study. Two hundred and ten patients of AR (138 males and 72 females) and 424 healthy controls were included in the study. The BMI of patients and controls were calculated and correlated.

Results
The percentage of AR patients with a low BMI was 9.5%, whereas 57.6% had a normal BMI; 21% were preobese and 9.5% were obese. In the control group, 48.6% subjects had normal BMI range followed by preobese 21.2%, underweight 20.3%, and obese 9.9%. Among the overweight (preobese+ obese) category, the maximum number of subjects belonged to cases, i.e., 32.8% with an odds ratio (OR) of 0.95 (95% confidence interval (CI) 0.91-1.07). Thus, AR was not associated with high BMI. Among the underweight, the maximum number of subjects belonged to the control group, i.e., 20.3% with an OR of 2.13 (95% CI 1.24-3.68). Thus, AR had no relationship with lower BMI also. It was also observed that more of the female patients (18, 29.1, and 12.5% were underweight, preobese, and obese respectively) had deranged BMI than male patients (5.3, 20.2, and 7.9% were underweight, preobese, and obese respectively). A relative risk of 1.124 (95% CI 1.01-1.23) and 1.04 (95% CI 0.95-1.13) was present in female patients with low and high BMI respectively, which is statistically significant (p = 0.0008).

Conclusion
It was concluded that BMI was not associated with increased prevalence of AR. Among the underweight and overweight, AR was more common in females than in males. Thus, BMI had a significant association with AR among female patients. Overall, BMI had no significant association with AR.

How to cite this article
Kala H, Bhagat S, Varshney S, Bist SS. A Clinical Study of Relationship of Body Mass Index with Allergic Rhinitis. Clin Rhinol An Int J 2016;9(1):33-36.
Mucociliary Clearance in Bronchiectasis
Authors: Gupta KB , Yadav Jyoti , Ranga Rupender K , Goel Anuj K 
Published: August 2016

ABSTRACT
Bronchiectasis is a chronic lung disease, defined pathologically as irreversible dilatation of the bronchi. There is ineffective clearance of pulmonary secretions because of damage to the cilia. The nasal mucociliary clearance was studied using the saccharine method in 75 patients of bronchiectasis and the results were compared with those of 25 healthy controls. The nasal mucociliary clearance was significantly prolonged in patients with bronchiectasis.

How to cite this article
Yadav J, Ranga RK, Goel AK, Gupta KB. Mucociliary Clearance in Bronchiectasis. Clin Rhinol An Int J 2016;9(1):37-39.
Maxillary Sinus Hypoplasia—A Not-so-uncommon Clinical Entity: A Review
Authors: Srivastava Saurabh , Shakeel Mohd , Varshney Prasoon 
Published: August 2016

ABSTRACTBilateral sinus maxillary sinus hypoplasia is a rare anomaly. Radiological diagnosis of maxillary sinus hypoplasia is important for diagnosis to prevent recurrent rhinosinusitis and complications during endoscopic sinus surgery. A high index of suspicion is required by outpatient department examination for proper clinical evaluation and further management of these patients.How to cite this articleBhargava A, Khanduri S, Shakeel M, Srivastava S, Varshney P. Maxillary Sinus Hypoplasia-A Not-so-uncommon Clinical Entity: A Review. Clin Rhinol An Int J 2016;9(1):43-45.
Posaconazole: An Only Oral First-line Antifungal for Rhinocerebral Mucormycosis
Authors: Jalal Muhammed JA , Fernandez Shirley J , Thomas Renu M , Kandathil Julio C , Menon Murali K , Kuruttukulam Gigy 
Published: August 2016

ABSTRACT

Introduction
Mucormycosis is a rare opportunistic invasive fungal infection. The most commonly reported form of the disease is rhinocerebral mucormycosis. Early diagnosis of the disease and aggressive medical and surgical intervention prevent the high morbidity and mortality associated with mucormycosis.

Case report
A 54-year-old diabetic and hypertensive male presented with severe frontal headache and retro-orbital pain of 4 days duration with high-grade fever. On examination, the patient was conscious and oriented with a blood pressure of 210/100 mm Hg. The pupils were anisocoric. Frontal sinus tenderness was present. Anterior rhinoscopy showed deviation of nasal septum to left without edema and nasal mucosal congestion. Eye examination revealed normal vision without any periorbital swelling and normal fundus. Plain axial computed tomography showed soft-tissue density material in sphenoid sinus with focal hyperdense component anteriorly. Cerebrospinal fluid study was negative for meningitis with a normal cerebrospinal fluid pressure. Axial T1-weighted image showed T1 intermediate to high signal soft tissue occluding the sphenoid sinus. Axial T2-weighted image showed T2 high signal soft tissue occluding the sphenoid sinus. Similar signal tissue was seen in the middle and posterior ethmoid air cells on both sides. Axial and coronal postcontrast T1-weighted fat-saturated images showed heterogeneously enhancing soft tissue in sphenoid and ethmoid sinuses. The patient underwent functional endoscopic sinus surgery and tissue sampling, following which antifungal therapy with posaconazole was initiated since biopsy from sinus mucosa was consistent with mucormycosis. The patient responded well to functional endoscopic sinus surgical evacuation of the fungal debris and posaconazole and is doing well on follow-up.

Conclusion
This report highlights the possibility of occurrence of this rapidly fatal condition even with normal-looking nasal mucosa. High index of suspicion is required to prevent the complications as the course of the disease is very rapid. This case report emphasizes the fact that posaconazole is the only available oral antifungal that can be used as a first-line agent in the management of mucormycosis, even in immunocompromised individuals.

How to cite this article
Jalal MJA, Fernandez SJ, Thomas RM, Kandathil JC, Menon MK, Kuruttukulam G. Posaconazole: An Only Oral First-line Antifungal for Rhinocerebral Mucormycosis. Clin Rhinol An Int J 2016;9(1):46-49.
Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature
Authors: Pati Sampurna , Pal Sudipta , Biswas Surajit , Saha Somnath 
Published: August 2016

ABSTRACT

Aims
To present two rare cases of ectodermal dysplasia presenting with maggot infestation due to atrophic rhinitis.

Study design
Case report.

Setting
A tertiary care referral hospital.

Presentation
Two male children aged about 5 and 8 years presented to the ear, nose, and throat emergency with a history of maggot infestation of the nose.

Results
Clinical examination was suggestive of ectodermal dysplasia. Intranasal examination was suggestive of atrophic rhinitis. Maggots were removed in the conventional manner. Following a conservative treatment, skin biopsy and nasal mucosal biopsy were done, which confirmed the diagnosis of ectodermal dysplasia.

Conclusion
Any ectodermal dysplasia patient should be suspected of having atrophic rhinitis and intranasal conservative therapy should be initiated at the earliest to prevent complications like maggots in the nose.

How to cite this article
Pati S, Pal S, Saha S, Biswas S. Ectodermal Dysplasia presenting with Atrophic Rhinitis: A Report of Two Cases and a Review of the Literature. Clin Rhinol An Int J 2016;9(1):53-55.
Changing Trends in Endoscopic Endonasal Medial Maxillectomy
Authors: Verma Hitesh , Arun TM , Kaur Amrinder 
Published: August 2016

ABSTRACTMedial maxillectomy is a surgical resection of the medial walls of the maxillary bone, medial part of the orbital floor, and ethmoid sinuses. Lateral rhinotomy or sublabial degloving is the traditional approach used for an open medial maxillectomy. Endoscopic medial maxillectomy is used as an alternative approach with similar cure rate with less morbidity. We report here a case of inverted papilloma of the medial wall of the right maxillary sinus where the disease clearance was done with preservative of nasolacrimal duct, inferior turbinate, and lateral nasal wall mucosa by the endoscopic medial maxillectomy approach.How to cite this articleVerma H, Dass A, Singhal SK, Gupta N, Arun TM, Kaur A. Changing Trends in Endoscopic Endonasal Medial Maxillectomy. Clin Rhinol An Int J 2016;9(1):56-58.
Sensory and Knee Range of Motion Responses of Slump Test on Unaffected and Radiculopathy Affected Limb in Patients with Lumbar Disk Herniation
Authors: Singh Amarjeet , Aggarwal Amita , Jayakrishnan Sarvanan 
Published: August 2016

ABSTRACT

Background
Disk herniation is common—it is seen in up to a quarter of magnetic resonance imaging (MRI) and can be detected even in asymptomatic adults. The slump test has become widely advocated as a neural tissue provocation test for clinical assessment of patients with spinal and lower limb pain. The purpose of this study was to determine the sensory and terminal knee extension limitation responses produced during slump test on radiculopathy affected and unaffected limb in patients with lumbar disk herniation.

Objectives
To compare the sensory and knee range of motion (ROM) responses produced during slump test on affected and unaffected limb.

Materials and methods
Fifty patients, 25 to 45 years of age chronic disk herniation patients with unilateral radiculopathy with/without lower backache. Patient underwent standardized history and physical examination followed by slump test. Outcomes included terminal knee extension limitations and sensory response produced in terms of intensity numeric rating scale (NRS), nature and location (pain drawings).

Results
During slump test end position, NRS score and restricted terminal knee ROM comparative results were highly significant (p < 0.001). Based on nature and location of sensory response, maximum number of subjects in affected limb had pain in center of lower back radiating to whole lower limb and for unaffected limb stretch at back of knee.

Conclusion
In this study, it was suggested that though sensory and knee ROM responses are present in both affected and unaffected limb but the radiculopathy affected limb was more affected in terms of intensity of pain and limitation of motion.

How to cite this article
Aggarwal A, Jayakrishnan S, Singh A. Sensory and Knee Range of Motion Responses of Slump Test on Unaffected and Radiculopathy Affected Limb in Patients with Lumbar Disk Herniation. J Postgrad Med Edu Res 2016;50(1): 1-4.
Effectiveness of Isokinetic Exercises in Preoperative Anterior Cruciate Ligament Tears Rehabilitation
Authors: Dhillon Mandeep , Adhya Bibek , Aggarwal Amita 
Published: August 2016

ABSTRACT
The present study compared the effectiveness of adding isokinetic exercise program to conventional rehabilitation protocol in preoperated patients with anterior cruciate ligament (ACL) tear. The subjects were randomly assigned into two groups (n = 10 each). Group A followed conventional rehabilitation protocol. In group B, isokinetic exercise for quadriceps and hamstring were advised. These consisted of 3 set of 10 repetitions at velocity of 60 and 120° sec. with 1 minute rest interval between the sets. The exercise protocol was performed 6 days a week for 4 weeks. Student t-test was used for analysis. Also subjects were evaluated for pain using visual analog scale (VAS). For the assessment of symptoms and functions Cincinnati knee rating system and Lysholm scoring scale were used. The effectiveness of isokinetic exercise was significantly better only with knee extension peak torque and peak work in case of quadriceps (p < 0.05). Hamstring testing showed no significant difference with isokinetic training in intragroup as well as intergroup comparison for any measured parameters. Also no significant differences were found with use of functional scales.

Conclusion
Isokinetic exercises are effective in improving quadriceps peak torque and peak work in patients with ACL tear.

How to cite this article
Aggarwal A, Adhya B, Dhillon MS. Effectiveness of Isokinetic Exercises in Preoperative Anterior Cruciate Ligament Tears Rehabilitation. J Postgrad Med Edu Res 2016;50(1):5-8.
Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study
Authors: Kaur Sukhpal , Das Karobi , Saini Ruchi 
Published: August 2016

ABSTRACT
Literature has presented nursing as a stressful profession. The present study was conducted to compare stress level and job stressors operating in two different units, i.e. intensive care units (ICU) and general wards of a tertiary care hospital of North India. This is a cross-sectional study involving 285 nurses (general wards = 176; ICU = 109). The nurses were selected conveniently. Demographic profile sheet, modified workplace stress scale (WSS), workplace stress symptom scale (WSSS) and coping checklist (CCL) of Rao, Subbakrishna and Prabhu (1989) was used in the study. Findings of the study revealed moderate to high stress level among general wards and ICU nurses with young female nurses experiencing more stress. Further, workload, role ambiguity and lesser social support accounted for significant amount stress among nurses working on both the units while external factors, such as physical environment and resources hardly contributed to stress. It was also found that the ICU nurses experienced stress more in the form of exhaustion (11.9%); irritation (11.9%) and reduced self-confidence (0.9%) that those working in general wards. However, the nurses on both the units use distraction, positive coping, problem-solving and religious strategies to manage and handle their stress. The findings of the study give insight into stress and stressors related to job which can be buffered using various stress management strategies by the nurse managers.

How to cite this article
Saini R, Kaur S, Das K. Stress, Stress Reactions, Job Stressors and Coping among Nurses Working in Intensive Care Units and General Wards of a Tertiary Care Hospital: A Comparative Study. J Postgrad Med Edu Res 2016; 50(1):9-17.
Risk Factors of Congenital Malformations in North India: A Case Control Study
Authors: Singh Amarjeet , Sinha Smita 
Published: August 2016

ABSTRACT
An increasing incidence of congenital malformations (CMF) has been reported in India.

Objective
To ascertain the determinants of CMF.

Methodology
This hospital based age-sex matched pair case control study was done at advanced pediatric center (APC), obstetrics and gynecology department (ANC clinic, maternity ward, labor room, etc.) and special clinics, PGIMER, Chandigarh, India in 2008. The mothers were interviewed to collect information about risk factors.

Results
Two hundred three CMF (under five children and gestational CMF) cases and same number of controls were studied. Significant association of CMF was observed with the use of sex selection drugs by mothers (OR = 4.35), habits of fathers like taking alcohol (OR = 3), smoking (OR = 4.5) and using tobacco (OR = 2.7). Mother's age at marriage < 18 years and history of abortion were also important predictors of CMF.

Conclusion
Most of the risk factors for CMF were avoidable viz. addiction, early marriage and use of sex selection drugs. People need to be educated about this.

How to cite this article
Singh A, Sinha S. Risk Factors of Congenital Malformations in North India: A Case Control Study. J Postgrad Med Edu Res 2016;50(1):22-27.
Sutureless Vitrectomy for Repositioning of in-the-Bag Single Piece Acrylic Dislocated Intraocular Lens
Authors: Singh Ramandeep , Parchand Swapnil Madhukar , Singh Rishiraj , Kumari Neha 
Published: August 2016

ABSTRACT
We report a successful outcome in a case of dropped in-thebag single piece intraocular lens (IOL), which was retrieved and refixated to sclera using 23-gauge transconjunctival sutureless vitrectomy (TSV). This technique of scleral refixation of same IOL using sutureless vitrectomy shows the versatility of the 23-gauge TSV in managing the difficult and cumbersome situations like above.

How to cite this article
Singh R, Parchand SM, Singh R, Kumari N. Sutureless Vitrectomy for Repositioning of in-the-Bag Single Piece Acrylic Dislocated Intraocular Lens. J Postgrad Med Edu Res 2016;50(1):28-29.