bluuebunny/crossref_metadata_2025_split huggingface dataset:
Technetium scintigraphy as a predictive tool of thyroid malignancy
Authors: Mohanty Sanjeev , . Sreenivas , T. Vinay Raj , . Devipriya , M. Vinoth 
Published: March 2017

<p class="abstract" style="display: inline !important;"><strong>Background:</strong> Thyromegaly is a common cause of physician consultation. Solitary thyroid nodules are conventionally viewed with suspicion. Clinical examination cannot reliably distinguish between a solitary thyroid nodule and a dominant nodule in multinodular goiter. Ultrasonographical examination has its own pitfalls. Technetium 99 is a commonly used modality for the functional assessment of solitary thyroid nodule detection. It has the advantage of low cost with lower radiation dose to the exposed patients. On literature search, studies on technetium 99 scintigraphy for thyroid in context to the Indian scenario do not yield much information and very few studies are notable. This study was conducted to correlate and qualify thyroid cold nodule as detected by Technetium 99 pertechnetate thyroid scan. <span lang="EN-IN">This study was conducted to correlate, qualify and compare the predictive value of Technetium 99 pertechnetate scintigraphy on solitary thyroid nodule via fine needle aspiration cytology and to countercheck with histopathological examination. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A prospective cohort study in a NABH, NAAC and JCI accredited tertiary care teaching university hospital was conducted over a period of 36 months. All the subjects underwent clinical assessment of the neck included standard examination techniques to segregate solitary thyroid nodules. They were then subjected to Technetium 99 pertechnate scintigraphy using the standard protocol. All the patients with solitary cold nodule underwent FNAC followed by nodule excision or hemi-thyroidectomy under general anaesthesia. All the specimens underwent histo-pathological examination by an experienced histopathologist. The results were statistically analysed using pearson chi-square test. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Cold nodules as detected by Technetium 99 pertechnetate thyroid scan is a reasonable indicator of probable malignancy via fine needle aspiration cytology. Occurrence of cold nodules is highest in 3<sup>rd</sup> to 5<sup>th</sup> decade of life (21-50 year age group). Occurrence of cold nodules is higher in females (83%) whereas occurrence of malignancy in cold nodules is higher in males (85%). Occurrence of malignancy in cold nodules is higher in subjects less than 21 and above 50 years. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Technetium 99m pertechnetate thyroid scintigraphy is an important preoperative tool in management of thyroid nodules and its routine use in all such patients is recommended especially to rule out cold nodules.</span></p>
A computed tomography and endoscopy assisted study of the anatomical variations of lateral wall of nose in patients of chronic rhinosinusitis- our experience at a tertiary care centre
Authors: Suligavi Shashidhar S. , Fathima Afshan , Patil Mallikarjun N. , Doddamani S. S. 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Chronic rhinosinusitis (CRS) is a common and persistent illness that ENT surgeons encounter in their day to day practice. The lateral wall of the nose contains the ostiomeatal unit which is the key area targeted in the management of CRS. The lateral wall of nose shows several variations which can alter the course of the disease. It is of utmost importance for the ENT surgeon to be aware of these variations as they decide the overall line of management. The objectives of the study was to study the anatomical variations of the lateral wall of nose using computed tomography (CT) scans and nasal endoscopy in patients of chronic rhinosinusitis.</span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A one year study from April 2015 to March 2016 involving 50 patients attending the ENT outpatient department clinically diagnosed as CRS using the criteria of task force on rhinosinusitis were included in the present study. Patients underwent a CT scan and DNE and the anatomical variations of the lateral wall of nose were studied. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Concha bullosa was the most common anatomic variation noted in 20 (40%) of the total 50 patients. The other anatomic variations noted were uncinate process variations in 15(30%) patients, agger nasi cells in 3 (6%) patients, hypoplastic middle turbinate in 1 (2%) patient, paradoxical middle turbinate in 2(4%) patients, bulla ethmoidalis in 4 (8%) patients and Haller cells in 1 (2%) patient. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The lateral wall of nose is made up of several structures showing variations which can lead to the development CRS and affect the overall management. They should be evaluated pre-operatively in order to avoid intraoperative complications. CT scan and DNE both complement each other and effectively evaluate the anatomical variations of the lateral wall of nose.</span></p>
A comparative study between nasal clips and anterior nasal packing in septoplasty/submucosal resection patients at VIMS Bellary, Karnataka
Authors: Kurle Geeta , Patil V. Shruthi , N. Manjunath 
Published: March 2017

<p class="abstract"><strong>Background:</strong> Nasal packing is used primarily to control bleeding, for internal stabilization and to prevent postoperative complications in endonasal surgeries. Nasal septal clip is one of the alternatives, whose effectiveness in surgical practice is less studied upon.<strong> </strong>To compare the effectiveness between nasal septal clip and anterior nasal packing following septoplasty/submucous resection.</p><p class="abstract"><strong>Methods:</strong> Prospective Randomised Controlled Study was conducted in Department of Otolaryngology at Vijayanagara Institution of Medical Sciences, Bellary, between November 2014 to May 2016. Study involved 100 patients fulfilling inclusion and exclusion criteria. Adopting sealed envelope technique, patients were allotted into two equal groups for anterior nasal pack and nasal septal clip following septoplasty or submucosal resection. Interventions were done following standard procedures and data was collected by using pre-tested proforma. </p><p class="abstract"><strong>Results:</strong> Mean age of anterior nasal pack group and nasal septal clip group was 27.86 and 25.24 years respectively. Intra-operatively, packing with nasal septal clip was easier with significantly less trauma to mucous membrane (X<sup>2</sup>= 6.353, P= 0.011), consuming significantly less time (t= 9.329, P&lt;0.0001) and support provided to septum could be assessed visually when compared to anterior nasal packing. During immediate post-operative period and while pack removal, nasal septal clip had significantly less complications (P &lt; 0.001). Follow-up complications like septal haematoma, synaechiae &amp; septal perforations were lesser in nasal septal clip group</p><p><strong>Conclusions:</strong> During intra-operative period, immediate post-operative period, during nasal pack removal and during follow-up period nasal septal clip provided technical superiority, smooth post-operative experience and lesser complications compared to anterior nasal packing proving nasal septal clip to be a better choice for nasal packing. Limitations of NSC are its availability and cost. </p>
Postoperative sore throat in patients undergone head and neck surgeries under endotracheal intubation and laryngeal mask anaesthesia
Authors: Rameshkumar Edakkattil , Ajayakumar Prathibha 
Published: March 2017

<p class="abstract"><strong>Background:</strong> Postoperative sore throat (POST) is a frequent complaint among the subjects undergoing head and neck surgeries. Orotracheal intubation with the endotracheal tube (ETT) and laryngeal mask (LM) was used for anaesthesia. This study was aimed to analyze the effect of variation in cuff pressure and size of ETT and LM mask anaesthesia on post-surgical pain.</p><p class="abstract"><strong>Methods:</strong> Patients (ages of 10-79) who underwent head and neck surgeries by ETT intubation and LM anaesthesia were included in the study. The pain was measured as pain score during different cuff pressure and size of tube or mask and data was statistically analyzed. </p><p class="abstract"><strong>Results:</strong> Total 100 subjects of each group and both genders were included in the prospective study. No statistically significant difference could be observed among the number of cases in both groups. Among the patients, females were dominant (p = 0.405). The intensity of pain was gradually decreased during the 2<sup>nd</sup> and 3<sup>rd</sup> post surgical days in both groups. The frequency of patients with pain in the LMA group was less than that of ETT group on the 1<sup>st</sup> day. No correlation between the pain score and cuff pressure or size of ETT and LMA could be evidenced.</p><p><strong>Conclusions:</strong> The postoperative sore throat can be effectively reduced by LMA. The pain score and frequency of patients with pain in the LMA group was less than that of ETT group. No correlation of pain score with different cuff pressure and size of tube or mask could be evidenced. </p>
Prospective study on sterilization of rigid endoscopes in various otolaryngology clinics
Authors: Lakshmanan Varun , M. K. Goutham , Karnaker Vimal , Aroor Rajeshwari , Kamath P. Shrinath , Bhat Vadish , Varghese Irene Gee 
Published: March 2017

<p class="abstract"><strong>Background:</strong> Rigid endoscopes have revolutionized the diagnosis and management of upper aerodigestive pathologies. Inadequate disinfection and sterilization techniques carry increased risk for cross infection. Hence, they require high level disinfection to effectively reduce the bacterial and fungal contamination of rigid endoscopes. The present study analyses the various techniques of sterilization practised in Mangaluru, Karnataka, at different Otorhinolaryngology clinics.</p><p class="abstract"><strong>Methods:</strong> This prospective descriptive study was done on 30 rigid endoscopes. Swabs were taken from the endoscopes and container, and send for detailed microbiological examination. The different methods practised at various centres were documented. </p><p class="abstract"><strong>Results:</strong> The various sterilization technique practised was predominantly cetrimide and chlorhexidine solution (savlon) wash, ETO and Formaldehyde. However, among all techniques the microbiological studies revealed no growth.</p><p class="MsoNoSpacing"><strong>Conclusions:</strong> Rigid endoscopes have emerged as the best diagnostic equipment for otorhinolaryngologists. With regard to high level disinfection and sterilization, the endoscope must undergo recommended techniques. In our study the most commonly used techniques was cetrimide and chlorhexidine solution wash and less commonly ETO and Formaldehyde. The use of standard sterilization technique and maintaining the rigid endoscopes in sterile storage container is the key to maintain an organism free environment. The standard technique of prewash with water and soap water, then washing with cetrimide and chlorhexidine solution, then store the endoscope in sterile container is our recommendation. </p>
A clinical study of the patients with elongated styloid process
Authors: Choudhari Suhas Y. , Sangavi Aravind B. 
Published: March 2017

<p class="abstract"><strong>Background:</strong> The elongation of styloid process is considered an anomaly which can cause throat pain and cervico-facial pain and trigger a series of symptoms such as dysphagia, odynophagia, facial pain, ear pain, headache, tinnitus and trismus. The present study was undertaken find out the length of styloid process in patients with throat pain.</p><p class="abstract"><strong>Methods:</strong> A prospective study was conducted among 150 patients. A detailed ENT and general examination was done apart from palpation of the styloid along the posterior tonsillar pillar, a routine Hematological tests with estimation of serum calcium levels, and X-ray towne view was done. </p><p class="abstract"><strong>Results:</strong> The female to male ratio was found to be 1.6:1. Of the 150 cases 92 were middle aged females, the severity of symptoms were directly proportional to the length and the thickness of the styloid. The symptoms ranged from foreign body sensation in the throat to cervicofacial pain and otalgia. Serum Calcium levels were elevated in 60% of the cases.</p><p><strong>Conclusions:</strong> Elongation of the styloid being multi-factorial in origin. A strong suspicion is required on the part of the surgeon to rule out this particular entity. A simple palpitation and an x- ray Towne view can establish the diagnosis of elongated styloid process.</p>
Clinicoetiological pattern and pharmacotherapy practices in patients with new onset vertigo: findings from a prospective multicenter registry in India
Authors: Kameswaran Mohan , Pujari Shripad , Singh Jasveer , Basumatary Lakshya Jyoti , Sarda Kushal , Pore Rakesh 
Published: March 2017

<p class="abstract"><strong>Background:</strong> The objective was <span lang="EN-IN">to evaluate the clinicoetiological pattern and pharmacotherapy practices of new onset vertigo in India. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This multicentre, prospective, registry was conducted in adult patients across 37 centres. Enrolled patients were followed at week 1, month 1 and 3 to assess clinicoetiological characteristics, prescribed pharmacotherapy, safety and effectiveness of treatment. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Of the 1520 patients enrolled, 1428 (93.95%) completed the study. The mean (SD) age was 50.2 (±15.37) years and 53.2% were women. Of 202 patients reporting co-morbidities, 55.4% had cardiovascular disease and 38.6% had diabetes mellitus. Peripheral causes were predominant in majority (74.3%); benign paroxysmal positional vertigo (BPPV) being the most frequent (67.58%). Migraine affected 68.9% (80/116) patients, .as the central cause. Betahistine (74.6%) and prochlorperazine (21.75%) were the top two drugs of choice irrespective of origin, preferred by all treating specialists. Both the drugs significantly prevented recurrence by week 1 (prochlorperazine: 76.6%; betahistine: 64.2%) (p&lt;0.001) and over 3 months. A lower daily dose of betahistine (15.6±5.26 mg) was preferred. Almost half complained of nausea and vomiting; prochlorperazine significantly reduced recurrence of both within a week (p&lt;0.001). The treatments were well-tolerated with no reported adverse drug reactions. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The study demonstrates vestibular vertigo, BPPV to be the dominant type in Indian patients with new onset vertigo. Betahistine and prochlorperazine top the physicians’ preference list, with equal benefits in preventing recurrence. Prochlorperazine has an additional antinausea and antiemetic property, thereby may improve patient satisfaction. Prescription of a lower dose of betahistine calls for the need to sensitize physicians.</span></p>
Sinonasal teratocarcinosarcoma: is minimally invasive resection followed by adjuvant histology directed chemo-radiation a better alternative to radical excision? Case report
Authors: Singh N. Dhaneshwar , Sen Kanwar , Sharma Arun , Bharadwaj Meenakshi 
Published: March 2017

<p class="abstract">Sinonasal teratocarcinosarcoma (SNTCS) is a rare higly malignant tumour occuring almost exclusively in the sinonasal tract. This aggressive tumour arising from the primitive embryonic or immature pluripotential cells of olfactory epithelium has high propencity for loco-regional recurrence and mortality. SNTCS generally presents with relatively benign symptoms like nasal obstruction and recurrent epistaxis in its early stage. In advance stage with orbital and intracranial spread other symptoms raising suspicion of malignancy, such as dysphagia, odynophagia, epiphora, vision loss, exophthalmos, anosmia, headache and altered sensorium appears. In view of its aggressive behaviour, radical excision with or without chemoradiation is advocated as the optimum treatment. Local recurrence of SNTCS after excision has been reported as high as 45% with a mean recurrence time of 21.3 months. Even though distant metastasis is rare, local recurrence frequently leads to treatment failure and subsequent death. <span lang="EN-IN">Here we share our experience of SNTCS in a 23 year old male managed with endoscopic craniofacial resection followed by histocytology directed chemotherapy with external beam radiation. He remains disease free in last 3 years of follow up.</span></p><p> </p>
Bilateral Hurthle cell adenoma of thyroid: a rare case report
Authors: Singh Rahul Kumar , Goyal Amit , Elhence Poonam , Kumar Amit 
Published: March 2017

<p class="abstract">Hurthle cell of adenoma of thyroid gland is rare neoplasms of the thyroid. Size more than 4 cm is rare finding and moreover the occurrence of a multifocal Hurthle cell adenoma is not supported by antecedents in literature. Sonography fails to identify its potentials for malignancy while fine needle aspiration cytology couldn’t differentiate it from Hurthle cell carcinoma of thyroid. The management of Hurthle cell adenoma and Hurthle cell carcinoma is quite different and hence diagnostic dilemma should be sorted out early. A 26 year old female presented with bilateral thyroid swelling. Ultrasonography of thyroid gland showed complex solid cystic nodules in bilateral thyroid lobes with right thyroid lobe measuring 4.1×3.4×2.5 cm and left thyroid lobe measure 3.1×1.7×1.6 cm. Fine needle aspiration cytology (FNAC) was suggestive of papillary malignancy with extensive Hurthle cell changes (Class V, Bethesda classification). The patient underwent total thyroidectomy with bilateral parathyroid gland preservation. Histopathology revealed it as Hurthle cell adenoma (HCA) involving bilateral lobe and multifocal in nature. The treatment of choice for Hurthle cell carcinoma is total thyroidectomy with neck dissection depending on the nature of the lesions. However the treatment of Hurthle cell adenoma is only hemithyroidectomy or lobectomy as it is a benign condition. Differentiation of these two entirely different conditions warrants more studies<span lang="EN-IN">.</span></p>
Our experience in endoscopic management of mucormycosis: a case series and review of literature
Authors: Singh Inderdeep , Gupta Vikas , Gupta Salil Kumar , Goyal Sunil , Kumar Manoj , Singh Anubhav 
Published: March 2017

Sinonasal mucormycosis is uncommon entity and it rarely infects a healthy host. When it does occur; it becomes very difficult to treat because of the speed of progress of disease and can have fatal outcomes. The mainstays of therapy are treatment of immunocompromised status, systemic high dose Amphotericin B, and surgical debridement of necrosed or nonviable tissue. The following six cases, managed at our centre from July 2016 to October 2016, outline nuances in the diagnosis of invasive sinonasal mucormycosis and highlight the importance of timely surgical debridement and importance of endoscopic approach in complete clearance of disease in order to facilitate medical management to work. All cases included in this study were found to be immunocompromised and had unilateral severe diminution of vision due to periorbital extension of disease. Diagnostic nasal endoscopy revealed black-brown crust and tenacious pus filling up nasal cavity, erosion of turbinates and nasal septal perforation. One patient showed erosion of hard palate and eschar formation. CECT/MRI of PNS showed evidence of bony erosion and orbital involvement. Biopsy taken during nasal endoscopy confirmed the presence of mucormycosis. All patients were started on Liposomal Amphotericin B and broad spectrum antibiotics in renal corrected dosages and taken up for urgent endonasal endoscopic debridement. All paranasal sinuses were cleared and orbital decompression was done. Postoperatively all patients were continued on Liposomal Amphotericin B in renal corrected dosages for two-three weeks and being followed up monthly. One patient could not survive due to several co morbidities and severe immunocompromised status. Only one patient showed recurrence of disease on one month postoperative follow up. Five patients showed improvement in visual acuity. Sinonasal mucormycosis if inappropriately diagnosed and treated can be a fatal condition. Energetic diagnostic workup, combined with equally energetic management, surgical and management leads to favourable outcome.<p> </p>
Case Study: A Two-Part Salt-Tolerant Friction Reducer System Enables the Reuse of Produced Water in Hydraulic Fracturing
Authors: Xu Liang , Lord Paul , He Kai , Riley Howard , Koons Justin , Wauters Todd , Weiman Sam 
Published: March 2017

Abstract
Friction reducers (FRs) are an important component of slickwater hydraulic fracturing applications. Using only a single FR system throughout the entire treatment is highly desired in water sources of salinity varying up to 300,000 ppm. This paper discusses field trials of a new salt-tolerant FR system in the Marcellus shale.
A three-well trial program was initiated in the Marcellus. Multiple water sources with varying salinities were used with up to 100% reuse of produced water. The new FR system enabled the pumping pressure to be reduced below 8,500 psi, and the pumping rates were increased and maintained at approximately 100 bbl/min.
This new salt-tolerant FR system consists of a water-in-oil cationic polymer and a surfactant inverter. Unlike other FRs, the distinctive advantage of this FR is that the ratio between polymer and inverter can be readily adjusted on-the-fly to achieve maximum friction reduction.
Zinc and Lead Interactions in Combined Sulphide Scales
Authors: Al-Harbi B. G. , Graham A. J. , Sorbie K. S. 
Published: March 2017

Abstract
Zinc sulphide (ZnS) and lead sulphide (PbS) have both been observed as mineral scale deposits in high-temperature high-pressure HT/HP oil and gas fields. ZnS and PbS deposition can pose safety hazards and have serious economic consequences. Some field results have revealed the formation of mixed ZnS/PbS scales despite sulphide being the limiting reactant to individual Pb and Zn ions, while contrary results have been obtained by using scale prediction and lab testing under the same conditions.
The objective of this study was to investigate the interaction between Zn and Pb within solutions containing sulphide over a wide range of conditions including varying salinity (sulphate-free North Sea Seawater (SFNSSW) and Glenelg formation water (GFW)), temperature (50 and 95°C), time and Zn:S, and Pb:S molar ratios. Static scale formation experiments coupled with inductively coupled plasma (ICP) analysis, pH monitoring and particle size measurements have been used to analyse the system.
When a mixed Zn/Pb brine was combined with sulphide brine, Pb ions were completely stripped from solutions where sulphide was in excess to Pb. In this region, sulphide was partially consumed by Pb and thus the remaining sulphide reacted with Zn to form ZnS. On the other hand, when both Zn and Pb existed in excess to sulphide, single PbS formed despite the fact that both scales have very low solubility. Similar behaviour was observed when the temperature was increased from 50 to 95°C and GFW was used instead of SFNSSW.
This study showed that, under the conditions examined, PbS will always form preferentially to ZnS in a mixture even at high Zn:Pb molar ratios. Understanding the interaction between Zn and Pb in the presence of sulphide is essential for accurate interpretation of scale inhibition results and scale formation predictions.