bluuebunny/crossref_metadata_2025_split huggingface dataset:
Squamous Cell Cancer of the Skin in a Patient on Maintenance Capecitabine for Metastatic Breast Cancer: A Case Report
Authors: Mahajan Sidharth , Moore Heather , Jolly Puneet , Kimmick Gretchen 
Published: September 2024

Abstract
Capecitabine is a widely used and effective oral chemotherapeutic agent for metastatic breast cancer and colorectal cancer; however, it is associated with several adverse effects. Of these effects, hand–foot syndrome (HFS) or palmar–plantar erythrodysesthesia, characterized by chronic inflammation, particularly of the hands and feet, is most notable. Chronic inflammation increases the risk of squamous cell cancers. We present a unique case of a patient with metastatic breast cancer whose disease was controlled with capecitabine for over a decade. She experienced chronic grade 1–2 HFS and subsequently developed squamous cell skin cancer on the palms and soles. To the best of our knowledge, squamous cell cancer associated with capecitabine exposure has not been previously reported. This case report aims to shed light on this association, thereby expanding the existing literature on the topic.
A Liposomal Irinotecan and S-1 Combination is Shown to be Efficacious in the Treatment of Metastatic Pancreatic Acinar Cell Carcinoma: A Case Report
Authors: Teng Ling-Chiao , Shih Yu-Hsuan 
Published: September 2024

Abstract
Pancreatic acinar cell carcinoma (PACC) represents a rare malignancy within the pancreatic tumor spectrum. Owing to its rarity, the establishment of a standardized chemotherapy regimen for patients presenting with either metastatic disease or recurrence after radical surgery remains elusive. Most previous studies and case reports have used gemcitabine-based and 5-fluorouracil-based regimens, however, no previous study has reported the use of liposomal irinotecan in combination with S-1. In this report, we present a patient with PACC who experienced disease progression with liver metastasis after radical tumor resection followed by chemoradiotherapy. The patient underwent second-line treatment with liposomal irinotecan in conjunction with S-1. Encouragingly, the patient has remained free of recurrence and progression during a follow-up period of 2 years and 3 months.
Targeted orbital intervention in the management of sino-orbital mucormycosis cases
Authors: Meel Rachna , Bajaj Mandeep S , Pushker Neelam , Agrawal Sahil , Tyagi Parag , Thakkar Alok , Sharma Sanjay , Pachaury Shuchita S , Wig Navneet 
Published: September 2024

Introduction:Many countries from South-East Asia reported an epidemic of sino-orbital mucormycosis (SOM), otherwise a rare disease, during the coronavirus disease 2019 pandemic. SOM, a potentially fatal disease, is typically treated with orbital exenteration and systemic antifungals after metabolic stabilization. There is no clear evidence of survival benefit of exenteration in the literature, and thus, there have been attempts at globe conserving treatments like orbital infusion after limited debridement and intraorbital injections with Amphotericin B (IOAB).Methods:We conducted a prospective comparative interventional study at a tertiary eye care hospital to evaluate treatment outcomes with the use of adjunctive IOAB in cases of SOM with mild to moderate orbital disease.Results:Thirty-six patients of SOM with mild to moderate orbital disease were recruited in the study. In the intervention group, 23/26 (885%) eyes had stable orbital disease at the end of treatment (4–6 weeks). No deterioration in visual acuity was noted as a result of treatment. In 8/26 (30.77%) patients, inflammation was noted as a side effect of IOAB requiring temporary discontinuation of injections. The mean follow-up for cases was 14.2 months (range 12–15 months). 1/23 (4.35%) patients had relapse of orbital disease at 3 months. Twenty-one patients are alive on last follow-up. Of the patients who refused treatment (controls), 2/9 (22.22%) patients relapsed. One of these patients with relapse underwent exenteration, while the other was managed with IOAB. At a follow-up of 14 months (range 12–15 months), eight patients are alive. On evaluating the ocular parameters in salvaged eyes, improvement in extraocular movements was noted in 75–80% cases. The degree of proptosis and resistance to retropulsion did not change significantly.Conclusion:In the current study, an improvement in the globe salvage rates was noted in cases of SOM with mild to moderate orbital disease treated with adjunctive IOAB as compared to controls at a mean follow-up of 14 months, although it did not achieve statistical significance. The study supports the inclusion of IOAB in routine management of mild to moderate orbital disease.
Posterior lamellar wedge resection of lower eyelid margin lesions
Authors: Diab Mostafa M , Allen Richard C , Ismail Ahmed A , Saif Ahmed T S 
Published: September 2024

Purpose:
Removal of clinically benign eyelid margin lesions is frequently desired for cosmetic concerns. Although surgical excision remains the standard therapy for such lesions, it carries the risk of unfavorable outcomes. Hence, this study aimed to evaluate a more aesthetic technique entailing a posterior lamellar wedge resection of lower eyelid margin lesions through an infraciliary incision.

Methods:
A retrospective review of patients who underwent posterior lamellar wedge resection for benign lower eyelid margin lesions between May 2017 and June 2022 was performed. Patient satisfaction using the visual analog score (VAS) and cosmetic outcomes using the Strasser score.

Results:
Forty-two patients met the inclusion criteria (61.9% female, mean age: 46.8 years). Nevus was the most frequent histologic diagnosis (57.1%). Furthermore, 66.7% of lesions extended to the back of the lid margin. The mean defect size was 5.8 mm (range: 3.5–8 mm). The mean follow-up interval was 24.1 months (range: 6–60 months). Thirty-two (76.2%) eyelids had scores indicating an excellent result, and 10 (23.8%) patients had a good result. The mean patient satisfaction VAS score for the eyelid appearance was 96 (range: 70–100). There were no cases of recurrence of resected lesions. No further surgery was performed on the operated eyelid for any reason during the follow-up period.

Conclusion:
Posterior lamellar wedge resection for lower eyelid margin lesions was associated with excellent cosmetic outcomes, high patient satisfaction, and minimal adverse events.
Volume measurement of the vitrectomised eye and its applications in practice
Authors: Agrawal Surbhi , Shanmugam P Mahesh , Mishra Divyansh Kailashchandra , Ramanjulu Rajesh , Ravishankar HN , Sagar Pradeep , Sahare Harshal , Suryakanth Shwetha 
Published: September 2024

Purpose:
To estimate the vitreous cavity replacement volume after pars plana vitrectomy and analyze its correlation with axial length and refractive error.

Methods:
Observational cross-sectional study on 103 eyes undergoing vitrectomy. Fluid-air exchange was performed using a soft-tip cannula connected to a PVC tubing, the distal end of which opened into a 10-cc syringe without the plunger. The collected fluid was measured (and correction factors applied) to estimate the vitreous cavity volume.

Results:
The mean axial length of 103 eyes was 23.43 ± 1.54 mm. The mean vitreous cavity volume was 4.46 ± 0.83 mL (2.8–8.1 mL). There was a strong positive correlation between axial length and vitreous volume, which was stronger for pseudophakic and aphakic groups than for phakic groups.

Conclusion:
Accurate assessment of vitreous cavity volume can enable precise quantification of tamponade, intravitreal drugs, and intravitreal chemotherapeutic agents. This will allow better surgical outcomes, decreased toxicity, and increased cost-effectiveness due to lesser wastage.

Objective:
To estimate the vitreous cavity replacement volume after pars plana vitrectomy and analyze its correlation with axial length and refractive error.
Ocular and adnexal manifestations post dengue hemorrhagic fever
Authors: Maan Veenu , Guha Subhamita , Sapra Himanshu , Chauhan Lokesh 
Published: September 2024

Objective:
This study aims to present a case series detailing sight-threatening ocular and adnexal manifestations following dengue fever.

Methods:
A retrospective observational study was conducted, analyzing records of patients presenting with ocular manifestations post dengue fever at a tertiary eye care institute in Uttar Pradesh from October 2023 to November 2023. Demographic details, systemic comorbidities, and detailed ophthalmic examinations were recorded.

Results:
Fifteen eyes of 13 patients with dengue fever were studied. The mean age of presentation was 39.07 years, with a male predominance (84.61%). Systemic comorbidities were noted in 30.76% (diabetes mellitus) and 23.07% (hypertension) of patients. Thrombocytopenia was observed in 53.84% of patients, while 23.07% required blood transfusions, and 15.38% experienced systemic bleeding episodes. The majority of cases were unilateral (84.61%), with the best-corrected visual acuity of perception of light in 84.61% of cases. Diminution of vision was the most common presenting symptom (84.61%), followed by pain (53.84%), redness (38.46%), and watering (23.07%). Major ocular manifestations included panophthalmitis (26.07%), total ophthalmoplegia (26.07%), endogenous endophthalmitis (20%), central retinal artery occlusion (20%), retinal hemorrhage (20%), ischemic optic neuropathy (20%), orbital cellulitis (13.3%), proptosis (13.3%), retrobulbar hemorrhage (13.3%), retinal detachment (13.3%), and foveolitis (6.7%).

Conclusion:
The diverse array of ocular and adnexal manifestations in dengue hemorrhagic fever may result in permanent visual loss, emphasizing the need for adequate treatment and timely intervention. The risk of sight-threatening complications underscores the importance of early screening by ophthalmologists and increased public awareness.
Audiological Profile of a Child with Landau–Kleffner Syndrome: A Clinical Case Study
Authors: Sao Tulsi , Kandra Toman Singh 
Published: September 2024

Abstract

Introduction:
Landau–Kleffner syndrome (LKS) is a childhood language disorder characterized by the most frequently described forms of acquired epileptiform aphasia. LKS is a rare age-related epileptic encephalopathy that usually occurs between 3 and 7 years of age in children with previously normal speech and language development until the onset of convulsion. The prevalence of LKS is unclear. However, it is male predominance exits with 2:1. Various literatures reported that LKS syndrome has auditory processing impairment and few may have hearing loss, but symmetry and magnitude of hearing loss were unexplained.

Aim:
Audiological profile of a child with LKS: A clinical case study.

Materials and Methods:
All audiological tests such as tuning fork test, otoscopic examination, pure-tone audiometry, immittance audiometry, otoacoustic emission, and auditory brainstem response tests were administered.

Results:
Audiological objective diagnostic test indicated that LKS syndrome has normal hearing sensitivity in both the ears.

Conclusion:
Postlingual communication skills may get severely hampered in LKS. Hence, the inclusion of audiological diagnostic test battery will increase the chances of early identification, accurate referral, diagnosis, and monitoring of a child with LKS which is extremely important for a positive prognosis. Finally, it is important to remember the genetic nature of LKS syndrome and its effect on communication. Educational planning should take the prospect of future postlingual speech disorder into consideration.
Exploring Dizziness Symptom Profile for Preliminary Diagnosis of Vestibular Disorders
Authors: Bhatt Shubhnagi S. , Sarda Sharda Ajay 
Published: September 2024

Abstract

Background:
The dizziness symptom profile (DSP) is a case history-based questionnaire that can differentially diagnose patient with vertigo into vestibular disorder at a preliminary level.

Aim of the Study
The current study explored and compared response patterns on different questions/statements of DSP questionnaire after adapting it into the Indian Language Marathi for different vestibular disorders.

Methods:
A prospective exploratory study was conducted on a clinical population having vertigo or dizziness due to different vestibular disorders. A total of 60 patients with primary complaints of dizziness filled the Dizziness Symptom Profile - Marathi (DSP-M) questionnair which was adpated into Indian Marathi language from its original English version (DSP-E). Test–retest reliability and internal consistency of the item were assessed for the adapted questionnaire and different symptom patterns were analyzed for patients with four peripheral vestibular disorders.

Results:
DSP-M was found to have good test–retest reliability with intraclass correlation value of 0.683. Internal consistency for all the questions was found to be strong with a Cronbach alpha value of α = 0.92. DSP-M depicted a similar symptoms response pattern as described by the original author of the questionnaire nevertheless few variations were also found for patients with vestibular neuritis and vestibular migraine.

Conclusions:
DSP-M can be used for preliminary diagnosis of patients with these abovementioned vestibular disorders.
Positional Variations and Surgical Implications of Bony Overhangs in the External Auditory Canal
Authors: Basavanthappa Prahlada Nayaka , Singh Amardeep , Shetty Anusha S. , Thomas Oshin , Panchami  , Kamath Ramya Ravindra , Raisa S. , Prahlada Amulya Nayaka 
Published: September 2024

Abstract

Background:
This study examines the anatomical differences in the external auditory canal (EAC), particularly bony overhangs that hinder middle ear access, affecting diagnosis and surgical procedures. It seeks to categorize these overhangs for better surgical planning, offering a classification system essential for otologists and middle ear surgeons aiming at improved surgical outcomes.

Materials and Methods:
This retrospective analysis at a tertiary care hospital reviewed patient records and surgical videos from November 2017, focusing on otological procedures. Excluding individuals with EAC erosions or previous surgeries, it recorded demographics, diagnoses, and details of surgeries, including bony overhang locations. The study employed descriptive statistics, Chi-squared tests, and predictive analysis to explore the impact of bony overhangs on surgical requirements.

Results:
This study analyzed 333 ears from 305 patients undergoing middle ear and mastoid surgeries, finding a significant association between EAC types and bony overhang distribution, confirmed by a Chi-square test (P value ≈ 1.63 × 10 −83). Despite a predominance of female patients (59%), no significant correlation was observed between EAC types and patient age or gender. However, disease duration showed a significant relationship with EAC types, with predictive analysis indicating a high likelihood of requiring canalplasty for specific EAC configurations.

Conclusion:
Our research presents a clinical classification for EAC and tympanic annulus overhangs, underscoring their role in surgical visibility and middle ear operation challenges. It corroborates earlier studies, stressing the need to grasp EAC variations for improved surgical planning, overcoming obstacles, and enhancing middle ear surgery outcomes, thus refining surgical methods for patients with such anatomical differences.
A Case Study of Novel Technique for Reconstruction of the Eroded Long Process of the Incus in Revision Stapedectomy
Authors: Temirbekov Dastan , Celikyurt Cengiz , Kulimbetov Amangeldy 
Published: September 2024

Abstract
Although otosclerosis surgery is considered an effective treatment option, there is an incidence of surgical failure that necessitates revision operations. Here, we report a case of revision otosclerosis surgery and propose a new technique for reconstruction of the eroded long process of the incus using a metal wire obtained from a Shepard grommet tympanostomy tube and ionomer bone cement.
Bilateral Double Window Otosclerotic Obliteration: A Case Report and Literature Review
Authors: Oren Keren , Klein Ayala , Soikher Eugene , Tamir Sharon Ovnat 
Published: September 2024

Abstract

Background:
Otosclerosis is a disorder characterized by abnormal resorption and bone deposition, resulting in progressive hearing loss. Obliterative otosclerosis describes a condition with bony overgrowth covering the oval and possibly the round window (RW) niche, sometimes indistinguishable from the surrounding area. The occurrence of RW obliteration is uncommon. In such cases, a careful and comprehensive diagnosis is important in the management of the condition.

Purpose:
We describe a patient with bilateral “double window” obliteration secondary to otosclerosis and the manifestations of the disorder on imaging. In addition, this article aims to review the literature regarding RW otosclerosis and the role of imaging in this pathology.

Methods:
For this narrative review, we performed a literature search in three electronic databases: PubMed, Scopus, and Web of Science databases, between January 1975 and March 2023 using the terms “round window obliteration,” “round window otosclerosis,” “far advanced otosclerosis,” and “cochlear obliteration.” Exclusion criteria included editorials, non-English language papers, editorial comments, and letters. Two masked reviewers screened the articles independently based on prespecified inclusion and exclusion criteria.

Conclusions:
This case report and narrative review emphasize the importance of double window otosclerosis diagnosis and the useful role of imaging in both diagnosis and management of the condition.
Cortical Auditory Evoked Potentials and Subjective Auditory Perception Responses in Children Using Cochlear Implant: A Preliminary Study
Authors: Sebastian Swapna , Augustine Ann Mary , Abraham Anjali , John Mary , Phillip Ajay , Gowri Mahasampath , Mathew John 
Published: September 2024

Abstract

Objective:
A cochlear implant (CI) is a management option for congenital severe to profound hearing loss in children with no residual hearing. Cortical auditory evoked potentials (CAEPs) have been found to be useful in evaluating the outcome using CIs. The study aimed at assessing the change in CAEPs and auditory perception using the categories of auditory perception (CAP) test with respect to the duration of auditory stimulation using a CI in children who were deaf and received a unilateral CI during childhood before the age of 5 years.

Materials and Methods:
Prelingually profound hearing-impaired children with normal cochlea who received a unilateral CI during childhood between 12 months and 5 years were recruited for the study. The duration of use of the implant ranged from 1 month to 5 years.

Results:
We found that with an increased duration of auditory stimulation using CIs, auditory responses matured regarding reduction in P1 latency and increased CAP scores. How long it takes for these children to achieve normal patterns of cortical maturation is a subject of further research.
Otological Surgical Training Using Haptic Feedback Device in Addition to Conventional Cadaveric Dissection Method: Is It Time for a Change?
Authors: Raj Poonam , Srivastava Tripti L , Singh Kamalpreet , Surya Naman 
Published: September 2024

Abstract

Introduction:
Medical education has always been a dynamic field, evolving alongside advancements in technology and pedagogical methodologies. Virtual reality platforms allow medical professionals to practice and refine their skills. This study delves into the importance of simulation-based temporal bone dissection, its benefits, and the future it holds for medical education when it is used as an adjunct to cadaveric bone dissection.

Aim:
This study aimed to compare the otological surgical competencies acquired by ENT residents trained additionally on the haptic handheld simulator vis-a-vis those trained by cadaveric temporal bone dissection alone.

Objective:
The objective of this study was to objectively assess the level of competency achieved by ENT residents additionally trained on the haptic handheld simulator as compared to those trained by cadaveric temporal bone dissection alone using postcortical mastoidectomy surgical outcomes as a measure.

Methodology:
This prospective observational study was conducted for 6 months and included 12 ENT postgraduate residents. The study was conducted in five phases which included a pretest, first cortical mastoidectomy, competency-based simulation training, second cortical mastoidectomy, and a posttest in the end along with feedback from participants and faculty. Three-dimensional system touch haptic device was used for simulation and assessment of cortical mastoidectomy was done using a grading scale.

Results:
On the assessment of cortical mastoidectomy, pre- and postcompetency-based simulation training mean scores were 12.3 ± 1.9 and 17.2 ± 2.8, respectively. The mean score difference was statistically significant as P < 0.05. Scores obtained by participants in posttest had also improved significantly.

Conclusion:
Simulation-based temporal bone dissection represents a groundbreaking advancement in medical education. By providing a safe, standardized, and realistic training environment, simulations empower future surgeons to develop and refine their skills with unprecedented precision.
Incidence of Early Complications of Cochlear Implants
Authors: Al Mansoury Alaa Mtashar , Aqeel Maha Badr , Ahmed Ahmed Salah 
Published: September 2024

Abstract

Background:
Cochlear implantation is an operation by which the cochlear implant (CI) device is inserted in the cochlea to stimulate electrically the Auditory nerve through its nerve ending in the cochlea. This procedure may be accompanied by some major or minor complications, and as the number of cochlear implantations has increased dramatically during the last decade, it is important to be aware of the potential complications and their management.

Objective:
The objective is to detect the incidence of early complications of CI in Al-Yarmouk Teaching Hospital.

Patients and Methods
A descriptive study of (173) patients had implantation in the Department of Otolaryngology in Al-Yarmouk Teaching Hospital/Baghdad through a period of 12 months starting from April 2021 to ending in April 2022. Preoperative assessments were done so that all patients were fit to do the operation; all of these patients have been followed up for 1 month for early detection of complications that classified as major and minor types.

Results:
There were (96) females and (77) males Patients, the age at implantation for these patients was ranging from 1 to 50 years, the mean age ± standard deviation = (4.95 ± 5.92). The overall rate of complications was 8.7% (15 of 173), with minor complications accounting for 6.9% and including; (unsteadiness 2.9%, facial swelling/forehead skin abrasion 1.1%, wound dehiscence 1.1%, hematoma 0.6%, seroma 0.6%, and simple wound infection 0.6%), these complications were treated conservatively by medical measures or by a minor surgical procedures. Major complications accounting for 1.8% which were; (wound infection that end with flap necrosis 0.6%, biofilm infection 0.6%, and facial nerve palsy 0.6%).

Conclusions:
CI is a safe technique with a relatively low complication rate. Most of these complications are minor which can be managed with conservative measures or minimal intervention. Skin flap complications range from minor wound infection to wound dehiscence, wound swelling and flap necrosis; this emphasizes the need for careful and delicate manipulation of tissues to avoid such complications. Pay further attention to strict sterilization and strategy regarding disposable towels and surgical kits is needed.