bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of negative pressure wound therapy in the management of chronic diabetic ulcers: a prospective study
Authors: Sharma Dhruv , Singh Biplav , Jaswal K. S. , Thakur Vishal , Nanda Vibhor , Nabh Rishi 
Published: March 2017

Background: Chronic ulcers in patients with diabetes are complex and treatment is often difficult. At the moment, negative pressure wound therapy (NPWT) is widely used for the treatment of several types of wounds. Nevertheless, the clinical evidence to support the application of this dressing in chronic diabetic ulcers is scarce. The aim of this study was to evaluate the efficacy of NPWT to treat chronic diabetic ulcers.Methods: Prospective time bound comparative study. Diabetic patients aged 18 years or older with an ulcer were assigned to treatment with NPWT. Primary efficacy end point was time in reaching complete ulcer closure. A size of sample of 15 patients was used. NPWT was prepared with a polyurethane foam dressing, a Silicone catheter, a transparent adhesive drape and continuous negative pressure of 125 mm Hg. The wound was treated for cycles of 5 days and evaluated at every dressing change. Descriptive and analytical statistics were used.Results: There were 15 patients, with a mean age of 54.4 years (73.3% men). The average time to complete ulcer closure was (41.2 [8.5] days).Conclusions: NPWT is an effective modality of treatment of chronic diabetic ulcers with early appearance of granulation tissue and faster rates of overall complete wound closure.
Indications of ventriculoperitoneal shunt: a prospective study
Authors: Jaykar Ritvik D. , Patil Shrikant P. 
Published: March 2017

Background: Shunts have been used to drain the Cerebrospinal fluid into practically every body cavity, organ system and tissue spaces. Scraff has critically reviewed the efficacy of various shunts. These are of historical interest. Ventriculo peritoneal and ventriculo cardiac shunts continue to remain the chief surgical techniques in the management of hydrocephalus.Methods: This study included sixty cases where VP shunt insertion surgery was indicated. Chhabra’s medium pressure VP shunt was used in all 60 cases. 32 out of 60 cases were below 2 years (53.3%) .70% of the patients were male and 30% were female. Male to female ratio was 2.3:1. Out of 24 cases of congenital hydrocephalus 16 were due to aqueductal stenosis i.e. 66.6 % of cases. Dandy Walker malformation was found in 2 cases. And in 2 more cases, Arnold Chiari malformation was found. In acquired group 22 cases had tuberculous meningitis, 4 cases were of post meningitis aetiology and 10 cases were of communicating hydrocephalus with history of trauma.Results: In congenital group of patients, most common clinical feature was ‘enlargement of head’ bulging of fontanelle. In acquired group of patients the common clinical features were headache, vomiting, fever and convulsions. USG cranium and CT scan proved to be highly informative investigations and were done wherever necessary. Out of 36 cases of acquired group the percentage of tuberculous meningitis was 61.6% and communicating hydrocephalus with trauma was about 27%. USG cranium was also used in follow up congenital hydrocephalus to assess the position and functioning of shunt. Even CT scan was used in adult age group to assess the position of shunt and condition of the brain. All patients of with VP shunt surgery were treated with higher antibiotics preoperatively and postoperatively.Conclusions: Common complications included, shunt infections, shunt obstruction, shunt malposition. Rare complications included shunt migration through anus and shunt ascites. Four patients died after VP shunt surgery, two were operated case of encephalocele with associated congenital anomalies with uremia and other two were with dreaded shunt infection with septicaemia. Ten (16.6%) patients required revision of VP shunt surgery in present study.
A rare case of squamous cell carcinoma with xanthogranulomatous pyelonephritis in a patient with chronic obstructive renal calculi
Authors: Gautam P. Varun , Litake Manjusha M. 
Published: March 2017

Squamous cell carcinoma (SCC) of the kidney is a rare entity. Often it is confused with Xanthogranulomatous Pyelonephritis (XGP), which is a chronic inflammatory disorder of the kidney, associated with the destruction of the renal parenchyma usually in the setting of an infectious process. A 76 year old male presented with right flank pain and vomiting. On examination, was found to have tenderness with localized guarding in the right flank. Investigations revealed a mass arising from the lower pole of the right kidney which was hydronephrotic and had features suggestive of stage III xanthogranulomatous pyelonephritis (XGP) with pyonephrosis and the presence of multiple calculi. Patient initially underwent a drainage of the pyonephrosis and subsequent nephrectomy. Histopathology revealed the presence of both XGP and SCC in the resected kidney specimen. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures. Chronic nephrolithiasis is a predisposing factor for both XGP and SCC. XGP shares many characteristics with SCC in terms of both its radiographic appearance and its ability to involve the adjacent structures.
Meatal ulcer: very rare complication of Foley catheterization
Authors: Yagnik Vipul D. 
Published: March 2017

A 65 year old gentleman was admitted with the diagnosis of exophytic tumor arising from the stomach wall. His vitals were normal. Patient was poorly built and poorly nourished with BMI of blood chemistry, ECG, and ECHO was normal. His past medical and surgical history was not significant. Urethral catheterization was performed pre-operative with strict aseptic technique. Patient underwent laparotomy with subtotal gastrectomy and gastrojejunostomy. Catheter care was done regularly by trained staff. Catheter was removed on third post operative day. After removal of catheter, Patient had a difficulty in passing urine. On examination, single meatal ulcer was noted (Figure 1). Post –operative course was unremarkable. Patient is in follow up since last six month without any problem.
Vestibular migraine- a dilemma no more
Authors: Rajguru Renu , Singh Inderdeep , Gupta Abhishek 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Vestibular migraine (VM) is an increasingly recognized cause of episodic vertigo. However, the pathophysiology of VM is still a matter of speculation and it is not known to what extent the dysfunction is located in the central or peripheral vestibular system. Though in its earlier version International Headache Society recognized only adult onset VM in the setting of basilar migraine, but in its latest 3rd edition beta version in consensus with Barany Society (2013), VM is included in the International Headache Society classification of migraine in appendix 1. It does not figure in the main list because it is yet to be validated by scientific research. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The purpose of this study is to record and describe the spectrum of clinical findings of VM patients, to study the vestibular system and find out the site of vestibular dysfunction. In this study we studied 20 patients with acute VM in the symptomatic and asymptomatic phase. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Abnormal findings in the vestibular work up were present in all 20 VM patients (100%). Central pathology in the vestibular system was seen in 10 patients (50%), 6 patients had peripheral vestibular pathology (30%), and in 4 patients (20%) the site of vestibular dysfunction was indeterminate as they had features of both central and peripheral dysfunction and the exact site of dysfunction could not be determined with certainty. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Acute VM should be considered in the differential diagnosis of vertigo. It can present both as a central and a peripheral vestibular disorder. However there are no definitive signs to pin-point the diagnosis. A careful clinical history combined with clinical findings and exclusion of other causes of vertigo, is fundamental for assessing the profile of patients with vestibular migraine.</span></p>
Montelukast: a better alternative than antihistaminics in allergic rhinitis
Authors: Kaur Gurpreet , Dhingra Rachna , Singh Manjinder , Kaur Manpreet 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Allergic rhinitis is associated with sleep disturbances, daytime somnolence, and fatigue. Hence, present study was undertaken to evaluate and compare the nocturnal symptoms such difficulty in going to sleep, night time awakening and nasal congestion/obstruction on awakening among allergic rhinitis patients after administration of montelukast, chlorpheniramine meleate, levocetrizine, desloratidine and fexofenadine and to find out anti-allergic drug with maximum improvement in total symptom complex score. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">The present study comprised of 125 patients suffering from allergic rhinitis on the basis of characteristic history, corroborative physical findings and blood eosinophilia. Night times symptoms including difficulty in going to sleep, night time awakenings and nasal congestion on awakening were evaluated after patients were given oral treatment with chlorpheniramine maleate, levocetrizine, fexofenadine, desloratadine and montelukast for a period of 6 weeks in different 5 groups and the result interpreted on the basis of symptoms relieved. Symptoms were recorded on day 1, 2 weeks, 4 weeks and 6 weeks of treatment and analysed. All the patients were randomly divided into five groups of 25 each. The results were tabulated and analyzed by chi-square, Kruskal-Wallis test. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The present study found that levocetirizine provided immediate effect at 2 weeks which is significantly better than other drugs. But at 6 weeks, montelukast is best among the drugs which were compared; followed by levocetrizine, fexofenadine, and desloratadine and chlorpheniramine maleate. Montelukast was found to be a better drug as it has no significant side effects. Desloratadine group had dryness of mouth. Chlorpheniramine maleate has maximum side effects. 6 patients who took chlorpheniramine maleate complained of sedation, 1 patient complain of psychomotor disturbance. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">The present study concludes that in terms of clinical efficacy, safety/tolerability and improvement in night time symptom scores at six weeks therapy in allergic rhinitis, montelukast is the better drug.</span></p>
Efficacy of single dose preoperative intravenous dexamethasone for postoperative pain relief in tonsillectomy patients
Authors: M. S. Lakhan , Ramlan Sharwak , Somayaji Gangadhara 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Tonsillectomy is one of the most commonly performed surgical procedures in otolaryngology. For managing post tonsillectomy pain, different modalities like use of intravenous opioids, NSAIDS, local anaesthetics, nerve blocks and steroids are available. The aim of this study is to determine the efficacy of single dose preoperative intravenous dexamethasone for postoperative pain relief in patients undergoing tonsillectomy. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This study was conducted with 120 patients who underwent tonsillectomy. Patients were divided into two groups of 60, where one group received preoperative dexamethasone. Postoperative pains of both groups were assessed. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">There is significant difference in pain in both the groups in 6<sup>th</sup> and 12<sup>th</sup> postoperative hours, but in 2<sup>nd</sup> hour there is no significant difference. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">A single dose of preoperative intravenous dexamethasone significantly decreased the postoperative pain in tonsillectomy patients.</span></p><p> </p>
Audiometric evaluation of type 1 tympanoplasty for hearing results
Authors: Tegnoor Mallikarjun S. , Ali Kazim , Mithun Sutrave 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">To evaluate the graft uptake rate of the type1 tympanoplasty performed by underlay technique using autologous temporalis fascia graft for the last two years and to assess the hearing improvement in the successfully operated cases with respect to age, sex, size and location of perforation. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective Study included 50 patients, who underwent type1tympanoplasty.All operations are performed using an underlay technique and by postural approach. In all the cases, temporalis fascia is used for the reconstruction of TM.<strong> </strong>The data of all the patients regarding preoperative disease, perforation size and location, surgical approach, graft material, pre and postoperative clinical and functional (hearing evaluation by pure-tone audiogram) results are analyzed. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Successful closure rate of the TM perforation is 88% and the graft failure rate is 12%. In this study, lowest and highest age of patients at presentation is 13 and 55 years respectively with a mean age of 26.6 years. Most common approaches is post aural. The mean pre and post-operative air conduction threshold in the successful cases are 33.34 dB and 20.20 dB respectively with a mean audiological improvement of around 13 dB. The improvement in the hearing is achieved in only 88% (44 out of 50) among the successful operated type 1 tympanoplasty. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Type 1 tympanoplasty is a safe and effective technique to improve the quality of life of patients. The most common approach is postural. The graft uptake rate is better at three months. The improvement in hearing is noted irrespective of age, sex, size and location of perforation.</span></p>
A study of clinical and audiometric profile in patients presenting with sudden sensorineural hearing loss
Authors: K. Vinod M. , Kaur Amanjot , Singh Jagdeepak , Singh Jatinder , Sandhu Kulwinder Singh , Singh Priyanka , Chabra Shiffali 
Published: March 2017

<p class="abstract"><strong>Background:</strong> To assess the clinical and audiometric profile in patients presenting with sudden sensorineural hearing loss (SSNHL).The study also aimed to find out any possible etiology of SSNHL, prognostic factors and effectiveness of treatment. Prospective, open label, randomized study conducted in department of ENT at the Ram Lal eye and ENT hospital attached to Government medical college, Amritsar, Punjab, India.</p><p class="abstract"><strong>Methods:</strong> 50 patients of either sex aged between 18 to 50 years suffering from unilateral or bilateral onset SSNHL included in the study on the basis of predetermined clinical criteria. The hearing assessments of patients were done before and after the treatment with tuning fork tests, pure-tone and impedance audiometry. </p><p class="abstract"><strong>Results:</strong> Most of the patients of SSNHL presented with unknown etiology. Steroid treatment gave a statistically significant improvement in pure tone averages. Maximum improvement is observed in patients who started treatment within one month of developing SSNHL. Post-treatment outcomes were not influenced by age of the patient and type of the pure tone audiometry graph. The presence of vertigo and diabetes are bad prognostic factors for hearing outcome in SSNHL.</p><p><strong>Conclusions:</strong> Most of the cases of sudden sensorineural hearing loss have unknown etiology. Patients with associated DM and vertigo are having poor recovery of hearing. Early starting of treatment gives maximum improvement of hearing. </p>
Oral cancer profile in a tertiary care center
Authors: Arora Nitin , Davessar Jai Lal , Singh Jyoti 
Published: March 2017

<p class="abstract"><strong>Background:</strong> Head and neck cancers constitute around 5-50% of all cancers worldwide. <sup> </sup>Head and Neck Cancers constitute about 30% of all cancers that are found in India. It is the 8<sup>th</sup> most common cancer in the world. Oral cancer forms a major public health issue in India due to its rising incidence, especially in women and in younger age group. The purpose of our study was to evaluate, the epidemiologic profile of patients with oral cancer, its incidence according to age and sex, site distribution, risk factors involved and clinical stage at presentation.</p><p class="abstract"><strong>Methods:</strong> It is a prospective study done from January 2014 to November 2014, in a total of 100 patients in age group 21 to 70 years, irrespective of gender, with a proven malignancy confined to the oral cavity. Patients were observed for the age and sex distribution, tumour staging, location and<strong> </strong>metastasis, commonly associated risk factor and most common site. </p><p class="abstract"><strong>Results:</strong> Oral cavity cancers were more common in males, than females. It is most prevalent in age group of 51-60 years. Oral tongue is the most common site. Betel nut chewing is the most significant risk factor associated with oral cavity cancer.T1 and T2 is the most the most common primary T stage. Neck metastasis occurs most commonly at N2 stage. Most common neck node level involved is level 2.</p><p><strong>Conclusions:</strong> Oral cancers presents at advanced stage and age. It has also been seen in younger generations, which is due to increasing use of tobacco, its related products and alcohol. We see patient’s reports at advanced age and stage, which is increasing the<strong> </strong>morbidity and mortality related to oral cancers. Hence, today there is great need to create awareness about oral cancers. Preventive strategies must be designed in order to lessen the burden of Oral cancers. </p>
Merits and demerits of endoscopic tympanoplasty
Authors: Ambani Kirti P. , M. Bhavya B. , Vakharia Sanket D. , Khanna Ankur , Katarkar Ashish U. 
Published: March 2017

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Aim of the study was to evaluate the merits and demerits of endoscopic tympanoplasty compared to conventional microscopic tympanoplasty. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">This prospective comparative study was carried out between October 2015 to September 2016 in our otolaryngology department, for a period of 12 months. Total of 40 patients who fit into inclusion criteria, underwent endoscopic tympanoplasty under local anaesthesia with sedation. All laboratory preoperative testing was done; hearing evaluation was done with audiometry. Postoperative follow up was done at 2<sup>nd</sup> and 3<sup>rd</sup> month’s period, graft status and hearing evaluation with PTA for all four frequencies 500, 1000, 2000 and 4000 Hz with air conduction and bone conduction thresholds were recorded. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Out of 40 patients, 16 (40%) were males, and 24 (60%) were females, there were 21 (52.5%) cases had moderate perforation, 15 (37.5%) cases had large perforation and 4 (10%) cases had subtotal perforation. Average time taken was of around 1hour and 30minutes, range was (70-140min.). All patients were evaluated for graft status, hearing gain and cosmetic results. Out of 40 patients, 35 (87.5%) patients had successful graft uptake, 2 (5%) patients had graft infection and 3 (7.5%) patients had residual perforation seen postoperatively. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Use of endoscope not only serves as a great teaching tool, but also helps to visualize the middle ear anatomy and pathology intraoperatively with minimal soft tissue manipulation better cosmesis and reduced postoperative morbidity. In our study, we found that endoscopic tympanoplasty had better graft uptake rate.</span></p>
Rozwój odnawialnych źródeł energii w Polsce w świetle unijnego pakietu klimatyczno-energetycznego oraz ustawy o odnawialnych źródłach energii
Authors: Ciepielewska Magdalena 
Published: March 2017

W artykule została podjęta próba oceny polskiego prawodawstwa związanego z wykorzystaniem energii ze źródeł odnawialnych, zwłaszcza tego, jak odnosi się ono do rozwoju OZE w świetle dokumentów narzuconych Polsce przez UE. Warto zauważyć, że Polska ma bardzo duży potencjał związany z rozwojem odnawialnych źródeł energii, jest on jednak w niewielkim stopniu wykorzystywany. Prognozy przeprowadzone przez liczne instytucje badawcze wskazują, że największy potencjał mają energia pochodząca z biomasy i biogazu, a także energetyka wiatrowa. Warto zauważyć, że Polska zobowiązała się wobec Unii Europejskiej do zwiększenia produkcji energii z OZE do 2020 roku, poprzez podpisanie pakietu ,,3x20%”. Zobowiązaliśmy się także do zmniejszenia szkodliwych emisji zanieczyszczeń i współpracy na rzecz ochrony środowiska. Wspierać owe działania ma ustawa o OZE, która weszła w życie w 2015 roku. Niestety dokument ten okazał się mało przyjazny dla inwestorów. Nakłada on wiele obowiązków, zaś ewentualne korzyści związane z produkcją energii z odnawialnych źródeł są niedoprecyzowane i opisane w zawiły sposób. Zapewnienie 15% udziału OZE w końcowym zużyciu energii brutto w 2020 roku jest możliwe, lecz pod warunkiem że rząd polski będzie wspierać przedsiębiorców i zapewni im wszystkie niezbędne instrumenty do tego, by mogli bezpiecznie inwestować i rozwijać swoją działalność gospodarczą.
Mensuração de ativos biológicos pelo método de custo histórico e valor justo na pecuária leiteira
Authors: Vieira Eloir Trindade , Itavo Luis Carlos Vinhas , Aranha Jose Aparecido Moura 
Published: March 2017

Na pecuária leiteira, a mensuração pelo custo histórico se faz pelo registro de todos os custos ocorridos no período, tais como gastos com insumos, manejo, salários, ou aquilo que se pode chamar de gastos operacionais. Ocorre que há ressalvas quanto a essa mensuração. Assim, surgiu a mensuração contábil pelo valor justo (fair value), sugerida por órgãos reguladores em todo o mundo, pois possibilita segundo autores, credibilidade nas informações.