bluuebunny/crossref_metadata_2025_split huggingface dataset:
Modified Radical Mastoidectomy: Open Mastoid Cavity versus Cavity Obliteration Using Periosteal Temporofascial Flap - A Comparative Study
Authors: R Vignesh Kumar , Bhardwaj Rohit , Uddin Shams , Dutta Borah Smrity Rupa , Bhattacharjee Abhinandan , Nath Kripamoy , Das Manas Pratim 
Published: December 2022

Introduction
The surgical treatment of Chronic Otitis Media by modified radical mastoidectomy usually results in an open cavity, with chronic discharge, hearing loss of 30 to 40 dB, frequent visits to OPD for debris removal and none the less dizziness on cold air exposure. One way to deal with these issues effectively is to obliterate the mastoid cavity. In our study we used vascularised periosteo-temporofascial swing flap with medicated bone dust to obliterate the mastoid cavity.
Material and Methods
In this prospective study, 50 patients who suffered from chronic otitis media, active squamous (cholesteatoma) disease, and underwent modified radical mastoidectomy with tympanoplasty procedure were and split between two equally sized groups. Group 1 had patients with open mastoid cavity and Group 2 had obliteration of mastoid cavity using vascularised periosteo-temporofascial swing flap with medicated bone dust. Patients were followed at 3rd week, 6th week, 3rd month and 6th month.
Results
Patients with cavity obliteration had better and statistically significant outcomes in term of discharge status of cavity and epithelization at 3 weeks. Patients with obliteration also had positive and statistically significant results in hearing levels and hearing gain at 6 months follow up.
Conclusion
Mastoid cavity obliteration with vascularised periosteo-temporofascial swing flap with medicated bone dust is a good and effective method for better post-operative outcomes and curtailing dependency on doctors for cavity care.
Hearing Assessment in Infants: A Retrospective Institutional Study
Authors: Nasser Arfan , U P Santosh , Patil Mugunagowda , B A Kavya 
Published: December 2022

Introduction
Disorders of hearing are one of the most common disabilities in the country, especially in children. Hearing impairment is the most common congenital disease (3.5–9%) considering all degrees of permanent unilateral or bilateral deafness. Hearing disability can further lead to lifestyle difficulties later on in life. Early identification and a comprehensive treatment can help these people lead a better and productive life.
Materials and Methods
A retrospective study from the hospital records was done of infants admitted in NICU/PICU in a rural setting in, Davangere, Karnataka from January 2017 to January 2021 who had undergone Oto-acoustic emission (OAE) upon discharge, with a Brainstem Evoked Response Audiometry (BERA) test done in cases that failed the initial test after 3 months.
Results
Out of the 1115 cases that was included 213(19.1%) cases were found to have hearing disability with low birth weight and hyperbilirubinemia counting for most of the cases with 326(29.2%) and 301(27.0%) cases respectively.
Conclusion
The findings of our study suggest that an early investigation for hearing disability in high-risk infants for early detection and comprehensive management of hearing disorders. It also points towards a further need for advocating a universal screening of neonates for detecting hearing disability when feasible.
Rhino-Orbital-Cerebral Mucormycosis: Clinico-Epidemiologic Study in a Regional Centre in Eastern India during the Second Wave of COVID-19 Pandemic
Authors: Bandyopadhyay Titli , Mukherjee Monoj , Verma Arvind Kumar , Vasamsetty V D Prasanna Kumar , Reddy Satty Satish 
Published: December 2022

Introduction
Rhino-orbital -cerebral mucormycosis (ROCM), a life-threatening acute fungal rhinosinusitis, has recently been reported in increasing numbers in post-COVID patients in the backdrop of uncontrolled hyperglycemia. We present our on-going experience with these patients.
Materials and Methods
A descriptive longitudinal study involving forty-three ROCM patients, during the 2nd wave of COVID -19, are presented here to discuss the epidemiology, clinical features, management approaches and outcomes.
Results
Commoner in males (65%), most ROCM patients belonged to lower socio-economic status and 41-50 years age group. Eighty six percent patients were known diabetics and confirmed COVID-19 illness were present in and 53% patients. Advanced disease (Stage-3&4) was found in 54% of patients at presentation. Diagnosis was confirmed by fungal culture and histopathological evidence of tissue invasion. All patients received injection Amphotericin B and undergone surgical debridement (endoscopic or external approach). Seventy two percent patients were discharged on oral antifungal post -debridement, 28% patients expired during course of treatment.
Conclusion
ROCM led to significant morbidity and mortality in post COVID patients due to its aggressive nature, late presentation and limited guidelines on management protocol. Early diagnosis in patients presented with suggestive background and a multidisciplinary team management approach is crucial. Randomized control trials on efficacy of various treatment modalities with duration of antifungal treatment will help in better management of these patients.
Surgical Approach to Rhino-Orbital Mucormycosis using Contrast Enhanced MRI as Roadmap
Authors: Kar Titas , Dubey Arya Brata , Biswas Subhradev 
Published: December 2022

Introduction
Increase in Mucormycosis cases following COVID-19 infection was major concern due to angio-invasive nature causing necrosis. Aggressive surgical resection is necessary to combat this infection. Identifying areas of involvement like orbit, infratemporal fossa and nature of involvement (enhancing or non-enhancing) is best assessed by MRI. Hence, we decided to use MRI as surgical roadmap for disease clearance.

Materials and Methods

All post-COVID suspected mucormycosis cases based on clinical suspicion underwent MRI and nasal endoscopic biopsy. In MRI we evaluated T1 with contrast and T2 with fat suppression. Once Mucormycosis was confirmed by biopsy, Amphotericin B was started with monitoring of biochemical parameters. Surgical resection till level of viable tissue was reached was done based on MRI findings. Post-operatively patients underwent nasal douching and endoscopic surveillance.

Results

Our surgical experience shows that maximum patients had to undergo unilateral FESS with modified endoscopic Denker’s approach and opening of pterygopalatine and infratemporal fossa. We conclude that all patients must minimally undergo the above surgery. Endoscopic Denker’s approach allows easy post-operative surveillance. The pterygopalatine and infratemporal fossa is anatomically hidden by posterior wall of maxilla. Since we found more than 50% involvement of these areas, the necessity to open and visualise the areas in our opinion is must in all cases of post-COVID rhino-orbital mucormycosis.

Conclusion
Post-COVID Rhino-Orbital Mucormycosis requires high index of suspicion. Underrated symptoms like headache, facial pain and facial swelling in post-COVID patients with associated immunocompromised state like diabetes mellitus must be thoroughly investigated by MRI nose, paranasal sinus and orbit. Surgical debridement as dictated by MRI and routine inspection of pterygopalatine and infratemporal fossa should be done.
Ambulatory ENT Surgery: Eight Years of Experience in A Tropical Environment
Authors: Do Santos Zounon Alexis Arnaud Wilfrid Comlan , Vodouhe Ulrich Bidossessi , Oke Faridath , Wannou Bignon , Fanou Lionelle , Adjibabi Wassi , Yehouessi Vignikin Bernadette 
Published: December 2022

Introduction
Ambulatory surgery allows minimizing the time spent in the hospital, which could reduce the transmission of nosocomial pathologies and the occupation of hospital resources and infrastructures. The objective of the study was to assess the ambulatory activity of the ENT department of Military Teaching Hospital of Cotonou since its creation.
Materials and methods
The study was monocentric retrospective covering an eight-year period from January 1, 2013, to January 1, 2021. It concerned all ENT surgeries where the patient was discharged on the same day, regardless of the type of anaesthesia used. A pre-established survey form was used to collect data from the medical records. The variables studied were socio-demographic factors, eligibility criteria, indications and conversion to inpatient mode.
Results
Over the study period half of the procedures performed (334 patients) corresponded to indications for outpatient surgery and then were included. Of these, 130 patients (38.9%) were rejected for various contraindications like geographical and financial accessibility and communication difficulties. A total of 204 patients (61.1%) underwent ENT ambulatory surgery. The sex ratio was 3 males to 5 females (0.6). Children under 15 years of age accounted for 43.7% (n=146). Tonsillectomy with or without adenoidectomy was the most frequent surgery accounting for half of the outpatient surgery cases. Pharyngeal surgery was the most performed: (126 patients) followed by cervico-facial surgery (44 patients). Reconversion to inpatient mode occurred in 39 patients (19.12%). No respiratory complications were noted. No deaths were recorded.

Conclusions
Ambulatory care is a mode of management mainly used for pharyngeal surgery, in particular tonsillectomy and adenoidectomy in children. The main contraindications to patient eligibility were geographical and financial accessibility and communication difficulties. This activity would benefit from being better structured with specific staff and premises.
Analysis of Stutterers Characteristics in Association with Age of Onset and Family History of Stuttering
Authors: Agarwal Vinish Kumar , Sharma Mukesh , Kumar Vijay , Bist Sampan Singh , Pant Swati 
Published: December 2022

Introduction
Stuttering is a common occurrence in children which is also known as stammering, dysfluency or clutching of words. Aims of present study was to study association of age of onset and family history of stuttering with stutterers characteristics.
Materials and Methods
Total 136 stutterers were included in the study. All stutterers were subjected to complete ear nose and throat examination. All stutterers were evaluated by speech language therapist for diagnosis of speech disorder.
Results
Out of 136 stutterers 124 (91%) were male while 12 (9%) were female ranging from 6 years to 56 years, 15 (11%) had age of onset below 3 years, 98 (72%) had 3 years to 6 years while 23 (17%) had onset after age of 6 years, 44 (36.4%) male and 1 (8.3%) female patient had first degree family history of stuttering, 15 (11%) had mild stuttering, 98 (72%) had moderate stuttering while 23 (17%) had severe stuttering, 102 (75%) had secondary stuttering characteristics including 94 (75.8%) male and 8 (67%) female stutterers.
Conclusion
Present study concluded that there is definite association of between age of onset and severity of stuttering, between duration of stuttering and secondary characteristics and between severity and number of secondary characteristics of stuttering. We couldn’t find significant association between positive family history of stuttering among first degree relatives and age of onset, severity and secondary characteristics of stuttering.
Ophthalmological Symptom Presentations in Ear, Nose and Throat Diseases - A Cross-sectional Study from a South Indian Centre
Authors: S Manjumol , C S Asha , Ahmed Sadarudheen 
Published: December 2022

Introduction
Ophthalmological symptoms are common in ear, nose and throat conditions. Orbital involvement and ophthalmological presentations may be indicative of the extensive and aggressive nature of the pathology. This study evaluated the causes of various ophthalmological presentations in relation to primary ENT diseases in patients attending the ENT Department of a government tertiary referral teaching hospital.
Material and Methods
Sixty patients with ophthalmological presentations arising out of primary ENT diseases were assessed in detail. Comprehensive physical, ophthalmological and ENT examinations were done. Ophthalmological and ENT diagnoses, treatment details, outcome and complications if any were also noted.
Results
Most number of patients were in the age group 51 to 60 years (14; 23.4%). Most common ophthalmological symptom was periorbital oedema (51.6%) followed by epiphora (48.3%); the most common ENT symptom was headache (50%) followed by nasal discharge (48.3%). Most common diagnosis among patients was sinusitis (46.7%) followed by mucocele (21.7%). Most common (47%) otorhinological diagnosis associated with proptosis in this study was infections in the form of orbital cellulitis or abscess associated with sinusitis. Majority (43, 71.7%) of the study sample had surgical management.
Conclusion
This study reiterates the need for a high index of suspicion from the part of the ophthalmologist to look beyond eye diseases as causes for ophthalmological presentations and from the part of otorhinolaryngologist to be aware of various non-ENT symptoms secondary to ear, throat and nose diseases. A close collaboration between the ophthalmology and ENT departments is essential in successful management of such patients.
Thyroid Lesions: Cytomorphological Classification of Fine Needle Aspiration Cytology into Modified Bethesda System: A 3-Year Retrospective Study
Authors: Kumar Gaurav , Sharma Ritu , Jaiswal Saurabh Kumar , Pal Desh 
Published: December 2022

Introduction
Thyroid nodule is a common disorder found among the Indian population. Fine Needle Aspiration Cytology (FNAC) is a useful initial screening test for thyroid nodules. FNAC also avoids unnecessary surgery done in the case of benign thyroid nodules.
Materials and Methods
A retrospective study over three years (January 2019 to December 2021). All Thyroid nodule patients were sent for FNAC.
Results
A total of 160 totals were studied in three years. The Cytopathological diagnosis was made and categorization was done on basis of, The Bethesda System for Thyroid Cytopathology (TBSRTC).
Conclusion
FNAC is the most cost-effective, simple, rapid, and useful preliminary method of examination that leads to the diagnosis of thyroid lesions. TBSRTC is a very valuable, practical, and universally acceptable standardized system of reporting thyroid lesions that helps in assessing the risk of malignancy in each Category.
Anterior Ethmoidal Nerve Syndrome - An Under-diagnosed Cause of Headache
Authors: Yadav Ramraj , Chakraborty Priyanko , Saini Rajat , Kumar Rajesh , Saroj Sanjay kumar , Yadav Shishupal 
Published: December 2022

Introduction
The anterior ethmoidal nerve syndrome is a group of symptoms resulting from irritation of the terminal branches of the anterior ethmoidal nerve. Middle turbinate compression against the septum or the lateral nasal wall may cause a neuropathic facial pain syndrome which is often confused with sinogenic headache or other causes of headache. The diagnosis of anterior ethmoidal nerve syndrome is based on clinical and radiologic findings and needs a high index of suspicion. Our objective is to determine the nasal cause of headache and to create awareness among young ENT surgeons about various local causes of craniofacial pain.
Materials and Methods
A retrospective observational study carried out in a tertiary care hospital of North India. 30 patients who fulfilled the clinical diagnostic criteria were selected for the study.
Results
All the patients were analysed, managed accordingly by conservative and surgical management and outcome analysed. All patients were managed with medical and surgical management. Out of 30 patients, 28 (93.33%) patients improved in which 2 patients improve by medical management and 26 patients by surgical management.
Conclusion
The diagnosis requires a strong clinical suspicion and appropriate evaluation including nasal endoscopy, scan and anesthesia of the suspected point of contact.
Study to Determine Role of Fungus in Cases of Chronic Rhinosinusitis with or without Nasal Polyps in Indian Population
Authors: Kumar Prem Shankar , Gupta Salil Kumar , Singh DK , Raina Sheetal 
Published: December 2022

Introduction

Chronic rhinosinusitis (CRS) with or without nasal polyps is a significant public health burden worldwide and owing to its multifactorial etiology, it is often encountered across various medical and surgical specialities. Role of fungus in etiology of CRS has been debated for decades altogether and there is plethora of researches on cellular, molecular and biochemical aspects of fungal presence in nasal cavity and paranasal sinuses and how it affects. Although, there is denial at large on fungal effects on development of CRS, but the question, that whether concomitant and demonstrable presence of fungus in cases of CRS aggravates classic symptoms and signs, largely remains unanswered.

Material and Methods

This cohort study includes 121 subjects, which were divided in CRS without nasal polyps (CRSsNP) and CRS with nasal polyps (CRSwNP) on basis of rigid nasal endoscopic findings. Severity of disease symptoms, among these groups was corelated with Lund – Mackay (LM) symptom scores and extent of disease with LM endoscopic staging scores and LM radiology scores. Histopathology samples for demonstrating presence of fungus were taken and cohort was further subdivided into Fungi positive CRS and Fungi negative CRS, and, LM scores were compared.

Results

In fungi positive CRS group, mean LM symptoms score was 7.09 with standard deviation (SD) ±1.07; mean LM endoscopy score was 6.64 with SD ±1.94 and LM radiological score was 14.58 with SD ±2.96. In Fungi negative group, mean LM symptoms score was 3.58 with

SD ±1.30; mean LM endoscopy score was 4.47 with SD ±1.57 and LM radiological score was 12.20 with SD ±2.98.

Conclusion

Results of this study were statistically significant that fungi positive group was found to have more severe symptoms and larger extent of disease as compared to fungi negative group which indicate that fungal presence may have a role in escalation of symptoms, signs and radiological scores and it may aggravate pre-existing CRS.
Challenges of Anaesthetic Management in Endoscopic Sinus Surgery in Post COVID Rhino Orbital Cerebral Mucormycosis Patients
Authors: Guha Banerjee Sarmila , Mukherjee Diptanshu , Mandal Kalyan brata , Bandyopadhyay Ujjwal , Roy Debabrata , Biswas Dipankar 
Published: December 2022

Introduction
Mucormycosis is a potentially lethal opportunistic, angioinvasive fungal infection with rapid progression and high mortality and predisposed by diabetes mellitus, corticosteroid other immunosuppressive drugs, haematological malignancies, haematological stem cell transplantation, solid organ transplantation and iron overdose. The aim of our study is to consider the challenge in providing anaesthesia in endoscopic sinus surgery for rhino orbital cerebral mucormycosis in post COVID patient.
Materials and Methods
A total of 20 patients after being COVID negative, posted for endoscopic debridement of paranasal sinuses and also of orbital contents were analysed with respect to outcome after surgery considering the comorbidities of the patients and toxic effect of antifungal drug. Patients’ comorbidities were optimised through preoperative evaluation prior to surgery. Adequate monitoring of haemodynamic status during intraoperative period and optimum anaesthetic management was provided in endoscopic sinus surgery. The patients were managed in recovery room in post operative period and their outcome was reviewed.
Results
Our patients posed 3 challenges: a) difficult airway in view of palatal perforation b) long standing diabetes mellitus with associated metabolic complications c) administration of amphotericin B could interact with anaesthetic agents and produced adverse outcome. After surgery mortality was experienced in 10% of cases.
Conclusion
Awareness of warning symptoms and signs, a high index of suspicion, early diagnosis and initiation of full dose of liposomal Amphotericin B and meticulous surgical management may help to optimise the outcome of ROCM in the setting of COVID 19 infection.
APPLICATION OF A STANDARD OPERATING PROCEDURE AS AN ORGANIZATIONAL TOOL FOR DIAGNOSIS AND CONTINUITY OF CARE IN SYSTEMIC ARTERIAL HYPERTENSION - AN INTEGRATIVE REVIEW
Authors: Moraes Armesto Leonardo , Roberto Alonso Thabata , Chaves Reis Priscila , Garbelini Ribeiro Anna Vict´ória , David Giovana , Freitas Baueb Jorge , Kawamoto Dela Torre Lucas , Bahov Shinnishi Juliana , Furst Vaccarezza Gabriela , De Alcantara Sousa Luiz Vinicius 
Published: December 2022

Hypertension is the number one cause of death worldwide, however, this occurrence can be prevented if proper follow-up is performed. One way to improve the accuracy of follow-ups is through tools that enable constant update and monitoring of hypertensive patients. Therefore, the objective of this study reflects on the application of a standard operating procedure that allows such actions to be performed ensuring that providing care needs to be continuous and the data has to be updated in order to have a better treatment plan for each patient enrolled in the Basic Health Unit. Thus, this article is based on an integrative review on tools for continuity of care for hypertensive patients. In this way, 95 articles were selected within the theme, and after applying the exclusion and inclusion criteria, only 20 were analyzed. The studies were published in journals with high to medium impact factors, recognizing the degree of relevance of the theme studied. One of the major issues currently existing for the effective monitoring of hypertensive patients is the lack of accurate tools that have practical application and that allow the primary care team to effectively monitor patients registered in their territory. Thus, the literature review supported this study to direct the understanding about problems inherent to hypertension in primary health care, supporting the argument and allowing new ways to monitor hypertensive patients so that future problems due to this chronic disease can be prevented.
Постать В. К. Турбовського у формуванні флейтової виконавської школи України
Authors: YEREMEIEV Bohdan 
Published: December 2022

Персоніфікований підхід у формуванні сучасних досліджень складає на сьогодні потенційно цікавий і недостатньо висвітлений ракурс досліджень. Українська музична культура тривалий час вивчалася з позицій загального охоплення своїх складових без належного вивчення окремих персон. Саме це обґрунтувало зміст даної статті, а саме, вивчення діяльності видатного представника київської флейтової школи Володимира Кириловича Турбовського. Зазначено, що В. К. Турбовський увійшов в історію формування виконавської флейтової галузі, як виконавець та викладач, творець власної викладацької школи, вихованці якої на сьогодні обіймають провідні посади відповідно до потенційної діяльності музиканта у оркестрах, ансамблях та закладах мистецької освіти України та світу. У статті розглянуто основні види його творчої діяльності, зазначено основні посади, де В. К. Турбовський реалізував свій талант виконавця в якості соліста та артиста оркестру, а також виокремлено специфічні складові методики його викладання. Так, у статті зосереджено увагу на початковому етапі формування виконавської майстерності, своєрідному ставленні до опанування стилю Віденських класиків, епохи бароко тощо. Акцентовано увагу В. К. Турбовського до виконання творів В. А. Моцарта з позицій методики навчання виконавству на флейті. Наголошено на змістовності групових занять для формування сценічно-виконавської та педагогічної компетентності учнів. Припущена думка щодо впровадження елементів інтегративності та STEAM- технологій у мистецько-освітній процес. У статті обґрунтовано правомірність твердження щодо наявності флейтової школи В. К. Турбовського через широкий спектр досягнень учнів у конкурсно-виконавській та викладацькій діяльності. Введено в науковий оббіг поняття флейтової школи В. К. Турбовського як потенційної теми для подальшого поглибленого вивчення.