Blog Archive

Αλέξανδρος Γ. Σφακιανάκης

Thursday, June 20, 2019

Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00302841026182,00306932607174,alsfakia@gmail.com,


The versatility of the thoracodorsal artery based composite flaps with vascularized rib and a systematic...
The versatility of the thoracodorsal artery based composite flaps with vascularized rib and a systematic review of the literatureRossella Elia MD  Giuseppe Di Taranto MD  Vittoria Amorosi MD  Sitpahul Ngamcherd MD  Reza Alamouti MD  Li‐Ying Liao MD  Michele Maruccia MD, PhD  Giuseppe Giudice MD … See all authorsFirst published: 13 June 2019 https://doi.org/10.1002/jso.25579Read the full textePDFPDFTOOLS SHAREAbstractPedicled and free composite flaps derived from the thoracodorsal artery system, including...
Αλέξανδρος Γ. Σφακιανάκης
1m
Cervical esophageal perforation during gastroscopy in adults: Case report – Report of two cases Apurva...
Cervical esophageal perforation during gastroscopy in adults: Case report – Report of two casesApurva Shah, Shravan BohraApollo Medicine 2019 16(2):100-102Cervical esophageal perforation is rare and associated with a high morbidity and mortality >20% if misdiagnosed. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract. We describe two cases of cervical esophageal perforations during negotiating the cricopharynx....
Αλέξανδρος Γ. Σφακιανάκης
2m
Cervical epidural anesthesia for radical mastectomy in an elderly patient with severe respiratory compromise...
Cervical epidural anesthesia for radical mastectomy in an elderly patient with severe respiratory compromiseVikas Gogia, Chitra Chatterji, Ramesh SarinApollo Medicine 2019 16(2):97-99Cervical epidural anesthesia for breast surgery has been described in a few trials on patients with good physical status. This case report describes the successful use of cervical epidural anesthesia in a patient with severe respiratory compromise without any complication. A 72-year-old female patient having infiltrating...
Αλέξανδρος Γ. Σφακιανάκης
2m
The Apollo Medicine Journal is the official, peer-reviewed publication of Apollo Hospitals Group and has been conceptualized with the idea of providing such a platform for researchers as well as clinicians ever since its inception in September 2004. The Journal is published Quarterly by Wolters Kluwer. It is circulated to all consultants of the Apollo Group and subscribers.
EditorialRN SrivastavaApollo Medicine 2019 16(2):69-69Effect of smoking in patients with ankylosing spondylitis: A cross-sectional study in state of Madhya Pradesh, IndiaAkshat Pandey, Ved Prakash, Mimansha PandeyApollo Medicine 2019 16(2):70-73Aim: Understanding the impact of smoking on the development and severity of ankylosing spondylitis (AS) is pivotal, as it affects the management of the disease. This study investigated the effect of smoking in patients with AS and its outcome on the disease....
Αλέξανδρος Γ. Σφακιανάκης
2m
Skull-base fractures: Pearls of etiopathology, approaches, management, and outcome K V. L Narasinga...
Skull-base fractures: Pearls of etiopathology, approaches, management, and outcomeK V. L Narasinga Rao, Padilla-Zambrano Huber Said, Luis Rafael Moscote-Salazar, Guru Duatta Satyarthee, V Anil Kumar, Ranabir Pal, Amit AgrawalApollo Medicine 2019 16(2):93-96Fractures involving skull bases usually results from high-velocity impacts, i.e., motor vehicular accidents. The estimated incidence of skull-base fracture varies from 4% of all head injuries to 7%–16% of closed head injuries. Many studies have...
Αλέξανδρος Γ. Σφακιανάκης
2m
Pediatric Cough Santosh Kumar Swain, Sampada Munjal, Suryakanta Pradhan Apollo Medicine 2019 16(2):87-92...
Pediatric CoughSantosh Kumar Swain, Sampada Munjal, Suryakanta PradhanApollo Medicine 2019 16(2):87-92Cough in the pediatric age group is a common presenting complaint, and the etiology of the cough is often elusive. Although there is a high prevalence of cough in the pediatric age group, the subject is still poorly researched. The management of pediatric cough is different from adults. Cough in children causes a significant anxiety among parents and often leads to the use of inappropriate or unnecessary...
Αλέξανδρος Γ. Σφακιανάκης
2m
Hearing loss in infant with congenital cytomegalovirus infection Tri Juda Airlangga, Jenny Endang Bashiruddin...
Hearing loss in infant with congenital cytomegalovirus infectionTri Juda Airlangga, Jenny Endang BashiruddinIndian Journal of Otology 2019 25(1):40-42Hearing loss is one of the sequels that often happened as a result of congenital cytomegalovirus (CMV) infection. Difficulties in diagnosing congenital CMV infection cause late detection of hearing loss which affects the patient's management and prognosis. We present three cases of hearing loss in infants with congenital CMV infection with other risk...
Αλέξανδρος Γ. Σφακιανάκης
5m
Otogenic tetanus though immunisable but still existing Seema Ramlakhan Gupta, Sanket Deepak Vakharia...
Otogenic tetanus though immunisable but still existingSeema Ramlakhan Gupta, Sanket Deepak VakhariaIndian Journal of Otology 2019 25(1):37-39Otogenic tetanus is an uncommon entity which may follow ear suppuration or ear injury. Straightforward diagnosis may not be possible if the otolaryngologist is not familiar with the entity. Delay in diagnosis may lead to serious consequences. The global incidence of tetanus is still estimated at about one million cases annually with a high case fatality ratio....
Αλέξανδρος Γ. Σφακιανάκης
5m
Paraganglioma of external auditory canal: A rare entity Renu S Rajguru, Shruti Anil Sharma, Ritu K...
Paraganglioma of external auditory canal: A rare entityRenu S Rajguru, Shruti Anil Sharma, Ritu K Mehta, Inderdeep SinghIndian Journal of Otology 2019 25(1):34-36We present the description of a painful paraganglioma of the external auditory canal. Atypical presentation made the diagnosis difficult. We discuss the role of histopathology and immunohistochemistry in the diagnosis of the condition. A 43-year-old male presented with left-sided otalgia and hearing loss. Physical examination revealed a...
Αλέξανδρος Γ. Σφακιανάκης
5m
Surgical excision of preauricular sinus Ashok Sharma, Vivek Taneja, Meenakshi Mehra, Pulkit Khandelwal,...
Surgical excision of preauricular sinusAshok Sharma, Vivek Taneja, Meenakshi Mehra, Pulkit Khandelwal, Madhurima BanerjeeIndian Journal of Otology 2019 25(1):31-33Background: Preauricular sinus is a congenital anomaly affecting both sexes. The sinus can be located near the tragus. The main difficulty arising in the treatment is the recurrence. Methods: A simple sinectomy technique along with dye infiltration and guidewire probing was used. Result: None intra-operative, post operative or complication...
Αλέξανδρος Γ. Σφακιανάκης
5m
Evaluation of different graft materials (Temporalis Fascia, Tragal Perichondrium, and Vein Graft) in...
Evaluation of different graft materials (Temporalis Fascia, Tragal Perichondrium, and Vein Graft) in Type 1 tympanoplastyVP Singh, Nikunj JainIndian Journal of Otology 2019 25(1):26-30Aims and Objective: The present study was undertaken to compare the results of various autogenous tissues temporalis fascia, tragal perichondrium, and vein as graft materials for the Type 1 tympanoplasty. Materials and Methods: A total of 120 cases with large, subtotal, and total perforation were considered in the study....
Αλέξανδρος Γ. Σφακιανάκης
6m
Otology
Epidemiology and predictive factors of fungal malignant otitis externaRim Bechraoui, Mohamed Dhaha, Houda Chahed, Amal Ksentini, Rim Zainine, Mohamed Ben Amor, Najeh Beltaief, Ghazi BesbesIndian Journal of Otology 2019 25(1):1-5Context and Aims: A recent upsurge of severe fungal forms of malignant otitis externa (MOE) has been recorded. Understanding the misleading clinical aspect of the disease allows earlier diagnosis, avoiding inadequate treatments that may complicate the adapted management. Our...
Αλέξανδρος Γ. Σφακιανάκης
6m
Modified Stennert's infusion protocol for posttraumatic delayed facial nerve palsy Dipak Ranjan Nayak,...
Modified Stennert's infusion protocol for posttraumatic delayed facial nerve palsyDipak Ranjan Nayak, Tulasi Kota Karanth, Shalini S Menon, Dheeraj KondamudiIndian Journal of Otology 2019 25(1):22-25Objective: The objective of the study is to validate the role of modified Stennert's infusion protocol in posttraumatic delayed facial nerve palsy. Materials and Methods: A retrospective chart review of 21 patients with delayed onset posttraumatic facial nerve palsy was carried out in a tertiary teaching...
Αλέξανδρος Γ. Σφακιανάκης
6m
Surgical management of traumatic intratemporal facial nerve paralysis: Looks matter! Uma Patnaik, Garima...
Surgical management of traumatic intratemporal facial nerve paralysis: Looks matter!Uma Patnaik, Garima Upreti, Ajith NilakantanIndian Journal of Otology 2019 25(1):11-17Objective: Patients with traumatic intratemporal facial paralysis often present late to the otologist, as assessment may be difficult due to altered neurological status, or the management of associated neurosurgical emergency takes precedence. Recommendations for surgical management of these patients are contentious, especially when...
Αλέξανδρος Γ. Σφακιανάκης
6m
Chinese Medicine and Culture
Revisiting the Medical Work of George Soulié De MorantJean Claude DuboisChinese Medicine and Culture 2019 2(2):53-56It is now time to revisit the medical work of George Soulié de Morant (1878–1955). Over the past 64 years, studies and research on acupuncture-moxibustion have undergone exceptional growth in China, and Western sinology has made remarkable progress. A careful rereading will bring a new light to this decisive work. Studies on Xin'an Medicine (新安医学) since the Ming and Qing DynastiesJian...
Αλέξανδρος Γ. Σφακιανάκης
7m
Barbed palatoplasty vs. expansion sphincter pharyngoplasty with anterior palatoplasty Mehmet Ali Babademez...
Barbed palatoplasty vs. expansion sphincter pharyngoplasty with anterior palatoplastyMehmet Ali Babademez MD  Fatih Gul  Yagmur Canan Teleke MDFirst published: 12 June 2019 https://doi.org/10.1002/lary.28136The authors have no funding or conflicts of interest to declare.Read the full textePDFPDFTOOLS SHAREAbstractObjective/HypothesisTo compare the functional outcomes and complication rates in patients who underwent expansion sphincter pharyngoplasty with anterior palatoplasty (ESPwAP) versus barbed...
Αλέξανδρος Γ. Σφακιανάκης
10m
Effects of ganciclovir treatment in a murine model of cytomegalovirus‐induced hearing loss Travis J....
Effects of ganciclovir treatment in a murine model of cytomegalovirus‐induced hearing lossTravis J. Haller BS  Melissa S. Price BS  Spencer R. Lindsay MPA  Elaine Hillas MS  Michael Seipp MS Matthew A. Firpo PhD  Albert H. Park MDFirst published: 11 June 2019 https://doi.org/10.1002/lary.28134Editor's Note: This Manuscript was accepted for publication on May 28, 2019.Presented as an oral presentation to Triological Society 122nd Annual Meeting at COSM, Austin, Texas, U.S.A., May 3.This work was supported...
Αλέξανδρος Γ. Σφακιανάκης
10m
Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo study Takao Yamada...
Effect of pirfenidone injection on ferret vocal fold scars: A preliminary in vivo studyTakao Yamada MD, PhD  Yoshihiko Kumai MD, PhD  Haruka Kodama MD, PhD  Kohei Nishimoto MD, PhD  Satoru Miyamaru MD, PhD  Satomi Onoue PhD  Yorihisa Orita MD, PhDFirst published: 10 June 2019 https://doi.org/10.1002/lary.28087Editor's Note: This Manuscript was accepted for publication on May 13, 2019.The authors have no funding, financial relationships, or conflicts of interest to disclose.Read the full textePDFPDFTOOLS...
Αλέξανδρος Γ. Σφακιανάκης
10m
Effect of sex hormones on extracellular matrix of lamina propria in rat vocal fold Ji Min Kim PhD  Sung‐Chan...
Effect of sex hormones on extracellular matrix of lamina propria in rat vocal foldJi Min Kim PhD  Sung‐Chan Shin MD, PhD  Gi‐Cheol Park MD, PhD  Jin‐Choon Lee MD, PhD  Yun Kyung Jeon MD  Sang Jeong Ahn MD  Susan Thibeault PhD  Byung‐Joo Lee MD, PhDFirst published: 10 June 2019 https://doi.org/10.1002/lary.28086Editor's Note: This Manuscript was accepted for publication on May 13, 2019.Presented at the American Laryngological Association's 2019 Annual Meeting at COSM, Austin, Texas, U.S.A., May 1–5,...
Αλέξανδρος Γ. Σφακιανάκης
10m
The endoscopic endonasal approach for sinonasal and nasopharyngeal adenoid cystic carcinoma Ryota Kashiwazaki...
The endoscopic endonasal approach for sinonasal and nasopharyngeal adenoid cystic carcinomaRyota Kashiwazaki MD  Meghan T. Turner MD  Mathew Geltzeiler MD  Juan C. Fernandez‐Miranda MD  Paul A. Gardner MD  Carl H. Snyderman MD, MBA  Eric W. Wang MDFirst published: 13 June 2019 https://doi.org/10.1002/lary.28100The project was supported by the following grants: 1) the National Cancer Institute Specialized Program of Research Excellence (SPORE) program of the National Institutes of Health grant numer...
Αλέξανδρος Γ. Σφακιανάκης
13m
Vagal stimulation and laryngeal electromyography for recurrent laryngeal reinnervation in children Christen...
Vagal stimulation and laryngeal electromyography for recurrent laryngeal reinnervation in childrenChristen L. Caloway MD  Gillian R. Diercks MD, MPH  Gregory Randolph MD  Christopher J. Hartnick MD, MPHFirst published: 12 June 2019 https://doi.org/10.1002/lary.28135Editor's Note: This Manuscript was accepted for publication on May 28, 2019.Presented as a poster at the American Broncho‐Esophagological Association Annual Meeting, Austin, Texas, U.S.A., May 1–5, 2019.c.l.c. was involved in execution...
Αλέξανδρος Γ. Σφακιανάκης
13m
Esophageal A‐ring is associated with the severity of gastroesophageal reflux Yuval Nachalon MD  Nogah...
Esophageal A‐ring is associated with the severity of gastroesophageal refluxYuval Nachalon MD  Nogah Nativ‐Zeltzer PhD  Shumon I. Dhar MD  Omid B. Mehdizadeh MD Antonio T. Cassady BA  Peter C. Belafsky MDFirst published: 14 June 2019 https://doi.org/10.1002/lary.28143Editor's Note: This Manuscript was accepted for publication on May 29, 2019.The study will be presented in the ABEA 2019 Annual Meeting to be held during the Combined Otolaryngology Spring Meetings (COSM) in Austin, Texas, in May 2019.The...
Αλέξανδρος Γ. Σφακιανάκης
14m
Acupuncture and Meridian Studies
Treatment of Plantar Fasciitis with the Yuan-Luo Point Pair: A Clinical Case ReportPublication date: Available online 3 June 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Jonathan DayAbstractThis case report chronicles the treatment of a case of plantar fasciitis with acupuncture and tuina over six clinic visits. The patient was a 41-year-old female with plantar fasciitis for two months. A variety of acupuncture and electroacupuncture protocols were used at first, with no benefit....
Αλέξανδρος Γ. Σφακιανάκης
15m
Association between operation‐ and operator‐related factors and surgical complications among patients...
Association between operation‐ and operator‐related factors and surgical complications among patients undergoing free‐flap reconstruction for head and neck cancers: A propensity score‐matched study of 1,865 free‐flap reconstructionsSpencer C. H. Kuo MD  Pao‐Jen Kuo MD  Yuan‐Hao Yen MD  Peng‐Chen Chien MSc  Hsiao‐Yun Hsieh MSc  Ching‐Hua Hsieh MD, PhD, FACSFirst published: 10 June 2019 https://doi.org/10.1002/micr.30477Funding information: Chang Gung Memorial Hospital, Grant/Award Number: CDRPG8H0011Read...
Αλέξανδρος Γ. Σφακιανάκης
17m
Complete Recovery Following Electroacupuncture Therapy in Refractory Unilateral Sensorineural Hearing...
Complete Recovery Following Electroacupuncture Therapy in Refractory Unilateral Sensorineural Hearing LossPublication date: Available online 26 April 2019Source: Journal of Acupuncture and Meridian StudiesAuthor(s): Warangkana Arpornchayanon, Supanimit TeekachunhateanAbstractRole of electroacupuncture (EA) in refractory unilateral sensorineural hearing loss (SNHL) remains unclear but might be promising for the Meniere's disease. Two cases of unilateral SNHL who were unresponsive to conventional treatment...
Αλέξανδρος Γ. Σφακιανάκης
18m
Life Research
Health-related quality of life in injury patients: the added value of extending the EQ-5D-3L with a cognitive dimensionAbstractIntroductionThe EQ-5D is frequently used to understand the development of health-related quality of life (HRQL) following injury. However, the lack of a cognition dimension is generally felt as disadvantageous as many injuries involve cognitive effects. We aimed to assess the added value of a cognitive dimension in a cohort of injury patients.MethodsWe analyzed EQ-5D-3L extended...
Αλέξανδρος Γ. Σφακιανάκης
28m
Oecologia
Species with moderate intraspecific trait variability are locally abundant within an environmentally heterogeneous subtropical forestAbstractSpecies with large intraspecific trait variability (ITV) have larger niche breadth than species with low ITV and thus are expected to be more abundant at the local scale. However, whether the positive ITV–abundance relationship holds in heterogeneous local environments remains uncertain. Using an individual-based trait dataset encompassing three leaf traits...
Αλέξανδρος Γ. Σφακιανάκης
29m
A 16-Year Cohort Analysis of Autism Spectrum Disorder-Associated Morbidity in a Pediatric Population...
A 16-Year Cohort Analysis of Autism Spectrum Disorder-Associated Morbidity in a Pediatric PopulationDavid Cawthorpe*Cumming School of Medicine, Departments of Psychiatry and Community Health Sciences, Institute for Child and Maternal Health, The University of Calgary, Calgary, AB, CanadaIntroduction: This chapter presents the analysis of physician-diagnosed International Classification of Diseases (ICD version 9) disorders and diseases associated with autism spectrum disorders (ASD) in a 16-year...
Αλέξανδρος Γ. Σφακιανάκης
31m
Temporal order of cancers and mental disorders in an adult population David Cawthorpe (a1), Marc Kerba...
Temporal order of cancers and mental disorders in an adult populationDavid Cawthorpe (a1), Marc Kerba (a2), Aru Narendran (a3), Harleen Ghuttora (a4) ...DOI: https://doi.org/10.1192/bjo.2018.5AbstractBackgroundPopulation-based examination of comorbidity is an emerging field of study.AimsThe purpose of the present population level study is to expand our understanding of how cancer and mental illness are temporally associated.MethodA sample of 83 648 056 physician billing records for 664 838 (56% female)...
Αλέξανδρος Γ. Σφακιανάκης
32m
Clean Technologies and Environmental Policy
The role of clean technology research in disaster debris managementWaste energy recovery improves price competitiveness of artificial forage from rapeseed strawAbstractIncreasingly frequent droughts are causing repeated shortages of forage and are creating imbalances in the livestock economy in many parts of the world. More and more rapeseed is being cultivated for biodiesel production, and its straw has to be removed from fields to minimize disease vectors. Despite good drought resistance, rapeseed...
Αλέξανδρος Γ. Σφακιανάκης
33m
MEFV gene mutations in children with Henoch–Schönlein purpura and their correlations—do mutations matter?...
MEFV gene mutations in children with Henoch–Schönlein purpura and their correlations—do mutations matter?AbstractObjectiveTo explore the frequency of MEFV gene mutations in children with Henoch–Schönlein purpura who had no prior familial Mediterranean fever diagnosis and to evaluate the association of MEFV mutations with the clinical and laboratory features of Henoch–Schönlein purpura.MethodsData of 1120 patients diagnosed with Henoch–Schönlein purpura were reviewed retrospectively. The spectrum...
Αλέξανδρος Γ. Σφακιανάκης
35m
Detection of Familial Mediterranean Fever attacks by using a connected activity tracker and assessment...
Detection of Familial Mediterranean Fever attacks by using a connected activity tracker and assessment of impact of attacks to daily physical activities: a pilot studyAbstractObjectiveThe objective of this study was to assess the impact of Familial Mediterranean Fever (FMF) attacks on daily physical activity and detect FMF attacks using a connected activity tracker.MethodsPatients with FMF according to the Tel-Hashomer criteria were included in this prospective observational study. Attack-related...
Αλέξανδρος Γ. Σφακιανάκης
35m
Clinical Rheumatology
Correction to: Neutrophil/lymphocyte ratio and platelet/lymphocyte ratio in Behçet's disease: which and when to use?The authors wish to acknowledge that whilst this study and that published in Hammad et al [1] explore different areas – blood cell ratios and serum endocan, respectively – the reader may identify some similarities between the papers owing to the same patient cohort being analysed in both studies.Correction to: Mortality in patients with systemic lupus erythematosus in Colombia: a case...
Αλέξανδρος Γ. Σφακιανάκης
38m
Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal...
Epidemiology and antifungal susceptibility patterns of Candida isolates from Greek women with vulvovaginal candidiasisSofia Maraki  Viktoria Eirini Mavromanolaki  Dimitra Stafylaki  Eleni Nioti  George Hamilos  Anna KasimatiFirst published: 27 May 2019 https://doi.org/10.1111/myc.12946Read the full textePDFPDFTOOLS SHARESummaryVulvovaginal candidiasis (VVC) is a common infection of the genital tract affecting millions of women worldwide. Data on epidemiological trends of VVC in Greece are scarce....
Αλέξανδρος Γ. Σφακιανάκης
41m
Accuracy of Raman spectroscopy in discrimination of nasopharyngeal carcinoma from normal samples: a...
Accuracy of Raman spectroscopy in discrimination of nasopharyngeal carcinoma from normal samples: a systematic review and meta-analysisAbstractObjectivesThe aim of this review was to systematically evaluate the diagnostic accuracy of Raman spectroscopy (RS) in the identification of nasopharyngeal carcinomas from normal nasopharyngeal tissue.MethodsWe searched six databases (PubMed, Embase, Cochrane Library, Web of Science, Scopus and CNKI) up to September 2018 for all published studies that assessed...
Αλέξανδρος Γ. Σφακιανάκης
42m
Neutrophil extracellular traps enhance procoagulant activity in patients with oral squamous cell carcinoma...
Neutrophil extracellular traps enhance procoagulant activity in patients with oral squamous cell carcinomaAbstractBackgroundHypercoagulability is a major cancer-associated complication linked to poor patient prognosis. The production of neutrophil extracellular traps (NETs) is increasingly found to be linked with the development and metastasis of cancer, as well as with thrombi formation in cancer patients. We hypothesized that the neutrophil NET release may be triggered by specific cytokines in...
Αλέξανδρος Γ. Σφακιανάκης
42m
Assessment of tumor-associated immune cells in laryngeal squamous cell carcinoma AbstractPurpose This...
Assessment of tumor-associated immune cells in laryngeal squamous cell carcinomaAbstractPurposeThis study investigated the characteristics of tumor-associated immune cells (TAICs) in laryngeal squamous cell carcinoma (LSCC) and their correlation with clinicopathological variables.MethodsThe immune cell infiltrates of 71 specimens of stages I–IV LSCC were examined. The density of TAICs expressing CD3, CD4, CD8, CD68, and CD163 was assessed using immunohistochemical staining and image analysis in peritumoral...
Αλέξανδρος Γ. Σφακιανάκης
43m
Cancer Research and Clinical Oncology
Stuttering as the first sign of CAR-T-cell-related encephalopathy syndrome (CRES)Combined loss of TFF3 and PTEN is associated with lethal outcome and overall survival in men with prostate cancerAbstractBackgroundTrefoil Factor 3 (TFF3) has been implicated in Prostate Cancer (PCa) progression. However, its prognostic value and association with other biomarkers have not been fully explored. We assessed the combined value of TFF3 and PTEN in two cohorts: one is managed surgically for localized PCa and...
Αλέξανδρος Γ. Σφακιανάκης
43m
Computational Neuroscience
Slow-gamma frequencies are optimally guarded against effects of neurodegenerative diseases and traumatic brain injuriesAbstractWe introduce a computational model for the cellular level effects of firing rate filtering due to the major forms of neuronal injury, including demyelination and axonal swellings. Based upon experimental and computational observations, we posit simple phenomenological input/output rules describing spike train distortions and demonstrate that slow-gamma frequencies in the...
Αλέξανδρος Γ. Σφακιανάκης
44m
Benign fibro-osseous lesion and odontoma of the mandible: A report of a rare, hybrid lesion and review...
Benign fibro-osseous lesion and odontoma of the mandible: A report of a rare, hybrid lesion and review of literaturePublication date: Available online 24 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Rekha Reddy, Rohan Jagtap, Deeba Kashtwari, Christopher C. Hambrook, Danielle L. Freburg-Hoffmeister, Mohammed N. Islam, Donald M. Cohen, Archana Shenoy, Indraneel BhattacharyyaAbstractThis report documents a case of a 12-year-old male with a combined benign...
Αλέξανδρος Γ. Σφακιανάκης
45m
huge mandibular tumor composed of ameloblastoma and high-grade sarcoma Publication date: Available online...
huge mandibular tumor composed of ameloblastoma and high-grade sarcomaPublication date: Available online 23 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Yusei Fujita, Hiromi Tamura, Shusuke Okunaga, Masakazu Hamada, Ken Wakabayashi, Hiroka Ando, Shiro Adachi, Tetsuro SumiAbstractAmeloblastoma is a benign odontogenic tumor of the jaw. Sarcoma is a rare neoplasm that accounts for only about 1% of all tumors. Here, we report a quite rare case of simultaneous...
Αλέξανδρος Γ. Σφακιανάκης
46m
large developing odontoma, so-called ameloblastic fibro-odontoma, of the mandible Publication date:...
large developing odontoma, so-called ameloblastic fibro-odontoma, of the mandiblePublication date: Available online 8 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Hideki Watanabe, Hitoshi Osano, Hisao Igarashi, Akihiro Dohi, Yoshiyuki MoriAbstractLarge developing odontoma is a rare odontogenic tumor showing proliferation of both odontogenic epithelium and ectomesenchyme, with enamel and dentin formation. A case of large developing odontoma affecting...
Αλέξανδρος Γ. Σφακιανάκης
46m
Calcium pyrophosphate dihydrate crystal deposition of the temporomandibular joint: A case report and...
Calcium pyrophosphate dihydrate crystal deposition of the temporomandibular joint: A case report and review of the literaturePublication date: Available online 8 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Isao Miyamoto, Atsushi Kasamatsu, Kazuya Hiroshima, Nao Ishida, Shin Takeuchi, Toshikazu Takahara, Sho Ishida, Shusaku Yoshimura, Takao Baba, Yasuhiro Saito, Manabu Iyoda, Hideki TanzawaAbstractCalcium pyrophosphate dihydrate crystal deposition disease...
Αλέξανδρος Γ. Σφακιανάκης
47m
Amelioration of limited mouth opening after treatment of primary biliary cholangitis: A case report...
Amelioration of limited mouth opening after treatment of primary biliary cholangitis: A case reportPublication date: Available online 8 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Takeshi Kaneuji, Daigo Yoshiga, Wataru Ariyoshi, Ikuo Nakamichi, Hironori Tanimoto, Junpei Tanaka, Ikuya Miyamoto, Manabu Habu, Sho Mitsugi, Tatsuji Nishihara, Tetsu Takahashi, Kazuhiro Tominaga, Izumi YoshiokaAbstractPrimary biliary cholangitis is a slow-progressing autoimmune...
Αλέξανδρος Γ. Σφακιανάκης
47m
Severe stomatitis caused by misuse of methotrexate in an elderly patient with chronic rheumatoid arthritis...
Severe stomatitis caused by misuse of methotrexate in an elderly patient with chronic rheumatoid arthritisPublication date: Available online 4 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Kohta Yamada, Kei Tomihara, Manabu Yamazaki, Makoto NoguchiAbstractMethotrexate (MTX) is an antifolate that has been used as a chemotherapeutic agent for the treatment of neoplasm, such as leukemia and osteosarcoma. Moreover, MTX is also commonly used for treatment...
Αλέξανδρος Γ. Σφακιανάκης
47m
Retrocerebellar arachnoid cyst of the posterior fossa presenting with headache Reddy Ravikanth BLDE...
Retrocerebellar arachnoid cyst of the posterior fossa presenting with headacheReddy RavikanthBLDE University Journal of Health Sciences 2019 4(1):28-29Arachnoid cysts are benign, fluid-filled, cyst-liked malformations related to the arachnoid mater. Arachnoid cysts involving the posterior fossa are less common and exert local mass effect resulting in the symptoms and signs of cerebellar and brainstem dysfunction. Here, we present a case of a 14-year-old female with a retrocerebellar arachnoid cyst.
Αλέξανδρος Γ. Σφακιανάκης
47m
Hyponatremia correction causing extrapontine myelinolysis Binoy Damodar Thavara, Harsha Padikkal Veettil...
Hyponatremia correction causing extrapontine myelinolysisBinoy Damodar Thavara, Harsha Padikkal VeettilBLDE University Journal of Health Sciences 2019 4(1):34-38Rapid correction of hyponatremia will result in extrapontine myelinolysis (EPM). We report a case of 25-year-old male patient who presented with traumatic brain injury (TBI) causing left temporal extradural hematoma (EDH). EDH was managed conservatively. The patient had addiction to alcohol, tobacco smoking, paan (containing betel nuts),...
Αλέξανδρος Γ. Σφακιανάκης
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BLDE University Journal of Health Sciences, a publication of BLDE University, is a peer-reviewed online journal with Semiannual print on demand compilation of issues published. The journal's full text is available online at http://www.bldeujournalhs.in. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI-compliant institutional / subject-based repository.
Digital health in India – As envisaged by the National Health Policy (2017)Suptendra Nath SarbadhikariBLDE University Journal of Health Sciences 2019 4(1):1-6An exploratory study to assess the prevalence and risk factors of malnutrition among under-five children residing in selected rural areas of district Sirmaur, Himachal PradeshPriyanka Devi, Simarjeet KaurBLDE University Journal of Health Sciences 2019 4(1):7-10INTRODUCTION: Nutrition is one of the most essential things of life, and it becomes...
Αλέξανδρος Γ. Σφακιανάκης
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Oral and Maxillofacial Surgery, Medicine, and Pathology
Intraparotid lymph node toxoplasmosis diagnosis by fine needle aspiration cytologyPublication date: Available online 31 May 2019Source: Journal of Oral and Maxillofacial Surgery, Medicine, and PathologyAuthor(s): Hélder Domiciano Dantas Martins, Beatriz Araújo Suassuna Vaz, Larissa Suellen da Silva Lins, Brenna Louise Cavalcanti Gondim, Lucio Roberto Cançado Castellano, Paulo Rogério Ferreti BonanAbstractToxoplasmosis is a relatively common disease caused by the Toxoplasma gondii parasite. Its clinical...
Αλέξανδρος Γ. Σφακιανάκης
49m
Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

The Apollo Medicine Journal is the official, peer-reviewed publication of Apollo Hospitals Group and has been conceptualized with the idea of providing such a platform for researchers as well as clinicians ever since its inception in September 2004. The Journal is published Quarterly by Wolters Kluwer. It is circulated to all consultants of the Apollo Group and subscribers.

Editorial
RN Srivastava

Apollo Medicine 2019 16(2):69-69



Effect of smoking in patients with ankylosing spondylitis: A cross-sectional study in state of Madhya Pradesh, India
Akshat Pandey, Ved Prakash, Mimansha Pandey

Apollo Medicine 2019 16(2):70-73

Aim: Understanding the impact of smoking on the development and severity of ankylosing spondylitis (AS) is pivotal, as it affects the management of the disease. This study investigated the effect of smoking in patients with AS and its outcome on the disease. Methods: This was a cross-sectional study from September 1, 2018, to November 30, 2018, in a rheumatology outpatient department enrolled patients aged >18 years diagnosed with AS and divided into two groups according to their smoking status. Demographic details and hematological and biochemical parameters were noted. Modified Schober's test, chest expansion, and duration of disease measurements were performed. Disease activity and functional state were evaluated using the Bath AS Disease Activity Index (BASDAI) and Bath AS Functional Index (BASFI). Results: A total of 48 patients were enrolled (smoker, n = 20; nonsmoker, n = 28). The mean age in smoker and nonsmoker groups was 39.40 years and 26.18 years, respectively, and male preponderance was observed; the mean duration of disease was 42.90 months and 43.14 months, respectively. BASDAI and BASFI scores were significantly higher in the smoker group (5.08 and 4.51, respectively) as compared to nonsmoker group (3.40 and 2.34, respectively) (P < 0.001). The modified Schober's test showed a significant decrease in the range of spinal mobility in the smoker group (2.67 cm) than in the nonsmoker group (4.40 cm) (P < 0.001). A significant decrease in the mean chest expansion was seen in the smoker group than the nonsmoker group (3.08 vs. 5.68 cm; P < 0.001). Conclusion: Results demonstrate the negative effect of smoking on disease and functional activity in patients with AS. 


Severe maternal outcomes: World health organization maternal near-miss and maternal mortality criteria in University Tertiary Hospital Egypt
Ahmed Samy El-Agwany

Apollo Medicine 2019 16(2):74-78

Background: The World Health Organization (WHO) maternal near-miss (MNM) approach was developed to evaluate and improve the quality of obstetric care worldwide. Aim: The aim of this study was to evaluate the incidence of MNM and quality of care at a tertiary hospital in Egypt by applying this approach. Methods: A facility-based, retrospective study was conducted between January 2015 and December 2016. Participants' data were collected from medical records of the intensive care unit. Results: Among 28,877 deliveries over 2 years, 185 women suffered severe maternal outcome (SMO): 171 MNMs and 14 deaths. SMO ratio is 6.5/1000 live birth, MNM incidence ratio of 5.9/1000 live births, maternal death incidence ratio 0.5/1000 live birth, maternal mortality ratio of 48.48/100,000 live births, MNM mortality ratio is 12:1, and a mortality index of 7.5%. Hemorrhage (n = 107, 62.5%) and hypertensive disorders, including fits and hemolytic anemia, elevated liver enzymes, and low platelet count syndrome (n = 44, 25.5%) were the most common MNM conditions. Hemorrhage (n = 8, 57%) was the leading cause of maternal mortality and then cardiac diseases (n = 3, 21.5%). All cases were not receiving antenatal care in the Shatby Hospital or were not compliant to the hospital ANC and were referred or showed up at the time of delivery or after delivery with complication encountered. Nearly 71.5% of the died patients cases were younger than 30 years and 21.5% were primigravida. Conclusions: MNM is common in Egypt. The approach enabled us to identify pitfalls in clinical practice and referral system. The private sector in Egypt needs to evaluated and medical license should not be permanent. 


Surveillance of microorganisms associated with dental caries patients attending at a Tertiary Care Indian Teaching Hospital
Smarita Lenka, Priyanka Debta, Mahesh Chandra Sahu

Apollo Medicine 2019 16(2):79-86

Backgrounds: Dental caries patients are developed day by day in all age groups and predominantly in children. It is caused due to microorganisms mainly. Here, we find the organisms associated with dental caries of patients attending at Institute of Dental Science, Bhubaneswar, India. Materials and Methods: This prospective study was carried out from February to May 2018 at Institute of Dental Science, Bhubaneswar, India. A total number of 135 samples were collected from dental caries patients and processed in different agar media for identification of organisms, and the percentage of antibiotic susceptibility was evaluated. Results: Out of 135 patient samples, 112 organisms were isolated and identified with both culture and biochemical tests. Among all, 9 Enterococcus sp. (6.66%), 27 coagulase-negative Staphylococcus aureus sp. (20%), 6 Bacillus sp. (4.44%), and 30 Streptococcus sp. (22.22%) were found as Gram-positive cocci; 3 Acinetobacter sp. (2.22%), 6 Pseudomonas sp. (4.44%), 21 Shigella sp. (15.55%), and 6 Citrobacter freundii sp. (4.44%) were identified as Gram-negative bacteria; and 6 Candida glabrata (4.44%), 3 Candida albicans (2.22%), and 3 Candida tropicalis (2.22%) were identified as budding yeast colonies. In antibiotic resistance patterns, it was revealed that penicillin is the most resistance (92%) and gentamycin is the most sensitive antibiotic (79.2%) for bacteria associated with dental caries. Conclusion: Dental caries caused due to microbial infection is cured with antibiotics. Out of all antibiotics, gentamicin is more sensitive and preferable for dental caries with this study. Hence, a clinician can prescribe gentamicin beside amoxicillin and cefixime for early treatments. 


Pediatric Cough
Santosh Kumar Swain, Sampada Munjal, Suryakanta Pradhan

Apollo Medicine 2019 16(2):87-92

Cough in the pediatric age group is a common presenting complaint, and the etiology of the cough is often elusive. Although there is a high prevalence of cough in the pediatric age group, the subject is still poorly researched. The management of pediatric cough is different from adults. Cough in children causes a significant anxiety among parents and often leads to the use of inappropriate or unnecessary medications. Cough in the pediatric population is due to multiple underlying causes and the most common are allergy, infections, asthma, foreign body aspiration, and gastroesophageal reflux. Detailed history-taking and physical examination with chest X-ray and spirometry are often recommended for getting the diagnosis. Treatment is done according to the underlying disease, and there is poor evidence for prescribing medications only for symptomatic relief. This review article discusses the etiopathology and clinical characteristics of pediatric cough and its management. 


Skull-base fractures: Pearls of etiopathology, approaches, management, and outcome
K V. L Narasinga Rao, Padilla-Zambrano Huber Said, Luis Rafael Moscote-Salazar, Guru Duatta Satyarthee, V Anil Kumar, Ranabir Pal, Amit Agrawal

Apollo Medicine 2019 16(2):93-96

Fractures involving skull bases usually results from high-velocity impacts, i.e., motor vehicular accidents. The estimated incidence of skull-base fracture varies from 4% of all head injuries to 7%–16% of closed head injuries. Many studies have emphasized the importance of the management of basal skull fractures as it can be associated with major neurological deficits, can carry a risk of being missed during clinical evaluation in a busy emergency room and can additionally lead to life-threatening complications including cerebrospinal fluid (CSF) leak and meningitis. In addition to the bony injuries, skull-base fractures can be accompanied by injury to cranial nerves, intracranial blood vessels, and CSF rhinorrhea or otorrhea (particularly fractures involving anterior and middle cranial fossa). In the presence of characteristics clinical features, patient should be thoroughly clinical examination and pertinent investigation with appropriate imaging modality for the presence of additional intracranial lesions and as delayed diagnosis can lead to increase in neurological morbidity and also rarely mortality. 


Cervical epidural anesthesia for radical mastectomy in an elderly patient with severe respiratory compromise
Vikas Gogia, Chitra Chatterji, Ramesh Sarin

Apollo Medicine 2019 16(2):97-99

Cervical epidural anesthesia for breast surgery has been described in a few trials on patients with good physical status. This case report describes the successful use of cervical epidural anesthesia in a patient with severe respiratory compromise without any complication. A 72-year-old female patient having infiltrating duct carcinoma of the right breast with coexisting chronic obstructive airway disease and bronchial asthma was planned for modified radical mastectomy with axillary clearance. Her forced vital capacity (VC) was 28% predicted with reversibility of 24% and forced expiratory volume in 1 s was 31% predicted with 35% reversibility. After discussion with the surgical team, a regional anesthetic was planned for the patient and a cervical epidural catheter placed at C7–T1 interspace was used to provide adequate dermatomal anesthesia for the surgery. Dexmedetomidine was used to achieve sedation for patient comfort with minimal respiratory depression. The SpO2 and end-tidal CO2 recordings remained stable throughout the procedure, with excellent intra- and postoperative analgesia. Despite the concerns of bilateral phrenic nerve palsy with the use of cervical epidural anesthesia and associated decrease in VC, a carefully conducted cervical epidural anesthesia can be used for patients with respiratory compromise undergoing major breast surgery. Radical mastectomy, cervical epidural anesthesia, low FEV1, FVC, dexmedetomidine. 


Cervical esophageal perforation during gastroscopy in adults: Case report – Report of two cases
Apurva Shah, Shravan Bohra

Apollo Medicine 2019 16(2):100-102

Cervical esophageal perforation is rare and associated with a high morbidity and mortality >20% if misdiagnosed. At least half of the perforations are iatrogenic, mostly related to endoscopic instrumentation used in the upper gastrointestinal tract. We describe two cases of cervical esophageal perforations during negotiating the cricopharynx. Both patients had malignant stricture in mid and lower esophagus, respectively, and developed iatrogenic perforation during palliative metallic stenting – one of the two by a pediatric gastroscope. Both the patients were diagnosed as having esophageal perforation in the first 6 h after procedure and successfully managed with medical management. Patients with small perforations and minimal extraesophageal involvement may be managed with nonoperative treatment. 


Laparoscopic management of rapunzel syndrome
Jayanth Bannur Nagaraja, Shashank Saraf, Nairuthya Shivathirthan, S Srinath

Apollo Medicine 2019 16(2):103-104

Rapunzel syndrome is caused by ingestion of hairs, which leads to formation of trichobezoar, which can extend up to small intestine especially in girls. Utility of laparoscopic approach for this condition is not well established in this population. We are presenting a case of Rapunzel syndrome in a 14-year-old girl presenting as a cause of gastric outlet obstruction. Early diagnosis and extraction of trichobezoar by laparoscopic-assisted approach in children may be a better approach with respect to cosmesis, lesser morbidity, and early recovery. 


Calcifying epithelial odontogenic tumor of the jaw: A report of two rare cases
Sanat Kumar Bhuyan, Ruchi Bhuyan, Mahesh Chandra Sahu, Sidhant Bhuyan

Apollo Medicine 2019 16(2):105-108

Calcifying epithelial odontogenic tumor (CEOT), also recognized as a Pindborg tumor, is a rare benign odontogenic neoplasm of epithelial derivation and is aggressive in the vicinity with a tendency to invade bone and neighboring soft tissues. It accounts for 1% of all the odontogenic tumors. Intraosseous CEOT is more common in comparison to extraosseous variant and is commonly situated at the posterior aspect of the mandible. Here, we report two cases of CEOT situated in the posterior aspect of mandible and both the cases were seen in female young adult age group. Partial mandibulectomy was performed in both the cases, and they were on regular follow-up. Both the cases were without any recurrence of tumor in 6 months of follow-up. Due to rarity of the case, we deliberate the radiologic features, histologic features, clinical presentation, and management of these two cases. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480

Otology

Epidemiology and predictive factors of fungal malignant otitis externa
Rim Bechraoui, Mohamed Dhaha, Houda Chahed, Amal Ksentini, Rim Zainine, Mohamed Ben Amor, Najeh Beltaief, Ghazi Besbes

Indian Journal of Otology 2019 25(1):1-5

Context and Aims: A recent upsurge of severe fungal forms of malignant otitis externa (MOE) has been recorded. Understanding the misleading clinical aspect of the disease allows earlier diagnosis, avoiding inadequate treatments that may complicate the adapted management. Our objective was to study the epidemiological and clinical aspects of the MOE in our department and to analyze some predictive factors of the fungal form of the disease. Materials and Methods: Medical data of 100 patients treated for MOE between 2004 and 2013 were retrospectively reviewed. Epidemiological findings were recorded. Clinical aspects and presentations were studied and noted. Analysis of some predictive factors of the fungal form of the disease was done. Results: Incidence of MOE was 10 new cases every year. The average age was 67.41 years, and the sex ratio was 0.92. All patients have diabetes. Otalgia was a constant symptom. Otorrhea was noted in 63% of cases. Hearing impairment and tinnitus were noted, respectively, in 23% and 18% of cases. Prior antibiotherapy was recorded in 33% of cases for a mean period of 21 days. Stenosis of the external auditory canal was observed in 92% of cases. Granulation tissue was present in 55% of patients. Twenty patients presented peripheral facial nerve palsy. Four others presented palsies of the VI, IX, and X nerves. Forty-one patients had mycological sampling. Twenty-six among them were diagnosed with fungal MOE. Identifying fungal agent took a mean delay of 40 days. Aspergillus and Candida were incriminated each one in half of the cases. Male gender and prior quinolone administration were predictive factors of fungal MOE with, respectively, P = 0.006 and P = 0.06. After multivariate analysis, only male gender was significantly correlated to fungal growth (P = 0.032). Conclusion: Management of fungal forms is challenging due to difficult and late diagnosis. An early mycological sampling is advisable with special attention to males and patients with prior quinolone administration. 


Detection of single-nucleotide polymorphism Gap junction protein Beta-2 genes in deaf schoolchildren of javanese population in Surabaya, Indonesia
Nyilo Purnami, Gwenny Ichsan Prabowo, Citrawati Dyah Kencono Wungu, Retno Handajani

Indian Journal of Otology 2019 25(1):6-10

Background: Genetic factors account for about 50%–75% responsible for hearing loss. The existence of single-nucleotide polymorphism (SNP) as genetic factors that affect hereditary hearing loss. The widely studied SNP was the gap junction protein beta-2 (GJB2) gene encoding the gap junction beta-2 protein (connexin26) that found in cochlea and required to convert sound waves into electrical nerve impulse. This study was aimed to detect the SNP GJB2 gene of hereditary hearing loss patients from Javanese population in Surabaya, Indonesia. Methods: The design of this study was a cross-sectional, analytic observational. The participant was taken randomly among the students from a deaf School in Surabaya. The questionnaire was completed by the parents of the deaf children. Blood sampling was taken from venous peripheral blood. DNA was extracted and amplified on GJB2 gene area by polymerase chain reaction (PCR). The positive results of PCR were processed further for sequencing. The sequencing results were analyzed to detect the GJB2 gene SNP with reference sequence/rs-80338939. Results: A total of 22 children participated in this study; all were profound sensorineural hearing loss (SNHL). The hereditary hearing loss was obtained with fewer in five children (22.73%), who had a history of hearing loss in their family. It was compared to 17 children (77.27%) who had no family history of hearing loss. It was found that the nucleotide variation in nucleotide number 8473 of GJB2 gene as much as 3 (13.64%) out of 22 children in hereditary hearing loss patients in Deaf School Type B Surabaya. Conclusions: This study did not found any SNP GJB2 gene (rs-80338939) of hereditary hearing loss patients from the Javanese population in Surabaya, Indonesia. There was the nucleotide substitution G to A in nucleotide number 8473 of GJB2 gene, which indicated the change of amino acid code genetic code table (valine) to amino acid code genetic code table (isoleucine). It may as the cause of SNHL. 


Surgical management of traumatic intratemporal facial nerve paralysis: Looks matter!
Uma Patnaik, Garima Upreti, Ajith Nilakantan

Indian Journal of Otology 2019 25(1):11-17

Objective: Patients with traumatic intratemporal facial paralysis often present late to the otologist, as assessment may be difficult due to altered neurological status, or the management of associated neurosurgical emergency takes precedence. Recommendations for surgical management of these patients are contentious, especially when the patient presents late to the otologist or when the history is dubious. The purpose of this study was to analyze the outcomes of surgery in these patients with regard to onset, clinical findings, timing of surgery, and recovery of facial nerve (FN) function; compare it with similar studies conducted in the past decade; and propose a management guideline for such cases. Study Design: Prospective cohort study. Methodology: Outcome analysis in patients who underwent surgical exploration for traumatic intratemporal FN paralysis at our tertiary care center from January 2008 to December 2015 was done. A detailed record of the history of onset and clinical findings with preoperative status of FN function and hearing status was made. Radiological findings and electrodiagnostic tests influenced the decision-making with respect to surgical exploration. Our observations regarding timing of surgery post trauma, intraoperative findings, and postoperative recovery of FN function were evaluated and outcomes were compared with similar studies in the last decade. Results: Eleven patients were included in the study. All patients had House–Brackmann Grade (HBG) V/VI paralysis prior to surgery. Time interval between injury and surgery ranged between 5 and 176 days (average 58 ± 55 days). Follow-up after surgery ranged from 9 to 72 months (average 31 ± 18 months). Two patients recovered to HBG I, 5 to HBG II, and 4 to HBG III. Conclusion: Surgical exploration for traumatic facial paralysis is often delayed due to late presentation to the otologist. Surgery should not be denied to patients presenting late, or with uncertain history, as it will still give significant recovery to the patient. We have also proposed a guideline for the management of such cases. 


Visual defects in hearing-challenged schoolchildren from Ludhiana, Punjab
Renu Thakur, Jaikishan JayaKumar, Sangeeta Pant

Indian Journal of Otology 2019 25(1):18-21

Purpose: We compared Visual attention of normal hearing students and congenitally deaf students, Deaf students are visually depended; respective study help us to find out visual attention of Deaf as compared with age matched hearing students. Method: Total 118 deaf students aged from 6 to 25 years were screened from School for the Deaf Children, Kitchlu Nagar, Ludhiana Punjab 141001. 30 students were randomly selected from age group 8.5 to 11.11 years. All 30 deaf students where compared with age-matched hearing students from Peace Public School NH 95, Ferozepur - Ludhiana Road, Ludhiana, Punjab 141102. Informed consent was taken from all students pears, all the participants where having best corrected distance visual acuity 6/6 (snellen chart) and near visual acuity N6. Anterior and Posterior eye examination where evaluated in Sankara Eye Hospital Ludhiana, prior to the test; Visual attention was evaluated using two different test type, SDMT Symbol digit Modality test and Attention Blink by Visual attention Brain Baseline App. Result: Symbol Digit Modality Test; didn't show significant difference between. Deaf (N= 30) and Hearing students (N=30), Deaf students (Mean 0.97, S.D 2.57 and SEM 0.47), Hearing students (Mean 0.47, S.D 0.97, SEM 0.18) T-ratio 1 and P-Value 0.32 there was no difference between deaf and hearing impaired group. Visual attention- Brain Baseline App, the attention blink showed significant difference between Deaf and hearing impaired students. Deaf students (Mean 0.09, S.D 0.08 and SEM 0.02), Hearing students (Mean 0.22, S.D 0.18, SEM 0.03) T-ratio 3.41 and P-Value 0.001. Conclusion: Deaf group had made less error, deaf showed better attention as compare with hearing group. This finding indicates that deaf students are having better attention in the central visual attention. It can be one of the factors for peripheral distraction of deaf students. 


Modified Stennert's infusion protocol for posttraumatic delayed facial nerve palsy
Dipak Ranjan Nayak, Tulasi Kota Karanth, Shalini S Menon, Dheeraj Kondamudi

Indian Journal of Otology 2019 25(1):22-25

Objective: The objective of the study is to validate the role of modified Stennert's infusion protocol in posttraumatic delayed facial nerve palsy. Materials and Methods: A retrospective chart review of 21 patients with delayed onset posttraumatic facial nerve palsy was carried out in a tertiary teaching hospital. All patients with delayed onset facial nerve palsy were treated with modified Stennert's protocol. It is a combination therapy which includes tapering doses of hydrocortisone, pentoxifylline, and low-molecular-weight dextran provided over 13 days. If the patient did not show signs of improvement with modified Stennert's protocol by the 10th day of therapy, they were advised to undergo transmastoid decompression of facial nerve. Analysis was performed based on House–Brackmann (HB) grading performed at the time of diagnosis and after 30 days of follow-up. Improvement was considered to have taken place if HB grading improved by minimum of two or reached normal value of one. Results: Twenty-one patients were started on modified Stennert's protocol of which 15 improved and 6 did not improve. They underwent transmastoid decompression of facial nerve and improved significantly afterward. Conclusion: A trial of modified Stennert's infusion protocols is a safe option in patients with posttraumatic delayed facial nerve palsy. 


Evaluation of different graft materials (Temporalis Fascia, Tragal Perichondrium, and Vein Graft) in Type 1 tympanoplasty
VP Singh, Nikunj Jain

Indian Journal of Otology 2019 25(1):26-30

Aims and Objective: The present study was undertaken to compare the results of various autogenous tissues temporalis fascia, tragal perichondrium, and vein as graft materials for the Type 1 tympanoplasty. Materials and Methods: A total of 120 cases with large, subtotal, and total perforation were considered in the study. Of the 120 cases, temporalis fascia graft was used in 60 cases (Group-I), tragal perichondrium graft in 40 cases (Group-II), and vein graft in 20 cases (Group-III). The results were evaluated in the form of rate of graft success, hearing gain, and mean residual air-bone gap with respect to the graft materials. Results and Observation: A nonsignificant association was observed between the groups, that is, temporalis fascia (Group-I), tragal perichondrium (Group-II), and venous graft (Group-III), and the graft uptake (P = 0.96 > 0.05) and air-bone closure (χ2 = 2.908, P = 0.059 > 0.05). Conclusion: The graft take up rate and hearing improvement are similar for the different graft materials used. Size of the perforation does not significantly influence the success rate of tympanoplasty as per our study. Normal translucent appearance of neotympanum in the postoperative period was seen only with temporalis fascia and venous graft, while in tragal perichondrial, the neotympanum was whitish, thicker, and translucent to opaque. 


Surgical excision of preauricular sinus
Ashok Sharma, Vivek Taneja, Meenakshi Mehra, Pulkit Khandelwal, Madhurima Banerjee

Indian Journal of Otology 2019 25(1):31-33

Background: Preauricular sinus is a congenital anomaly affecting both sexes. The sinus can be located near the tragus. The main difficulty arising in the treatment is the recurrence. Methods: A simple sinectomy technique along with dye infiltration and guidewire probing was used. Result: None intra-operative, post operative or complication related to local anaesthesia were seen, The surgical site healed well in all except for two patients who had wound infections which were managed by antibiotic therapy. Conclusion: A recurrence-free success rate could be achieved with the combination of dye infiltration, guidewire probing, and en bloc excision of the sinus tract and its branches. 


Paraganglioma of external auditory canal: A rare entity
Renu S Rajguru, Shruti Anil Sharma, Ritu K Mehta, Inderdeep Singh

Indian Journal of Otology 2019 25(1):34-36

We present the description of a painful paraganglioma of the external auditory canal. Atypical presentation made the diagnosis difficult. We discuss the role of histopathology and immunohistochemistry in the diagnosis of the condition. A 43-year-old male presented with left-sided otalgia and hearing loss. Physical examination revealed a firm swelling arising from the posterosuperior portion of the left external auditory canal. Differential diagnosis of exostosis and squamous cell carcinoma of the external auditory canal was considered. The high-resolution computed tomography of the temporal bones was suggestive of neoplasia. The patient underwent excision biopsy. The hemorrhage during surgery led to suspicion of a vascular tumour. The histopathology and immunohistochemistry confirmed the diagnosis of paraganglioma. Early intervention with imaging and biopsy should be sought for unusual masses of the external ear. 


Otogenic tetanus though immunisable but still existing
Seema Ramlakhan Gupta, Sanket Deepak Vakharia

Indian Journal of Otology 2019 25(1):37-39

Otogenic tetanus is an uncommon entity which may follow ear suppuration or ear injury. Straightforward diagnosis may not be possible if the otolaryngologist is not familiar with the entity. Delay in diagnosis may lead to serious consequences. The global incidence of tetanus is still estimated at about one million cases annually with a high case fatality ratio. These patients initially present with discharging ears; therefore, this case report is intended to increase awareness among otolaryngologists who would be the first to diagnose and initiate appropriate management. In spite of simple preventive measures available through immunization, tetanus remains a major cause of mortality in some developing countries such as India. 


Hearing loss in infant with congenital cytomegalovirus infection
Tri Juda Airlangga, Jenny Endang Bashiruddin

Indian Journal of Otology 2019 25(1):40-42

Hearing loss is one of the sequels that often happened as a result of congenital cytomegalovirus (CMV) infection. Difficulties in diagnosing congenital CMV infection cause late detection of hearing loss which affects the patient's management and prognosis. We present three cases of hearing loss in infants with congenital CMV infection with other risk factors such as hyperbilirubinemia, low birth weight, premature birth, and ototoxic drug usage. The results of hearing assessment, imaging findings, and antiviral treatments are discussed. Hearing assessments in patient with congenital CMV infection should be checked routinely because hearing loss in this disease can be progressive and fluctuating. 


Alexandros Sfakianakis
Anapafseos 5 . Agios Nikolaos
Crete.Greece.72100
2841026182
6948891480