Pattern of Hearing Loss Among Patients Attending ENT Department of a Tertiary Hospital in Nepal: A Retrospective Study

xlomafota13 shared this article with you from Inoreader Pattern of Hearing Loss Among Patients Attending ENT Department of a Tertiary Hospital in Nepal: A Retrospective Study Via Otolaryngology Indian Abstract This study aims to analyze the pattern of hearing loss among patients visiting ENT department in Nepal Police Hospital. Pure tone audiometry results of 1654 patients with a complaint of the hearing loss were analyzed and the results were expressed in number and percentage. Among 1654 patients, 294 patients had normal hearing on both ears. So, a total of 1360 patients had hearing loss. Among 1360 patients, 897 (66%) cases were male and 463 (34%) were female. Most commonly affected age group was 31–40 years followed by 21–30 years age group. Out of 1360 patients, 432 (31.76%) patients had unilateral hearing loss whereas 928 (68.24%) cases had bilateral hearing loss. Sensorineural hearing loss was the most common 1349 (49.60%), followed by conductive 683 (25.11%) and mixed 256 (9.41%) hearing losses respectively. Conductive hearing loss was more common in younger age groups whereas sensorineural hearing loss was more common in older age groups. Mild he aring loss was seen in 1079 ears (39.67%), moderate in 671 (24.67%), severe in 368 (13.52%) and profound in 170 (6.25%). The mean hearing threshold was 42.90 ± 19.26 dB on right ear and 42.60 ± 18.76 dB on left ear with no statistically significant difference (p value −0.68). Hearing loss was more common in male population with younger age group involvement. Sensorineural hearing loss was the most common type. Mild degree of hearing loss and bilateral involvement was most common. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Correlation of TIRADS and Bethesda Scoring Systems with Final Histopathology of Thyroid Nodules – An Institutional Experience

xlomafota13 shared this article with you from Inoreader Correlation of TIRADS and Bethesda Scoring Systems with Final Histopathology of Thyroid Nodules – An Institutional Experience Via Otolaryngology Indian Abstract Fine needle aspiration cytology (FNAC) reduces the number of unnecessary thyroid surgeries for patients with benign nodules and appropriately triages patients with thyroid cancer to appropriate treatment. This was a observational study done on cases presenting with clinical suspicion of thyroid malignancy which underwent ultrasonography followed by FNAC of thyroid nodule. Ultrasonographic characterization of nodules was based on Thyroid Imaging Reporting and Data System (TIRADS) and cytology reporting was based on Bethesda system. All recruited patients underwent thyroidectomy. Pre-operative cytology and ultrasonography features were compared with final histopathology report. In our study, Bethesda system of cytology reporting for thyroid nodules had a better sensitivity, specificity and diagnostic accuracy than TIRADS system of ultrasound reporting. Bethesda system in FNAC had a larger area under the ROC curve (0.91) as compared to ultrasound TIRADS (0.70). Mali gnancy rate of TIRADS 5 nodules was 97.1% with significant p value (0.022). 100% of Bethesda VI lesions were malignant according to final histopathology report. Ultrasound TIRADS could pre-operatively predict malignancy in 63.6% of indeterminate thyroid nodules which were malignant according to post-operative histopathology. The overall concordance of ultrasound TIRADS, Bethesda system and histopathology was 69.8%. Higher TIRADS and Bethesda scoring among thyroid nodules was associated with increased risk of malignancy. US TIRADS is a good predictor of malignancy in indeterminate thyroid nodules. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Distribution of sole Pacinian corpuscles: a histological study using near-term human feet.

xlomafota13 shared this article with you from Inoreader Distribution of sole Pacinian corpuscles: a histological study using near-term human feet. Via radiol anat Related Articles Distribution of sole Pacinian corpuscles: a histological study using near-term human feet. Surg Radiol Anat. 2021 Jan 20;: Authors: Sugai N, Cho KH, Murakami G, Abe H, Uchiyama E, Kura H Abstract INTRODUCTION: Fast-adapting afferent input from the sole Pacinian corpuscles (PCs) is essential for walking. However, the distribution of PCs in the plantar subcutaneous tissue remains unknown. MATERIALS AND METHODS: Using histological sections tangential to the plantar skin of eight near-term fetuses, we counted 528-900 PCs per sole. RESULTS: Almost half of the sole PCs existed at the level of the proximal phalanx, especially on the superficial side of the long flexor tendons and flexor digitorum brevis. Conversely, the distribution was less evident on the posterior side of the foot. The medial margin of the sole contained fewer PCs than the lateral margin, possibly due to the transverse arch. In contrast to a cluster formation in the anterior foot, posterior PCs were almost always solitary, with a distance greater than 0.5 mm to the nearest PC. DISCUSSION AND CONCLUSION: Because a receptive field of PCs is larger than that of the other receptors, fewer solitary PCs might cover the posterior sole. In infants, the amount of anterior sole PCs seemed to determine the initial walking pattern using the anterior foot without heel contact. Anterior PCs concentrated along flexor tendons might play a transient role as tendon organs during the initial learning of walking. During a lesson in infants, mechanical stress from the tendon and muscle was likely to degrade the PCs. In the near term, the sole PCs seemed not to be a mini-version of the adult morphology but suggested an infant-specific function. PMID: 33471166 [PubMed - as supplied by publisher] View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series

xlomafota13 shared this article with you from Inoreader Recovery of Cranial Nerve Deficits in Patients Presenting with Pituitary Apoplexy: A Case Series Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722668 Background Pituitary apoplexy (PA) is a rare complication of pituitary tumors that can present with a myriad of symptoms, including sudden onset cranial nerve deficits. After patient stabilization and hormone replacement, surgical decompression is often recommended. The timing of surgical decompression remains controversial. In this case series, we describe our institutional experience pertaining to the cranial nerve recovery in patients who underwent endoscopic endonasal transsphenoidal (EETS) surgery for PA while evaluating outcome based on tumor stage using the suprasellar infrasellar parasellar anterior posterior (SIPAP) classification. Design Present study is a single-institution retrospective cohort. Methods A retrospective review of all EETS cases for pituitary tumor resection between November 2009 and August 2018. Queries of the hospital database were completed by trained personnel to identify cases of PA treated using the EETS approach. Baseline characteristics, tumor type, endocrine data, and SIPAP classification based on preoperative magnetic resonance imaging (MRI) and operation characteristics were extracted from medical records. Postoperative results were extracted for the duration of the follow-up period available for each patient. Results Fifteen cases of PA were identified. Patient follow-up period was a mean of 30 months. The cranial nerve deficits present at admission were visual deficit (33%); unilateral third nerve palsy (47%) and unilateral sixth nerve palsy (27%). No fourth nerve palsies were observed. Following EETS, 60% of patients with preoperative visual deficit had normal visual fields. For those with third and sixth nerve palsies preoperatively, 43 and 75%, respectively, had return to normal function postoperatively. SIPAP tumor characteristics were not related to postoperative cranial nerve recovery. Conclusion In this series of surgically treated patients with pituitary apoplexy, all cranial nerve deficits normalized or improved following surgery. The tumor SIPAP classification was not associated with patient outcome. Though in a small series, the presented results suggest surgical treatment is beneficial for these patients. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract&nbs p; |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Olfactory Outcomes after Resection of Tuberculum Sella and Planum Sphenoidale Meningiomas via a Transcranial Approach

xlomafota13 shared this article with you from Inoreader Olfactory Outcomes after Resection of Tuberculum Sella and Planum Sphenoidale Meningiomas via a Transcranial Approach Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722671 Objectives Controversy exists surrounding the optimal approaches to tuberculum sella meningioma (TSM) and planum meningioma (PM). Olfaction is infrequently considered within this context but is nonetheless an important quality of life measure. The evolution of olfactory outcomes following contemporary transcranial surgery remains unclear. This study reviews olfactory outcomes after supraorbital craniotomy for TSM or PM and defines temporal trends in its recovery. Study Design A prospective study of a patients who underwent a minimally invasive supraorbital craniotomy for TSM or PM was conducted at a single neurosurgical center. Participants & Main Outcome Measures All patients were questioned about olfaction at presentation 3 months postoperatively, 12 months postoperatively, and annually thereafter (median follow-up = 37 months). The olfactory status of patients was categorized as normosmia, anosmia, hyposmia, parosmia, (altered perception of odours), or phantosmia, (olfactory hallucinations). Results Twenty-two patients were included in the study analysis, (range = 27–76). Precisely, 3 months after surgery, seven patients had normal olfaction (32%). Six patients were anosmic, (27%) four hyposmic, (18%), three parosmic, (14%), and two were phantosmic (9%). At 1-year follow-up, almost half of patients (10; 48%) were normosmic, while two patients (9.5%) were anosmic. There were no further improvements in olfaction between 1 year and long-term follow-up. Conclusion Subfrontal transcranial approaches for TSM or PM appear to be associated with changes in olfaction that can improve with time; these improvements occur within the first year after surgery. Impacts upon olfaction should be considered when selecting a surgical approach and patients counseled appropriately. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |   Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Anterior Skull Base Sarcomas: Report of Characteristics and Outcomes at a Tertiary Care Cancer Center

xlomafota13 shared this article with you from Inoreader Anterior Skull Base Sarcomas: Report of Characteristics and Outcomes at a Tertiary Care Cancer Center Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722667 Objective This study was aimed to describe our institutional experience on characteristics and treatment outcomes of sinonasal sarcomas invading the anterior skull base. Design Present study is a retrospective review. Setting The study was conducted at an academic cancer care center. Participants Thirty-one patients with skull base sarcomas treated with primary surgery from 1979 to 2015 were identified for this study from a preexisting database. Main Outcome Measures Survival and recurrence outcomes using the Kaplan–Meier method were the focus areas of the study. Results The median age was 44 years (range: 13–69 years). Twenty patients were male (64.5%). Twenty-nine patients underwent open craniofacial resection (93.5%) and two patients underwent endoscopic resection (6.5%). The majority of tumors were staged pT4 (77.4%). The most common pathologies were leiomyosarcoma (19.4%), osteosarcoma (16.1%), and chondrosarcoma (12.9%). Of those with known margin status, 10 patients had positive/close margins (32.2%) and 16 patients had negative margins (51.6%). Most tumors were high grade (74.2%). Twenty-three patients (74.2%) received adjuvant radiation and four patients (12.9%) received adjuvant chemotherapy. There were nine postoperative complications (29%) including one mortality and three cerebrospinal fluid leaks. There were 10 local, 2 regional, and 5 distant recurrences over a median follow-up of 74 months (range: 1–300 months). The 5-year disease-specific survival (DSS) was 69.8%. The 5-year locoregional recurrence-free probab ility (RFP) was 63.2% and the 10-year distant RFP was 71.7%. The 5-year DSS for high grade tumors was 64.2 and 85.7% for low grade tumors (p = 0.117). Conclusion This study contributes an updated analysis of anterior skull base sarcomas. Five-year DSS is approximately 70%. Analysis of survival outcomes based on grade, tumor size, and other factors is limited by small sample size and the rarity of these tumors. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Auditory Brain Stem Response Predictors of Hearing Outcomes after Middle Fossa Resection of Vestibular Schwannomas

xlomafota13 shared this article with you from Inoreader Auditory Brain Stem Response Predictors of Hearing Outcomes after Middle Fossa Resection of Vestibular Schwannomas Via Journal of Neurological Surgery Part B: Skull Base J Neurol Surg B Skull Base DOI: 10.1055/s-0040-1722718 Objectives To analyze the relationship between preoperative and intraoperative auditory brain stem response (ABR) characteristics and hearing outcomes in patients with vestibular schwannomas (VS) undergoing hearing preservation (HP) surgery via a middle cranial fossa (MCF) approach. Design Prospective study. Setting Academic tertiary skull base referral center. Methods Pre- and postoperative pure-tone average (PTA) and word recognition score (WRS) were examined. Intraoperative ABR wave III latency, wave V latency, and amplitude were recorded. HP was defined as postoperative WRS ≥50%. Participants Adult patients with VS and WRS ≥50% who underwent MCF tumor resection between November 2017 and September 2019. Main Outcome Measures Postoperative hearing outcomes. Results Sixty patients were included. Mean tumor size was 9.2 mm (range, 3–17). HP rates were 56.7% for the cohort and 69.7% for tumors <10 mm. A complete loss of wave V was associated with an 82.9% increase in postoperative PTA (p < 0.001) and 97.2% decrease in WRS (p < 0.001), whereas a diminished wave V was correlated with 62.7% increase in PTA (p < 0.001) and 55.7% decrease in WRS (p = 0.006). A diminished or absent wave V, but not increased wave III/V latency or decreased wave V amplitude, was correlated with a decline in postoperative hearing class (r = 0.735, p < 0.001). Receiver-operating characteristic analysis demonstrated that a stable wave V has the highest accuracy in predicting HP (sensitivity of 82.6%, specificity of 84.8%). Conclusion Of the examined preoperative and intraoperative ABR characteristics, a stable wave V intraoperatively was the strongest predictor of HP after MCF resection of VS. Level of Evidence Level III. [...] Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany Article in Thieme eJournals: Table of contents  |  Abstract  |  Full text View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

The histone deacetylase inhibitor, entinostat (MS-275), induces the odontogenic differentiation of an odontoblast-like cell line in the absence of an osteoblast mineralization medium

ola Kala shared this article with you from Inoreader The histone deacetylase inhibitor, entinostat (MS-275), induces the odontogenic differentiation of an odontoblast-like cell line in the absence of an osteoblast mineralization medium Μέσω Odontology Abstract The aim of this study was to determine whether histone deacetylase inhibitors (HDACi), including entinostat (MS-275), valproic acid (VPA), trichostatin A (TSA), and sodium butyrate (NaB), promoted the odontogenic differentiation of the odontoblast-like cell line, MDPC-23 in the absence of an osteoblast mineralization medium. The cells were cultured in basal medium (Dulbecco's modified Eagle medium) with and without (controls) the inhibitors. The cell viability and migration were assessed using the cell proliferation reagent WST-1 and a scratch wound healing assay, respectively. The mRNA expression levels of bone morphogenetic protein (Bmp)-2 and -4, collagen 1 alpha 1 (Col1α1), osteocalcin (Oc), dentin matrix protein 1 (Dmp1), dentin sialophosphoprotein (Dspp), runt-related transcription factor 2 (Runx2), Krueppel-like factor 5 (Klf5), and Msh homeobox 1 (Msx1) were evaluated by quantitative real-time polymerase chain reaction (qRT-PCR). Alizarin red and alkaline phosphatase assays were performed to determine the extent of mineralization in the culture systems. No significant differences in cell numbers were observed between the controls and the MS-275-, VPA-, and NaB-treated cells; however, a significant difference was observed with TSA (concentration, 1000 nM). The scratch wound healing assay showed no effect of cell migration in the MS-275 (1.0 µM)-treated cells when compared with the controls at 24 h. Furthermore, MS-275, VPA, and NaB increased the mRNA expression levels of Bmp-2 and -4, Oc, and Runx2 followed by the mineralization of the cells. Only MS-275 significantly increased the expression levels of Dmp1, Dspp, Klf5, and Msx1 in the cells. These findings indicated that MS-275 may be considered as a reliable candidate for the odontogenic differ entiation of dental pulp cells. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Gerontology in a Time of Pandemic: An Introduction to the Special Collection

ola Kala shared this article with you from Inoreader Gerontology in a Time of Pandemic: An Introduction to the Special Collection Μέσω The Gerontologist - current issue In December 2019, a novel coronavirus, severe acute respiratory syndrome coronavirus 2, was identified in Wuhan, China and spread rapidly during the spring of 2020 to become a worldwide pandemic. The Centers for Disease Control and Prevention (CDC, 2020) notes that the disease caused by this virus, labeled Coronavirus Disease–2019 (COVID-19), has been especially deadly for older people and those with certain chronic diseases commonly, but not exclusively, seen among older adults. The rapid spread of the disease led many governments to institute stay-at-home orders, business closures, and contact limitations that have varied among countries and in the United States, between and within states. As of this writing, the world continues to battle a rising tide of infection while also seeing advances in treatment and the possibility of a vaccine on the horizo n. The pandemic appears to have myriad implications related to aging and the lives of older people. With the recognition that older people may be at higher risk for infection and mortality related to the virus, we have seen international media, social media, and public health officials framing "the elderly" as a homogeneous and vulnerable group, seemingly conflating physical vulnerabilities common in later life with chronological age. The pandemic has even led to hate speech in the form of monikers such as "Boomer Remover" that could promote generational conflict. This negative framing, the antithesis of "reframing aging" themes promulgated by The Gerontological Society of America (GSA), could have lasting effects on attitudes toward aging and older persons. Such framing ignores uniquely valuable skills, knowledge, historical memory, and learned temperamental strategies that older adults may possess to share with and model for younger generations during such a crisis. It also ignores the fact that many older adults remain in the workforce in critical positions and support their families. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Surgery on giant meningiomas in very old patients entails frequent postoperative intracranial hemorrhages and atypical histopathology

ola Kala shared this article with you from Inoreader Surgery on giant meningiomas in very old patients entails frequent postoperative intracranial hemorrhages and atypical histopathology Μέσω Latest Results for Journal of Neuro-Oncology Abstract Purpose Surgical resection of intracranial meningiomas in patients that are 80 years old and older, i.e. very old patients, is increasingly considered. Meningiomas with a largest diameter of at least 5 cm—'giant meningiomas'—form a distinct entity, and their surgical resection is considered more difficult and prone to complications. Here, we evaluated functional outcome, morbidity and mortality, and the prognostic value of tumor size in very old patients who underwent resection of giant supratentorial meningiomas. Methods We retrospectively reviewed clinical and radiological data, functional performance (Karnofsky Performance Score), histopathological diagnosis and complications of very old patients who underwent surgery of a supratentorial meningioma at the Helsinki University Hospital between 2010 and 2018. Results We identified 76 very old patients, including 28 with a giant meningioma. Patients with a giant meningioma suffered from major complications more commonly than those with a non-giant meningioma (36% vs. 17%, p = 0.06), particularly from postoperative intracranial hemorrhages (ICH). At the 1-year follow-up, functional performance and mortality rate were comparable between patients with giant meningiomas and those with non-giant meningiomas. An exceptionally high rate of giant meningiomas were diagnosed as atypical meningiomas (WHO II) at an (11 out of 28 cases). Conclusions Giant meningioma surgery entails a high complication rate in frail, very old patients. The prevention of postoperative ICH in this specific patient group is of utmost importance. An atypical histopathology was notably frequent among very old patients with a giant meningioma, which should be taken into account when planning the surgical strategy. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Influence of feldspar ceramic thickness on the properties of resin cements and restorative set

gnorimies2015 shared this article with you from Inoreader Influence of feldspar ceramic thickness on the properties of resin cements and restorative set Via European Journal of Oral Sciences Abstract This in vitro study evaluated the influence of feldspathic ceramic thickness on the properties of light‐ and dual‐cured resin cements. For each cement (RelyX Veneer, Allcem Veneer, RelyX Ultimate, and Allcem Dual), three ceramic specimens were prepared, with seven thicknesses for each (0.5, 1.0, 1.5, 2.0, 2.5, 3.0, and 3.5 mm). The degree of conversion, Vickers microhardness, irradiance power, color variation (ΔE 00), and translucency parameters were assessed. Microhardness and irradiance power were analyzed using analysis of variance (ANOVA) with post hoc Tukey's test, while ΔE 00, translucency parameters, and degree of conversion were analyzed using ANOVA of ranks with post hoc Duncan's Multiple Range Test. The relationship between each of the dependent variables (degree of conversion, ΔE 00, and translucency parameter tests) and the specimen thickness was described using linear regression for each of the four resin cements. The significance level for all analyses was set at 5%. RelyX Ultimate yielded the lowest degree of conversion values among all resin cements. Allcem Veneer produced the lowest microhardness values, without statistical differences between thicknesses, of up to 1 mm. Allcem Dual produced the highest ΔE 00 and translucency parameter values. Feldspathic ceramic thickness influenced the mechanical properties of resin cements and optical aspects of the restorative set. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.