MAGNITUDE OF DIABETES MELLITUS IN PATIENTS OF SUDDEN SENSORINEURAL HEARING LOSS AND ITS EFFECT ON CORTICOSTEROID THERAPY

Objective: To determine the magnitude and effects of diabetes mellitus in patients of sudden sensorineural hearing loss and on the final outcome of therapy. Study Design: Cross sectional study. Place and Duration of Study: ENT unit of Medical Teaching Institution Abbottabad, from Jul 2018 to Jun 2020. Methodology: A total of 84 patients presented who had idiopathic sudden sensorineural hearing loss by using non probability consecutive sampling enrolled in the study. Basic parameters, age, diabetes mellitus and hearing loss were used for data collection. The data was analyzed by using SPSS version 23. Results: Out of total 52 (61.9%) were male and 32 (38.1%) were female, mean age was 45.62 ± 14.12 years from 14-85 years. A large number of patients presented within one week of onset of hearing loss 57 (67.86%). In our patient group 18 patients (21.4%) had diabetes mellitus and 66 patients (78.6%) did not have diabetes mellitus at presentation. Initial Hearing loss at presentation was significantly more in patients who had diabetes mellitus p=0.006 and there was statistically strong association between the final hearing improvement and diabetes mellitus p<0.001. Conclusion: Diabetes mellitus is associated with more severe hearing loss at initial presentation and poorer final outcome in patients with Idiopathic sudden sensorineural hearing loss. As glycemic control does not affect the result so corticosteroid therapy must be given to all patients of sudden sensorineural hearing loss with diabetes mellitus.

Influence of contextual factors on physical demands and technical-tactical actions regarding playing position in professional soccer players

Background The aim of this study was to analyse the physical demands and technical-tactical actions for each playing position according to game location and final outcome in professional soccer players. Methods A convenience sample was obtained from twenty-one professional male soccer players, belonged to same soccer team of the Spanish Second Division. Players’ physical demands were monitored during each match using a portable 18 Hz GPS unit and 600 Hz triaxial accelerometer. These analysed demands were total distance, moderate speed running distance (>14.4 km·h-1), high-speed running distance (>19.8. km·h-1), sprint distance (>25.0 km·h-1), number of accelerations between 2 and 4 m·s-2 and above 4 m·s-2, and number of decelerations between 2 and 4 m·s-2 and above 4 m·s-2. The data related to technical-tactical actions were obtained from WyScout®, a computerized multiple-camera tracking system based on the OPTA® track analysis tool. The obtained indicators were general, defensive and offensive. Results For all players, higher total distance (p = 0.045; effect size [ES] = 0.24, small effect) was covered and greater deceleration 2-4 m·ss-2 (p = 0.001; ES = 0.68, medium effect) was performed when the team plays at home and lose and for all players, playing at home and winning demanded higher defensive volume (p =0.014; ES = − 1.49, large effect) and nº interceptions (p =0.031; ES = − 1.40, large effect) in comparison to playing at home and losing. Conclusions The physical demands and technical-tactical actions vary when contextual game factors (i.e., match location and final outcome) are considered. We can confirm that, although the training of physical demands does not influence the final result of the match, the training of technical tactical actions could help to achieve an optimal performance of the team to win matches.

The apodictic method and the dialogue between theology and science (I)

Many today’s scientists think that religion can never come to terms with science. In sharp contrast to the widespread opinion, the authors of this paper consider that historically scientific reasoning and religious belief joined hands in their effort to investigate and understand reality. In fact, the current divorce between science and religion is nothing else than the final outcome of a gradual long-term, and deliberately assumed process of science secularization of science. However, especially during the last decades, we have all been equally confronted with the advance of a new concern over the fact that contemporary scientists have been approaching an area of investigation that had been usually addressed by the theological thought. This recent development has generated an emerging new field of investigation of Science and Religion within modern scientific epistemology.Against this background, the purpose of this paper is three-fold: firstly, to briefly emphasize that one of the defining dimensions of the dialogue between science and religion is given by the discontinuity, in which, the knowledge acquired through scientific reasoning is placed in relation to the divinely revealed knowledge; secondly, to argue that another defining dimension of the dialogue consists in the hierarchical harmony mediating the encounter between the two, thus transgressing the discontinuity and making the dialogue between theology and science possible and viable; and thirdly, to advocate the idea that the apodictic method (based on antinomic logic) can successfully structure such a dialogue.

Intramedullary Sclerosing Meningioma in Meningiomatosis: Case Report and Review of the Literature

Sclerosing meningioma is a rare histological variant of meningioma, first described in the literature by Davidson and Hope in 1989 as an invasive bulking mass consisted of whorling collagen bundles with a minimum percentage of meningothelial resembling cells [1]. The literature showed very rare cases of the intramedullary location of sclerosing meningiomas: in our opinion, it is mandatory to describe its clinical, surgical, histological and immunohistochemical features in order to reach the best final outcome. Sclerosing meningiomas are often misdiagnosed because of their invasive behaviour: it does require a correct diagnosis in order to prevent unnecessary postoperative treatment. Literature reports only 30 cases of sclerosing meningiomas and only 2 of them are intramedullary. We present the case of a cervical intramedullary sclerosing meningioma presenting with gait disturbances, sensory deficits, four extremities weakness and hypereflexia in a patient with the history of meningiomatosis.

Fate and Free Will in Chronicle of a Death Foretold

In García Márquez, the magical is associated with fantasy, myth, literariness, and the unknowability of reality, while realism suggests seeing through fictitious versions of reality constructed by hegemonic discourses. Chronicle of a Death Foretold (1981) is about fate and ambiguity, but also encourages the challenging of convention and the assertion of an independent identity: the “magic” of the imagination is a path to alternative ways of being and a new reality. The title suggests the circularity of a mystical destiny and the investigative desire to recuperate historical truth. Santiago Nasar’s death is inevitable because of an honor code rooted in religious and social conformity (his killing is necessary to purify the Vicario family name following a bridegroom’s discovery that his bride, Angela Vicario, has already lost her virginity, possibly to Santiago). Moreover, there is a performative, ritualistic, sacrificial dimension to the planning of the death, as Angela’s brothers act out their compulsion according to what they believe is required of them. Behind this is the idea that the magic of love has become little more than a social contract and has ceased to be “real.” The investigation of the detective-like chronicler (into a real event now being transformed into a fiction) implies a quest for “truth,” and the final outcome is a not entirely ironic achievement of “true” love, independently chosen. This article explores how agency and authorship are mobilized to test the limits of fatalism and convention.

The long-journeying poor cousin before the shut EU door: How the Western Balkans are metaphorically conceptualised in the context of the EU integrations

Summary In this paper we critically analyse how the identity of the Western Balkans (WB) has been metaphorically conceptualised in the latest stages of the EU integration processes in a corpus of internet news articles recently posted in Serbia, Montenegro and Bosnia and Hercegovina. Unlike the accession processes of the former membership candidates from Europe, the WB’s integration has proven to be a very long one, hindered by many, perhaps insurmountable obstacles and subject to a great deal of uncertainty regarding its final outcome. Although this process is predominantly conceptualised through the already established metaphors employed to depict such processes of the former member candidates (journey, house, circles/rings, family, etc.), their evaluative content is different, given that the roles and the positions of the EU and the WB are starkly asymmetrical, i. e. that the WB is deeply marginalised. We identified some new metaphors that this specific political situation has engendered, also reflecting the said asymmetry – the WB is perceived as a colony, self-imprisoned state, Trojan horse, victim of blackmail, immature person, experimenting ground and waste-collector for immigrants. These metaphors construct an image of the WB as that of the very inferior Other.

Radiological changes, infections and neurological complications after reverse shoulder arthroplasty related to different design types and their rates: Part II

Early reported complication rates with the Grammont-type reverse shoulder arthroplasty (RSA) were very high, up to 24%. A ‘problem’ is defined as an intraoperative or postoperative event that is not likely to affect the patient’s final outcome, such as intraoperative cement extravasation and radiographic changes. A ‘complication’ is defined as an intraoperative or postoperative event that is likely to affect the patient’s final outcome, including infection, neurologic injury and intrathoracic central glenoid screw placement. Radiographic changes around the glenoid or humeral components of the RSA are very frequently observed and described in the literature. High complication rates related to the Grammont RSA design led to development of non-Grammont designs which led to a dramatic fall in the majority of complications. The percentage of radiological changes after RSA is not negligible and remains unsolved, despite a decrease in its occurrence in the last decade. However, such changes should be now considered as simple problems because they rarely have a negative influence on the patient’s final outcome, and their prevalence has dramatically decreased. With further changes in indications and designs for RSA, it is crucial to accurately track the rates and types of complications to justify its new designs and increased indications. Cite this article: EFORT Open Rev 2021;6:1109-1121. DOI: 10.1302/2058-5241.6.210040

Recent Methods of Neck Femur Fixation A Systematic review and meta-analysis

Background Femoral neck fractures in adults younger than age 50 years are uncommon and often the result of high energy trauma. They account for only 2-3% of all femoral neck fractures. Femoral neck fractures are associated with aging and osteoporosis and can occur after relatively trivial trauma in elderly patients. femoral neck fractures are associated with higher incidences of femoral head osteonecrosis and nonunion. Fixation options include cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. A systematic review of literature done to evaluate which technique is better. Methods After literature search thirteen articles were found and were reviewed to evaluate final outcome of fixation of neck femur fractures by cannulated screws, non parallel cannulated screws, medial augmentation plate, and fixed angle femoral neck fixation implants. Results After evaluation of all studies the incidence of nonunion, osteonecrosis of femoral head, implant failure & revesion surgery is lower in comparing Targon plate with multiple cannulated screws while we need further studies for application of non parallel screws and medial plate. Conclusion Targon plate recorded low incidence of complications in the final outcome in comparison with multiple cannulated screw while we need further studies for application of Non parallel screws and medial plate.

Our comprehensive experience with tracheostomy in tertiary multi-speciality hospital over four years

<p class="abstract"><strong>Background:</strong> Tracheostomy is a common surgical procedure used to achieve a secure airway in patients in elective as well as emergency conditions. Our study accounts for our first-hand experience with the procedure in our tertiary multi-speciality hospital.</p><p class="abstract"><strong>Methods:</strong> It is a four year (January 2017 to February 2021) retrospective study in which all the 246 cases of tracheostomies were taken into account which were performed during this study period in the department of otorhinolaryngology (ENT), Surat Municipal Institute of Medical Education and Research (SMIMER), Surat (India). The patients were thoroughly followed up until the final outcome of the tracheostomy was established. </p><p class="abstract"><strong>Results:</strong> A total of 246 tracheostomies were performed, 63.82% of which were in men. The mean patient age was 42 years. The majority (76%) were elective, performed for various indications, while the remaining 24% were emergency tracheostomies. All tracheostomies were performed by otorhinolaryngologists. Complications relating to tracheostomy were documented in 40 patients (16%) intra-operatively and/or post-operatively which included bleeding, surgical emphysema, granulations along the stomal site and rarely shock. The mean time to decannulation was 13.48 days.</p><p class="abstract"><strong>Conclusions:</strong> Our study takes into account and discusses the findings of all the 246 tracheostomies which were performed during the study period of 4 years. Elective cases form the majority although there is a significant case series of emergency tracheostomies performed for a range of pathologies.</p><p class="Default"> </p>