Evaluation of hearing loss in patients with type 2 diabetes mellitus

Background: This study had been undertaken to examine the relationship between diabetes mellitus and hearing loss quite debated for many years.Methods: Hearing status in fifty patients of type 2 diabetes mellitus, aged within 50 years and duration of diabetes less than 120 months was compared to fifty ages and sex matched healthy volunteers using pure-tone audiometry, transient evoked otoacoustic emissions, and auditory brainstem responses.Results: In diabetic patients, compared to healthy subjects, the mean hearing threshold in the pure-tone audiometry was significantly higher at all frequencies, the mean amplitude of TEOAE was lower, and latency times of waves III, V and intervals I-III, III-V and I-V in ABR were longer.Conclusions: This study confirms the presence of SNHL in relatively young type 2 diabetes mellitus. The use of audiological tests to monitor hearing in diabetic patients should be considered as a routine procedure

Mucosal and lacrimal flaps for endonasal dacryocystorhinostomy (DCR):a systematic review

Background: Historically dacryocystorhinostomy (DCR) has been performed externally with very good outcomes. Current literature shows comparable success rates between endonasal and external approaches. A common reason for the failure of a DCR is the re-closure of the nasolacrimal stoma by granulation tissue and synechiae.Objective of review: A systematic review and critical evaluation of the evidence relating to the preservation of nasal mucosal flaps in DCR surgery.Type of review and evaluation method: A systematic review using the consort guidance for review of randomised control trials.Search strategy: A search of the following evidence-based medicine databases was performed: Cochrane database of systematic reviews (DSR), Database of abstracts of reviews of effectiveness (DARE), Cochrane central register of controlled trials (CCTR), Ovid, Medline, EMBASE, PubMed. The search was limited to English language articles and the following key words were used: Endonasal, Endoscopic, Dacryocystorhinostomy, DCR, Mucosal Flaps, between years 1970 and 2015.Results: The best available evidence was level 1B, comprising 2 randomised control trials and 3 comparative studies included in the review. The main outcome measures used were lacrimal irrigation and absence of epiphora. Two of the studies demonstrated a statistically significant benefit of mucosal sparing either with nasal mucosal flaps or lacrimal flaps. More debridement was needed and granulation tissue was also seen in the groups without mucosal preservation. There was no difference in surgical complications between a mucosal and non-mucosal sparing technique.Conclusions: The overall quality of current evidence is poor, there does however appear to be a trend towards improved outcomes and reduced granulation in groups where nasal mucosal and lacrimal flaps were preserved, but this is not clear-cut. There was no evidence of increased complication rates with mucosal sparing techniques. We recommend that until further good quality research is available we should be performing a mucosal sparing technique when performing DCR routinely.</p

A comparative study of serum calcium and magnesium levels in women with pre-eclampsia and normotensive women

Background: Pre-eclampsia is transient but potentially dangerous complication of pregnancy. Despite of pre-eclampsia's prevalence and severity, the pathophysiology of this multisystem disorder is still poorly understood and its aetiology has not yet been fully elucidated. Recently, nutritional deficiency especially micronutrients deficiency is gaining prominence in the pathogenesis of pre-eclampsia. Hypocalcaemia and hypomagnesaemia have been implicated in the pathogenesis of pre-eclampsia. This study has been done to compare serum calcium and magnesium levels in women with pre-eclampsia and normotensive women and their association with severity of pre-eclampsia.Methods: 50 women with pre-eclampsia and 50 normotensive women were included in the study and serum calcium and magnesium levels were measured. Data were analyzed.Results: The serum ionic calcium concentration was significantly lower in the pre-eclamptic cases compared to the normotensive controls (3.34±1.35 versus 4.37±0.74, p=0.0000) similarly serum magnesium concentration was significantly lower in the pre-eclamptic cases compared to the normotensive controls (1.68±0.41 versus 1.94±0.42, p-0.002). Mean serum ionic Ca levels in severe pre-eclampsia group was significantly lower than normotensive pregnant women (p=0.0000) as well as mild pre-eclampsia group (p=0.001). Mean serum Mg in severe pre-eclampsia was significantly lower than normotensive pregnant women (p=0.0008) as well as mild pre-eclampsia group (p=0.03). Serum ionic Ca and Mg had a negative correlation with systolic and diastolic blood pressure.Conclusions: Based on this study, measurements of serum ionic calcium and magnesium among women at risk of for pre-eclampsia may be used to predict the onset and severity of pre-eclampsia

A cross-sectional study to evaluate sonographic foetal humerus length for estimation of gestational age in normal singleton pregnancies at a tertiary care centre

Background: Accurate knowledge of gestational age of the foetus is essential for planning a timely and uneventful outcome. Biparietal diameter, head circumference, abdominal circumference and femur length reliably predict gestational age. The humerus length is not widely used as biometric parameter for determining the GA so the present study was done to estimate foetal gestational age by measuring humerus length between 18 to 36 weeks of normal singleton pregnancies and to compare humerus length with routine parameters.Methods: This was a hospital based descriptive cross-sectional study, 200 women with viable singleton pregnancy, with known LMP, between 18 weeks to 36 weeks of gestation were included. Various foetal measurements such as biparietal diameter, head circumference, abdominal circumference, femur length and humerus length were measured using electronic calipers on ultrasound. Data were statistically analyzed.Results: The mean humerus length at 18 weeks was 25.27±1.16 mm and at 36 weeks of gestation was 57.11±1.58 mm. Simple linear regression analysis shows a strongly significant linear relationship between humerus length and gestational age. Where, gestational age (weeks) Y= 0.5213 x humerus length (X) + 4.905; with high degree of correlation coefficient (R2 =0.9785 and P≤0.0001). When Compared with BPD, HC, AC and FL, humerus length also shows a linear correlation.Conclusions: The measurement of the humerus length can be an important additional parameter for estimating gestational age along with other parameters and can be used to predict the gestational age of fetuses in special circumstances

Evaluation of hearing loss in patients with type 2 diabetes mellitus

Background: This study had been undertaken to examine the relationship between diabetes mellitus and hearing loss quite debated for many years.Methods: Hearing status in fifty patients of type 2 diabetes mellitus, aged within 50 years and duration of diabetes less than 120 months was compared to fifty ages and sex matched healthy volunteers using pure-tone audiometry, transient evoked otoacoustic emissions, and auditory brainstem responses.Results: In diabetic patients, compared to healthy subjects, the mean hearing threshold in the pure-tone audiometry was significantly higher at all frequencies, the mean amplitude of TEOAE was lower, and latency times of waves III, V and intervals I-III, III-V and I-V in ABR were longer.Conclusions: This study confirms the presence of SNHL in relatively young type 2 diabetes mellitus. The use of audiological tests to monitor hearing in diabetic patients should be considered as a routine procedure

Myoepithelial Cell-Rich Pleormorphic Adenoma of Minor Salivary Gland of Parapharyngeal Space

Parapharyngeal space tumors are rare and constitute only 0.5–1.0% of head and neck tumors. Minor salivary gland tumor is still rare in parapharyngeal space. We are reporting a case of pleomorphic adenoma of minor salivary gland of parapharyngeal space. A 42-year-old female presented with a history of mass in the oropharynx for 3 years. She presented with “hot potato voice” and dysphagia. CECT and MRI were done, showing large parapharyngeal space tumor. FNAC was suspicious for tumor of nerve cell origin. Tumor was excised using “paramedian mandibulotomy with mandibular swing approach”. Histopathological examination was inconclusive, suggesting possibility of extraskeletal myxoid chondrosarcoma, solitary fibrous tumor, neurogenic tumor. On immunohistochemistry, tumor was positive for cytokeratin, EMA (dim), S-100, and P 63 and negative for SMA thus proving the case as myoepithelial cell-rich pleomorphic adenoma

Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis and Polyposis and Asthma

ABSTRACT There has been an increasing awareness of the inter-relationship between inflammatory disease of the upper and lower airway. Both epidemiological and physiological data suggest that the respiratory tract, from the middle ear mucosa, through the nose and sinuses, and into the pulmonary tree behave as an integerated unit. Recent progress in understanding the biology of airway disease has identified that systemic inflammatory responses play a critical and integerating role in these diseases. The role of sinus surgery in the management of asthma patients has been a matter of debate for many years. We are presenting a well-designed prospective, controlled study in 50 patients with asthma and chronic rhinosinusitis (CRS) with nasal polyposis who were submitted to either functional endoscopic sinus surgery (FESS) or medical therapy. How to cite this article Sonkhya N, Sharma K. Functional Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis and Polyposis and Asthma. Clin Rhinol An Int J 2014;7(2):52-57. </jats:sec

Prospective study of 100 cases of underlay tympanoplasty with superiorly based circumferential flap for subtotal perforations

OBJECTIVE: Underlay Tympanoplasty with superiorly based circumferential flap for dry subtotal perforations. STUDY DESIGN: A prospective study of cases with dry subtotal perforations, which underwent surgery between August 2001–Feb. 2004. SETTING: Study was conducted on patients attending ENT OPD in S.M.S. Medical College and Hospital from August 2001–Feb. 2004 with dry subtotal perforations. RESULTS: It was noted that 89% of the cases were in the age group of 11 to 40 years, while one case was of 7 years of age and 9% of cases were between the age of 41–50. 50% of the cases had dry ear for less than 3 months while 75% of cases had dry ear for less than 1 year. Graft take rate was 97% with completely healed tympanic membrane. Rejection of the graft was observed in 2% of the cases. Hearing gain of 10–30dB was achieved in 95% of the cases. 7% of the cases suffered minor complications like otitis media with effusion (2%) retraction (2%) and lateralization (1%). CONCLUSION: Duration for which ear has been dry did not affect the results. 49% of cases had dry ear for less than 3 months, with good graft take up rate and hearing gain. Pneumatization of mastoids, had a direct relationship with, post operative hearing gain, which ranged from 10–30 dB, in 95% of the cases. We observed, 97% graft take rate. Rejection of the graft was found in only 2% of the cases. 97% of the graft take rate and good hearing gain in our study can be correlated with expertise technique to deal with subtotal perforations