Notes

Ultrasensitive and also turn-on homogeneous Hg2+ detecting with different target-triggered isothermal cycling impulse and dsDNA-templated birdwatcher nanoparticles.
Diseases of adenoids are commonly observed in children. It indirectly leads to pathology in the middle ear cleft. It has been demonstrated both by radiological techniques and middle ear pressure studies that adenoids can and do obstruct the Eustachian Tube. The Adenoid-Nasopharyngeal Ratio (ANR), can offer a simple arithmetic measure of nasopharyngeal obstruction. Coupled with tympanometry, it also predicts the degree to which the middle ear is affected. Multicentric study done at two centres in India. 230 patients were studied. Children were in the age group of 5-14 years. The nasopharyngeal and adenoid dimensions were measured separately using the Fujioka method. The adenoid-nasopharyngeal ratio was derived by the arithmetic method. All patients were also subjected to tympanometry. ANR decreased from 0.728 to 0.663 with an increase in age from 5 to 12 years. ANR between 0.701-0.800 had maximum number of Type B (140) and Type C (71) Tympanogram whereas between 0.801 and 0.900, all Tympanogram were found to be of Type B or Type C with none belonging to Type A. Using ANR and Tympanometry, the effects of the adenoids on the middle ear can be quantified indirectly. Both these modalities are easily available, economical, safe and can be performed at the Out Patient Level. This aids in timely and appropriate management thus preventing discomforting symptoms caused by the adenoids locally and also the morbidity caused to the middle ear in the long term.In newborns, both term and preterm, cochlear hearing loss is common due to different pathologies. Currently accepted methods for hearing screening in newborns are otoacoustic emission (OAE) and auditory brainstem responses. Among these two, OAE is quicker, economical and more accessible. In the present study we assessed OAEs in sick newborns, both term and preterm, having different pathological conditions. This descriptive study was conducted over 3 months in sick newborn care unit (SNCU) in a tertiary care hospital. All sick newborns admitted to SNCU in the study period were tested for otoacoustic emission. The results were subjected to the Chi square test (test of independence). Among 640 sick newborns, 184 were preterm; the rest being term newborns. Among the term sick newborns, 4.8% of those with birth asphyxia, 8.6% of those having septicaemia, 25% of those with hyperbilirubinemia needing exchange transfusion, 22.9% of those having meningitis and 33.3% of those with major congenital anomalies, had "refer" on OAE. Among preterm sick newborns, 30.8% of those with birth asphyxia, 32.5% of those having septicaemia, 75% of those with hyperbilirubinemia needing exchange transfusion, 41.7% of those having meningitis, 40% of those with major congenital anomalies and 8.7% of those with no co-morbidity had "refer" on OAE. Upon computing the p value of Chi square test performed on the results, the results were not significant (p = 0.85). Hence we didn't find any statistically significant difference between term and preterm sick newborns on OAE. The incidence of "refer" result in OAE increases with co-morbidities in both term and preterm sick newborns, somewhat more in preterm newborns. But preterm sick newborns do not seem to have an increased incidence of hearing impairment.In present world of contemporary techniques of microscopic ear surgery and single handed endoscopic ear surgery, we propose the technique of two handed endoscopic tympanoplasty using endoscope holders. The aim of the study is to evaluate the functional and anatomical results of our technique of endoscopic type 3 cartilage tympanoplasty using endoscope holder. It is a Retrospective Non Randomized Clinical Study. A total of 67 endoscope holder assisted exclusively two handed endoscopic type 3 cartilage tympanoplasties performed from December 2014 to March 2017 with our technique were included in the study. Patients with pars tensa retractions and perforations with absent incus were included in the study. Those with cholesteatoma were excluded from the study. Full thickness tragal cartilage disc of 3 × 3 mm dimensions with a circular slot of 1 mm to fit onto the head of the stapes was used for reconstruction. Tympanic membrane reconstruction was done along with attic reconstruction, using sliced tragal cartilage of 0.5 mm thickness. Patients were assessed at 6, 12 and 24 months for graft status. In early follow up period ranging from 24 to 52 months, the graft take up was seen in 64 ears with three perforations giving a success rate of 95.52%. The pre-operative air-bone gap was 42.6 ± 3.26 dB and the post-operative air-bone gap at 6 months, 1 and 2 years was 18.36 ± 3.46 dB, 19.42 ± 4.32 dB and 19.53 ± 4.33 dB respectively. The study reports good air-bone closure to 20 dB postoperatively following type 3 endoscopic tympanoplasty using endoscope holder. Slotted cartilage graft is definitely an excellent option for ossiculoplasty in cases of absent incus providing a stable assembly. Level of evidence Level 4.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. this website 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 hearing 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.This study compares the results of Tympanoplasty in terms of graft uptake and hearing improvement in patients with Chronic Otitis Media which are divided on the basis of discharging ear and non discharging ear with perforation at the time of surgery. Total 110 patients were selected suffering from chronic otitis media. Out which 55 patients had discharging ear (wet ear) and 55 patients had non discharging ear (dry ear). Tympanoplasty was performed using temporalis fascia graft. Hearing improvement and graft uptake was seen in both wet and dry ears. No statistically difference is noted in the results between the two. Mucoid ear discharge at the time of surgery is not a contraindication for Tympanoplasty as it has no adverse effects on the outcomes of the surgery in respect to graft uptake and hearing improvement.With technological improvements leading to enhanced image resolution, as well as recognized acceptance of endoscopes within the field of rhinology, there has been greater implementation of endoscopes in otologic and neurotologic procedures. Surgeons now use endoscopes for a wide range of otological procedure, one such procedure is endoscopic stapedotomy for otosclerosis. This study is done to compare merits and demerits of endoscopic stapedotomy with microscopic stapedotomy. This is a prospective observational study conducted in SMBT Medical College and Hospital, Nashik from January 2018 to January 2020. 40 patients who presented to ENT OPD with clinical features suggestive of otosclerosis and who fulfilled inclusion and exclusion criteria were included in the study. Detailed history, complete ENT examination and audiological investigations were done. Preanesthetic evaluation was done and patients were randomly allotted into two groups. Group A consisted of twenty patients who underwent microscopic stapedotomy under local anesthesia Group B consisted of twenty patients who underwent endoscopic stapedotomy under local anesthesia. Data was collected in pre-structured proforma and analyzed. There was no statistically significant difference between microscopic and endoscopic procedure in terms of duration of the surgery, hearing improvements or complications. However, surgeons noted that ease of visualization of middle ear structures and the better image quality favors endoscopic procedure over microscopic procedure. There is no increased risk of complications with endoscopic stapedotomy and hearing improvement is same as that of microscopic stapedotomy however the ease of visualization of middle ear structures and the better image quality favors endoscopic procedure over microscopic procedure. Hence, we conclude that endoscopic stapedotomy is a safe alternative to microscopic stapedotomy.Tympanoplasty is a commonly performed surgical procedure done by Otorhinolaryngologist for treatment of chronic suppurative otitis media. Postoperative period requires the use of analgesics which are given regularly. The study aims to assess the efficacy of a single dose of preemptive pregabalin in decreasing postoperative pain after postauricular type 1 tympanoplasty. This randomized prospective study was carried out in a tertiary care hospital between July 2017 and April 2018. A total of 60 patients were divided into two groups of 30 each. This study analyzed the effect of single preoperative use of pregabalin 150 mg oral 1 h before type 1 postauricular tympanoplasty for postoperative pain as a VAS (visual analogue scale) score and requirement of rescue analgesia and results were compared with the placebo group. Pain scores (VAS score) was significantly lower in the pregabalin group as compared to the placebo group at 6, 12, 24, and at 48 h. Rescue analgesia requirements were also lower in the pregabalin group than the placebo group. Preemptive use of a single dose of oral 150 mg pregabalin reduces postoperative pain and rescue analgesic requirement in patients undergoing type 1 tympanoplasty.Acquired external auditory canal stenosis is a challenging condition to treat and can affect any age group. Post inflammatory lateral canal atresia is uncommon. This article focuses on a 2 year old child who presented with hearing loss with history of otitis externa. The lateral part of Auditory Canal was completely stenosed. He underwent debrider assisted endoscopic ear surgery and stenting, and a patent External Auditory Canal with normal hearing was achieved.
Different studies have shown that a significant number of medical graduates do not achieve the necessary preparedness for delivery of effective health care in a safe and acceptable manner. Various studies have been undertaken to explore the competencies of surgical residents in otorhinolaryngology. This study was carried out to find out the status of training in otology being provided across different institutions in India. This is a cross sectional study undertaken at All India Institute of Medical Sciences (AIIMS), Jodhpur. An online survey questionnaire enquiring about different aspects of otologic training being followed at various centres was developed and was sent online to all prospective responders. Out of the 217 responders, 88 were faculty members and 129 residents. 62% of the faculty members and 56.5% of residents mentioned that their centre has a temporal bone dissection lab. 64.7% of the faculty members and 58.2% of the residents responded that temporal bone dissection is mandatory before live surgeries.
My Website: https://www.selleckchem.com/MEK.html