Interval Tonsillectomy: 27 Cases of Peritonsillar Abscesses Managed in Medical College Hospital.

Background and objectives: Peritonsillar abscess (quinsy) is the most common deep infection of the head and neck. The surgical treatment whether abscess tonsillectomy or interval tonsillectomy should be done is a subject of controversy, which still remains unresolved. Setting: Dept. of ENT, Head and Neck Surgery, KVG Medical College, Sullia, Karnataka. Material and methods: This was a comparative case series analysis study done in our department during the study period of 54 months from January 2007 to June 2011. Twenty-seven patients with clinical features of peritonsillar abscess who underwent medical line of treatment with incision and drainage and later interval tonsillectomy were included in the study. Results: The mean age was 30.4 years, mean hospital stay during incision and drainage was 3.51 days. The patient turned up for surgery within a mean duration of 9.4 months. The mean blood loss during the procedure was 100.5 ml and the mean visual analog scale (VAS) scores after interval tonsillectomy were 4.78. Mild-to-moderate difficulty was seen during the dissection of the abscess scarred tonsillar bed. Conclusion: Interval tonsillectomy is the standard treatment for managing peritonsillar abscess in many institutions. We recommend interval method of tonsillectomy done after a minimum of six weeks after incision and drainage of the peritonsillar abscess.

Scalpel Cautery Adenotonsillectomy Done in a Case of Crouzon’s Syndrome.

Background/Objectives: Crouzon syndrome is characterized by premature closure of the cranial sutures, midface hypoplasia, orbital deformities and other associated abnormalities. Children with Crouzon syndrome frequently have obstructive sleep apnea due to the underdevelopment of the midface. Setting: Dept. of ENT, Head and Neck Surgery and Anesthesia, KVG Medical College, Sullia. Case report: A 12-year-old boy of Crouzon syndrome with chronic adenotonsillitis was managed by adenotonsillectomy under general anesthesia by scalpel cautery method. The boy responded well to surgery and the mild sleep disorder disappeared within a week uneventfully. Conclusion: Sleep disorders in this condition can be treated by improving the airway by selective procedures like midface advancement, mandibular expansion, adenotonsillectomy, uvulopalatopharyngoplasty, anterior tongue reduction and endoscopic tracheal granuloma excision.

Single-nucleotide polymorphisms in peroxisome proliferator-activated receptor γ and their association with plasma levels of resistin and the metabolic syndrome in a South Indian population.

Studies on the association of the Pro12Ala and C1431T polymorphisms of PPARγ with diabetes and obesity have revealed extensive population-dependent variations. However, association of these polymorphisms with the metabolic syndrome and its individual components has not been well investigated in the Indian population. The Indian population harbours the maximum number of diabetics in the world who are thus more susceptible to metabolic disorders. We screened a South Indian population (N = 699) for a possible association of these polymorphisms with the metabolic syndrome (MS) and type 2 diabetes. We also investigated the correlation of these two single-nucleotide polymorphisms (SNPs) with plasma resistin levels. The C1431T SNP was associated with higher levels of plasma resistin (P = 0.017). Furthermore, C1431T was associated with resistin in different tertiles. Prevalence of the ‘Pro-C’ haplotype decreased with increasing tertiles of resistin (84.1% to 75.4%, P = 0.037). Plasma resistin levels were not found to be associated with MS and type 2 diabetes. These results point to a likely association of plasma resistin levels with PPARγ polymorphisms in the Indian population.

Premature coronary artery disease: role of free radical nitric oxide.

AIMS/OBJECTIVES: Over the last several decades, it has become amply evident that oxidative stress plays a significant role in the pathogenesis of coronary artery atherosclerosis and its complications. Relatively recent studies have demonstrated an association between increased oxidative stress and coronary artery disease. We therefore undertook this study to see the effect of free radical nitric oxide in patients with premature cardiovascular disease. METHODS AND RESULTS: The study included 50 individuals with premature coronary artery disease aged below 45 years, and 50 age- and sex-matched normal individuals for comparison. Free radical nitric oxide was estimated using the Griess reagent as previously described. Mean plasma nitric oxide was found to be high in the patient group as compared to the control group, which was found to be statistically significant at p > 0.0001. CONCLUSION: Increased NO production was present in the plasma of patients with premature coronary artery disease individuals as compared to normal controls. Since NO seems to have a role in tissue damage, high concentrations of NO could have probably given rise to the said clinical manifestations. Further studies are needed in this context as to whether the changed lifestyles in the young individuals or the type of occupation is leading to the oxidative stress and thereby to the disease.