Coblation Tonsil Resection (TR): Our Experience For A Powered Instrument Feasibility With Advantages And Disadvantages

Background:Tonsillectomy is one of most commonly performed surgical procedure in otorhinolaryngology. In past, various surgical techniques for tonsillectomy have been de veloped. And coblation tonsillectomy is one of the latest techniques developed. We carried this study to check feasibility of powered instrument (coblator) in view of patient and surgeons benefit with advantages and disadvantages for tonsillectomy. Material And Methods:We carried out this study in randomly selected total 125 patients who presented to our ENT department with chief complain of recurrent tonsillitis. All patients underwent coblation techniques and were analysed for total time consumption during operation, amount of bloodloss during operation, immediate postoperative pain, postoperative haemorrhage whether primary or secondary, time needed to return back to the normal activity and diet ,total percentage of healing post operatively. Each patient had preoperative blood investigation to exclude any coagulation disorder and anemia. Postoperative analgesics and broad spectrum antibiotics were administered. Result:Mean operation time was 12±2.45 minutes in coblation group. Intraoperative blood loss turned out to be 20.00±5.0 ml for the coblation. Mean return to normal diet period was significantly shorter (5.00±1.50). Otherwise, return to normal behaviour was significantly earlier with coblation(10.50±2.00 ). Postoperative we have not seen any case of primary hemorrhage or secondary hemorrhage in our study.Conclusion:We found that coblation technique for tonsillectomy offers considerable advantages in the operation time and intra operative blood loss. Coblation is related with timely return to routine activities and normal adequate diet. To endorse its significance over conventional tonsillectomy warrants further study.

A Study Of Anosmia In Covid-19 Patients

Background:Clinical features of COVID infection are varied and sometimes non-specific. Anosmia is one such clinical feature, for which limited evidence is available.Material And Methods:Subjects were contacted via telephonic interviews and data was collected regarding their perceptions about COVID infection.Result:Prevalence of anosmia in our study was 12.8% overall but significantly more (18%) in hospitalised patients/symptomatic. More than 30% of patients were having anosmia as their first symptom. Anosmia was more in patients having co morbidities.Conclusion:Loss of smell is one of the important clinical features of COVID infection. Anosmia may be the sole or fir st symptom in COVID.

Incidence Of Tuberculosis In Otorhinolaryngology - Our Experience From A Tertiary Care Centre In Western India

Background:Tuberculosis (TB) is a worldwide leading public health problem even today. It affects all tissues of the body, but pulmonary tuberculosis is the most common type of tuberculosis (80% total tuberculosis cases). Extrapulmonary TB (EPTB) has major challenge for its clinical detection, definitive diagnosis and treatment. Out of all extrapulmonary cases, TB occurring in head and neck region is uncommon.Material And Methods:A prospective analytical studyof 50 patients who presented toENT OPD setupof ourtertiary carehospital with extra pulmonary TB. We look at the various clinical and laboratory aspects of tuberculosis of theotorhinolaryngeal region that would help to diagnose this uncommon but important form of extra pulmonary tuberculosis.Result:Male: Female ratio was 1.8:1 exhibiting male preponderance. Majority of the patients belonged to the age group of 20-40 years. Our study included patients with tuberculous cervical lymphadenopathy (84%), laryngeal TB (2%), tuberculous otitis media (12%), and retropharyngeal abscess (2%). FNAC seems to be de finitive and easier mode to diagnose TB of cervical nodes and Excision Biopsy can be done when FNAC is inconclusive.Conclusion:Extra pulmonary TB is significant health problem worldwide. It presents as a challenging task for diagnosis and overall surveillance of the treatment. The ear, nose, PNS, pharynx, larynx and cervical nodes are very important anatomical sites of extra pulmonary affliction. Its early diagnosis and definitive management will seize its sequence and further complications. The practical implications of an awareness of ENT tuberculosis are a benefit of anti-tubercular therapy and hence conservative management usually suffices.

Health care delivery practices in the rural part of the Yavatmal district regarding IUD insertion.

A cross-sectional survey of Cu T users in a rural area of the Yavatmal district was carried out using stratified sampling, to identify interventions that can improve intrauterine device (IUD) service provision processes and their acceptance. The average age at Cu T insertion was 23.8 years. Cu T acceptance with one child was 55.5%. 80.8% of Cu Ts were inserted within 10 days of menstruation, while there were no post-partum Cu T insertions. 51.8% Cu Ts were inserted in PHC's. At the time of the survey, 48.2% users already have their Cu T removed. Only 22.7% couples utilized some alternate contraception after Cu T removal. Post-discontinuation contraceptive use was lower in a tribal area. 30% Cu T acceptors received less than two health checkups. 78.8% (58.1% in a tribal area and 84.9% in a non-tribal area) beneficiaries received information about Cu T from health workers. Only 6.6% Cu T acceptors received specific advice of checking the Cu T string. Utilization of private facility was more common among tribals. Reach of health service regarding Cu T need to be improved in tribal areas. Health service providers need to be more proactive, especially about utilization of the immediate post-partum period for Cu T insertion, clients counseling, and follow up of users.

Transjugular liver biopsy using Tru-cut biopsy needle: KEM experience.

BACKGROUND AND AIM: Transjugular liver biopsy is accepted procedure in patients in whom percutaneous liver biopsy is contraindicated. We report our experience with this procedure, its indications, efficacy and safety in Indian population over 5 years. MATERIAL & METHODS: A retrospective study of 145 consecutive patients who had undergone transjugular liver biopsy from May 2002 to Nov. 2007 was done from the database maintained in our department. We evaluated the indications, technical success, complication and impact of histological diagnosis on the management of those patients. RESULTS: 145 Transjugular liver biopsies were performed of which 74 were males and 71 were females aged between 5 and 74 years. Two procedures were abandoned due to failed hepatic vein cannulation because of venous occlusion. Out of 143 biopsies, 4 were inadequate while 139 yielded adequate tissue for histopathological diagnosis. Histopathological examination in our study showed cirrhotic changes in 56, hepatitis including both acute and chronic in 48, periportal fibrosis in 9, Wilson's disease in 5 and obstructive cholangiopathy in 2 patients. The remaining 19 were normal. Minor complications occurred in 2 patients. CONCLUSION: Transjugular liver biopsy is a safe procedure in the trained hands and provides adequate tissue for diagnosis when percutaneous liver biopsy is contraindicated.

Active contrast extravasation in spontaneous rupture of hepatocellular carcinoma: a rare CT finding.

Spontaneous rupture of hepatocellular carcinomas are uncommon but constitute a critical and life threatening condition. Diagnosis is important so that either surgery or emergency arterial embolisation can be considered for hepatic haemostasis. We describe active extravasation of intravenous contrast medium on CT in a patient who presented with intraperitoneal haemorrhage secondary to spontaneous rupture of hepatocellular carcinoma.