Aural hygiene practices among underprivileged children of Delhi.

Background. Though ear hygiene is important for proper hearing, it is usually neglected. Improper ear care practices may have serious consequences such as loss of hearing. In childhood, loss of hearing may affect learning and development. There is scarcity of information on ear care practices in the community in India. We aimed to ascertain the magnitude of problems related to aural hygiene and assess ear care practices among children of schoolgoing age in a resettlement colony of Delhi. Methods. A cross-sectional community-based survey was done among 1398 children 5–14 years of age. The houses were selected by systematic random sampling and all eligible children in the selected house were interviewed and examined. The data were analysed using SPSS version 12 and chi-square test was used to ascertain significance between two variables. Results. Almost two-thirds (60%; 834) of the children gave a history of themselves or an elder cleaning the ear using unhealthy methods. Earbuds were used by 21.7% (304) of children. Match and broomsticks were used for cleaning by 18.3% (256) and 3% (43) of children, respectively. One hundred and fifty-nine children (11.3%) were applying oil to clean the ear canal. Ear cleaning with unhealthy means was significantly higher (56% v. 44%, p<0.03) among children belonging to low socioeconomic strata. There was a significant association between unhealthy ear cleaning practices and middle ear infection (p<0.001). Conclusion. A majority of children practised unhealthy/ not recommended methods for cleaning their ear. There is a need to raise awareness about healthy ear cleaning practices in the community. Natl Med J India 2015;28:280–1

Hearing Sensitivity in 40-60 Years Old Hypertensive Male Adults.

Declining hearing sensitivity is appreciated as a normal age related change. However, studies reveal that health variables other than age play significant role in hearing impairment over time. Hypertension is one such variable. The objective of this study was to assess whether the hypertension has an accelerating effect on age related reduction in hearing function in males in the age group of 40-60 years. Systolic and Diastolic blood pressure and Pure Tone thresholds in frequency range 250-8000 Hz were measured in 30 known hypertensive (HT) male subjects in the age group of 40-60 years and 30 age and sex-matched normotensive (NT) controls. There was no significant difference in hearing thresholds at various frequencies between HT and NT group and between uncontrolled HT (n=15) and controlled HT subgroups (n=15). However, a significantly positive correlation between the systolic blood pressure and Air conduction thresholds at 4000 Hz and 8000 Hz and Bone conduction thresholds at 4000 Hz were noted in uncontrolled HT subgroup. Results of the current study demonstrated towards the potentially negative impact of uncontrolled hypertension on the auditory function in the age group of 40-60 years.

Primary tuberculosis of tonsil and posterior oropharyngeal wall.

Pharyngeal tuberculosis is rare and usually occurs in association with primary pulmonary disease. Primary tuberculosis involving the palatine tonsils and the posterior oropharyngeal wall is still a rare clinical entity. We report one such case of primary tuberculosis involving both the palatine tonsils and the posterior oropharyngeal wall in a 22 year-old male. The patient responded to anti-tubercular treatment with complete disappearance of lesion and no sign of recurrence on one year follow-up. The final diagnosis was based upon histopathological report.

Lupus Vulgaris of external nose.

Lupus vulgaris is the most common morphological variant of cutaneous tuberculosis. In India, the most common sites of involvement are trunk and buttocks. The involvement of other sites like nose, periocular region and face, have been occasionally reported from India. This report presents an unusual case of lupus vulgaris involving the external nose. The diagnosis was confirmed on histopathology of the deep biopsy taken from an ulcerated part of the lesion. The response to six months of anti- tubercular treatment was dramatic.

Tubercular Osteomyelitis of Zygomatic bone.

A case of tubercular osteomyelitis of the zygomatic bone in a child is presented here because of its rarity and clinical interest. A high index of suspicion should be kept in mind to reach the diagnosis.

Two unusual cases of foreign body larynx.

Two adult patients of foreign body larynx who presented to us with a short history of foreign body inhalation with severe respiratory distress are being reported. They underwent elective tracheostomy preoperatively for maintenance of airway and the foreign body was removed successfully. We conclude that preoperative tracheostomy can be attempted to secure a patient's airway before resorting to removal of foreign body lodged in the larynx.

Thorny foreign bodies of upper airway.

Twenty cases of unusual thorny foreign bodies (seeds of Xanthium strumarium) in laryngo-pharynx area are reported. The aetiopathogenesis, clinical features and management are briefly discussed.