Evaluation of Recurrence and Hearing Outcome for Inactive Squamosal Disease after Cartilage Strengthening Tympanoplasty

Abstract Introduction Inactive squamosal disease is unique for having a conflicting treatment protocol, with an age-old debate between early surgical intervention or keeping patients in a long-term follow-up. The shifting paradigm is early intervention to prevent further progress into active disease and improve hearing outcome in its nascent stage. Objective To evaluate recurrence and hearing outcome in cases of inactive squamosal disease after cartilage strengthening tympanoplasty. Methods The study was conducted on 50 patients with inactive squamosal disease. Detailed examination was done to grade the retraction. All patients underwent autologous conchal cartilage tympanomastoidectomy with temporalis fascia grafting. Recurrence and hearing evaluations were done by pure tone audiogram at regular intervals for one year. Results Hearing loss was the most common presenting symptom. Isolated pars tensa retractions were more common (54%) than pars flaccida (12%), or those involving both (34%). Ossicular status was normal in only 14% of the cases, and the most common ossicular damage was to the lenticular process of the incus (52%). Three of the patients (6%) had residual perforation at the 3rd month of follow-up. Subjective improvement in hearing was reported by 42% patients. Hearing improvement greater than 10 dB was found in 24 patients (48%). Air-bone gap reduced from 25.16 ± 8.15 dB preoperatively to 12.90 ± 6.20 at 1 year of follow-up. Recurrence was seen in three patients (6%). Conclusion Early intervention by cartilage strengthening of weakened tympanic membrane and ossicular reconstruction not only offers better hearing results, but also prevents progress to active disease.

Conceptual And Applied Aspect Of Agnikarma In The Purview Of Cauterization

In Ayurveda, Shalyatantra is one of the eminent branches based on six major methods of management among which Agnikarma is boon for local Vata and Kaphaja Vyadhi. Its effect can be assessed as Sthanik Karma (local action), Saarvadaihik Karma (Action throughout the body) and Vishista Karma (Special actions). Based on amount of Agni needed, the condition and site of disease, Dahanupakarana are used to produce therapeutic burns during Agnikarma Chikitsa. It can be classified according to Dravya used, site, disease, Akritiand Dhatu to be cauterized. Based on the Dagdha (Burn), it is again of four type viz. scorched burn, blistered burn, superficial burn and deep burn. Its indication is in all seasons except in summer and autumn. Indications and contraindications are well expounded in classics with detail information on Purva Karma, Pradhana Karma and Paschat Karma during Agnikarma as it is superior to every other procedure used in Ayurveda Surgery. In modern medicine, there is no use of therapeutical burn i.e., Samyak Dagdha Chikitsa but its use is in other form eg., Cauterization is used for coagulation and tissue destruction. Agnikarma is considered as the best therapy to pacify Kaphanubandha Vata Dosha because Agni possesses Ushna, Tikshna, Sukshma, Aashukari Gunas, which have anti Vataja and anti Kaphaja properties. It is done by red hot Shalaka. It gives quick relief to the patient and hence is termed as best therapy.

Savitzky-Golay Filter for Denoising Lung Sound

ABSTRACT For computerized analysis of respiratory sounds to be effective, the acquired signal must be free from all the interfering elements. Different forms of noise which can degrade the quality of lung sounds are recording artifacts, power line/Radio Frequency (RF) interferences, ambient acoustic interferences, heart sound interference etc. Such interferences adversely affect the diagnostic interpretations. Powerful denoising techniques are necessary to resolve this issue. A denoising scheme for lung sounds, based on Savitzky-Golay (S-G) filter is proposed in this paper. The order and frame length of the SG filter is determined objectively using the Signal to Noise Ratio (SNR) and computational time as objective function. Maximum SNR is observed when the frame length is nearest to the value just higher than the polynomial order. This observation holds good for different levels of simulated addictive Gaussian noise. The polynomial order of 8 and frame size of 9 are found to be promising with SNR of 10.401db at computation time of 2.1ms.

Interactions between the renin-angiotensin system and dyslipidemia: relevance in atherogenesis and therapy of coronary heart disease.

Hypertension and hypercholesterolemia, two major risk factors for atherosclerotic disease, frequently coexist in patients with hypertension and CAD. Data from clinical studies suggest the existence of lipoprotein-neurohormonal interactions that may adversely affect vascular structure and reactivity. Data from preclinical studies suggest that RAS may be upregulated by abnormal lipids, most likely via production of ox-LDL. On the other hand, activation of RAS leads to release of ROS and transcriptional upregulation of LDL and ox-LDL uptake in macrophages, smooth muscle cells and endothelial cells. These findings extend our understanding of the interplay among risk factors to synergistically increase cardiovascular risk, and of the anti-atherosclerotic effects of local ACE inhibition to reduce cardiovascular risk. Trials aimed at modifying RAS along with drugs lowering total- and LDL-cholesterol levels and inhibitors of oxidative modification of LDL-cholesterol will address the clinical relevance of this biological interaction.

Application of polymerase chain reaction (PCR) for diagnosis of equine herpes virus-1 (EHV-1).

Fifty aborted foetus samples were diagnosed for the presence of equine herpes virus-1 (EHV-1) by polymerase chain reaction (PCR) technique. Specific primer pair for amplification of a particular segment of EHV-1 DNA in gc region having 3 Hae III restriction endonuclease sites was used. A 409 base pair segment obtained as PCR amplification product in 9 samples was digested with Hae III to confirm the presence of EHV-1 as the infectious agent in aborted tissues. It was observed that PCR technique was more sensitive, specific and rapid than the conventional virological diagnostic methods.

Production of monoclonal antibodies against equine influenza A/Equi-2 (H3N8) Indian isolate.

Seven hybrid cell lines of mouse myeloma cell line NSO and spleen cells of BALB/c mice producing monoclonal antibodies (MAbs) against equine influenza A/Equi-2/Ludhiana/87 (H3N8) virus were developed. These MAbs were purified, isotyped and characterised by enzyme linked immunosorbent assay (ELISA), fluorescent antibody test (FAT), haemagglutination inhibition (HI) and virus neutralization (VN) tests. The titres of ascitic fluids induced by hybridomas as estimated by ELISA ranged from 1:25,600 to 1:51,200. Monoclonality of these clones was confirmed using a panel of 5 viral antigens, each belonging to a single isotype. MAbs (5) belonged to IgM and one each to IgG1 and IgG2a. Two epitopes appeared to be closely resembling by HI and VN tests but other two epitopes appeared to be different.