The-pattern-of-cut-throat-injuries-early-management-and-outcomea-prospective-study-in-a-tertiary-care-hospital

Objective: To analyze pattern, sex and age ratio, common causes, the most common site and extent of the injury in the patients with cut throat injury at our hospital. To compare the same with previous similar studies conducted at other centers in different parts of the world. Also to note the early management and outcome in our study. DepartmentSetting: of ENT and Head and Neck Surgery, Gauhati Medical college and Hospital, Guwahati, from January 2022 to January 2023. Methods: A total of 60 cases of cut throat injury were included in our study. Proforma was prepared to collect data. Results: 60 cases of cut throat injury patients were included in the study. Out of 60 cases 51 were males and 9 were females. Simple primary wound closure was done in 58 cases and 2 required secondary wound repair. In 20 patients, tracheostomy with primary repair was done. 32 patients needed psychiatric consultation. In our study,Conclusion: majority were males between 20 years to 40 years from lower middle socioeconomic status. Early and improved management will reduce the mortality and morbidity.

Use of complementary and alternative medicines in ENT outpatient department of tertiary care hospital in Southern Rajasthan

Background: Complementary and alternative medicine (CAM) use is highly gaining popularity along with main treatment streams these days. Physicians cannot ignore this fact and should question and counsel patients about pros and cons of CAM for cure of different ailments. Aim and Objectives: The objective of the study was to know about use of CAM among patients visiting Ear, Nose, and Throat (ENT) outpatient department (OPD) in tertiary care hospital of Southern Rajasthan. Materials and Methods: An observational cross-sectional study was conducted in ENT OPD for 2 months. Two hundred and fifty patients were considered for the study. Semi-structured questionnaire was prepared and made to be filled by the patients during their visit to ENT OPD after taking informed consent. Various questions were asked like extent of use of alternative therapies, type of CAM used by the patients, patient’s knowledge about ADRs and drug interactions, reasons for which alternative medicine might have been used. Results: Among 250 patients, CAMs were used by 36 patients. The most common CAMs were either Ayurveda or Homoeopathy medicines or both. The majority of patients obtained their information from family and friends. Maximum patients used these alternative medicines for relief of cough and hoarseness of voice. Conclusion: The study throws light on use of alternative drug therapy and streams of medicine along with routine hospital treatment among patients visiting ENT OPD. This knowledge helps to understand about patients’ alternative approach to diseases, about self-medication, patient’s belief about different types of therapies and also ignorance of possible health hazards, side effects, and complications due to use of concomitant main and alternative medicines for treatment purposes.

Usage of Surgical Antibiotic Prophylaxis in Routine Otolaryngologic Surgeries in Turkey

Abstract Introduction: Inappropriate antibiotic use in the world leads to an increase in both health care costs and antibiotic resistance. Surgical antibiotic prophylaxis (SAP) is used by most surgeons, especially in the postoperative period. Objective The aim of the study is to determine the approach of ear, nose, and throat (ENT) specialists to surgical antibiotic prophylaxis in routine surgeries, and to raise awareness regarding inappropriate antibiotic use. Methods ENT specialists from all over Turkey participated in the study by filling out a data collecting form. The form consisted of 6 questions and was sent to specialists via email. Routine ENT operations such as adenoidectomy, tonsillectomy, adenotonsillectomy, ventilation tube application, septoplasty, rhinoplasty, septorhinoplasty (non-complicated), tympanoplasty, and simple mastoidectomy were chosen for the study. Data were analyzed statistically. Results The form results of 110 ENT specialists were evaluated. The rate of participants who used and did not use SAP was 77.3% and 22.7%, respectively. The SAP usage rates of septoplasty, rhinoplasty, and septorhinoplasty operations were 84.7%, 81.2%, and 75.3%, respectively. For tympanoplasty and ventilation tube application operations, the rates were 82.4% and 24.7%, respectively. Finallly, the SAP usage rates of adenoidectomy, tonsillectomy, and adenotonsillectomy were 57.6%, 75.3%, and 72.9%, respectively. Conclusion Otolaryngological surgeries are often classified as clean or clean-contaminated surgeries. In most studies in the literature, it is reported that SAP use is unnecessary in routine otolaryngological surgery. Providing inservice training, regularly updating the prophylaxis guidelines and sharing these guidelines with surgeons may prevent inappropriate SAP use.

A cross-sectional study of enterovirus nucleic acid test with throat swabs for term late neonates during coronavirus disease 2019 / 中国当代儿科杂志

OBJECTIVES@#To investigate the positive rate of enterovirus (EV) nucleic acid in throat swabs of term late neonates hospitalized during the coronavirus disease 2019 (COVID-19) epidemic and the clinical characteristics of the neonates.@*METHODS@#A single-center cross-sectional study was performed on 611 term late infants who were hospitalized in the neonatal center from October 2020 to September 2021. Throat swabs were collected on admission for coxsackie A16 virus/EV71/EV universal nucleic acid testing. According to the results of EV nucleic acid test, the infants were divided into a positive EV nucleic acid group (8 infants) and a negative EV nucleic acid group (603 infants). Clinical features were compared between the two groups.@*RESULTS@#Among the 611 neonates, 8 tested positive for EV nucleic acid, with a positive rate of 13.1‰, among whom 7 were admitted from May to October. There was a significant difference in the proportion of infants contacting family members with respiratory infection symptoms before disease onset between the positive and negative EV nucleic acid groups (75.0% vs 10.9%, P<0.001). There were no significant differences between the two groups in demographic data, clinical symptoms, and laboratory test results (P>0.05).@*CONCLUSIONS@#There is a certain proportion of term late infants testing positive for EV nucleic acid in throat swabs during the COVID-19 epidemic, but the proportion is low. The clinical manifestations and laboratory test results of these infants are non-specific. Transmission among family members might be an important cause of neonatal EV infection.

Post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.@*METHODS@#Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.@*RESULTS@#Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (P<0.01), and the values of the observation group were lower than those of the control group after treatment (P<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (P<0.05).@*CONCLUSION@#The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.

Quality Marker （Q-marker） of Tinosporae Radix Associated with Efficacy of "Relieving Sore Throat" / 中国实验方剂学杂志

ObjectiveTo study the potential quality marker （Q-marker） of Tinosporae Radix associated with efficacy of "relieving sore throat" based on ultra-performance liquid chromatography-quadrupole time-of-flight mass spectrometry （UPLC-Q-TOF-MS）， multivariate statistical analysis （MSA）， and network pharmacology. MethodUPLC-Q-TOF-MS was used to identify the main chemical components in 18 batches of Tinosporae Radix. On this basis， principal component analysis （PCA） and orthogonal partial least squares-discriminant analysis （OPLS-DA） were employed to screen out the main marker components that caused differences between groups. Moreover， network pharmacology technology was applied to predict the potential "sore throat-relieving" components， and the molecular docking between the common components resulting from MSA and network pharmacology and the core targets was carried out to verify the marker components. ResultA total of 17 compounds， including alkaloids， diterpenoid lactones， and sterols， were identified by UPLC-Q-TOF-MS. Five main differential components were found by MSA： Columbamine， jatrorrhizine， palmatine， menisperine， and columbin. Network pharmacology analysis yielded six compounds： tetrahydropalmatine， palmatine， menisperine， fibleucin， neoechinulin A， and columbin which were selected as potential "sore throat-relieving" components of Tinosporae Radix. They may relieve sore throat by acting on interleukin-6， epidermal growth factor receptor， prostaglandin G/H synthase 2， matrix metalloproteinase-9， proto-oncogene tyrosine-protein kinase Src and other targets， and regulating Hepatitis B， influenza A， human T-cell virus infection， human cytomegalovirus infection， coronavirus disease-2019， and other signaling pathways. The common active components in Tinosporae Radix resulting from MSA and network pharmacology analysis were palmatine， menisperine， and columbin， which had high binding affinity with six core targets and can be used as the Q-marker components of Tinosporae Radix in "relieving sore throat". ConclusionThis study predicts the "sore throat-relieving" Q-marker of Tinosporae Radix， which lays a basis for developing the quality standard of Tinosporae Radix based on the efficacy and improving the quality evaluation system of the medicinal.

Drug utilization pattern in ENT outpatient department in tertiary care teaching hospital in Southern Rajasthan

Background: Drug utilization study is one of the most potent tool to promote rational drug use in medical, social, and economic scenario. Very less or no study has been done in Southern Rajasthan, hence this study shows valuable insights in Drug Utilization pattern. Aim and Objectives: To evaluate the drug utilization pattern in ear, nose and throat (ENT) outpatient department (OPD) in M.B. government hospital, Udaipur, Rajasthan. Materials and Methods: A prospective observational study was done in ENT OPD for a period of 9 months. Total 445 prescriptions were taken into consideration. All patients of the age group 18 years and above were included in the study. Results: Of total 445 cases, maximum number of patients (7.19%) suffered from bilateral chronic suppurative otitis media and minimum (2.02%) from eustachian tube block. A total number of drugs prescribed were 60. Maximum utilized drug was ibuprofen and minimum was Acyclovir. Mean number of drugs prescribed were 2.615. Maximum drugs were given by oral route and minimum as gargles. Total prescribed drugs were 1164. Most common prescribed drug group was NSAIDS (23.19%). Total cost of therapy was 58,584, cost per patient was122.6. Prescribed daily dose/defined daily dose ratio was calculated for antibiotics. Conclusion: Study shows rational drug prescribing. Account of Alternative medicine was taken in consideration, isolation of microorganisms prior drug prescribing was not done.

Two Cases with Foreign Body Sensation of the Throat Treated with Ryokeijutsukanto and Goshuyuto / 日本東洋医学雑誌

The patients with foreign body sensation in the throat often visit the hospital. However, they have no problem in Western medicine and may be prescribed with anxiolytics. In Kampo medicine, hangekobokuto is effective in most cases for the symptom of qi stagnation. This time, we report that 2 cases, in which hangekobokuto was ineffective, responded to the combination of ryokeijutsukanto and goshuyuto. The combination, which is a mixture of hontonto (Zhouhou fang), bukuryo, jutsu, and taiso, excluding hange, was effective in these 2 cases as running piglet.

Association between voice symptoms and college professors' home working conditions during online classes in times of COVID-19 pandemic / Asociación entre síntomas vocales y condiciones de trabajo en casa durante las clases online en tiempos de COVID-19 de docentes universitarios

Introduction. Due to the COVID-19 pandemic, teaching conditions changed around the world from in-person classes to online classes, which also determined changes on teachers' working conditions. Method: Exploratory cross-sectional study with the aim of determining the association between two voice symptoms (vocal fatigue and throat pain) with home working conditions during online classes in times of COVID-19 pandemic. Professors answered an online survey including 27 questions about four components: sociodemographic factors, characteristics of home working, quarantine characteristics, and health conditions (including voice functioning). Results: 177 college professors from Argentina, Colombia, and Chile participated in this study. First, incidence of vocal fatigue, during online classes in times of COVID-19 pandemic, represented around 50%. Although throat pain had a smaller incidence, it was also important (35%). Second, days in quarantine, number of classes per week, people living with during quarantine, and history of vocal fatigue before quarantine were important associated factors of vocal fatigue. Third, important associated factors of throat pain were number of classes per week, level of stress, years of experience, and history of throat pain before quarantine. Conclusion: Similar to pre-COVID-19, vocal fatigue and throat pain were frequently reported voice symptoms among college professors. Associated factors of these symptoms included years of experience, number of classes per week, stress, people living with during quarantine due to COVID-19, and history of voice symptoms. Workplace Health Promotion programs should include activities that facilitate a healthy occupational voice use during and post-COVID-19 pandemic, considering the implications of online teaching on teachers' health and safety

Introducción: Debido a la pandemia del COVID-19, las condiciones de ense-ñanza-aprendizaje cambiaron alrededor del mundo, pasando de clases presen-ciales a clases virtuales, lo que también determinó cambios en las condiciones de trabajo docente. Métodos: Estudio transversal exploratorio que tuvo como propósito determinar la asociación entre dos síntomas de voz (fatiga vocal y dolor de garganta) con las con-diciones de trabajo docente durante las clases virtuales en tiempos de COVID-19. Los profesores diligenciaron una encuesta virtual que incluyó 27 preguntas sobre los siguientes cuatro componentes: factores sociodemográficos, características del tra-bajo en casa, características de la cuarentena, y condiciones de salud (incluyendo funcionamiento vocal). Resultados: 177 profesores universitarios de Argentina, Colombia y Chile parti-ciparon en este estudio. Primero, la incidencia de la fatiga vocal durante las clases virtuales en tiempos de COVID-19 representó alrededor del 50%. Aunque el dolor de garganta tuvo una menor incidencia, también fue importante (35%). Segundo, los días en cuarentena, número de clases por semana, personas con las que vivió durante la cuarentena, y los antecedentes de fatiga vocal antes de la cuarentena estuvieron estadísticamente asociados a la fatiga vocal. Tercero, los factores asociados al dolor de garganta fueron el número de clases semanales, los niveles de estrés, los años de experiencia y los antecedentes de dolor de garganta antes de la cuarentena.Conclusión: Similar a hallazgos previos al COVID-19, la fatiga vocal y el dolor de garganta son síntomas vocales frecuentemente reportados en docentes universitarios. Factores asociados de estos síntomas incluyen años de experiencia, número de clases semanales, estrés, personas con las que vivió durante la cuarentena y antecedentes de estos síntomas vocales antes del trabajo en casa. Los Programas de Promoción de la Salud en los Lugares de Trabajo deben incluir actividades que faciliten el uso ocupacional saludable de la voz durante y después del COVID-19, considerando las implicaciones de la enseñanza virtual en la salud y seguridad de los profesores.

Caractéristiques de l'automédication en ORL à l'Hôpital d'Instruction des Armées-Cotonou au Bénin / Characteristics of self-medication in ENT at Military Teaching Hospital Cotonou in Benin

Etudier l'ampleur et les caractéristiques de l'automédication en consultation ORL. Méthode: Etude descriptive du 1er juin 2020 au 1er février 2021 dans le service d'ORL-CCF/ Hôpital d'Instruction des Armées. Ont été inclus tous les patients reçus en consultation ORL ayant déclaré avoir utilisé des substances actives sans prescription médicale pour soulager leur plainte actuelle. 6 Résultats: L'automédication a été retrouvée chez 373 patients soit une prévalence de 47,88%. La moyenne d'âge était 32,26 ans (02 mois et 80 ans). Les sujets âgés 0 à 20 étaient plus représenté (68,4%). La sex-ratio était de 0,86. Les professions libérales étaient plus représentées (30%). La quasi-totalité des patients (98%) a pu énumérer au moins deux effets nocifs de l'automédication. Les médicaments en cause étaient les médicament en vente libre OTC (80%). Les principales raisons ayant motivé l'automédication ont été le coût élevé des prestations médicales (41,3%) et le manque de temps (33,2%). Conclusion: L'automédication a été retrouvée chez des patients volontiers jeunes, de sexe féminin, porteurs d'affections rhinologiques. Les OTC étaient en cause dans huit cas sur dix. Les principales motivations à l'automédication ont été le coût élevé des prestations médicales et le manque de temps.

Clinical analysis of 252 children with Epstein-Barr virus infection / 中国基层医药

Objective:To investigate the clinical manifestations of Epstein-Barr virus infection in children and the efficacy of interferon combined with ganciclovir.Methods:A total of 252 children with Epstein-Barr virus infection who received treatment in Liaocheng Maternal and Child Health Hospital from June 2018 to February 2020 were included in this study. They were randomly assigned to undergo treatment either with ganciclovir alone (control group, n = 126) or interferon combined with ganciclovir (experimental group, n = 126). General condition, clinical manifestation, clinical outcomes, and clinical efficacy were compared between the two groups. Results:The 252 children with Epstein-Barr virus infection were divided into four groups according to different age brackets: infancy (3.97%), early childhood (53.57%), preschool (28.97%), school age (13.49%). Children at the early childhood and preschool ages accounted for high proportions. Their clinical manifestations included fever, pharyngeal congestion, cervical lymph node swelling, and pharyngeal pain. Children with hepatosplenomegaly accounted for the highest proportion (44.12%) among those at the school age, and children with binocular edema accounted for the highest proportion (10.37%) among those at the early childhood age. The time to defervesce, eyelid edema, and lymph node regression in the experimental group were (3.55 ± 1.58) hours, (3.82 ± 1.17) hours, and (9.55 ± 1.60) hours respectively, which were significantly shorter than those in the control group [(4.40 ± 1.80) hours, (5.33 ± 1.58) hours, (10.44 ± 1.66) hours, t = 3.64, 2.47, 2.67, P < 0.001, P = 0.024, 0.009]. The total response rate was significantly higher in the experimental group than in the control group [96.03% (107/126) vs. 84.92% (121/126), χ2 = 9.03, P = 0.003]. Conclusion:Epstein-Barr virus infection has different clinical manifestations in children at different ages. Interferon combined with ganciclovir is more effective on Epstein-Barr virus infection than ganciclovir alone.

SHENG Can-ruo's experience in treatment of goiter with integrated acupuncture and herbal medication / 中国针灸

The paper introduces professor SHENG Can-ruo's experience in treatment of goiter with the combination of acupuncture and herbal medication. Professor SHENG believes that this disease is mostly related with emotional injury, improper diet and geographical and climatic factors, as well as body constitution. Qi stagnation, phlegm retention, blood stagnation and interaction of phlegm and stasis are the essential pathogenesis of goiter. Either acupuncture or herbal medication should focus on "phlegm and stasis" in treatment. Besides, the theory of western medicine should also be considered. In western medicine, thyroid enlargement is classified into Ⅰ, Ⅱ and Ⅲ degrees of struma, thus, the pathogenesis and treatment with Chinese medicine should be adjusted accordingly. The created "four throat points", combined with acupuncture at distal points, relieve the local masses. The basic herbal formula is prepared and the couplet medicines are modified based on syndrome differentiation. The integrated acupuncture and herbal medication regulates emotions and provides a comprehensive treatment for goiter.

Ossification of bilateral stylohyoid ligament with Bell facial paralysis: a case report and literature review / 口腔疾病防治

Objective @# investigate the correlation between the ossification of the styloid hyoid ligament and Bell’s facial paralysis and provide a reference for clinical diagnosis and treatment.@* Methods@# A case of ossification of the bilateral stylohyoid ligament with Bell's facial palsy caused by ossification of the bilateral stylohyoid ligament was diagnosed by clinical manifestations, differential diagnosis and imaging examination. The surgical plan was determined, and combined surgical resection of the ossified area of the styloid hyoid ligament and the greater horn of the hyoid was performed. Postoperative cefoxitin sodium anti-inflammatory treatment, methylprednisolone hormone treatment, acyclovir antiviral treatment, mecobalamin nutritional neurotherapy, and the relevant literature were analyzed. @* Results@# The patient experienced pain when swallowing before surgery, disappearance of right frontal ridges, incomplete eyelid closure, and ptosis of mouth corners. An MRI scan of the brain excluded intracranial space-occupying lesions and resulted in the diagnosis of Bell’s facial paralysis. High-resolution CT of the styloid process confirmed ossification of the styloid hyoid ligament. Styloid process shortening and partial hyoid resection were performed under general anesthesia. Half a month after discharge, the symptoms of sore throat and pain in swallowing disappeared, facial nerve function recovered well, right eyelid closure function recovered well, and right mouth droop improved. The facial nerve function basically returned to normal after 1 month of follow-up. A review of the relevant literature showed that ossification of the stylohyoid ligament to form pseudojoint dilation can locally stimulate the peripheral facial nerve and lead to facial paralysis symptoms. @*Conclusion@# Ossification of the styloid hyoid ligament is usually characterized by pharyngeal pain, which can be confirmed by imaging examination. Ossification of the styloid hyoid ligament with facial paralysis is rare in the clinic, so it is necessary to make a clear diagnosis and treat the symptoms.

Effect of dexamethasone combined with oxybuprocaine hydrochloride gel on prevention of postoperative sore throat after nasal endoscopy / 北京大学学报(医学版)

OBJECTIVE@#To explore the effectiveness and feasibility of dexamethasone combined with oxybuprocaine hydrochloride gel on the prevention of postoperative sore throat after nasal endoscopy.@*METHODS@#In the study, 60 patients with American Society of Anesthesiologist (ASA) physical statuses Ⅰ to Ⅱ, aged 18 to 72 years, scheduled for elective nasal endoscope surgery under general anesthesia requiring endotracheal intubation were randomly divided into dexamethasone combined with oxybuprocaine hydrochloride gel group (G group, n=30) and control group (C group, n=30). The patients in the G group received dexamethasone 0.1 mg/kg before induction and the oxybuprocaine gel was applied to the endotracheal catheter cuff and the front end within 15 cm. The patients in the C group received the same dose of saline and the saline was applied to the endotracheal catheter cuff and the front end within 15 cm. Then, all the patients in the two groups received the same induction and anesthesia maintainance. The operation time, anesthesia time, emergence time, extubation time and departure time were recorded. The intraoperative infusion volume, blood loss volume, propofol, remifentanil, rocuronium dosage were also recorded. The adverse reactions such as intraoperative hypotension, bradycardia and postoperative agitation were recorded. The postoperative sore throat score was recorded at the end of operation and 4 h, 8 h, 12 h, and 24 h after operation.@*RESULTS@#Compared with the C group, the emergence time [(8.4±3.9) min vs. (10.8±4.7) min], extubation time [(8.8±3.7) min vs. (11.9±4.8) min], and departure time [(20.0±5.3) min vs. (23.0±5.8) min] were significantly shorter, and the propofol dosage [(11.8±1.8) mg/kg vs. (15.9±4.6) mg/kg], remifentanil dosage [(10.9±4.7) μg/kg vs. (14.1±3.6) μg/kg] were significantly less in the G group, and there was no difference of rocuronium dosage in the two groups. Compared with the C group the incidence of intraoperative hypotension [10%(3/30) vs. 30%(9/30)], bradycardia [16.7%(5/30) vs. 20%(6/30)] and postoperative agitation [6.7%(2/30) vs. 23.3%(7/30)] were significantly lower in the C group. The postoperative sore throat score at the end of operation, 4 h, 8 h, 12 h and 24 h after operation in the G group were significantly lower than in the C group respectively [0 (0, 1) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (1, 2), 0 (0, 0) vs. 1 (0.75, 1), 0 (0, 0) vs. 1 (0, 1)].@*CONCLUSION@#Dexamethasone combined with oxybuprocaine hydrochloride gel was effective and feasible on the prevention of postoperative sore throat after nasal endoscopy.

Determination of the antimicrobial property of oregano (Plectranthus amboinicus (Lour.) Spreng.) crude aqueous leaf extract against throat pathogens using broth and checkerboard dilution methods

@#<p style="text-align: justify;"><strong>Objective:</strong> This study aimed to determine the antimicrobial property of oregano (Plectranthus amboinicus) crude leaf extract against pathogens that infect the throat, specifically Streptococcus pyogenes and Candida albicans using the broth and checkerboard dilution methods.</p><p style="text-align: justify;"><strong>Methods:</strong> This study employed an experimental study design using broth dilution method for the determination of the minimum inhibitory concentration (MIC), minimum bactericidal concentration (MBC) against Streptococcus pyogenes ATCC 19615, and minimum fungicidal concentration (MFC) against Candida albicans ATCC 14053 of P. amboinicus crude extract (PA extract). Checkerboard dilution method was then used for determination of the synergy between PA extract and the standard antimicrobials.</p><p style="text-align: justify;"><strong>Results:</strong> In vitro growth inhibition of S. pyogenes (MIC 0.13 g/mL) and C. albicans (MIC 0.03 g/mL) was exhibited by the PA extract. The highest concentration of PA extract used in this study was not sufficient to demonstrate bactericidal and fungicidal activity (MBC >0.25 g/mL, MFC >0.25 g/mL). Results of checkerboard dilution method revealed that PA extract when combined with either penicillin (for S. pyogenes) or nystatin (for C. albicans) demonstrated indifference.</p><p style="text-align: justify;"><strong>Conclusion:</strong> The crude extract of Plectranthus amboinicus has the capability to inhibit the growth of both S. pyogenes and C. albicans. This demonstrates its potential use in the treatment of throat infections caused by these organisms.</p><p style="text-align: justify;"><strong>Key Words:</strong> Plectranthus amboinicus, oregano, antimicrobial, throat infections, herbal medicine</p>

A Prevalence Study of Pharyngitis and Its Associated Factors Among Adults With a Sore Throat in Three Primary Clinics in Selangor, Malaysia

@#Introduction: Since pharyngitis in adults is one of the most common infectious diseases seen in general practitioner consultations in Malaysia, data on pharyngitis among adults concerning to its prevalence, socio-demographic, risk factors and clinical manifestations is very much lacking. This study aims to determine the prevalence of pharyngitis among adults in Sepang, Selangor, Malaysia from 2016 to 2017 and its associated demographic and risk factors. Methods: We conducted a cross-sectional study on 215 adult patients with a sore throat as the main symptom and who did not receive any antibiotic treatment within two weeks at three Malaysian primary care clinics. The researchers assessed the participants’ clinical manifestations and collected throat swabs for culture to determine the presence of group A streptococcus (GAS). Data on demographic characteristics, clinical manifestation and throat swab culture results were analyzed using chi-square test and multivariate logistic regression. Results: Pharyngitis was diagnosed in 130/215 (65%) adults with a sore throat. Only six isolates (2.8%) were identified as GAS. The overall mean age ± S.D was 36.43 ± 15.7. The majority of the participants were in the age group of 18-28 years. There were 42.3% males and 57.7% females; most participants were Malay 62.8%, followed by 30.2% Indian, 5.1% Chinese, and 1.9% other ethnicities. The most common symptom among the participants was cough 196 (91.2%), followed by rhinorrhea 161 (74.8%), tonsillar swelling or exudates 68 (31.6%), inflamed or reddish of pharynx 62 (28.8%), swollen anterior cervical lymph nodes 50 (23.3%), and fever ≥37.5°C 28 (13.0%). Conclusion: Besides, there was no significant association between pharyngitis and the demographic variables; the current findings emphasized that inflamed or reddish pharynx, tonsillar swelling or exudates were among the factors associated with pharyngitis.

Therapeutic effects study on the contents of dihydromyricetin in ampelopsis grossedentata from different places and their compatibility with fructus arctiine / 药学实践杂志

Objective To study the content differences of Dihydromyricetin in Ampelopsis grossedentata from different origins, parts and processing techniques, and improve the therapeutic effects by optimizing the compatibility of Ampelopsis grossedentata with Fructus arctiine. Methods The HPLC separation of Dihydromyricetin was performed on an Agilent ZORBAX SB-C18 column with methanol, 0.05 % phosphoric acid (30∶70) as the mobile phase. The flow rate was 1 ml/min, the detection wavelength was 291 nm, and the column temperature was 25 °C. Compatibility efficacy verification was performed with the inflammation model caused by cotton ball implantation in rats and ear swelling in mice. The net granulomatosis in the rats with cotton ball implantation and the swelling rate of mouse ears were recorded. Results Dihydromyricetin had a good liner recovery between 0.019 9-0.318 mg/ml (r=0.999). The extracted recovery was in the range of 95.04 %-100.4 %. The sample was stable within 24 h. This method had good repeatability. The combination of optimized high-dose Ampelopsis grossedentata with Fructus arctiine resulted in significantly lower net granuloma in rats and ear swelling rate in mice compared to the blank control group. Conclusion This method is simple and accurate. The content of dihydromyricetin varies greatly with different origins, parts, and processing techniques. Among them, the natural sun-dried vine tea in Jiangkou County, Guizhou Province has the highest content. The combination use of Ampelopsis grossedentata and Fructus Arctiine can significantly alleviate the pharyngeal symptoms, reduce the degree of inflammation, and achieve the therapeutic effect of clearing pharynx.

A Case of Cut Throat and Penis

Aims: The management of cut throat injuries with genital self-mutilation is very challenging due to the complex anatomy of the neck and the need to attain acceptable cosmetic and functional outcomes of penile reconstruction. This report thus seeks to highlight the importance of a multidisciplinary approach to the management of these cases and to raise awareness of the need for early suspicionanddiagnosis of mental diseases especially among young people.Presentation of Case: We present an 18-year old newly diagnosed paranoid schizophrenic man who presented with cut throat and penis after an attempted suicide and was successfully managed at our facility. The family had not suspected any mental disorder. He had repair of the cut throat (involving both trachea and esophagus) after elective tracheostomy, refashioning of the penile stump and psychiatric treatment.Discussion: Cut throat injuries happen in cases of attempted suicide and among patients with psychiatric problems. Cases of cut throat and genital self-mutilation though rare, have been reported among schizophrenics. Some of such individuals have an impression that destroying their genitals could help them overcome their excessive sexual desires and for others to help them remain righteous.Our patient wasdiagnosed of schizophrenia after he attempted suicide.Conclusions: Young people with mental illness must be identified and given appropriate treatment early. Patients presenting with cut throat and penis require a multidisciplinary team approach involving at least an otorhinolaryngologist, a urologist, a general/gastrointestinal surgeon and a psychiatrist for optimum care

Comparative study of prophylactic dexamethasone versus placebo for reducing post-operative sore throat after tracheal intubation: a prospective, randomised, double blinded clinical study

Background: Tracheal intubation for elective surgical procedures can result in pathological changes, trauma and nerve damage which may account for postoperative sore throat, hoarseness and cough. Dexamethasone is a very potent long acting glucocorticoid with analgesic, anti-inflammatory and antiemetic effects which helps to reduce post-operative sore throat.Methods: A prospective double blinded randomized study was conducted involving 80 patients, dividing them into 2 groups. Group D received dexamethasone 0.1 mg/kg and group S received an equivalent volume of normal saline (placebo) intravenously before induction. Intubation was performed by an experienced anesthesiologist. Anesthesia induction and maintenance dosage were standardized for all patients. The incidence and severity of sore throat, hoarseness and cough were recorded at 1, 6 and 24 hours postoperatively by using four-point scale.Results: The overall incidence of sore throat and hoarseness was significantly reduced in dexamethasone group compared to placebo (normal saline) group. Incidence and severity of sore throat and hoarseness were assessed at 1 hour, 6 hours and 24 hours interval and found out that they were reduced in dexamethasone group compared to placebo group which was statistically significant at all intervals. But incidence and severity of cough reduced significantly only in the first hour. It was comparable at 6 and 24 hours between the groups.Conclusions: Dexamethasone was effective in reducing the incidence and severity of sore throat and hoarseness at 1, 6 and 24 hours. Incidence of postoperative cough was reduced significantly at 1 hour in the dexamethasone group.

A Rare Case Report on the Role of Anaesthetist in Management of Homicidal Cut Throat Injury

Homicidal cut-throat injuries are potentially life threateningbecause of the many vital structures that course through thisarea. Management of homicidal cut-throat injuries requires amulti-disciplinary approach. The role of an anesthesiologist ininstituting an airway using an endotracheal intubation ortracheostomy before wound exploration and repair oftransected tissues, is challenging, as, such injuries are most ofthe time associated with distortion of the normal anatomy ofthe airway. Anaesthesiologist is pivotal in securing a definitiveairway in such cases thereby facilitating the wound explorationand surgical repair. We present a patient who was the victimof a homicidal cut-throat injury.