RESUMEN
Introduction: Leprosy is a chronic infectious granulomatous disease caused by Mycobacterium leprae, also known as Hansen’sdisease. The disease affects the peripheral nervous system, skin, and mucous membrane. Dissemination and transmission ofM. leprae are primarily from nasal mucosa of infected persons.Materials and Methods: A record-based retrospective observational study was done in the Department of Dermatology andENT, ASCOMS Hospital, Jammu, Jammu and Kashmir, to know the prevalence of otorhinolaryngological manifestations ofleprosy using records of 49 leprosy patients retrieved for 5 years from 2013 to 2018.Results: Forty-nine patients with 40 (82%) males and 9 (18%) females were included in the study having male–to-female ratio4.5:1. A majority of the patients (47%) were in the age group of 20–40 years. Forty-seven (96%) patients had a multibacillarytype of leprosy, while only 2 (4%) patients had paucibacillary leprosy. Seven (14%) patients showed reaction. Four (8%) showedtype I and 3 (6%) showed type II reaction. Nasal manifestations were predominantly encountered among the otorhinolaryngealmanifestations. All the otorhinolaryngeal manifestations were in the multibacillary type of leprosy. The main nasal symptomswith which patients presented were nasal stuffiness (14%), crust formation (8%), and recurrent mild epistaxis (6%). On anteriorrhinoscopy, mucosal changes (pale mucosa and edema) and nasal crusting were seen in 7 (14%) patients, atrophic conchawas seen in 3 (6%) patients and ulceration of the septal perforation was seen in 2 (4%) patients. Saddle nose deformity wasseen in 1 patient. Among the otological manifestations, two patients had erythematous nodules on pinna, while diffuse infiltrationof ear lobules was noted in five patients. Labial edema was seen in two patients and nodular lesion on the lip in one patient.Conclusion: Among the otorhinolaryngological manifestations, nasal involvement was the most commonly seen in leprosypatients. An otolaryngological examination should be routinely done in the diagnosed patients of leprosy
RESUMEN
Parathyroid glands always remain at risk of damage during the thyroid surgery as they lie in close proximity to the thyroid gland. Parathyroid glands are small endocrine glands that produce parathyroid hormone. The major function of parathyroid hormone is to maintain the level of calcium and phosphate within a narrow range in the body. Aim of the present study was to locate and identify the parathyroid glands during thyroid surgery and to observe their relationship with the surgical landmarks. The present study was a prospective study conducted in the department of otorhinolaryngology and HNS in SMGSH, GMC, Jammu for a time period of 1 year from Nov.2015 to Oct. 2016. 40 patients undergoing thyroid surgery were included in the study. Meticulous technique was employed during dissection and parathyroid glands were identified in the surgical field. Location of the each parathyroid gland was determined in relation to a nearby surgical landmark. The study included 12 right (R) and 8 left (L) hemithyroidectomies, 10 sub- total thyroidectomies and 1 total thyroidectomy. An average of 1.2 parathyroid glands were identified in hemithyroidectomies and 2.4 was the average number of parathyroid glands identified in subtotal and total thyroidectomies. Location of parathyroid glands was observed in relation to cricothyroid (CT) joint, recurrent laryngeal nerve (RLN), inferior thyroid artery (ITA) and tubercle of Zukerkandl for superior parathyroid glands, and in relation to RLN, RLN & ITA junction, tubercle of Zukerdandl & lower pole for inferior parathyroid glands. In this study RLN was the most frequent landmark for identification of superior parathyroid gland while the inferior parathyroid glands were frequently seen related to the lower pole of the thyroid gland.