The morphology of central tympanic membrane perforations.

The objective of this study was to assess the extent of conductive hearing loss in relation to different sizes and sites of simple central tympanic membrane perforations. Total 100 cases attending ENT OPD, BPKIHS during period of April 2003 to Mar 2004 without any discrimination of sex, race and religion were taken for the cross sectional prospective study. Dry, clean central tympanic membrane perforations due to various causes like chronic suppurative otitis media-tubotympanic, post acute suppurative otitis media residual perforations or simple traumatic perforations with conductive hearing loss and without preexisting hearing loss were clinicoaudiologically evaluated and analyzed. Hearing loss was found to be directly proportional to the size of perforation irrespective of their cause, which was statistically significant. Hearing loss in the study was found to range from negligible to 53dB. Overall, perforations involving posterioinferior quadrant were found to have maximum hearing loss.

Prevalence of otitis media in school going children in Eastern Nepal.

OBJECTIVES: To find out the prevalence of otitis media in school going children from lower socio-economic strata. MATERIAL AND METHODS: This study was carried out in a government school, Shree Naragram Secondary School in Morang district, eastern Nepal, and included 1050 children aged between 5-15 years. RESULTS: Of the 1050 school children, 346 children were found to have various ENT related problems. Hearing assessment revealed a conductive hearing loss on one or both sides in 114 cases (87%). Various middle ear pathologies were detected in these children, out of which chronic suppurative otitis media "Tubotympanic type" was the most common, followed by otitis media with effusion. The prevalence of otitis media in these children was found to be13.2% and those with hearing loss comprised 12.47%. Prevalence of otitis media is found to be much higher in school going children as compared to adults, and is even higher amongst children belonging to the lower socio-economic strata. Conditions complicating otitis media are more common and severe in children as compared to adults. CONCLUSION: Primary ear care education to teachers, students and guardians can prevent these vulnerable children from developing hearing impairment. School based study could be one of the useful and cost-effective modality aimed at community oriented program.

Time dependent immunomodulatory response of exogenous melatonin to killed Pasteurella multocida (P52 strain) vaccine in albino rats.

The effect of time of administration of exogenous melatonin (M) at the rate of 100 microg/Kg BW of rat/day for 14 days on immunomodulation to killed Pasteurella multocida (P52 strain) vaccine (KPMV) was investigated in male albino rats during spring season with photoperiod of LL 13: DD 11 h and 25 +/- 2.5 degrees C air temperature and 70 +/- 4% relative humidity. The experiment was conducted at an altitude of 172 mts above mean sea level at latitude 28.20 degrees north, longitude 79.24 degrees east (Bareilly, U.P. India). The experimental animals were divided in-groups of 8 rats each, as KPMV + M at 4.00 h; KPMV + M at 16.00 h; KPMV and their controls M4, M16, PBS respectively. Humoral immune response was monitored at weekly intervals by an indirect ELISA and cellular immunity by leukocyte migration inhibition test (LMIT) and delayed type of hypersensitivity (DTH). As evinced by in-vitro assays and in-vivo protection studies, both humoral and cellular immune responses to KPMV were augmented in rats receiving exogenous melatonin at 4.00 h as compared to slightly reduced responses in rats treated with melatonin at 16.00 h. It was concluded that the circadian timings of melatonin administration modulate immune response in rats.

Fibrocalculus pancreatic diabetes in western Orissa.

Skiagram proved 35 cases of fibrocalculus pancreatic diabetes in order to analyse the clinical profile and its correlation with different descriptive epidemiological parameters were studied. Mean age was 25.17 +/- 7.85 years and male to female ratio was 6:1; 65.7% patients were poor (income < Rs 500 per month) and another 28.6% having average income (Rs 500 to Rs 1,000 per month); 74.3% came from rural areas having a family size of about > or = 7 members and sanitation was poor in all the cases. Mean body mass index was 15.93 +/- 3. Severe diabetes (ie, fasting blood sugar level > 251 mg%) and moderately severe diabetes (ie, fasting blood sugar level > 181 mg% but < 250 mg%) were noted in 51.4% and 11.4% cases respectively. Recurrent pain abdomen, infections, neuropathy, retinopathy, nephropathy and keto-acidosis were observed in 52.2%, 40.0%, 42.9%, 8.6%, 11.4% and 2.9% cases respectively. Mean soluble insulin requirement was 41.81 +/- 13.94 units. Four cases in whom pancreatic lithotomy was done, showed less insulin requirement and disappearance of pain. Parotid swelling, chronic diarrhoea and insulin resistance were not observed. Insulin requirement, epidemiological and biochemical parameters were similar to other young diabetics.

Tetanus with local palsy.

Five cases of tetanus with local palsy are reported. They presented with palatal palsy, pseudohernia, paralysis of both lower limbs, 3rd and 7th cranial nerve palsies and only 7th nerve palsy. Except the last tetanus became generalised in all.