RESUMEN
Background: Sinusitis causes inflammation of the middle ear mucosa with increased and persistent mucoid/ mucopurulent discharge and remains as a active mucosal disease. Without correcting the sinusitis the management of ear including surgery has frequently led to failures and poor prognosis Objectives: To establish the role of Sinusitis as Focal sepsis in Chronic Otitis media active mucosal disease. An additional objective was to accentuate the need of proper diagnostic endoscopic evaluation and improvement in middle ear mucosal disease status after functional endoscopic sinus surgery. Material and methods: A total of 50 patients aged 18-49 years with Chronic otitis media active mucosal disease (Tubotympanic type of C.S.O.M.) patients with persistent ear discharge even following culture directed topical and systemic antibiotics with 3 months and more of ear discharge seeking care at Otorhinolaryngology outpatient department were included in this study. Results: Mean age of patients was 42.5 ± 10.6 years. 76% subjects were found having septal deviation/ turbinoseptal deformity which was the most common anatomical variant, 34% had enlarged middle turbinate, 32% had medialised uncinate, 30% had enlarged bulla, 22% had enlarged bulla with prominent agger and 18% had paradoxical middle turbinate. Of these 22 patients had the accessory ostium in the posterior fontanel and 10 patients had accessory ostium in the anterior fontanel. Majority (26, 52%) of subjects had Grade I disease i.e. minimal disease limited to Osteo Meatal Complex followed by Grade II 24% i.e. moderate incomplete opacification of one or more sinuses. On otoendoscopy, 36 patients (72%) had a large central perforation, while 14 patients (28%) had a subtotal central perforation Conclusion: A thorough diagnostic nasal evaluation of all Chronic Otitis Media active mucosal type of patients is essential in comprehensive management of the disease. Deviated nasal septum, enlarged middle turbinate, medialised uncinate predispose to sinusitis.
RESUMEN
Background: Common problems related to self medication are wastage of resources and increasing antimicrobial resistance. They generally entail serious health hazards such as adverse reaction and prolonged suffering. Aim: The study aimed to analyze the pattern, factors influencing and potential adverse effects of self-medication among the undergraduate medical students Material and methods: The present cross sectional study was carried out by the Department of Pharmacology, MSDS Medical College, Fatehgarh among the undergraduate students currently studying in a rural medical school from western Uttar Pradesh. A 25 item self administered questionnaire was administered to the students in the classrooms just after completion of classes. Time allocated for the completion of the questionnaire was 30 minutes. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Data of 256 study subjects was analyzed. Overall prevalence of self medication among study subjects was found to be 71.5% (87.6% among males and 50.5% among females). 82.5% had trust in allopathic medicine system. 81.5% students learnt self medication from doctors prescriptions provided during their prior illness. Regarding categories of drugs commonly self-prescribed, they commonly used antipyretics (81.4%), anti-tussives (72.1%) and analgesics (68.9%). ‘Illness too trivial for consultation’ was the most common (71%) reason for self-medication cited by them. Almost 69% of them were aware of possible adverse effects. 7.7% of them even experienced the side effects of self-medication. Conclusion: The study highlighted growing trend of self-medication among medical students. Policies prohibiting the supply of medicines without a valid prescription should be enforced strictly. A robust monitoring system among the physicians and pharmacists is need of an hour.
RESUMEN
Introduction: Knowledge of the normal and variant anatomy and anomalies of coronary circulation is definitely a crucial component in the management of heart diseases. Complex cardiac surgical repairs demand enhanced understanding of the basic anatomy to improve the operative Outcomes Material and methods: The present study was planned by Department of Anatomy and was executed in collaboration with Department of Internal Medicine and Cardiology during 2010 to 2014 at a tertiary care teaching hospital located in western Uttar Pradesh. The angiographic data of 5,532 patients who underwent coronary angiography were considered for anomalous origin of the left circumflex coronary artery (LCx). Results: The incidence of anomalous origin of the LCx was found to be 0.36%. The LCx arose from the left coronary sinus of valsalva (there was separate orifice for the LCx and the left anterior descending coronary artery) in 45.0% patients, from the right coronary sinus of valsalva, (there was a separate orifice for the LCx and the right coronary artery) in 25.0% patients, from the proximal part of right coronary artery in 30.0% patients. Conclusion: On the basis of findings of the current study it can be concluded that, the anomalous origin of the LCx may not be benign all the time. In case where ischemia does not resolve accurately after successful treatment of a coronary stenosis, anomalous coronary arteries must be considered.