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Nasopharyngeal carcinomas (NPCs) are one of the most chemo- and radio- sensitive cancers of the head and neck region. It differs from other head and neck cancers in terms of signs and symptoms, treatment response and overall survival. Surgery is not the preferred treatment option, with chemoradiation being the treatment of choice, with an excellent local control rate, prognosis and overall survival. But the management of recurrent NPC is quite challenging and the treatment options available includes re-irradiation, chemotherapy, brachytherapy or surgery in rare cases. Re-irradiation in case of recurrent NPC is very difficult due to the already irradiated tissue in the radiation path, but re-irradiation with brachytherapy is an excellent treatment option for giving further doses of radiation to the nasopharynx in cases of recurrence or residual disease, by taking in consideration the already irradiated area and the radiation dose given before, and achieving a good local control rate and overall survival.
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Objectives:As a part of an ongoing research programme on vector-borne viral diseases especially Dengue, a retrospective analytical study on the occurrence and distribution of Dengue virus serotype(s) in the state of Manipur – a small state situated in the northeastern region of the Indian subcontinent was carried out at Viral Research & Diagnostic Laboratory (VRDL), Department of Microbiology, Regional Institute of Medical Sciences (RIMS), Imphal which is a tertiary care hospital.Materials & Methods:A total of 914 blood samples from clinically dengue-suspected patients were screened for the presence of Dengue infection by adopting the ELISA (IgM) technique during the period from 01/06/2022 to 02/12/2022. Further, anti-Dengue IgM antibody-positive samples having high Optical Density (OD) value(s) were selected and subjected to RT PCR to determine the serotype(s) of the Dengue virus.Results:Of the 914 blood samples examined for the presence of Dengue infection, 111 (12.14%) were found positive for anti- Dengue IgM antibody indicating acute infection of Dengue virus.Of the positive patients, there were 56 (50.45%) males and 55 (49.54%) females.Predominant clinical features observed among the Dengue-confirmed patients included – fever (74%), headache (19%), arthralgia / joint pain (9%), myalgia (6%) and vomiting (6%) respectively.The study revealed that while the circulation of three (03) Dengue virus serotypes, namely DENV – 1, DENV – 2 & DENV – 3 were observed in the Tengnoupal district,the circulation of two Dengue virus serotypes i.e., DENV – 1 & DENV – 2 was evident in Imphal West & Bishnupur districts respectively.The present study also reveals the occurrence of Dengue virus serotype – 1 (DENV - 1) in Churachandpur district. Conclusion:The present study reveals the circulation/distribution of three Dengue virus serotypes namely, DENV – 1, DENV – 2 and DENV – 3 among the studied samples.
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Background: The MTP (Amendment) Act 2021 has allowed termination of pregnancy up to 24 weeks on only certain indications. Decision of two medical practitioners are required for termination beyond 20 weeks. Misoprostol is one drug used for medical termination of pregnancy. It can be used alone in single or multiple doses, or in combination with other drugs. The study was undertaken to determine the efficacy of a single dose of 800 ?g of misoprostol in the first trimester pregnancy termination.Methods: It was a cross-sectional study conducted among 124 women in the first trimester who were undergoing termination of pregnancy. After administering 800 ?g of misoprostol vaginally, participants were kept under observation for 48 hours. Data were collected and analysed.Results: Around half of the participants (56.4%) expelled the conceptus completely by 12 hours, 78.2% by 48 hours. Seven (5.6%) out of those 27 failed cases were given further doses of misoprostol, while in the remaining 20 (16.1%), surgical intervention was undertaken.Conclusions: The efficacy of a single dose of misoprostol for 1st trimester termination of pregnancy varies widely from study to study, but, the efficacy increases with adding further doses of the same drug or addition of mifepristone. Misoprostol is a safe, cost effective, and reasonable drug for the termination of pregnancy in first trimester.
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Brinjal is an important vegetable crop grown in India, Asia, and many parts of the world. The primary objective of brinjal breeding is to develop varieties that are resistant to pests and diseases, have higher yields, and better fruit quality. In this study, 10 brinjal varieties were crossed to obtain F1’s hybrids. The F1’s were evaluated for yield and yield-related characters. The results showed a wide range of variation for all characters. The estimates of heritability in F1 varied from 45.43% (number of primary branches per plant) to 97.69% (Average Fruit weight). The genetic advance percent over mean for F1 varied from 6.25 % (Number of primary branches per plant) to 62.16 % (Average Fruit weight). Seven characters showed high performance viz. Average Fruit weight (62.16%) , Number of Fruit per Plant (50.37%), Fruit yield per plant (49.37), Fruit circumference (35.18), Plant height (32.77), Number of Secondary branches per plant (29.14%) and Fruit length (27.11%); three medium performance viz. Days of 50% Flowering after transplanting (18.09), Days of First Fruit harvest after transplanting (15.35) and Fruit T.S.S (11.92%); one low performance i.e., Number of primary Branches per plant (6.25%). The PCV was higher than GCV indicate the role of environment in performance of characters while value of both have narrow difference indicate the mainly genetic factors is responsible for the performance of the characters of genotypes.High heritability coupled with high genetic advance was found for yield and yield attributing characters, which indicates that selection for these traits will be effective.
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A study was conducted at the Student Instruction Farm, Chandra Shekhar Azad University of Agriculture and Technology, Kanpur, during the rabi season of 2022–2023, to estimate the genetic variability, correlation, and path coefficient analysis of yield and its contributing traits in cross combination. Ten wheat cultivars were grown in a randomized block design with three replications. The analysis of variance revealed that the treatments were highly significant for all the characters. The higher magnitudes of genotypic coefficient of variation (GCV) and phenotypic coefficient of variation (PCV) were recorded for grain yield, biological yield, harvest index and plant height. The high heritability in broad sense was estimated for all the characters except for day to 50% heading, flag leaf area (cm2), number of leaves/main tiller, number of spikelets/ear and protein content (%).A high value of heritability suggests that it could be due to a higher contribution of genotypic components. High heritability associated with high genetic advantage as a percentage of the mean was found for plant height, harvest index, biological yield, and grain yield, indicating a predominance of additive gene action in the inheritance of these traits. The estimated correlation coefficients showed high direct genotypic and phenotypic correlations for days to 50% flowering, days to maturity, plant height, productive tillers/plant, test weight, biological yield, and harvest index. In contrast, flag leaf area (cm2), number of leaves/main picks, number of kernels/spike, and seed hardiness were negatively correlated with grain yield. Path analysis showed that biological yield had the largest direct positive effect on grain yield, followed by harvest index, ear length, plant height, and days to 50%, indicating that these factors were the largest contributors to grain yield.
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Background: India represents 3% related to the global malaria problem. Early diagnosis and treatment that are complete alongside preventive measures are modalities essential to managing the situation. Rapid diagnostic tests (RDTs) and polymerase chain reaction (PCR) that are malaria that is real-time be used to obtain an exceedingly really very early diagnosis in acutely febrile customers. Aims and Objectives: This study aims to gauge the effectiveness of RDT bloodstream that is utilized entire from clients clinically suspected of malaria and compare it with real-time PCR. Materials and Methods: The cross-sectional study is observationally done and made up of 158 patients admitted to Index Hospital, Indore, having a serious illness that is febrile and medical suspicion of malaria. RDT for malaria antigen and PCR that are real-time done in the bloodstream that is whole examples depending on kit guidelines. Results: There exists a difference that is significant the nice and examples which are negative by both techniques. RT-PCR is diagnostic PCR that is real-time RDT has been good in 62 (44%) clients, whereas, real-time PCR detected the parasite in 136 (91%) customers. RDT was in reality negative for malaria antigen in 16 (12.8%) consumers, in whom RT-PCR was good. RDT failed to identify Plasmodium falciparum antigen in RT-PCR samples that can be good. RT-PCR indicates basic greater sensitiveness (82.4–95% CI 79.2–84.5%) in diagnosing malaria set alongside the quick test is an antigen. The sensitiveness of RT-PCR in detecting P. falciparum had been also high (74.2%, 95% CI 71.4–77.2). This has greater specificity than RDT in detecting P. falciparum disease (91.3%, 95% CI 89.4–95.4) in detecting P. falciparum than RDT. Conclusion: RT-PCR has better efficacy to look for the presence of malaria parasites in acutely clients being febrile remain undiscovered by RDT. Therefore, it might be helpful for the verification of diagnoses and studies which are epidemiological.
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Background: NRHM provides health facilities with unlimited flexible funds to improve the quality of care, in addition to funds for the upkeep and improvement of health facilities, human resources (contractual appointments), equipment, supplies, and medicine, training, and capacity building. The Untied Funds (to be used at the discretion of the facility in charge, primarily as a contingency fund). This study was conducted to gain a better understanding of the financing strategy, knowledge, facilitators, and barriers to underutilization of untied funds. Methods: A mixed-methods study was carried out to determine the utilisation patterns and knowledge of health workers about untied fund. A qualitative study that used a grounded theory approach to identify the facilitators and barriers to effective use of Untied funds. RHTC-Mandawar and its six subcenters were included in our study. Results: The entire mixed-method study clearly demonstrated the barriers and facilitators observed at the subcenter sites. Because health workers were understaffed and overburdened with work, their knowledge was also alarmingly low. Furthermore, no refresher training was provided to them. Finance, a tricky aspect of this programme, was handled with extreme caution. Conclusions: Before untied funds lapse, they must be reviewed and monitored. Refresher training and detailed guidelines are required before funds can be used to improve the health facility and provide additional services to beneficiaries.
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To study the etiology of papilloedema in north indian population. Our hospital based retrospective study enrolled 50 patients of papilloedema, who fullfilled our inclusion criteria. Demographic details, chief complains and detailed history was taken from all the patients. All the patients underwent blood pressure measurement by a mercury sphygmomanometer, Visual Acuity testing, Slitlamp Biomicroscopy, IOP measurement, Fundus examination. Fundus photographs were obtained using a fundus camera. Other investigations included B-scan, MRI, MRV, CT and required blood investigations were done wherever necessary. Although papilloedema occured in a vast variety of age group but maximum patients (32%) were from the age group of >18-31 years and males (64%) were more affected than females according to our study. 66% of the patients had good vision with papilloedema. In our study all the patients had bilateral papilloedema and 54% of patients were diagnosed with early papilloedema. Idiopathic Intracranial Hypertension was the main etiology for papilloedema. In this study we concluded IIH (a diagnosis of exclusion) as the most common underlying etiology for papilloedema
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Introduction: The Integrated Child Development Services (ICDS) Scheme, the largest program for promotion of maternal and child health nutrition in India, is operational for more than four decades. Objective: To evaluate Integrated Child Development Services Scheme in Kangpokpi District of Manipur in terms of input, process and outcome indicators. A community-based cross-sectional studyMethod: was conducted at a tribal hilly district of Kangpokpi in Manipur. The study included ICDS staff and beneficiaries of 35 randomly selected Anganwadi Centres (AWCs). Data related to ICDS was collected by using interview schedules and checklists. The descriptive data were expressed in terms of mean, standard deviation and percentage. Association between important background characteristics and Anganwadi centre attendance was analysed using chi-square test. Ethical clearance was obtained from the institutional Ethic Committee of JNIMS, Imphal before conducting the study (study period: May 2018 to April 2021) Input indicators: The study found that 86% anganwadi centres were run inResults: anganwadi worker’s own house. Two-thirds of the anganwadi workers (65.7%) were found to have separate toilet and 22.9% had separate kitchen. Process indicators: Even though the proportions of beneficiaries accessing services from anganwadi centres were high, the number of days Supplementary Nutrition (SN) was provided in a month was comparatively low (mean: 2.97 and SD: 0.618 for under-6 children and mean: 1 and SD: 0.000 days for adolescent girls, pregnant women and lactating mother in a month) due to frequent interruption of supplementary nutrition supply. There was no supplementary nutrition stock in 74.3% of the anganwadi centres on the day of visit. Outcome indicators: Regarding the nutritional status 90% of Under-6 children were found to be normal, 9% underweight and 0.6% severely underweight. The Integrated Child Development Services Programme in the study area wasConclusion: found to have several short-comings both in terms of inputs and process. There were not only inadequate facilities and infrastructure, but the anganwadi centres also lacked essential equipment like weighing machines and medicine kits, rendering a vital activity like growth monitoring to be almost completely absent. Supervisory visits were far below satisfactory.
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Introduction: In compliance with the COVID-19 lockdown restrictions, many nonessential workplaces and public spaces were closed or left sub-operational with no or low occupancy for several months. The abrupt and unprecedented long periods of building closures have raised concerns about the proliferation of opportunistic premise plumbing pathogens that may be a biohazard for returning occupants. Objective: In this review paper, we discuss microbiological water quality concerns during periods of no or low occupancy, as experienced during the COVID-19 lockdowns. Methods: PubMed and Google Scholar databases were searched for peer-reviewed articles using specific keywords. The literature search was extended to grey literature. The paper focuses on Legionella, as a pathogen of concern, in building water systems that are not well managed and the potential risks to workers and other occupants. Results: Most articles suggest a positive relationship between stagnation or reduced water usage and compromised microbiological quality of building water systems, but the effects are site-specific and are associated with biofilm formation and disinfectant decline. Considerations for building water risk assessment are discussed as a decision-making framework for selecting appropriate responses to anticipated changes in water quality. Conclusion: The unprecedented building closures due to COVID-19 lockdowns present a hazardous event likely to impact building water quality. Building owners and facility managers, especially in high-risk settings, should consider conducting risk assessments of water systems during low-occupancy periods to identify potential risks and apply appropriate corrective measures, where necessary.
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Humanos , Masculino , Femenino , COVID-19RESUMEN
Background: Congenital anomalies are important cause of morbidity and mortality in newborns and are defined as structural and functional abnormalities including metabolic disorders present at birth. These defects are of prenatal origin resulting from defective embryogenesis or intrinsic abnormalities in the process of development and are associated with various risk factors.Methods: Our study is a cross sectional study done at Regional Institute of Medical Sciences, Imphal over period of 3 years from January 2015 to December 2017. Aim of study was to find out incidence of congenital anomalies and proportions of different types of congenital anomalies. Outcome was studied in relation to maternal age, religion, parity, and gestational age, sex of the baby, outcome and sex of the baby.Results: Total numbers of congenital anomalies were 257 babies out of 29879 births giving the incidence of 0.86%. Most common congenital anomalies in this study are musculoskeletal followed by craniospinal, genitourinary, cardiovascular and gastrointestinal. It was more common in preterm babies and parity 1-3, more common in 21-30 years of maternal age. Consanguinity was seen in 7 out of 257 patients.Conclusions: Congenital malformations are a major cause of still births and infant mortality. Targeted scan should be done at 18-20 week to find out anomalies and reduce the prevalence. There should be widespread education in the community regarding the common congenital malformations, their outcomes and possible available mode of treatment
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RESUMEN La insuficiencia ovárica prematura es la pérdida de la función ovárica antes de los 40 años de edad. Se caracteriza por hipogonadismo hipergonadotrófico y amenorrea u oligomenorrea. Su etiología es multifactorial, pudiendo deberse a causas iatrogénicas, genéticas, metabólicas, autoinmunes y ambientales; siendo de origen idiopático en el 90 % de los casos. Su incidencia es de 1 cada 100 mujeres menores de 40 años y 1 cada 1000 mujeres menores de 30 años. En la actualidad no existe un único marcador que se pueda utilizar para calcular la reserva ovárica; sin embargo, en los últimos años la hormona antimülleriana ha demostrado presentar algunas ventajas respecto a los biomarcadores clásicamente utilizados. Además, diversos estudios indican que existe una correlación positiva entre los niveles de esta hormona y el recuento de folículos antrales, que es, por el momento, el método más confiable para evaluar reserva ovárica debido a las actuales dificultades técnicas para la determinación de hormona antimülleriana.
ABSTRACT Premature ovarian insufficiency, the loss of ovarian function before the age of 40 years, is characterized by hipergonadotrofic hipogonadism and amenorrhea or oligomenorrhea. The etiology is multifactorial, and can be due to genetic, metabolic, autoimmune, environmental or iatrogenic causes, being idiopathic 90% of cases. Currently there is not a single marker that can be used for estimate ovarian reserve in this patients; however, in recent years antimüllerian hormone has proved to have some advantages over other classical biomarkers. Moreover, several studies indicate a positive correlation between antimüllerian hormone concentration and antral follicle count, considered nowadays the most reliable method for ovarian reserve estimation.
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Humanos , Femenino , Insuficiencia Ovárica Primaria/diagnóstico , Insuficiencia Ovárica Primaria/etiología , Biomarcadores , Hormona Antimülleriana/fisiología , Reserva OváricaRESUMEN
Postpartum headache is the complaint of head, neck, or shoulder pain occurring during the first 6 weeks following delivery. Among the women who underwent neuraxial aneasthesia Post Dural puncture headache is one of the most common presentations. However, physicians should be aware that post Dural puncture headache is not the only cause of postpartum headache. Authors present a series of four cases that had varied presentation of post partum headache with varied diagnosis, the first case was of subdural haematoma where CT scan revealed an acute on chronic SDH. The second case was diagnosed as meningitis and the CSF for culture sensitivity grew Streptococcus Pneumoniae .In our third case of cortical vein thrombosis , NCCT followed by MR venogram revealed left transverse venous sinus thrombosis and our last case in the series was of posterior reversible encephalopathy syndrome where MRI confirmed the findings of typical findings are symmetric edema involving the white matter of the posterior regions of the cerebral hemispheres. The diagnostic dilemma was resolved by neuroimaging because the clinical presentation was not making us reach a satisfactory diagnosis of the cause of headache. Early resort to neuroimaging and multidisciplinary team effort paved way to early diagnosis and appropriate recovery of the patients.
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Background: POAG occurs in elderly, rarely seen earlier than 40 years of age and tends to run in families. Glaucoma is a neurodegenerative disease characterized by the slow, progressive degeneration of retinal ganglion cells. Aim: To study the changes, in retinal nerve fibre layer thickness in primary open angle glaucoma (POAG). Materials and methods: The present cross sectional study was carried out at a tertiary care hospital in North India. 100 patients of primary open angle glaucoma were matched with 100 controls and evaluated with the aim to assess their RNFL thickness and compare with each other. Results: The data distribution analysis of retinal nerve fibre layer thickness in different optic nerve head quadrants in POAG group in relation to overall severity of glaucoma shows that in superior quadrant maximum number of patients in preperimetric group 6 (50%) cases, in mild 9 (45%) cases and in moderate group 25 (44.6%) were in the range 100±10μm. But in severe glaucoma cases majority 7 (58.3%) cases had the RNFL thickness in the range of 60±10 μm. The temporal quadrant RNFL thickness was least in all grades of severity of glaucoma i.e. preperimetric 6 (50%), in mild cases 9 (45%), in moderate 25 (44.6%) cases and in severe 8 (66.7%) cases. Conclusion: Overall RNFL thickness variation, regardless of severity of glaucoma, follow the normal pattern of thickness being thicker in superior and inferior quadrant compared to nasal and temporal quadrant. It was interesting to note that the RNFL thickness in all the quadrants of optic nerve head area continues to become thinner as the severity of glaucoma increases.
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Background: Metabolic syndrome (Mets), which consist of several metabolic abnormalities, is an important clinical issue in patients with schizophrenia and a key risk factor for cardiovascular diseases and type-2 diabetes mellitus, both of which impact heavily upon life quality as well as expectancy. Objectives: The aim of this study was to determine the prevalence of Mets in chronic institutionalized patients with schizophrenia and to find out association between Mets, sociodemographic and clinical variables. Materials and methods: The study was carried out at Psychiatry wards of the Psychiatric Hospital, SMS Medical College, Jaipur. Sixty male schizophrenic inpatients (with at least 6 months of hospital stay at their last admission), diagnosed according to ICD-10 criteria were evaluated for Mets as per the criteria of the International Diabetes Federation (IDF). Patients with Mets were compared to those without Mets on the basis of demographic and clinical characteristics. Binary logistic regression analysis was conducted to find out the association between Mets, demographic and clinical variables. Results: Schizophrenia patients with Mets were older, have a longer duration of illness, using 2nd generation antipsychotics and more likely to be smokers as compared to patients without Mets. Mets was significantly correlated with age, waist circumference, BMI and presence of negative symptoms. Conclusion: The study showed that prevalence of Mets in chronic institutionalized patients with schizophrenia as per IDF was 31.66 percent. This mandates systematic screening as well as elimination of risk factors such as poor lifestyle, obesity and metabolic disturbances in these indoor patients. Further study on a larger number of samples is needed to be done.
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Background & objectives: Leprosy type 1 reactions (T1R) are acute episodes of immune exacerbation that are a major cause of inflammation and nerve damage. T1R are diagnosed clinically and supported by histopathology. No laboratory marker is currently available that can accurately predict a T1R. Increased plasma and tissue expression of inducible nitric oxide synthase (i-NOS) and chemokine CXCL10 have been demonstrated in T1R. We studied the gene expression and immunoexpression of i-NOS, CXCL10 and its receptor CXCR3 in clinically and histopathologically confirmed patients with T1R and compared with non-reactional leprosy patients to understand which biomarker has better potential in distinguishing reaction from non-reaction. Methods: Gene expression of i-NOS, CXCL10 and CXCR3 was studied in 30 skin biopsies obtained from patients with borderline tuberculoid (BT), mid-borderline (BB) and borderline lepromatous (BL) leprosy with and without T1R by real-time PCR. Further validation was done by immunhistochemical expression on 60 borderline leprosy biopsies with and without T1R. Results: Of the 120 patients histopathological evaluation confirmed T1R in 65 (54.2%) patients. CXCR3 gene expression was significantly (P<0.05) higher in BT- and BB-T1R patients compared to those without T1R. The CXCL10 gene expression was significantly higher (P<0.05) in BB leprosy with T1R but the difference was not significant in patients with BT with or without T1R. Immunoexpression for CXCR3 was significant in both BB-T1R and BB (P<0.001) and BT and BT-T1R (P<0.001). Immunoexpression of CXL10 was significant only in differentiating BB from BB-T1R leprosy (P<0.01) and not the BT cases. i-NOS immunoexpression was not useful in differentiating reactional from non-reactional leprosy. Interpretation & conclusions: Both CXCL10 and CXCR3 appeared to be useful in differentiating T1R reaction in borderline leprosy while CXCR3 alone differentiated BT from BT-T1R. CXCR3 may be a potentially useful immunohistochemical marker to predict an impending T1R.
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Background: Acne vulgaris is one of the most common skin disorders in puberty. The widespread and indiscriminate use of antibiotics in the treatment of acne has resulted in the spread of resistant bacterial strains and treatment failure. Aim: The study aimed to analyze the microbiological spectrum in acne vulgaris and to evaluate its susceptibility to the antibiotics widely used for acne. Material and methods: The present cross sectional study was carried out by the Department of Microbiology and Dermatology, MSDS Medical College, Fatehgarh among the patients seeking care for acne vulgaris with pustular and nodulocystic skin lesions in the Dermatology OPD of a rural medical school from western Uttar Pradesh. Patients with pregnancy or endocrinal problems like hirsutism, menstrual dysfunction or adrenal dysfunction and those taking drugs or contraceptives were excluded. The samples were cultured individually on blood agar and Muller-Hinton media. The cultures were then incubated under both aerobic and anaerobic conditions for 2-7 days . Bacteria were identified and their resistance to common antibiotics was evaluated according to the standard procedures. After compilation of collected data, analysis was done using Statistical Package for Social Sciences, version 21 (IBM, Chicago, USA). Results: Aerobically, Staphylococcus aureus, Staphylococcus epidermidis, Propionibacterium acne and Micrococcus spp were detected in 44%, 47%, 1% and 46% of samples respectively whereas anaerobically these were 39%, 21%, 34% and 1% respectively. Propionibacterium acne Staphylococcus epidermidis and Staphylococcus aureus were more sensitive to rifampin (almost 90%) compared to other drugs. Neomycin was found to be least sensitive. Conclusion: The study highlighted the need to discourage antibiotics' abuse. Rifampin is a suitable antibiotic for acne patients, but to achieve a better result, combination of rifampin with other antibiotics should be tried. It is also suggested that studies with bigger sample size on evaluation acne vulgaris treated by rifampin should be undertaken.
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Background: Despite having a well documented relationship of cleft palate with middle ear effusion, little data exists regarding otopathology in Indian children with cleft palate. Objectives: Therefore, the present study was planned with an objective to determine the various otological manifestations that occur in patients with cleft palates seeking care at a tertiary care teaching hospital. Material and methods: The present study was carried out in the Department of Otorhinolaryngology of a tertiary care teaching hospital of northern India during June 2012 to May 2014 among 30 cases of cleft palate. On the first visit, history and thorough clinical examination are undertaken. Next, common and special investigations are undertaken to evaluate and assess the status of disease. X-ray mastoids, Pure tone audiometry and Tympanometry were also carried out. Results: The ears are found affected in 86.7%, 60.1% ears had an intact but dull tympanic membrane whereas 16.7% ears had CSOM with a central perforation. On pure tone audiogram (n=18) 33.33% had a hearing loss in one ear and 44.44% had a hearing loss in both ears in the form of a mild or moderate degree of conductive deafness. On tympanogram, 23.3% had an ‘A’ type of tympanogram whereas 44 ears had a `B’ type of tympanogram indicative of recurrent effusions in the middle ear. Majority from this sub-group >80% had associated conductive hearing loss-mild to moderate degrees. Conclusion: Cleft palate individuals should always be evaluated for possible otological manifestations.
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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.
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Background & objectives: Genetic polymorphisms in glutathione-S-transferase genes (GSTM1 and GSTT1) have been studied intensively for their potential role in lung cancer susceptibility. However, most of the studies on association between the polymorphisms and lung cancer do not distinguish between genotypes with one or two copies of the genes. The present study investigates the gene dosage effects of GSTT1 and GSTM1 copy number and their environmental interactions to examine the association of lung cancer risk with trimodular genotypes of the GSTs in a high-risk population from north-east India. Methods: A total of 154 lung cancer cases and 154 age and sex matched controls from the high risk region of north-east India were analyzed by multiplex real-time PCR to determine the trimodal genotypes (+/+, +/- and -/-) in both the genes (GSTM1 and GSTT1). Results: No significant association and gene dosage effect of GSTM1 gene copy number with lung cancer risk (Ptrend=0.13) were found. However, absence of GSTT1 conferred 68 per cent (OR=0.32;95%CI=0.15-0.71;P=0.005) reduced risk compared to the two copy number of the gene. tThere was evidence of gene dosage effect of GSTT1 gene (Ptrend=0.006). Tobacco smoking was a major environmental risk factor to lung cancer (OR=3.03;95%CI=1.73-5.31;P<0.001). However, its interaction with null genotype of GSTT1 conferred significant reduced risk to lung cancer (OR=0.30;95%CI=0.10-0.91;P=0.03). Further in only tobacco smokers, null genotype was associated with increased reduced risk [0.03(0.001-0.78)0.03; Ptrend=0.006]. No effect modification of GSTM1 was observed with lung cancer risk by environmental risk factors. Interpretation & conclusions: The results suggest that absence of GSTT1 null genotype may be associated with a reduced risk of lung cancer and the effect remains unchanged after interaction with smoking.