Correlation between cone-beam computed tomographic findings and the apnea-hypopnea index in obstructive sleep apnea patients: A cross-sectional study

Purpose@#The aim of this study was to explore the correlations of cone-beam computed tomographic findings with the apnea-hypopnea index in patients with obstructive sleep apnea. @*Materials and Methods@#Forty patients with obstructive sleep apnea were selected from the ear-nose-throat (ENT) outpatient clinic, Faculty of Medicine, Mansoura University. Cone-beam computed tomography was performed for each patient at the end of both inspiration and expiration. Polysomnography was carried out, and the apneahypopnea index was obtained. Linear measurements, including cross-sectional area and the SNA and SNB angles, were obtained. Four oral and maxillofacial radiologists categorized pharyngeal and retropalatal airway morphology and calculated the airway length and volume. Continuous data were tested for normality using the KolmogorovSmirnov test and reported as the mean and standard deviation or as the median and range. Categorical data were presented as numbers and percentages, and the significance level was set at P<0.05. @*Results@#The minimal value of the cross-sectional area, SNB angle, and airway morphology at the end of inspiration demonstrated a statistically significant association (P<0.05) with the apnea-hypopnea index, with excellent agreement. No statistically significant difference was found in the airway volume, other linear measurements, or retropalatal airway morphology. @*Conclusion@#Cone-beam computed tomographic measurements in obstructive sleep apnea patients may be used as a supplement to a novel radiographic classification corresponding to the established clinical apnea-hypopnea index classification.

The role of cone-beam computed tomography in the radiographic evaluation of obstructive sleep apnea: A review article

The apnea-hypopnea index is widely regarded as a measure of the severity of obstructive sleep apnea (OSA), a condition characterized by recurrent episodes of apnea or hypopnea during sleep that induce airway collapse. OSA is a catastrophic problem due to the wide range of health issues it can cause, including cardiovascular disease and memory loss. This review was conducted to clarify the roles of various imaging modalities, particularly conebeam computed tomography (CBCT), in the diagnosis of and preoperative planning for OSA. Unfortunately, 2-dimensional imaging techniques yield insufficient data for a comprehensive diagnosis, given the complex anatomy of the airway. Three-dimensional (3D) imaging is favored as it more accurately represents the patient’s airway structure. Although computed tomography and magnetic resonance imaging can depict the actual 3D airway architecture, their use is limited by factors such as high radiation dose and noise associated with the scans. This review indicates that CBCT is a low-radiation imaging technique that can be used to incidentally identify patients with OSA, thereby facilitating early referral and ultimately enhancing the accuracy of surgical outcome predictions.

Isolation and Identification of Orange M2R and Green GS Dye Decolourizing Bacteria from Textile Sludge (Soil) Samples and Determination of Their Optimum Decolourization Conditions

Objectives: Azo dye accounts for majorly produced synthetic dye substances in industries, posing a threat to all possible life forms. This study was focused to isolate azo dye “Orange M2R” and “Green GS” degrading bacterial strain from textile effluent soil samples and optimization of their optimum physio-chemical growth conditions. Methodology: To achieve above-mentioned objective, sludge samples were collected from textile industrial area and were applied to 1%, 3% and 5% dye containing SM broth to observe the dye degrading capability of those samples that contain acclimatized bacteria. ABIS microbiology software (Advanced Bacterial Identification Software) was used to justify and determine the identity of these bacteria with the aid of results obtained from the biochemical tests that were undertaken. Results: Bacterial strains identified in this study were Enterococcus termitis, Enterococcus camelliae, Bacillus farraginis, Bacillus muralis, Paenibacillus macerans, Bacillus decolorationis, and Macrococcus brunensis. Out of these isolates Enterococcus termitis, Bacillus farraginis, Paenibacillus macerans, Bacillus decolorationis emerged out to be most potent decolourizer, being selected for further studies. Bacillus farraginis was identified as the best decolourizer of OM2R (Orange M2R) dye that decolourized 98% of the dye and Paenibacillus macerans showed maximum decolourization on GGS(Green GS) dye that decolourized 97% of the dye. The effect of pH, NaCl, temperature and initial concentration of dye was studied with an aim to determine the optimal conditions required for maximum decolourization. The research showed different decolourization rate with varying parameters. The optimum pH for decolourization of OM2R and GGS dye was 7.0, the optimum NaCl concentration for decolourization was 2%, initial dye concentration was 1% and the temperature was 37°C for optimum decolourization by the selected isolates. Conclusion: The findings are well acclimatized and have potentials for bioremediation in textile waste effluent treatment plants.

Pneumothorax, music and balloons: a case series

We describe two cases of spontaneous pneumothorax in young healthy adults with no underlying structural lung disease. The onset of pneumothorax was following physical activity including playing musical instruments and blowing of balloons. There is sparse data evaluating the pathophysiology of primary spontaneous pneumothorax in relation to increased mouth pressures. These cases highlight the possible physical effect of valsalva manoeuvre on transpulmonary pressures, and the potential risk of developing pneumothorax in otherwise healthy individuals. This aspect of pneumothorax development is worthy of further exploration, to better elucidate the mechanism and enhance our understanding of this common respiratory presentation

case presentation of a large rhinolith

Rhinolith is like a stone formation within the nasal cavity. Although stones rarely form in the nasal cavity, the findings of calcified objects or stones anywhere within the body has long been a subject of interest. Though infrequently observed, nasal concretions can be the source of bad smell from the nose and therefore a social concern for the patient. The salient features of such Rhinoliths and their relevance to clinical practice are discussed and a case of a large Rhinolith is presented in this article. So as to enable the attending clinician to be aware of this forgotten entity, which requires a high index of suspicion

Correlation between traffic noise induced hearing loss [NIHL] and occupation

To examine the subjects who are more prone to traffic noise exposure such as auto rickshaw drivers, traffic constables and shop keepers in central business area in Karachi [Pakistan]. This was hospital based prospective study comprising of 200 subjects. The results were obtained by testing the subjects which were investigated on the basis of interviews by [a] completing performa [b] Pure tone audiometry [PTA]. Correlation between traffic NIHL and occupation was found statistically significant with P<0.001 distributed as 15 [34.1%] in auto rickshaw drivers, 34 [40%] in shopkeepers and 29 [34.1%] in traffic constables. The fact that road traffic is the most significant source of noise pollution in Karachi was established by investigating our subjects. They had significant degree of hearing impairment i.e. 42%

case of an unusually large tonsillolith

Tonsilolith is like a stone formation within the tonsil. Though stones rarely form in the tonsil or peritonsillar area, the findings of calcified objects or stones anywhere within the body has long been a subject of interest. Although infrequently seen tonsillar concretions can be the source of both fetor oris and physical and social concern for the patient, the salient features of these tonsilloliths and their relevance to clinical practice are discussed and a case of an unusually enlarged tonsilolith is presented in this article