BERA in the detection of hearing loss in high risk children: an observational study in two tertiary care teaching hospitals in upper Assam region

Background: Significant hearing loss affects children globally (1-3/1,000 infants at birth). Early diagnosis (<6 months age) and subsequent early intervention facilitates normal development of language, regardless of the severity of hearing loss. Methods: A hospital-based, descriptive, retrospective study was done in two tertiary-care centres of Upper Assam region, upon total (55 + 46 =) 101 high risk children (<15 years) during a study period of 1 year. Patients were subjected to a questionnaire, and hearing tests (BERA/OAE) were performed. Results: Majority of the cases were <5 years of age, with male preponderance (66.30% cases). NICU graduates with history of ototoxic medications/mechanical ventilation, neonatal hyperbilirubinemia and caregiver concern were the common presenting risk factors identified. Conclusions: 49.50% cases (n=50) suffered from hearing loss [most common was severe degree of hearing loss, n= 24]. 75% cases in AMCH and 63.6% in LMCH with caregiver concern, 55.55% cases in AMCH and 50% in LMCH with past neonatal hyperbilirubinemia; 50% cases with positive family history; and 46.66% NICU graduates tested positive for hearing loss. Ideally, all high risk children <15 years should be screened for hearing loss with earliest intervention and rehabilitation, to enable them to lead a normal life and reduce the burden of handicap in the community.

Complications of chronic otitis media and their management: a study at tertiary care centre

Background: Chronic otitis media is a disease associated with complications. Due to ignorance, poor literacy and late presentation the management becomes challenging and difficult. The aim is to find the incidence of complications of COM and their management. Methods: This is a hospital based observational study carried out on 50 patients with COM admitted in the Department of Otorhinolaryngology of a tertiary care centre during a period of 1 year. Results: Out of 50 patients, 19 cases of safe COM and 31 of unsafe COM. 31% of safe COM patients had complications with 100% extracranial complication (mastoiditis). 45% of unsafe COM had complications, where most common extracranial complication was mastoiditis and intracranial complication was brain abscess. Complications were more common in the age group of 21-30 years. In all the patients, multiple intravenous antibiotics were given covering gram positive, gram negative and anaerobic organisms. The intracranial complications were initially managed by neurosurgery or neurology followed by disease eradication at source. 2 mortalities were seen in cases with intracranial complication due to late presentation. Conclusions: The complications of COM still pose a great challenge. Late presentation leads to difficulty in management and consequently higher mortality. This study mainly emphasizes the importance of early diagnosis and prompt treatment to avoid complications.

Serological diagnosis of dengue in laboratory practice in Kolkata.

Purpose: To find out the most suitable serological investigative procedures to diagnose dengue cases effectively in the laboratory practice identifying primary and secondary cases as well as period of suffering. Materials and Methods: Dengue suspected cases sent to the laboratory in 2012 in central Kolkata by the local physicians were categorised into seven panels according to the investigations asked for such as (1) only dengue‑specific NS1 antigen (2) only IgM antibodies, (3) NS1 + IgM + IgG antibodies, (4) only IgM and IgG, (5) NS1 + IgM, (6) NS1 + IgG and (7) only IgG. Results: Out of 1892 suspected cases, dengue was diagnosed in 725 (38.3%). Through panels I, II, III, IV, V, VI and VII, it was possible to diagnose dengue in (I) 35.98% (435/1209), (II) 37.5% (24/60), (III) 49% (173/354), (IV) 30.8% (68/221), (V) 60.5% (23/38), (VI) 40% (2/5) and (VII) 0 of cases respectively. Detail information such as confirmed diagnosis, duration of the disease (whether early or prolonged) and classification of primary and secondary dengue in such early or prolonged stages would only be possible in panel III, which information would be helpful for effective monitoring and treatment of dengue patients. In all other panels, merely fragmentary information would be obtained. Conclusions: Serodiagnostic tests dengue‑specific NS1 antigen and IgM and IgG antibodies when conducted simultaneously would be able to diagnose confirmed dengue cases categorising primary and secondary dengue along with the duration of the disease, whether early or prolonged.

Histopathology based cancer pattern in Mymensingh region of Bangladesh.

To our knowledge, population-based published data regarding the cancer profile in Mymensingh region of Bangladesh is not available. This study was designed to provide information regarding the frequencies of cancers through sample data retrieved from histopathology (surgical pathology) laboratory based cancer registry from two laboratories in Mymensingh. All malignant tumours recorded in 2006 in the register of pathology laboratory of Mymensingh Medical College and one private pathology laboratory in Mymensingh town were taken as sample data for analysis in terms of age groups, gender and types of cancer with relation to site. A total of 470 cases diagnosed as cancer were found in the register, of which males were 249(53%) and females were 221(47%) with male to female ratio 1.2: 1. Highest numbers of cases were found in the age group of 51-60 years. In male group frequency of malignant tumours was found in the age group of 51-60 years and the female group it is 41-50 years. Top five sites of cancer, irrespective of sex, were of stomach, uterine cervix, colo-rectum, lymph nodes and breast. According to decreasing order of frequency, in the males, the top five cancers were of stomach, lymph node, oesophagus, urinary bladder and colo-rectum. In the female groups these were of uterine cervix, breast, ovary, colo-rectum and stomach. Cancer cases in the age group of 51-60 years were significantly higher in males than in females (p<0.001). The commonest cancers in males and females were of stomach and cervix, respectively. As the analysis was based only on surgical specimens, the exact incidence of cancer of lung and liver could not be evaluated. Because, majorities of the malignancies in these organs are diagnosed mainly on cytological examination. Population-based cancer registry should be maintained to explore the exact patterns of cancer in the study region. Cervical cancer screening program and eradication of H. pylori infection program may be helpful for the reduction of incidence of cancer in this region.

Eighth nerve involvement in meningo-encephalitis.

Seventy-two patients suffering from meningo-encephalitis were studied, clinically, biochemically, microbiologically and virologically. Evidence of rising titre in serum and CSF of antibodies to Japanese encephalitis were present in 50% of cases, and recent past infection in 20% of cases. Cranial nerve involvement particularly the "8th" was present in 70% of cases though there was a 2.5% involvement of the 2nd, 3rd and 6th nerves. All the patients belonged to plain Tribal population and all had a history of eating pork 7-10 days prior to development of the infection.