Dil ve Konuşma Terapisi Alanında Tele-Terapi Hizmeti Alan Bireylerin Memnuniyetlerinin Íncelenmesi

Amaç: COVID-19 sebebi ile ilan edilen pandemi süreciyle birlikte ülkemizde dil ve konuşma terapisi alanında tele-terapi hizmetinin kullanımında artış gözlenmiştir. Bu araştırma kapsamında vakaların bu süreç içerisinde aldıkları tele-terapi hizmetlerindeki memnuniyet düzeylerinin incelenmesi amaçlanmıştır. Çalışmada, dil ve konuşma terapisi alanında tele-terapi hizmeti alan bireylerin, terapiye yönelik memnuniyet düzeylerinin aldıkları tele-terapi seansı sayısına ve bozukluk türlerine göre incelenmesi hedeflenmiştir. Yöntem: Bu çalışma 0-64 yaş aralıǧında, 42 katılımcıdan (24E, 18K) alınan veriler doǧrultusunda oluşturulmuştur. Araştırmacılar tarafından hazırlanan "Dil ve Konuşma Bozukluklarında Tele-Terapi Danışan Memnuniyet Anketi" katılımcılara çevrimiçi platformlar aracılıǧı ile ulaştırılmıştır. Hazırlanan anket, 26 soru ve altı alt boyuttan oluşmaktadır. Bu alt boyutlar;"Terapistin Yetkinliǧi", "Íletişim Yeterliliǧi", "Erişilebilirlik ve Ödemeler", "Tele-terapiye Yönelik Donanım", "Genel Tele-terapi Memnuniyeti" ve "Anket Toplam Puan" olarak düzenlenip, analizleri gerçekleştirilmiştir. Elde edilen veriler, normal daǧılıma uygun olmadıǧı (Shapiro Wilk test;p <. 05) için verilerin istatistiksel analizi Mann Whitney U ve Kruskal Wallis testleri kullanılarak gerçekleştirilmiştir. Sonuçlar %95 güven aralıǧında, anlamlılık ise p < .05 düzeyinde deǧerlendirilmiştir. Bulgular: Analizler sonucunda bozukluk türü, alınan tele-terapi seansı sayısı deǧişkenlerine göre "Íletişim yeterliliǧi" alt boyutu dışında diǧer alt boyutlar ve toplam skorda anlamlı farklılık bulunmamıştır. "Íletişim yeterliliǧi" alt boyutunda akıcılık bozuklukları-konuşma sesi bozuklukları (Mann Whitney U test;p = ,044 < ,05) ile akıcılık bozuklukları-ses bozuklukları (Mann Whitney U test;p = ,019 < ,05) olan katılımcılar arasında istatistiksel anlamlılık ortaya çıkmıştır. Sonuç: Çalışmamıza katılan bireylerin bozukluk türü, terapistin yetkinliǧi ve alınan tele-terapi seansı sayısı deǧişkenlerine göre tele-terapi memnuniyetleri arasında anlamlı bir farklılık bulunmamaktadır. Yalnızca akıcılık bozuklukları -konuşma sesi bozuklukları ile ses bozuklukları olan katılımcıların "Íletişim yeterliliǧi" alt boyutunda anlamlı derecede daha yüksek puanlar verdikleri sonucuna ulaşılmıştır. Elde edilen sonucun iki grup arasındaki katılımcı sayılarından kaynaklandıǧı düşünülmektedir. Bu çalışma kapsamında ülkemizde tele-terapinin memnuniyetine yönelik bilgilerin ilk verilerine ulaşılmıştır. Bu çalışmanın katılımcı sayısının arttırılarak tekrar edilebileceǧi düşünülmektedir.Alternate :Purpose: Due to the COVID-19 outbreak, the usage of tele-therapy services has been increased in Turkey. There also seems to be an increase in the use of tele-therapy in speech and language pathology services. Therefore, the satisfaction levels of the clients in tele-therapy appears to be an important subject to examine. The aim of this study was to investigate the satisfaction levels in individuals who receive tele-therapy services for speech and language therapy. The data has been examined based on tele-therapy sessions the participants received and, the type of disorder they had. Method: This study is based on data from 42 participants (24 men, 18 women). The "Tele-therapy Client Satisfaction Questionnaire in Speech and Language Disorders" was prepared by the researchers and delivered to the participants through online platforms. The questionnaire consists of 26 questions and six sub-dimensions. These sub-dimensions "Therapist's Competence", "Communication Adequacy", "Accessibility and Payments", "Equipment for Tele-therapy", "Generalized Tele-therapy Satisfaction", and " Questionnaire Total Point" were analyzed. Since the data did not show normal distribution (Shapiro Wilk test;p < .05), the statistical analysis was carried out u ing non-parametric Mann Whitney U and Kruskal Wallis tests. The results were evaluated at a 95% confidence interval, and significance was evaluated at p < .05 level. Results: The results revealed no significant difference between the sub-dimensions and total score, except for the "Communication competence" sub-dimension, based on the variables of the type of disorder and the number of tele-therapy sessions received. In the "Communication Adequacy" sub-dimension, a statistical significance was found among the participants with fluency disorders-speech sound disorders (Mann Whitney U test;p = .044 < .05) and fluency disorders-voice disorders (Mann Whitney U test;p = .019 < .05). Conclusion: According to the variables in our study;type of disorder, the competence of the therapist, and the number of tele-therapy sessions received, there is no significant difference between the satisfaction of the tele-therapy in speech and language services. It was concluded that the participants with fluency disorders, speech sound disorders, and voice disorders gave significantly higher scores on "Communication Adequacy". It is thought that the result obtained is due to the number of participants between the two groups. Within the scope of this study, the first data on the satisfaction of tele-therapy in Turkey was reached. It is thought that this study can be repeated by increasing the number of participants. Future studies may also examine the satisfaction levels of participants with speech and language disorders separately.

Emergency visits of otorhinolaryngology department during COVID-19 pandemic, Saudi Arabia, 2020

Aim: In this study, we aimed to assess the frequency of patient emergency visits to the Otorhinolaryngology (ORL) Department during coronavirus COVID-19 pandemic and compare it with that before coronavirus COVID-19. Material(s) and Method(s): A retrospective comparative study was performed at Al-Al-Hada Armed Forces Hospital, Taif (Saudi Arabia), and data regarding various diagnoses of ORL cases were collected from medical records of patients who visited/admitted to ORL-ED during the lockdown (Group 1) and those who visited/ admitted to ORL-ED before the pandemic (Group 2). Result(s): Group 2 had a significantly higher percentage of cases who had no ENT-related disorders, hypertrophy inferior turbinate (HIT), stridor, obstructive sleep apnea (OSA), epistaxis and who had no complications, had general ENT, foreign body ingestion-aspiration, trauma, otology and who had more than one disorder and Group 1 had a significantly higher percentage of those having nasal obstruction, tonsil hypertrophy grade 3, had emergency head and neck cancer, had deep neck space infections and who had complicated. Discussion(s): During coronavirus COVID-19 pandemic period, cold ENT visits were much less and foreign body ingestion remains the highest reason for ENT visits. Additionally, telemedicine has been shown to be effective in reducing ED visits during the pandemic period. Furthermore, older cases with chronic ENT problems who had regular follow-up ENT visits were less likely to visit ED during the pandemic.Copyright © 2022, Derman Medical Publishing. All rights reserved.

Smell disorders associated with COVID-19 infection

Background: We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, nose, anosmia, hyposmia, smell, olfactory, ORL, different ENT related symptoms. We reviewed published and peer-reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. Main text: Within the included 2549 COVID-19 laboratory-confirmed positive patients, smell affection was reported in 1453 patients (57%). The other reported ENT manifestations were taste disorder (49.2%), headache (42.8%), nasal blockage (26.3%), sore throat (25.7%), runny nose or rhinorrhea (21.3%), upper respiratory tract infection (URTI) (7.9%), and frequent sneezing (3.6%). Conclusion(s): Smell affection in COVID-19 is common and could be one of the red flag signs in COVID-19 infection. With a sensitivity of utilized questionnaire in smell identification, a homogenous universal well-defined COVID-19 questionnaire is needed to make the COVID-19 data collection more sensible.Copyright © 2021, The Author(s).

Some key aspects of telemedicine development to support human illness: a systematic review

The aim of this research is to describe the use of telemedicine applied to patients characterised by a particular state of illness, which often drives them toward a frail and chronic status, in a systematic manner. This work employed the Tranfield approach to carry out a systematic literature review (SLR), in order to provide an efficient and high-quality method for identifying and evaluating extensive studies. The methodology was pursued step by step, analysing keywords, topics, journal quality to arrive at a set of relevant open access papers that was analysed in detail. The same papers were compared to each other and then, they were categorised according to significant metrics, also evaluating technologies and methods employed. Through our systematic review we found that most of the patients involved in telemedicine programs agreed with this service model and the clinical results appeared encouraging. Findings suggested that telemedicine services were appreciated by patients, they increased the access to care and could be a better way to face emergencies and pandemics, lowering overall costs and promoting social inclusion.Copyright © 2022 Inderscience Enterprises Ltd.

Comprehensive evaluation of otorhinolaryngological symptoms in COVID-19 patients

Introduction: The aim of this study is to comprehensively evaluate the incidence and natural course of otorhinolaryngological symptoms of COVID-19 infection and its relations to each other and patient's demographics. Method(s): This is a prospective study conducted on symptomatic adult patients proven to be infected with COVID-19. Detailed history was taken from each patient including onset of symptoms. Symptoms were followed up tightly. We focus on otorhinolaryngological (ORL) symptoms and their duration and onset in relation to other symptoms. Data were collected and analyzed in detail. Result(s): Six-hundred eighty-six patients were included in the study, their age ranged from 19-75 years old, and of them 55.1% were males. Cough was found in 53.1% of cases followed by sore throat in 45.8%, anosmia/ hyposmia in 42.3%, headache in 42%, rhinorrhea in 19.5%, dry mouth in 7.6%, globus in 6.1%, epistaxis in 4.4%, and hearing loss in 0.6%. In non-ORL symptoms, fever was found in 54.2%, malaise in 55.1%, dyspnea in 49.3%, and diarrhea in 27.2%. The first symptom was anosmia in 15.7% of cases, sore throat in 6.1 %, cough in 7.9%, and headache in 13.4% of cases. Fever was the first symptom in 22.7%, malaise in 25.1%, and diarrhea in 6.4%. Headache occurred for 5.5 +/- 2 days, anosmia/hyposmia 3 to > 30 days, sore throat 4.1 +/- 1.2 days, rhinorrhea 4.3 +/- 1.1, cough 7.4 +/- 2.5 days, fever 4.7 +/- 2 days, and malaise 6.5 +/- 2.4 days. The cluster of COVID-19-related symptoms showed nine principal components. Conclusion(s): Otorhinolaryngological symptoms are main symptoms in COVID-19 infection, and they should be frequently evaluated to detect suspected cases especially in pauci-symptomatic patients and to properly manage infected patients.Copyright © 2022, The Author(s).

Clinical Characteristics of COVID-19 from the Otorhinolaryngologist's Perspective: First Report from Oman, Middle East.

To study the otorhinolaryngological clinical characteristics of COVID-19 positive patients. A prospective cross sectional study on sixty five patients who were SARS-CoV-2 PCR positive, and completed 14 days of isolation period were surveyed with a questionnaire. The responses were evaluated and assessed. Sixty five SARS-Cov-2 PCR positive cases were included in the study. There were 57 (87.6%) males and 8 (12.3%) females. Thirty five (53.8%) were in home isolation, whereas, 30 (46.2%) were under institutional care. Forty five patients (72.6%) presented with mild symptoms, and 4 (6.4%) developed moderate symptoms. Thirteen (21%) were asymptomatic. Overall, 46 patients (70.7%) presented with upper airway symptoms with or without general symptoms. More than half of the patients experienced pharyngodynia or sorethroat, smell and taste dysfunction as common symptoms (66.7%, 61.4% and 50.7% respectively). Severe headache was noticed by eighteen (27.7%) patients. Other respiratory symptoms such as nasal congestion, rhinorrhoea, sneezing, facial pain, etc. were present with less frequency. In more than half of the patients (61.5%), all the symptoms recovered within 5 days, in 12 (18.5%) between 5 and 8 days, and in 9 (13.8%), between 9 and14 days. However, in four patients, symptoms lasted for 28-30 days. In seven patients (10.7%), symptoms recurred after the period of isolation, however, the retest was negative. Fever, cough and or shortness of breath are the commonly reported prominent symptoms of COVID-19, however, there is a changing trend of clinical presentation towards variable otorhinolaryngologic manifestations. Pharyngodynia, taste and smell dysfunctions are common in patients with COVID-19, and could represent potential characters.

Mucormycosis of the bones of the facial skull, nasal cavity and paranasal sinuses in patients with COVID-19.

Currently, the relevance of the issues of diagnosis and treatment of invasive fungal diseases has increased significantly due to the pandemic of a new coronavirus infection COVID-19 and the massive use of corticosteroids for the treatment. The key success factors in the outcome of invasive fungal diseases are early diagnosis and treatment, including the applying of an adequate systemic antifungal therapy and surgical treatment. Extensive areas of mycotic lesions of the facial bones and paranasal sinuses are life-threatening conditions due to anatomical proximity to brain structures and a high risk of dissemination of I invasive fungal diseases with a fatal outcome. The objective of this work was to study the risk factors, possible pathogenesis, diagnosis and treatment strategy of invasive fungal diseases of the orofacial region in convalescents of COVID-19. We present case-series data on six patients in the clinics of maxillofacial surgery and otorhinolaryngology of the Pavlov First Saint Petersburg State Medical University over the period of 2021-2022. Predisposing factors, clinical and radiological symptoms, features of diagnosis, therapy and surgical strategy were analyzed. The presented observations confirm the relevance and danger of complications after a COVID-19 in the form of the development of invasive fungal diseases with damage to the maxillofacial region caused by mucormycetes and Aspergillus spp., as well as importance of early diagnosis and treatment.Copyright © 2021, Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy. All rights reserved.

New Year's Eve in otorhinolaryngology: a 16-year retrospective evaluation.

PURPOSE: Pyrotechnics are a long-standing tradition at the turn of the year. There are little data available on New Year's Eve-associated ORL injuries. Due to restrictions during the Corona pandemic, the handling of fireworks and meetings on New Year's Eve 2020-2022 had been significantly changed. Our aim was to analyze first data about New Year's Eve-associated ORL injuries. METHODS: A retrospective analysis of 16 turns of the year (2006-2022) at a University ORL department was performed. The 2 recent years were influenced by the changes and restrictions of the COVID-19 pandemic. RESULTS: Of 343 emergency presentations, 69 presented with New Year's Eve-associated reasons (20%). 72% were male, 15.9% were underage. 74% presented for fireworks-related injuries, 19% due to violent altercations. Noise trauma was present in 71%. The average number of New Year's Eve-associated emergency patients per year and the average total number of patients were reduced by more than half under COVID-19 pandemic conditions. CONCLUSIONS: New Year's Eve-associated ORL injuries range from inner ear trauma to midface fractures. Long-term damage may include hearing loss and tinnitus. These results shall support the responsible use of fireworks even after the end of the special regulations of the COVID-19 pandemic.

Impact of Covid-19 Pandemic on Otorhinolaryngology Practice in India

Background: Covid-19 has dramatically changed everyday life across the globe. Otorhinolaryngologists were at the forefront of being exposed to the virus. As the virus evolved so did the practice of otorhinolaryngology in the country. Some innovative tacks for protecting otorhinolaryngologists and improving patient care were put into our practice by many doctors. Assessment of these techniques will help us to overcome the difficulties if a similar situation arises in the future. Material(s) and Method(s): An online survey was conducted among Indian otorhinolaryngologists. The invitation to participate in the survey was circulated among otolaryngology consultants and postgraduates all over India through multiple modalities on social media. The survey consisted of 4 sections with a total of 24 questions, related to covid vaccination status, changes made in practice, OPD (outpatient department) consultations during the lockdown period, and modifications done in outpatient and operation theatre setups. Google forms were kept open for one month. Result(s): There were changes in outpatient and operation procedure management like screening of patients before treatment and surgery, patient health care declarations, vaccination status, improvisation done in the methods of sterilization of ENT instruments, endoscopes, case selection of elective OT (operation theatre) cases. This paper aims to give a brief overview of current knowledge about the impact of covid 19 on otolaryngology practice using the best available evidence. Conclusion(s): COVID-19 had made crucial changes in ENT practice forever which will help otorhinolaryngologists in the better care of patients if a similar situation arises in the future.Copyright © 2022, Dr Yashwant Research Labs Pvt Ltd. All rights reserved.

Melanoma of unknown primary: a case series and review of the literature

Melanoma of unknown primary (MUP) was originally defined in 1963 as melanoma in the subcutaneous tissue, lymph nodes or visceral organs without the presence of a cutaneous, ocular or mucosal primary. The incidence of MUP is reported to be between 1% and 8% of all melanomas. MUP can be divided into lymph node involvement only and organ metastases. The aetiology of MUP is elusive. Possibilities proffered include an unrecognized melanoma, a previously excised melanoma that was misdiagnosed as benign, a primary melanoma that has completely regressed or the de novo malignant transformation of an aberrant melanocyte within a lymph node. We report our experience in a single tertiary referral centre. A database of all melanomas diagnosed between January 2018 and December 2021 was analysed for MUP. The total number of melanomas diagnosed in that timeframe was 298. Six patients (three males, three females) were identified as having MUP, with an incidence of 2%. Median age was 63.3 years (range 45-84). One (17%) presented with primary dermal metastatic deposits, 67% (n = 4) presented with isolated lymph node metastases, 0% presented with visceral metastases and 17% (n = 1) presented with isolated brain metastases. All six patients were reviewed by dermatology and ophthalmology. Fifty per cent (n = 3) were reviewed by ENT. One (17%) was referred to gynaecology. No primary melanoma was identified in any of the patients. All patients underwent a positron emission tomography-computed tomography (CT) scan to investigate for further metastases, and all underwent dedicated brain imaging via CT and magnetic resonance imaging. All patients underwent surgical resection of their MUP, and all were reviewed by medical oncology, with 83% (n = 5) undergoing treatment with immunotherapy. There have been no associated deaths to date. In five patients (83%) the MUP was diagnosed in 2021, and one (17%) was diagnosed in 2018. Recent studies have shown the impact of the COVID- 19 pandemic on the presentation of cutaneous melanoma, including an increased Breslow thickness at the time of presentation vs. a similar period pre-COVID-19. Our data indicate an increased rate of MUP presenting after the onset of the COVID-19 pandemic;however, given the low number overall, no conclusions can be drawn. There is no current literature regarding the increased rate of MUP since the COVID-19 pandemic. Further studies are required to investigate this. Recommendations for the evaluation of those with MUP include a full skin examination by a dermatologist and ocular examination to exclude primary melanoma. Patients should undergo imaging of the brain, thorax, abdomen and pelvis to assess disease burden. Referral to otorhinolaryngology can be considered to assess for mucosal melanoma of the nasopharynx. Gynaecology referral should be considered for those with inguinal lymphadenopathy. MUP is rare. Guidelines for the investigation of MUP are currently lacking and are needed to ensure the delivery of consistent evidence-based care for patients.

An Unconventional Presentation of Mucormycosis in a 10-Year-Old Child: A Case Report

Since the Coronavirus Disease (COVID-19) pandemic, there have been several unusual presentations of mucormycosis in India, especially amongst immune-competent adults. COVID-19 infection has been found to have profound effects on the patient's immunity and some patients, though asymptomatic for COVID-19, can be infected by mucormycosis and develops dangerous complications. Skin involvement of the orbital, zygomatic and maxillary areas is a common occurrence in extensive cases of rhino-orbital mucormycosis, however, isolated involvement of the alar skin is an extremely rare occurrence in such patients. Paediatric cutaneous mucormycosis is by itself a rare entity, seen majorly in children with history of allogeneic hematopoietic stem cell transplantations, chemotherapeutic treatment, or patients with human immunodeficiency virus infections, herpes and other life-threatening viral infections. Patients receiving long-term steroid therapy are also predisposed to invasive fungal infections. This case was about a 10-year-old boy presented with a black crusted lesion over the nose to the otolaryngology outpatient department. The patient had history of contact with a COVID-19 positive individual. Examination revealed a necrotic patch over the palate and Non Contrast CT Scan of (NCCT) the paranasal sinuses showed pansinusitis. A KOH mount showed fungal elements and the patient underwent emergency debridement of nasal skin with endoscopic sinus and palatal debridement. Injectable liposomal Amphotericin-B was started. Over a period of one month, the patient showed significant clinical improvement. Though rare, sinonasal mucormycosis can present in the form of a cutaneous lesion which is an unconventional symptom. A general awareness amongst healthcare professionals, with a multidisciplinary approach, timely diagnosis and specialist intervention can improve outcomes in this sinister disease.Copyright © 2023 Journal of Clinical and Diagnostic Research. All rights reserved.

An Otorhinolaryngology Perspective Into a Hospital COVID-19 Cluster

In this commentary, we share our experience of a COVID-19 cluster which developed within a frontline healthcare facility designated for treating COVID-19 patients. We provide an Otorhinolaryngology perspective into the key challenges, analyses and responses. We discuss how we identified and isolated infected patients and staff, uncovered the responsible COVID-19 variant strain B1.617.2 and instituted various measures to overcome this cluster. The measures include ceasing non-essential services, limiting transfers of patients, a heightened stance of personal protective equipment, ring-fencing of staff and enhanced COVID-19 testing. With rapid hospital wide efforts, there were no new non-isolated cases from our hospital cluster 3 days after the wards were locked down. The cluster which developed on 28-April-2021 was closed on 6-Jun-2021, with 48 cases, ten of whom were healthcare workers. Some of these lessons may be useful for consideration should another healthcare institution face a similar crisis in the future.Copyright © The Author(s) 2022.

Effects of Covid-19 Protocols on Treatment of Patients with Head-Neck Diseases

This work aims to report how COVID-19 pandemic affects the operations of the department of Otolaryngology, in two hospitals in Campania: University Hospital "San Giovanni di Dio and Ruggi d'Aragona” of Salerno and at the hospital "A.O.R.N. A. Cardarelli” of Naples (Italy). In the last years, COVID-19 has become the main type of disease affecting subjects with possible lung infections (pneumonia). SARS-cov-2 infection has been reported as severe acute respiratory syndrome that mainly affects the respiratory system and lungs, but the virus also involved other organs such as cardiac, renal and nervous ones. In the study the attention is turned to the department of Otolaryngology because the operators are very exposed. Data were collected for the year 2019, in the absence of Covid-19, and in the year of the pandemic, 2020. The purpose of the work was to make a comparison between the situation of the department before and during the epidemic from Covid-19 to the individual hospital, in addition a comparison was made between the two hospitals. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Diagnostic accuracy and management concordance of otorhinolaryngological diseases through telehealth or remote visits: A systematic review & meta-analysis.

INTRODUCTION: COVID-19 has led to delays in providing healthcare in both emergency and non-emergency settings, especially in surgical subspecialties which rely heavily on referrals and in-person visits. Without an established telehealth infrastructure, many otorhinolaryngological departments experienced decreases in consultations. Telemedicine has attempted to bridge the gap between pre- and post-pandemic periods by creating a safe avenue of communication between otorhinolaryngologists and patients. This review hopes to address the accuracy of telemedicine in patient diagnosis and management. METHODS: Searches were conducted since study conception until June 30, 2022, on multiple databases including PubMed, SCOPUS, and CINAHL for this systematic review and meta-analysis. Diagnostic accuracy, management accuracy, kappa, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were meta-analyzed by comparing virtual visits to in-person visits (gold standard). RESULTS: Nineteen studies were included in this review. A total of 1518 patients were included across all studies. When comparing virtual visits against in-person visits, accurate diagnosis was made in 86.2% [82.1,89.9, I2 = 73.5%, P < 0.0001] of patients and management accuracy was 91.5% [86.1,95.7, I2 = 81.8%, P < 0.0001] when treating patients. Kappa value determining interrater reliability was 0.8 [0.7,0.9, I2 = 81.8%, P < 0.0001]. CONCLUSION: Our data suggest that diagnostic and management concordance is above 80% when comparing diagnosis and management strategies in patients who underwent both telehealth and in-person visits with an otorhinolaryngologist. In uncomplicated patients, telehealth might be a reliable source for diagnosis and management however, in-person consultation is likely still required for pathologies in which physical exam, imaging or procedural elements represent a vital component of the work-up.

Audiological Assessment in Post COVID-19 Patients- A Cross-sectional Study

Introduction: Hearing loss following a viral infection is a common entity. In recent studies, hearing loss has been seen among Coronavirus Disease 2019 (COVID-19) infected patients, but its association is yet to be established. Aim: To determine the presence of hearing loss and its type in patients after COVID-19 infection. Materials and Methods: A cross-sectional study was conducted at a tertiary health centre, Department of Otorhinolaryngology at Chettinad Academy of Research and Education, Chettinad Hospital and Research Institute, Chennai, from October 2021 to April 2022. Total of 125 patients, who had a positive history of COVID-19 infection, were reviewed in the Otorhinolaryngology Department, one month after they were tested Real Time-Polymerase Chain Reaction (RT-PCR) positive. After obtaining proper clinical history and examination, Pure Tone Audiometry (PTA) were done. Audiological report was assessed and analysed. Qualitative variables will be expressed in proportions and quantitative variables in Mean±SD/ Median (IQR), Chi- square test was applied. Results: This study included 65 males (52%) and 60 females (48%), and the mean age was 38.44±10.9 years years. Among the 125 patients, 12 (9.6%) were diabetic, 14 (11.2%) were hypertensive, 5 (4%) had dyslipidaemia, 3 (2.4%) were hypothyroid, while remaining 91 patients (72.8%) had no co-morbidities. Sensorineural Hearing Loss (SNHL) was found among 45 patients (34 with unilateral and 11 with bilateral involvement). Out of them, 2 (4.5%) (4.5%) were in the age group of 18-30 years, 19 (42.2%) in 31-45 years and 24 (53.3%) between 46-60 years age group. Based on the World Health Organization (WHO) classification of hearing loss, 27 patients had mild sensorineural hearing loss, 12 patients with moderate, and 6 patients with moderately severe sensorineural hearing loss. Conclusion: SNHL were found among patients who had COVID-19 infection, but due to the absence of a pre COVID-19 documented audiogram, it was difficult to conclude whether the hearing loss had occurred due to COVID-19, pre-existing hearing loss, or age-related. Further studies are required for proper understanding and correlation.

Universal COVID-19 pre-procedural swabs in children in a developing country: A comparison of findings over two transmission waves

Aim: The Coronavirus disease (COVID-19) pandemic has strained healthcare systems worldwide. Some institutions have implemented additional precautionary measures such as pre-procedural swabbing (PPS) to reduce transmission in patients and healthcare workers. We evaluate our experience with universal pre-procedural screening for COVID-19 in low-risk pediatric patients. Method(s): We performed a retrospective review of patients aged 18 years and below who underwent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) real-time reverse transcription-polymerase chain reaction (rRT-PCR) assay swabs in our center over two waves (1st May 2020 to 31st July 2020 and 1st April 2021 to 30th June 2021). We included patients who underwent rRT-PCR for SARS-CoV-2 prior to any procedures requiring general anesthesia and were deemed low risk for COVID-19 according to our institutional screening criteria. All study patients were followed up for 14 days post-procedure. Result(s): Of 2065 swabs done for patients aged 18 years and below during the study period, 645 (31.2%) were pre-procedural swabs. Patients were aged 4.2 years (median, interquartile range: 1.6 years-9.8 years). Two patients (0.3%) tested positive for COVID-19 by PPS, detected during Period 2 - both had risk criteria which were overlooked by healthcare workers. Within 14 days post-procedure, 10 patients had unscheduled readmissions and 15 required repeat rRT-PCR, all of which were negative. Conclusion(s): In patients deemed low risk for COVID-19 infection according to our screening criteria, routine pre-procedural swabbing returns a low positive rate. Our findings can guide screening protocols at institutions that provide surgical services during the COVID-19 pandemic. Copyright © The Author(s) 2022.

Accuracy and Reliability of German Websites for Information on Monoclonal Gammopathy of Undetermined Significance

Background: Monoclonal gammopathy of undetermined significance (MGUS) is a clonal, premalignant plasma cell or B-cell disorder. MGUS patients often seek disease-related information online. However, the quality of online resources available for MGUS is questionable. Method(s): The quality of 900 German websites from Google, Bing, and Yahoo was evaluated. Result(s): The websites did not differ regarding their search rank or between the search engines. The 83 unique websites showed a medium to poor general quality (median JAMA score 3 of maximum 4 points, only 4% websites with a valid HON certificate). The patient- (user-) focused quality was poor (median sum DISCERN score 24 of maximum 80 points). The reading level was very difficult (29 of maximum 100 points according to the Flesch Reading Ease score). The content level was very low (11 of maximum 50 points). 23% of websites contained misleading/wrong facts. Websites provided by scientific/governmental organizations had a higher content level compared to websites provided by foundation/advocacy or news/media. Discussion(s): Similar previously published analyses often focus on otorhinolaryngology- related topics, idiopathic pulmonary fibrosis, SARSCoV- 2 or neurological disorders. Precancerous conditions and cancer entities were rarely in the focus of such evaluations. This study was performed in a reproducible and objective score-based manner, applying a set of well-established scores covering the aspects of general, patient- (user-) focused quality, and MGUS-related content. Conclusion(s): MGUS-relevant online sources showed low general and patient-focused quality and poor content. Information is provided on a high reading level. Incorporation of quality indices and regular review of content is warranted.