Evaluation of a Possible Association Between Severity of Allergic Rhinitis and the Level of Depression in Patients in a Tertiary Care Hospital in South India: A Cross-Sectional Study.

Introduction Allergic rhinitis is one of the most common diseases in the world. It affects all people irrespective of age, sex and race. Allergic rhinitis leads to the development of social and interpersonal problems and loss of productivity which in turn causes depression. The depression was an underestimated iceberg phenomenon in allergic rhinitis patients. Objective The study evaluates the association between the severity of allergic rhinitis and the level of depression in patients attending tertiary care hospitals in south India. Methodology This cross-sectional study was conducted among 250 patients with allergic rhinitis. All the patients were subjected to the semi-structured questionnaire. And the severity of allergic rhinitis has been made based on the allergic rhinitis, and its impact on asthma classification and depression has been diagnosed and classified based on the Hamilton depression rating scale. And the association between allergic rhinitis and depression has been evaluated with the chi-square test. Results Two hundred fifty patients participated in the study, with a mean age of 33+/-2. Surprisingly the prevalence of depression among the allergic rhinitis patient was 88%. Most of them suffered from mild depression based on the Hamilton depression rating scale. A significant association was seen among allergic patients with age, gender, smoking status, locality, socioeconomic status, and co-morbidities. And the study shows the severity of allergic rhinitis is directly related to the severity of depression with a significant association. Conclusion Depression is one of the underestimated and under-treated problems in today's world. This study concludes that the severity of allergic rhinitis directly and significantly correlates with the severity of depression. The prevalence and intensity of depression should be evaluated and appropriately treated in patients with allergic rhinitis to improve the quality of life.

Bilateral Supernumerary Teeth Presenting as Nasal Masses and Recurrent Rhinitis: An Interesting Case Report.

The presence of a tooth inside the nasal cavity is a rare clinical entity. The exact pathophysiology is not clear and most of the times, these patients present with non-specific symptoms. We encountered a 51-year-old male with symptoms of bilateral recurrent nasal obstruction and nasal discharge of 10 years' duration. Anterior rhinoscopy and diagnostic nasal endoscopy revealed a greyish white hard gritty mass covered with mucopurulent discharge in the floor of left nasal cavity and a mucosal covered bulge was noted in the floor of right nasal cavity. CT showed 2 hyperintense lesions in the maxilla reaching the floor of both nasal cavities. Diagnosis of supernumerary teeth was made and treated accordingly. Although the presence of tooth has been reported in ovaries, maxilla, maxillary sinus, mandibular condyle, mediastinum, this is the rare case reported with supernumerary teeth in both nasal cavities.

A Prospective, Randomized, Double-Blind Study on the Efficacy of Different Modes of Topical Application of Nasal Anesthetics in the Diagnostic Nasal Endoscopy Procedure.

Introduction In the current otorhinolaryngology practice, technology has always been an essential part. Therefore, diagnostic nasal endoscopy (DNE) has become a vital examination in today's practice. In order to visualize the nasal cavity in a systematic manner without any discomfort to both patient and doctor, the nose should be well anesthetized and decongested. Objective The study is to compare and evaluate the efficacy of 4% lignocaine-oxymetazoline cotton pledget packing versus topical sprays in the preparation of nasal cavities for DNE. Methodology The prospective, randomized, double-blind study was conducted among 246 patients and was divided into two groups. In the first group, the nose was packed with cotton pledgets containing 4% lignocaine-oxymetazoline and another group with 4% lignocaine-oxymetazoline spray. Following DNE, patients and surgeons were questioned on a pre-formed questionnaire to evaluate their experience during the procedure. Results It was observed that the time taken for the pre-endoscopic preparation of the packing group was more than the spray group. A total of 91.9% of the spray group had pain during the pre-endoscopic preparation and more burning and tingling sensation than in the nasal pack (75.6%). A total of 69.9% of the patients among the spray group participants compared to 32.5% of the packing group patients experienced more throat discomfort. In addition, 12% of the packing group had mucosal bleeding during the preparation. A total of 32.5% of the spray group experienced severe pain when compared to 12.2% of the packing group during the endoscopic procedure. Most of the participants from both groups had difficulty visualizing the superior turbinate and sphenoethmoidal recess during the procedure. There was a significant difference seen between both the groups with respect to pain during the pre-endoscopic procedure (p=0.0005), burning/tingling sensation (p<0.0001), throat pain (<0.0001), mucosal bleed (p=0.0003), pain during the procedure (p=0.0001), and discomfort after the procedure (p<0.0001). Conclusion Both methods of nasal preparation have merits and demerits in terms of discomfort, pain, and visualization of structures. Still, the packing of the nasal cavity with cotton pledgets is better when compared to spraying with 4% lignocaine-oxymetazoline. However, 4% lignocaine-oxymetazoline spray can be used during an emergency situation and with sensitive patients.

A Clinical Retrospective Study on the Transmission of COVID-19 From Mothers to Their Newborn and Its Outcome.

Introduction India is the second most populated country in the world. The declaration of the COVID-19 pandemic has caused significant morbidity and mortality in pregnant women and newborns. Due to the decreased lung volume and immunocompromised state, pregnant women are more prone to rapid clinical deterioration. Regarding the transmission of COVID-19 infection to newborns, there is no clear-cut evidence regarding the intrauterine or vertical transmission of COVID-19 from the affected pregnant women to their neonates. Aim This study aimed to assess the outcome of neonates born to mothers with COVID-19 in a tertiary care hospital in Puducherry, India. Methods This retrospective case record-based study was conducted among all neonates born to COVID-19-positive mothers at a tertiary care institution in Puducherry from April 2020 to June 2020. All the newborns born to COVID-19-positive mothers during the specified period of time were included in the study. Results A total of 98 COVID-positive mothers were included in the study. Of these, 13.27% showed mild upper respiratory infection, and one had a moderate category. The mean gestational age was 38.4+1.12 weeks. About 53.06% of COVID-19-positive mothers had C-sections, 45.92% had a normal vaginal delivery, and only one had an instrumental vaginal delivery. All the mothers gave birth to singleton neonates; of 98 newborns, 51 were female, and 47 were male with the mean birth weight of 3.1 ± 0.4 kg. Among the 98 neonates, only six developed COVID-19 infection. Among the six, four acquired infections during the first to second week of the postnatal period and two acquired infections during the fourth week. Three neonates born by normal vaginal delivery only had a fever; two neonates manifested fever, cough, and increased respiratory rate; and only one neonate developed hypoxia. Conclusion The study showed that vertical transmission from the mother to the newborn is extremely minimal. In our study, six neonates acquired infection mostly due to the close contact of the newborn with the mother during rooming-in and breastfeeding.

Knowledge, attitude and practices towards COVID-19 among higher education students in India: a cross sectional study.

Aim: This study explored the knowledge, attitude and practices (KAP) of higher education students towards COVID-19. In addition, this study analysed the association of socio-demographic variables with KAP apart from finding the relationship between KAP. Subject and methods: This is a cross-sectional study conducted in India. Study participants were selected using a convenient sampling method from various higher educational institutions across 22 states in India. Data was collected using self-administered close-ended questionnaires via Google forms. The data were analysed using frequencies and percentage for descriptive purposes. A chi-square test was used to determine the association between groups, and correlation analysis was used to illustrate the significant relationship between KAP. Results: The majority, that is, 65.5% of students possess a high level of knowledge about the disease. It was noteworthy that 71.0% of them had a positive attitude towards COVID-19 and 66.7% of them exhibited desirable practices to mitigate COVID-19. Furthermore, the results showed a significant association between KAP and some of the socio-demographic variables studied. Social media emerged as a vital source of information regarding COVID-19 for the majority (81.0%) of students. Also, a strong significant positive correlation was observed between KAP variables. Conclusion: One-fourth of the students demonstrated only low and moderate levels of knowledge, negative attitude and undesirable practices in preventing COVID-19. The implications suggesting various approaches to enhance KAP to moderate the spread of COVID-19 among the students were recommended to aid the higher educational institutions.

Knowledge and attitudes about the use of emergency contraception among college students in Tamil Nadu, India.

BACKGROUND: In India, a large number of pregnancies are unplanned resulting in unsafe and illegal abortion. For every legal abortion, 10 to 11 illegal abortions are occurring which endangers the health and survival of the women. In recent years, there is an increase in unwanted and unintended pregnancy at the early age group. Usage of emergency contraception (EC) can decrease the unwanted pregnancy and provide a healthier life. AIM: The aim of study is to assess the knowledge and attitude regarding EC among college students in Thiruvarur District, Tamil Nadu, India. METHODS: A cross-sectional study was conducted among the college students of Thiruvarur district, Tamil Nadu, India. A total of 758 students were selected by convenient sampling technique. Data was collected by administering a pretested semi-structured questionnaire. RESULTS: Out of 758 students, 183(24%) heard about EC. The commonest source of information was the internet 91 (49.7%). The majority 116 (63.4%) knew that it does not prevent STDs. Of those who were aware, 42% were aware of 42.6% are aware of the time limit to use EC. The knowledge level of about the EC was moderate (60.1%), and it was significantly (p < 0.05) more among students > 25 years old, married participants, students in private institution, of lower socio-economic status, Muslim students and days' scholars. The negative attitude towards EC was 59%. Nearly 38.8% believed that the EC will affect the next menstrual period, and 35.5% informed it will increase high risk behaviour among adults. The attitude level was significantly associated with the same factors associated with the awareness level with the factors Christian religion replacing Muslim and higher socioeconomic class replacing lower class participants. CONCLUSION: The knowledge level of the studied college students was moderate, and they mostly had negative attitude towards the EC. Reproductive health education should be given in educational institutions to promote awareness and to remove misconceptions about EC.

Chloroquine induced urticaria: A newer adverse effect.

Malaria an endemic disease of India caused by plasmodium species. Chloroquine, a member of quinolone group of drugs is used to treat malaria. Although it has a very safety profile as it is used during pregnancy, many adverse effects have also been reported. Here we report a case of 30-year-old male admitted with fever diagnosed to be having malaria, who developed urticaria immediately after being treated with first dose of chloroquine which was treated successfully. This is the first case reported ever in an adult having chloroquine induced urticaria.

An interesting case of acute disseminated encephalomyelitis following E. coli infection.

Acute disseminated encephalomyelitis (ADEM) is a rare inflammatory demyelinating disease of central nervous system (CNS), characterized by multifocal white matter involvement with neurological deficits and accompanied by encephalopathy. ADEM is thought to be caused by autoimmune etiology. CNS autoantigens are produced by molecular mimicry triggered by an environmental stimulus, mostly infection (viral/bacterial) or post vaccination, in genetically susceptible individuals. ADEM is sometimes referred to as post/para-infectious or post-immunization ADEM. ADEM is characterized by multifocal neurological signs and occasionally it rapidly progresses to coma. Magnetic resonance imaging (MRI) is used to confirm the diagnosis. The treatment is based on intravenous high-dose methylprednisolone, which usually leads to a rapid improvement. Recently, the use of intravenous immunoglobulins and plasma exchange (PLEX) has also been suggested. We report a case of a 6-year-old girl who was admitted for urinary tract infection but developed neurological complications which was treated successfully.