Effect of Health Education on Knowledge and Behaviour Towards Consanguineous Marriage and Infantile Hearing Loss.

Awareness regarding consanguineous marriage and other risk factors of infantile hearing loss is essential for prevention, early detection and timely intervention which can save deaf children from lifelong consequences of hearing disability. A pre-post study was done among the general population of Puducherry, India to evaluate the effect of health education on knowledge and behaviour towards consanguineous marriage and infantile hearing loss. Individual direct interviews were done using a questionnaire to assess their awareness about consanguineous marriage and other risk factors of infantile hearing loss, its early detection and intervention. The assessment was repeated after a health education given for the same by direct interaction and pamphlets. The study showed that 65% participants were unaware of consanguinity being a risk factor for congenital hearing loss. More than half of them were unaware of other risk factors, neonatal hearing screening and treatment. Only 35.3% were aware that early identification and intervention enables a deaf child to learn optimum speech and language. Prior to health education, 33.7% were in support of consanguineous marriage whereas, after the health education, only 6.7% supported it showing significant improvement in their attitude towards consanguineous marriage. Post health education, there was overwhelming 100% improvement in their knowledge regarding infantile hearing loss. The study shows the poor awareness among the population of Puducherry regarding consanguineous marriage and infantile hearing loss, thus requiring a widespread sensitization about infantile hearing loss which can prevent lifelong consequences of the hearing disability.

Otological Manifestations in Head Injury: Experience from a Tertiary Academic Centre.

Head injuries are most commonly associated with serious otolaryngological involvement. This study was done to identify the otological manifestations and its sequelae among patients with head injury. A prospective study conducted in a tertiary care centre, among patients attending the Emergency medicine, Otorhinolaryngology and Neurosurgery departments from August 2017-July 2018 with head injury and associated otological manifestations. They were examined within 48 hours of admission and followed up for two months. There were 243 patients with head injury, among which 201 were male and 42 were female patients. Majority of them (44.8%) were between 21 and 40 years of age. Road traffic accidents (RTA) was the commonest cause of head injury occurring in 91.8% patients. Among them, 58 patients (23.9%) had otological manifestations, the most common symptom and sign being ear bleed (72.4%) and temporal bone fracture (46.6%) respectively followed by facial nerve palsy (24.1%) and hearing loss (22.4%). Temporal bone fracture had statistically significant association with ear bleed, hearing loss, facial palsy and CSF otorrhoea (p = 0.0001) and tympanic perforation (p = 0.03). Otological involvement occurred in almost one fourth of the patients with head injury, the most common serious complication being temporal bone fractures which was diagnosed in almost half of this population followed by facial nerve palsy. Ear bleed, hearing loss and CSF otorrhea are significant indicators of underlying temporal bone fractures, necessitating early ENT evaluation and HRCT temporal bones for timely detection and prevention of disabling otological complications.

Innovations in Health Professionals' Education; the 'Video Case Scenario' or MOSCE.

To develop a new model of case scenarios for medical students attending practical exams, in a more feasible and effective method for practical assessment exams, so as to improve the quality of assessment both subjectively and objectively, and bridge the gap produced by paper cases and clinical scenarios. We involved real patients as well as mock subjects who voluntarily co-operated for the video recordings, and used typical formats for 'history taking' which were carefully curated, edited and drafted into their final form and shape before presenting to the students. This was combined with clinical and local examination findings of the respective case history. Combining both, the students were asked to write case sheets and narrate them. A greater number of students reported increased satisfaction and level of confidence after exposure to the video case scenarios, compared to discussing paper cases in either online or offline mode, and this difference was statistically significant. A chi-square test was used to measure the satisfaction score with paper cases and video case scenarios, using the number of students who provided responses on a Likert type scale presented through a Google survey. Video case scenarios are an effective method for teaching clinical case presentation, and are also a more efficient way for assessment, fostering active listening skills and critical thinking. This exam model can bring about a uniform, objective and standardized way of evaluating the students.

Effectiveness of Over-The-Counter Intranasal Preparations: A Randomized Trial.

To compare the effectiveness of over-the-counter normal saline with nasal decongestant drops for the symptomatic relief of nasal congestion, and to determine if nasal drops used alone are effective in the treatment of patients suffering from nasal congestion. Prospective, randomized double blinded study. Otorhinolaryngology Outpatient Department. Patients suffering from nasal congestion and similar symptoms such as nasal discharge, dryness, crusting, sneezing, itching and loss of smell. Resolution of symptoms based on visual analog scale and objective findings on anterior rhinoscopy. Chi-square test was done for comparison between the saline and decongestant groups. Subgroup analysis was done for patients on additional medication such as antibiotics. The p value is 0.701671 for the effectiveness of saline against that of decongestant, thus no significant difference exists between them for the relief of nasal congestion. The p value is 0.007497 for those on antibiotics and those that were treated only with nasal drops, thus showing a significant difference (level of significance being p < 0.05). The effectiveness of both nasal saline and decongestant drops in bringing about relief of nasal congestion is similar, and both of them may also cause headache though the mechanism is not well understood from this study. Relief might be primarily obtained with the help of oral medication and not the use of nasal drops. Level of evidence: Single-center randomized trial, level II b.

Reliability of Thyroid FNAC as a Single Diagnostic Modality: A Systematic Review.

To determine the reliability of thyroid FNAC as a single diagnostic modality in the case of nodular neoplastic lesions of the thyroid. Multiple databases were searched using the MESH terms thyroid*lesion*nodule*neoplasm*fine needle aspiration*histopathology*correlation. Meta analyses, RCTs, cohort or case control studies and case series were searched. 61 studies were examined to verify the search results after applying the inclusion and exclusion criteria. 422 studies were excluded after the first screening, leaving 61 full text articles. These were further analyzed for outcomes, and ultimately 9 studies were chosen for the final synthesis on the basis of clear recommendations given. FNAC as a single modality for the diagnosis of nodular neoplastic thyroid lesions is highly variable and therefore unreliable. The diagnostic yield may be improved if the Bethesda system of reporting is applied.

Review Article: Retropharyngeal Abscess-Mimickers and Masqueraders.

To discuss a case of suspected retropharyngeal abscess having important clinical and academic significance. This paper discusses an unusual presentation and evolution of a well known condition such as retropharyngeal abscess. Though the diagnosis in this case was initially a retropharyngeal abscess, several unusual findings were evident, which interfered with the optimal management of the patient. A literature review revealed rare causes and lesions mimicking a retropharyngeal abscess, such as retropharyngeal calcific tendinitis and Kawasaki disease, which are neither familiar to otolaryngologists nor other specialists such as orthopedicians. It is possible that this patient was both over treated and undertreated at the same time. Though the diagnosis in this case could not be established with certainty, several important pieces of information came up, especially unusual causes of retropharyngeal abscess and management of the same. Retropharyngeal abscess is a well-known condition with established modes of management. However, certain variations may occur and may pose challenges in diagnosis and management. These variations are little known and need to be highlighted so that optimal management is ensured.

Erratum to: Review Article: Retropharyngeal Abscess-Mimickers and Masqueraders.

[This corrects the article DOI: 10.1007/s12070-017-1105-6.].

Working mothers: how much working, how much mothers, and where is the womanhood?

Motherhood confers upon a woman the responsibility of raising a child. This process also changes the way in which she is perceived in society and at her workplace. It can necessitate her to take more than available leave options, and job security can be at risk. Significant social and personal adjustments are necessary to cope with such a situation. A working mother, especially one who has the good fortune to be able to balance her home and work, enjoys the stimulation that a job or career provides. She develops the ability of raising a useful member of society and at the same time gains financial independence. Along with motherhood, work adds to the completeness of being a woman.

Medicine as a corporate enterprise: a welcome step?

The medical profession is set for a change. It is being redesigned as a corporate enterprise. The health-care industry has proved to be lucrative and therefore has seen the entry of newer players from the corporate field into the market. The "Medical-Industrial complex" has led to the commercialization of health care well beyond what traditional practitioners would consider ideal. Medicine is being treated as a business, with cost curtailment measures and profit margins often dictating physicians' choices. A number of factors decide working environment in a corporate setup, all of which may affect the sacrosanct physician-doctor relationship and "physician" ethics. On the other side, the ability of the corporate sector to bring about a welcome change in the health-care sector in terms of availability of newer modalities of management, implementation of preventive and personalized health-care programme and, at the same time, adding to the comfort of the treating physician cannot be ignored.