A Retrospective Study of Clinical Profile of Patients with Autoimmune Inner Ear Disease.

Bilateral sensorineural hearing loss can be a very distressing symptom and can affect the efficiency of a person and one's quality of life. Conditions causing bilateral hearing loss are very few and autoimmune aetiology is one of them. Autoimmune ear disease is characterised by bilateral, mostly fluctuating audiovestibular symptoms and symptoms which respond to steroids. Diagnosis of AIED presents a unique challenge to clinicians due to the lack of standardized diagnostic criteria or reliable pathognomonic tests. The purpose of the study is to evaluate the patients who fit into criteria of autoimmune inner ear disease and understand the clinical features and response to medications for the same. A retrospective chart review of patients presenting with rapidly progressive bilateral hearing loss was done. The clinical presentation including detailed history and examination findings along with the blood investigation reports and audiograms were recorded in a tabular form. The study included 6 patients - 3 male and 3 female patients. Age of the patients at onset of hearing loss varied between 24-35 years. 3 of 6 patients presented with primary autoimmune ear disease and other 3 had hearing loss secondary to systemic autoimmune disease. All patients were treated with systemic steroids, but however showed a varied response. Patients with primary AIED were administered inner ear steroid therapy as well. AIED is thus a diagnosis of exclusion done with high index of suspicion. Patients with bilateral progressive sensorineural hearing loss should be evaluated for autoimmune etiology. Oral steroids with intratympanic steroids are currently the mainstay of treatment for AIED. Guarded prognosis of hearing improvement is noted in these patients. Hence, emphasis should be placed on early hearing rehabilitation for better quality of life.

A Feasible, Low-Cost, Capsicum and Tomato Model for Endoscopic Sinus and Skull Base Surgery Training.

To describe and standardize an easily available, viable, low-cost capsicum and Tomato model for endoscopic sinus and Skull Base surgery training. Rhinology fellows performed the following stimulated endoscopic sinus exercises using the capsicum and tomato models at our centre using a Karl Storz angled Endoscope and Medtronic Debrider with various angled blades. Each student dissected 10 specimens before training these procedures on human patients, and the benefit of the capsicum and tomato models training was evaluated. 10 rhinology fellows of comparable academic level participated in the training. All participants agreed that the capsicum and tomato model dissections improved their skills in using powered instruments and endoscopic instruments, 90% agreed that the dissections improved their hand-eye coordination, precision, the manoeuvrability of angled blades and confidence with respect to their further training in human patients. A novel technique of low-cost model using Capsicum and Tomato has been used for training fellows in endoscopic sinus and Skull Base surgery. However, no standardization of this training has been performed to ensure that it is a valuable tool for learning and skill-building. The standardized method described in this study increased the skills and confidence of the fellows before beginning their training on human patients. Moreover, our results demonstrate the feasibility of the model, considering its cost-effectiveness and easy availability. A novel technique of low-cost simulation exercises using capsicum and tomato have been described. Future studies with this model should be conducted to assess whether the resulting increase in skills prevents and reduces medical errors, increases patient safety, reduces training costs, and improves the quality of otolaryngological care.

Sodium Fluoride and Fluoride Contaminated Ground Water Induced Altered Reproductive Performances in Male Rats.

Present study was undertaken to investigate the toxic effect of sodium fluoride (NaF)- and fluoride (F)-contaminated ground water on reproductive performances of male rats. Healthy adult male rats were categorised into three groups, first group of rats were served as control, whereas second group of rats were orally intubated with NaF (10 mg/kgbw/1 ml/rat) and third group of rats were allowed to drink F-contaminated ground water (5 mg/L) through drinking water bottles for 52 days. Exposure of NaF- and F-contaminated ground water caused significant decline in sperm motility, serum concentration of testosterone, and increase in sperm abnormality compared with controls. Further, significant histological alterations characterized with shrunken seminiferous tubules and degeneration of different stages of spermatogonial cells were observed in rats treated with NaF- and F-contaminated ground water. After the confirmation of toxic effect of F, these NaF- and F-contaminated ground water-treated male rats were allowed to mate with proven fertile untreated female rats to study the reproductive performances of male rats. There was a decline in parturition index, fertility index of male and female, gestation index and number of pups delivered in NaF-treated male rats compared with controls. However, gestation index and number of pups delivered were declined in F-contaminated ground water-treated male rats compared with controls. These results clearly indicate that F exposure affected the reproductive performances of male rats. The present study further revealed the fact that F-induced decline in testosterone levels, reduced sperm motility, and loss of spermatogonial cells affected the reproductive performances of male rats.

Time-dependent effect of ground water fluoride on motility, abnormality and antioxidant status of spermatozoa: An in vitro study.

The present study was undertaken to investigate the toxic effect of ground water fluoride (F) on motility, abnormality, and antioxidant status of spermatozoa. Treatment of ground water F with epididymal sperm suspension caused complete loss of sperm motility and decrease in the activities of superoxide dismutase (SOD) and catalase (CAT) and increase in the concentration of malondialdehyde (MDA) and abnormality of spermatozoa at 15 and 30 min time intervals. Further, incubation of spermatozoa with ground water F for 5, 10, and 15 min time intervals significantly reduced the sperm motility and activities of SOD and CAT and increased the concentration of MDA and abnormality of spermatozoa. The study revealed that F-induced effect on sperm motility and antioxidant status is time dependent. Increase in oxidative stress and concomitant decrease in motility of spermatozoa in ground water F clearly indicates that F-induced oxidative stress affected the sperm motility. The present study for the first time demonstrated the toxic effect of ground water F on spermatozoa at shorter duration of exposure, which affects the capability of spermatozoa in fertilization.