Minimum Allergen Screening Panel for Allergic Rhinitis in Bangalore: A Cross Sectional Study.

Allergic rhinitis (AR) is a very common condition presenting to an Otorhinolaryngologist. Prevalence of AR is on the increase and it has significant impact on quality of life of the patient. Skin prick test (SPT) is a simple test to determine allergen sensitization status in patients with AR. There is wide variation in allergen panel used in SPT among various allergy clinics and many centres use a large panel of allergens which requires multiple skin pricks for the patient undergoing the test. Our aim was to identify a minimum panel of allergens among patients with symptoms of AR undergoing SPT which could be used as a screening panel for AR. The present study is a cross sectional study in patients with symptoms of AR undergoing SPT at Allergy clinic of Bangalore Baptist hospital over a period of 18 months from January 2018. 149 patients were included in the study and 26 patients who had negative SPT for all allergens tested were excluded. Prevalence of sensitization for individual allergens was calculated. House dust mite (Dermatophagoides pteronyssinus and Dermatophagoides farinae) was the most prevalent allergen to which 73.9% and 65.8% of our study population was sensitized respectively. We identified a minimum allergen panel of 3 allergens (Dermatophagoides pteronyssinus, Lambs quarter and Dermatophagoides farinae) which could identify > 90% of patients sensitized in the study group.

Fiberoptic Endoscopic Evaluation of Swallow (FEES) in Intensive Care Unit Patients Post Extubation.

Intensive care unit patients frequently require prolonged intubation and ventilator support. Swallowing dysfunction often occurs in patients who receive prolonged mechanical ventilation. Intubation can cause transient injury to the larynx with a subsequent reduction in protective mechanism and increased incidence of oropharyngeal secretions once patient is extubated. Aim of this study was to evaluate the anatomical damage caused by intubation and the occurrence of aspiration/silent aspiration in patients following extubation, using fiberoptic endoscopic evaluation of swallow (FEES) as diagnostic and therapeutic tool. Participants in the study included all adult ICU patients who were intubated for ≥ 48 h. Head injury patients, patients with abnormal neurological status, completely disoriented patients were excluded. We performed FEES in 41 patients. Duration of intubation was in the range of 2-9 days. We studied 41 patients, among them 19(44%) patients had laryngeal injury and 6 (14%) had aspiration. we noticed that all patients who had aspiration had some laryngeal injury. All 6 patients who had aspiration initially recovered their swallowing function fully as noticed during repeat FEES done after swallow therapy. There is a significant impact of intubation on occurrence of aspiration (14%) and laryngeal abnormality (44%). We found in our study that there is a significant correlation to duration of intubation and occurrence of laryngeal injury.