Correlation Between Allergic Rhinitis and Body Mass Index: An Observational Study.

Allergic rhinitis is one of the most rampant diseases in the world and many studies have been conducted to find its risk factors. Various studies have shown that there is a correlation between allergic rhinitis and increased Body Mass Index (BMI). Obesity has several effects on the immune system that could play a major role in increasing allergic disease. Allergic rhinitis is known to produce mild eosinophilia. The purpose of this study is to assess the correlation between BMI and allergic rhinitis using the Absolute Eosinophil Count (AEC). Over a period of 6 months, 55 cases of allergic rhinitis were selected. The patients were investigated by Absolute Eosinophil Count and their Body Mass Index values were calculated based on weight and height measurement. There was a positive correlation between Absolute Eosinophil Count and BMI with a p value of < 0.0001 which in turn revealed a positive correlation between BMI and allergy. We conclude that patients with high BMI are more prone to allergic rhinitis and have higher Absolute Eosinophil Counts probably due to the immunological effects of adipose tissue on the progress of the allergic disease.

Bacteriological Profile and Antimicrobial Susceptibility Pattern in Chronic Suppurative Otitis Media: A 1-Year Cross-Sectional Study.

Inadequate antibiotic treatment, misuse/improper choice of antibiotic and poor compliance of patients have resulted in changes in susceptibility to antibiotics of the causative organisms and also development of resistance to commonly used antibiotics. Thus, this study aimed to identify the bacteriological profile and determine antibiotic susceptibility pattern in CSOM patients. This 1-year cross-sectional study was conducted on 120 clinically diagnosed cases of CSOM attending ear, nose, and throat outpatient department. Ear discharges obtained were processed for bacterial culture (aerobic and anaerobic). Antimicrobial susceptibility testing was done by Kirby-Bauer disc diffusion method. Demographic and clinical characteristics of the patients were recorded. Of total 120 cases, pathogens were isolated from 116 cases. The commonest aerobic organism isolated was Pseudomonas aeruginosa (38.79%) followed by Staphylococcus aureus (32.75%). Staphylococcus aureus showed maximum sensitivity to erythromycin (71.05%), followed by cotrimoxazole (63.15%) and ampicillin (55.26%). Maximum resistance was observed for ciprofloxacin (78.9%), followed by amoxiclave (55.26%). Pseudomonas aeruginosa showed maximum sensitivity to piperacillin (91.11%) followed by gentamicin (71.11%), amikacin (71.11%), moderate sensitivity to ceftazidime (51.11%); however resistance to carbpenicillin (60%). Ciprofloxacin was the most prescribed topical agent showing an increase in resistance to common organisms of CSOM. Hence, it is mandatory to study each case of CSOM bacteriologically to formulate local antibiotic policy for appropriate use of antibiotics. This will certainly help in achieving a safe ear and to control the organisms developing resistance to prevalent antibiotics.

Prevalence of Chronic Suppurative Otitis Media Among School Children Residing in Rural Area of Belagavi, South India.

To study the prevalence of chronic suppurative otitis media among school children in Belagavi, rural area of South India. A community based descriptive cross sectional survey was conducted in 7 schools of rural areas of Belagavi district in Karnataka over a period of 2 months between 15th July and 15th September 2018. A survey demographic data collection was done on 694 school children aged between 6 and 14 years attending these schools. A detailed history and otoscopic examination was done in the school premises. Data received from the study was entered and statistical analysis was done. CSOM was present in 36 (5.2%) out of 694 students examined among which 22 (6.8%) of them lived in families with overcrowding. H/o cleaning the ear with various materials was given by 27 (7.4%) of them. 29 (9.3%) of them had recurrent respiratory tract infection, 7 students had active disease. The prevalence of CSOM in this study is relatively lower in this part of the rural South India. There is a higher prevalence of safe disease with central perforation than unsafe disease. Recurrent respiratory tract infections and history of cleaning of ear were the predictors of CSOM among school children. There is a need for better knowledge of illness and screening programme for early detection and management.

Hearing Evaluation in Patients with Chronic Renal Failure: A 1 Year Cross-Sectional Study in a Tertiary Care Centre.

(1) To study the prevalence of sensorineural hearing loss among chronic renal failure patients. (2) To study the correlation between degree of hearing loss and the duration of chronic renal failure. This cross sectional study was conducted in the department of Otorhinolaryngology and Head and Neck Surgery at KAHER's Jawaharlal Nehru Medical College and KLEs Dr. Prabhakar Kore Hospital and Medical Research Centre, Belagavi from January 2018 to December 2018. 60 ears (30 patients) with chronic renal failure were included in the study. All 60 ears were subjected to ENT examination, pure tone audiometry and measurement of glomerular filtration rate. Patients with type 2 diabetes mellitus, suppurative otitis media, and other known causes of sensorineural hearing loss were excluded. The prevalence of sensorineural hearing loss was calculated among the chronic renal failure patients. The correlation, if any, was studied by statistical analysis between SNHL and duration of chronic renal failure, as well as type and degree of hearing loss. Sensorineural hearing loss was seen in 51.67% of the 60 ears with 18.33% had mixed hearing loss (p < 0.0001). Robust correlation was seen between severity of SNHL and the duration of chronic renal failure. Positive correlation was seen between SNHL and age of the patient. High prevalence of SNHL was seen in the chronic renal failure patients. Long standing cases had tendency of worse hearing levels. Age of the patients also seemed to have a positive correlation with SNHL severity. While evaluating a chronic renal failure patient, auditory impairment should always be kept in mind.

Study of Outcome of an Implanted Autologous Auricular Cartilage: A Preliminary Experimental Research in Rabbits.

To investigate the viability of the implanted crushed and uncrushed auricular cartilage graft with intact perichondrium with respect to macroscopic and microscopic parameters. Cartilage grafts from 8 white New Zealand rabbits were harvested from the right auricle, with intact perichondrial layers. There were two categories Pre implant and Post-implant and two types, mildly crushed and uncrushed cartilage graft. The cartilage grafts were implanted into the subcutaneous pockets over the right upper paraspinal area. At the end of 2 months, implanted grafts were retrieved and examined histopathologically. There was a difference among the both types of cartilages in both the categories with respect to chronic inflammation, fibrosis, cartilage mass viability and vascularization. The mildly crushed auricular autologous cartilage with intact perichondrium does not lose the viability and maintains the structural integrity and thus increasing the clinical predictability for cosmetic correction of nose in rhinoplasty.

Tracheo-bronchial foreign body aspiration in children: a one year descriptive study.

The aim of this work was to study the clinical presentation of tracheo-bronchial foreign body aspiration in children for its early diagnosis. This article attempts to address the potential hazards of foreign body inhalation in children and its subsequent management by rigid bronchoscopy. This study was conducted in Department of Otorhinolaryngology, K.L.E.S Dr. Prabhakar Kore Hospital, Belgaum, for a period of 1 year. Children less than 16 years of age with history suggestive or suspicious of foreign body aspiration were screened clinically and radiologically and those patients with high index of suspicion of foreign body were included in the study. All patients were subjected to rigid bronchoscopy under general anaesthesia and the results were analyzed. This study comprises of 29 patients with suspected foreign body aspiration. On rigid bronchoscopy, foreign body was found and successfully removed in 22 patients. Highest incidence was seen in boys between 1 and 2 years age. History of foreign body aspiration was absent in most cases and children presented with combination of symptoms. Obstructive emphysema was commonest chest X-ray finding. There was no significant difference in the site of foreign body aspiration on the right and left bronchus and commonest foreign bodies were vegetative type. Complication rates in this study were low as compared to previous studies. Tracheo-bronchial foreign body aspiration is very common in children. Foreign body aspiration usually presents as an un-witnessed episode and a high index of suspicion by the surgeon, even in absence of a positive history is necessary to prevent morbidity and mortality due to delayed or misdiagnosis. Foreign body aspiration is an emergency and should be removed by rigid bronchoscopy at the earliest to prevent complications.

Prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy.

The aim of the study is to compare the subjective (relief of symptoms) and objective (endoscopic visualization of ostium patency at the time of syringing) outcomes at the end of two procedures-Endonasal DCR versus External DCR with Mitomycin C and to assess the role of Mitomycin C in maintaining patency of nasolacrimal drainage system. Prospective randomized comparative study was performed. Thirty-five patients were enrolled in each endoscopic and external dacryocystorhinostomy groups with Mitomycin C (MMC) application. The 37 eyes underwent endonasal DCR (28 unilateral primary eyes + 1 bilateral primary eyes + 5 unilateral revision eyes + 1 bilateral revision eye) while 35 eyes underwent external DCR (34 unilateral primary eyes + 1 unilateral revision eye). Mitomycin C 0.2 mg/ml was applied intra-operatively for 5 min to the ostium site at the end of endonasal or external DCR procedure. Objective assessment by syringing at the end of 1 year in the endonasal group showed 35 eyes (94%) were patent, 1 (3%) was partially blocked and 1(3%) was completely blocked; while in external group all 35 eyes (100%) were patent. Endoscopic visualization of the ostium at the time of syringing showed only one eye (3%) in the endonasal group was blocked while all the other eyes in both groups were patent. Both groups had a mean follow-up of 6-36 months. No complications were associated with use of Mitomycin C. In conclusion, intra-operative use of Mitomycin C in both endoscopic DCR and external DCR is safe and effective in increasing the success rate.

Ossiculoplasty: revisited.

Conductive hearing loss from ossicular chain abnormalities may result from either discontinuity or fixation of the ossicular chain. The ideal prosthesis for ossicular reconstruction should be biocompatible, stable, safe, readily available, and capable of yielding optimal sound transmission. At present ossiculoplasty techniques using alloplast materials are becoming popular but the fate of these synthetic materials in human middle ear requires further study. Autologous ossicle or cortical bone grafts maintain their morphologic contour, size, shape, and physical integrity for long periods of time, over 25 years making them still the choice at present. The choice of technique will still depend on the causative pathology, availability of graft, surgical experience.

Prevalence of Nasal Septal Deviation in New-borns and Its Precipitating Factors: A Cross-Sectional Study.

To estimate the prevalence of neonatal nasal septal deviation and to identify the precipitating factors. 250 neonates were examined on the 2nd day using Gray's struts for the presence of deviated nasal septum. Struts passing up to the 4 cm mark was taken to be normal, while struts getting stuck before the 4 cm mark was diagnosed to have deviated septum on that particular side. Out of 250 neonates, 49 had nasal septal deviation. There was significantly higher number of deviations in neonates of primiparas, emergency LSCS and in high birth weight babies. Neonatal septal deviation is quite common, being present in approximately 20% of all newborns. Greater amount of birth trauma increases its incidence further.

Innovative surgical management of large vallecular cysts.

Vallecular cysts are rare and vary from small cysts to large ones occupying the whole vallecula obscuring the view of the larynx. In the latter situation careful assessment and planning of airway management is required as in our case.

A comparative study of endoscope assisted myringoplasty and micrsoscope assisted myringoplasty.

OBJECTIVE: To determine the advantages and disadvantages of the endoscope as compared to the microscope in myringoplasty surgery and to compare the results of both groups. METHODS: Between January 2003 and September 2006, 100 patients underwent myringoplasty, 50 were endoscope assisted and 50 were microscope assisted. Results of surgery were compared at the end of six months post operation. RESULTS: In the endopscope group 82% of patients had a successful outcome and in the microscope group 86% of patients had a successful outcome. CONCLUSION: In myringoplasty surgery the endoscope has several advantages and a few disadvantages. The surgical outcome of endoscope assisted myringoplasty was comparable to the conventional microscope assisted myringoplasty, but in terms of cosmesis and post operative recovery patients in the endoscope group had better results.

Endonasal dacryocystorhinostomy: a prospective study.

OBJECTIVE: The objectives of this study are to report the results of Endonasal Dacryocystorhinostomy (EnDCR) and the role of silicon intubation in EnDCR in Indian population. STUDY DESIGN: The authors conducted a prospective case series. METHODS: 290 patients underwent EnDCR between January 2002 and July 2007 - 240 cases without silicon intubation and 50 cases with silicon intubation. Patients were followed up for an average of 18.6 months in first group and 5.2 months in second group. Outcome was evaluated subjectively and objectively. RESULTS: In EnDCR without silicon intubation, the procedure was successful in 93.3% of cases. In EnDCR with silicon intubation, the procedure was successful in 96% of cases. CONCLUSION: EnDCR is a safe procedure with good success rate and has potential advantages in chronic dacryocystitis cases. The use of silicon intubation in nasolacrimal pathway helps in maintaining the patency of rhinostomy.

An unusual cause of stridor-a case report.

Slridor in children is usually acute in onset and most commonly caused by infections such as acute laryngitis, laryngotracheobronchitis, and acute epiglottitis. Stridor due to foreign body is also not uncommon. The case reported is that of a large upper thoracic pre and paravertebral abscess presenting with stridor. Although a rare cause, it presents as a life threatening entity requiring urgent treatment.