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The term "idiopathic lymphoplasmacellular mucositis" (ILPM) refers to a set of conditions marked by extensive lymphocyte and plasma cell infiltrates in the submucosa which can involve the oral cavity, upper respiratory tract and the genital epithelium. There is no recognized cause of ILPM, and the diagnosis is mostly done on an exclusion basis. Herein, we report a 32-year-old man presented with an erosive ulcerated lesion on the hard palate and review the literature regarding the possible differential diagnosis including squamous cell carcinoma. We also reviewed the previously reported cases of ILPM with palatal involvement to summarise clinical presentation, treatment, and outcome of the entity to date.
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BACKGROUND: During the COVID-19 pandemic-associated mucor epidemic, acute antifungal drug shortage necessitated the exploration of other antifungals based on culture sensitivity. Itraconazole is a cheap, safe, and effective antifungal in sensitive cases. METHODOLOGY: We enrolled itraconazole-sensitive COVID-19-associated mucormycosis during the mucormycosis pandemic. After the intensive phase course of liposomal amphotericin B, Itraconazole was offered in susceptible cases during the maintenance phase along with standard of care. These patients were clinically and radiologically followed for 6 months. RESULTS: We enrolled 14 patients (Male: Female-11:3) of Rhino-orbito-cerebral mucormycosis (ROCM) which included 12 diabetics. All patients had facial swelling, orbital swelling, visual impairment, and headache. MRI showed involvement of bilateral sinus (10/14), orbital extension (13/14), cavernous sinus (5/14), cerebral part of the internal carotid artery (3/14), and brain infarcts (4/14). All 14 patients showed sensitivity to Itraconazole with 12 having minimum inhibitory concentration (MIC) ≤ 1 µg/ml and 2 having MIC ≤ 2 µg/ml. Follow-up at 6 months showed clinical improvement in the majority (11/14) and radiological improvement in six out of seven scanned patients. CONCLUSION: Our study shows the potential therapeutic role of oral Itraconazole in ROCM.
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Anfotericina B , Antifúngicos , Itraconazol , Mucormicosis , Rhizopus oryzae , Humanos , Masculino , Itraconazol/uso terapéutico , Itraconazol/administración & dosificación , Femenino , Mucormicosis/tratamiento farmacológico , Anfotericina B/uso terapéutico , Anfotericina B/administración & dosificación , Antifúngicos/uso terapéutico , Antifúngicos/administración & dosificación , Persona de Mediana Edad , Adulto , Rhizopus oryzae/efectos de los fármacos , Pruebas de Sensibilidad Microbiana , COVID-19/complicaciones , Anciano , Quimioterapia Combinada , Resultado del TratamientoRESUMEN
Northeastern states of India are known for unique landraces of Capsicum spp. with geographical indications. However, little information is available about these valuable landraces of chillies. Surveys and collections were carried out in niche areas to find out their ecology and diversity through morphological traits and molecular analysis using microsatellite markers. Our result characterized the ecology of niche areas as cool (11.0°C-20.7°C) and humid (>60% relative humidity) climates for dalle-chilli (Capsicum annuum L.); mild-warm (12.2°C-28.6°C) and humid for king-chilli (C. chinense Jacq.); and cool to warm (11.3°C-33.1°C) and humid for bird's eye chilli (C. frutescens L.) during the crop period. The canonical correspondence analysis has shown the significant impact of temperature on the agro-morphological traits and distribution of the landraces in their niche areas. A wide variability was observed for different quantitative traits and yield attributing characters (fruit length, diameter, weight, and yield), showing high heritability (97.0%-99.0%), and genetic advance as a percentage of the mean (119.8%-434.0%). A total of 47 SSR markers used for the molecular analysis generated 230 alleles, ranging from 2 (HPMSE-7) to 10 (HPMSE-5), with an average of 4.89 alleles per locus. The average polymorphism information content was also high (0.61) and ranged from 0.20 (HPMSE-7) to 0.85 (CAMS-91). The observed average heterozygosity was lower than the expected value. Analysis of molecular variance has shown significant variation within (69%) and between (31%) of the populations of Capsicum spp. Based on Nei's genetic distance, bird's eye chilli and king-chilli were found to be closer to each other, whereas dalle-chilli, a tretraploid species, was closer to hot pepper (C. annuum). However, the flower size of dalle-chilli was large and found closer to king-chilli in color and differs from C. chinense due to the presence of calyx teeth. For quality traits, landraces king-chilli, dalle-chilli, and bird's eye chilli have shown 2.8, 2.0, and 1.4 times higher average capsaicin and 0.46, 0.25, and 0.22 times higher average oleoresin content over the hot pepper, respectively. The knowledge of ecology and diversity can be used in identifying new areas for production, selection of elite lines, conservation, and crop improvement.
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In the present study, an attempt has been made to assess the impact of vehicular noise upon the 3-wheeler tempo drivers and to know whether there is any relationship between hearing loss and cumulative noise exposure. For this purpose, 3-wheeler tempo drivers (Exposed group) and non-commercial light motor vehicle car drivers (Unexposed group) were chosen as study subjects. Three traffic routes were selected to assess the noise level during waiting and running time in the exposed and unexposed groups. Among all three routes, the highest mean noise level (Leq) was observed on the Chowk to Dubagga route for waiting and en-route noise measurement. It was measured as 84.13 dB(A) and 86.36 dB(A) for waiting and en-route periods of 7.68 ± 3.46 and 31.05 ± 6.6 min, respectively. Cumulative noise exposure was found to be significantly different (p < 0.001) in all age groups of exposed and unexposed drivers. Audiometric tests have been performed over both exposed and unexposed groups. The regression analysis has been done keeping hearing loss among tempo drivers as the dependent variable and age (years) and Energy (Pa2 Hrs) as the independent variable using three different criteria of hearing loss definitions, i.e., World Health Organization, National Institute for Occupational Safety and Health (NIOSH), Occupational Safety and Health Administration criteria. Among these three criteria, the NIOSH criterion of hearing loss best explained the independent variables. It could explain the total variation in dependent variable by independent variable quite well, i.e., 68.1%. The finding showed a linear relationship between cumulative noise exposures (Pa2 Hrs) and the exposed group's hearing loss (dB), i.e., hearing loss increases with increasing noise dose. Based on the findings, two model equations were developed to identify the safe and unsafe noise levels with exposure time.
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Sordera , Pérdida Auditiva Provocada por Ruido , Ruido en el Ambiente de Trabajo , Enfermedades Profesionales , Exposición Profesional , Humanos , Pérdida Auditiva Provocada por Ruido/diagnóstico , Pérdida Auditiva Provocada por Ruido/epidemiología , Pérdida Auditiva Provocada por Ruido/etiología , Ciudades , Ruido en el Ambiente de Trabajo/efectos adversos , Exposición Profesional/efectos adversos , Exposición Profesional/análisis , Análisis de Regresión , India/epidemiologíaRESUMEN
Oral submucous fibrosis (OSMF) is a chronic debilitating and a well-recognized potentially malignant condition of the oral cavity, sometimes involving oropharynx associated with trismus and burning sensation. Apart from medical management and counselling, local injection of hyaluronidase mixed with triamcinolone acetonide has been used at our centre for the last 20 years with satisfactory clinical results and without any significant side effects. The problem with the treatment was that the doses and duration of treatment has not been standardized. Therefore, in this study, authors aim to evaluate and compare the efficacy of Triamcinolone alone versus Triamcinolone acetonide plus Hyaluronidase at weekly interval and improvement in Clinical and Histopathological staging of disease after 6 weeks of treatment. This study was conducted in Department of Otorhinolaryngology & Head Neck Surgery, with a total sample of 80 participants divided into two Groups, group A received Inj. Triamcinolone acetonide and group B received Inj. Triamcinolone Acetonide and Hyaluronidase 1500 IU at weekly interval. Pre-treatment and post-treatment clinical and histopathological profile of the patients were recorded and analyzed using SPSS 16 software. According to pre-treatment status, the proportion of clinical grades I, II and III were found in proportion 12.5%, 18.8% and 15.0% respectively. No significant difference was found in proportion of various grades between the groups (p = 0.388). At post treatment, the grading was reduced with changed proportion of grades I, II and III cases as 33.8%, 41.3% and 7.5% respectively. There was no significant difference in proportion of various grades between the groups (p = 0.681). Further, the intragroup comparison showed significant improvement Pre to post in group A (p = 0.002), Group B (p < 0.001) and overall, as well (p < 0.001). The inj. Triamcinolone acetonide and Inj. Hyaluronidase showed a better improvement on post treatment histopathological grading although the difference between the two groups was not significant statistically.
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AIM: Analysis of newborn hearing screening (NBS) outcomes and proposing a modified strategy for better performance of NBS in developing world. DESIGN: Descriptive (retrospective and prospective) study. METHODS: A total of 8412 newborns/neonates were subjected to risk factor assessment followed by a set of subjective (behavioral audiometry: BoA) and objective (OAE: otoacoustic emissions, ABR: auditory brainstem-evoked responses) hearing-screening in different combinations. DPOAE (primary objective tool) was undertaken in 2565 cases. Predictive value of risk factors on deafness was statistically analysed along with affectivity of objective, subjective and questionnaire-based screening tools. RESULTS: Amongst 8412 babies, 45.5% were 'at risk' (major 36.41%, minor 9.17%). The OAE was abnormal in 299 cases (11.6% of 2565 & 3.5% in 8412). The abnormal OAE rate in prospective cases was 3.5% while in retrospective cases that underwent initial screening with BoA was 41%. A significant correlation was seen with consanguinity, high blood pressure, NICU stay>5 days, low birth weight, neonatal jaundice, delayed birth cry, pre-mature status, birth asphyxia and maternal excessive vomiting, while regression models of OAE outcome (sensitivity 99%, accuracy 89%) revealed highest predictive value for the initial 3 factors. BoA-screening revealed a sensitivity of 72.6%, and negative predictive value of 42.4%. Also a perfect correlation was evident between OAE-ABR, OAE-BoA and ABR-BoA. CONCLUSION: A subjective NBS screening through questionnaire-based-risk-assessment and modified-BoA followed by selective referral for objective assessment is more practical and focussed approach for poor resourced countries that is likely to screen a larger population.
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Asfixia Neonatal , Recién Nacido , Lactante , Humanos , Estudios Retrospectivos , Consanguinidad , Potenciales Evocados Auditivos del Tronco Encefálico , AudiciónRESUMEN
The objective of this study was to find distribution of ABO blood group in patients of allergic rhinosinusitis and also to map evidence of the association of TNF-α in different blood groups of patients suffering from allergic rhinitis with or without nasal polyp. Prospective Observational study. Patients with allergic nasal symptoms aged between 18 and 70 years attending outpatient department were assessed and eligible patients who gave consent for the study were included. Patients of allergic rhinosinusitis with nasal polyp had higher serum Ig E count as compared to patients without nasal polyp. 97 patients of allergic rhinosinusitis were Rh positive. Allergic rhinosinusitis was most common in blood group O + ve and B + ve. Allergic rhinosinusitis with polyp was most common in B + ve and without polyp was in O + ve. The frequency of GG, GA and AA genotypes of TNF-α (-308) G/A were 40%, 58%, 2%. The frequency TNF-α (-308) GA was maximum in patients of allergic rhinosinusitis with polyp. In patients of allergic rhinosinusitis without polyp TNF-α (-308) GA and GG had equal distribution of patients (48.6%). The frequency of single allele G in both groups was high as compared to allele A. Association of blood group with allergic rhinitis and TNF-α might help clinicians in better understanding and management of patients suffering from allergic rhinitis in future.
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Aroids are an important group of indigenous tuber crops, grown widely for their leaves, petioles, stolons, corms, and cormels. A total of 53 genotypes were evaluated for their genetic diversity in northeastern region of India. At household level, a total of 16 landraces of Aroids were recorded having different ethnobotanical uses. Based on the population study under Jhum/Shifting farming, landrace Rengama was dominant in area with 47% of the total population followed by Tamachongkham and Tasakrek. However, Pugarkusu and Chigi occupied 33.0 and 24.0% of the population, respectively under backyard farming, and were considered as major landraces. Tamachongkham, high in acridity and total oxalate content (0.82%), was used for cooking with meat, while Tasakrek was used as a baby food due to high total sugar (>3.0%), low in acridity, and total oxalate content (<0.12%). The Simpson's diversity index of the backyards was higher (0.80) as compared to Jhum field (0.63). The genotypes showed wider variability in growth and yield attributes like; plant height (89.4-206.1 cm), number of side shoots (1.84-5.92), corm weight (38.0-683.3 g), cormel weight (14.0-348.3 g), yield (0.24-1.83 kg plant-1). Similarly, wide variations were also observed for quality traits like total sugar (1.93-4.94%); starch (15.32-32.49%), total oxalate (0.10-0.82%), and dry matter (16.75-27.08%) content. Except for total oxalate, all the growth and yield attributes have shown high heritability and moderate to high genetic advance. Molecular analysis (33 polymorphic SSR markers) detected a total of 136 alleles, ranged 3 to 8 alleles per marker. The observed heterozygosity (0.24) was less than expected heterozygosity (0.69). The group-wise maximum genetic divergence was observed between Colocasia fallax (cv. Chigi) to C. esculenta var. aquatilis (cv. Tharsing); C. fallax (cv. Chigi) to C. gigantea (cv. Ganima) and C. gigantea (cv. Ganima) to Xanthosoma spp., while it was least between eddo and dasheen. The findings indicated, a wider diversity and distinct ethnobotanical uses of Aroid landraces at the house hold levels, which should be conserved and popularized to ensure nutritional security.
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The eastern Himalayas, one of the important hotspots of global biodiversity, have a rich diversity of wild edible fruit trees. The fruits of these tree species have been consumed by the tribal people since time immemorial. However, there is limited information available on the biochemical and antioxidant properties of the fruits. Therefore, the present investigation was undertaken to study the physico-chemical and antioxidant properties of the nine most important wild fruit trees. Among the species, Pyrus pashia had the maximum fruit weight (37.83 g), while the highest juice (43.72%) and pulp content (84.67%) were noted in Haematocarpus validus and Myrica esculenta, respectively. Maximum total soluble solids (18.27%), total sugar (11.27%), moisture content (88.39%), ascorbic acid content (63.82 mg/100 g), total carotenoids (18.47 mg/100 g), and total monomeric anthocyanin (354.04 mg/100 g) were recorded in H. validus. Docynia indica had the highest total phenolic content (19.37 mg GAE/g), while H. validus recorded the highest total flavonoids and flavanol content. The antioxidant activities of the different fruits ranged from 0.17 to 0.67 IC50 for DPPH activity and 3.59-13.82 mg AAE/g for FRAP. These fruits had attractive pigmentation of both pulp and juice and were a good potential source for the extraction of natural edible color in the food industry. The fruits also possess high market prices; Prunus nepalensis fetched $ 34.10-$ 141.5 per tree. Therefore, these fruits are rich sources of antioxidants, pigments and have a high market value for livelihood and nutritional security.
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An epidemic of mucormycosis followed the second wave of COVID 19 in the state of Uttar Pradesh, India in May 2021. This epidemic, however, had additional challenges to offer in the form of acute shortage of all forms of amphotericin B, posaconazole and isavuconazole. It was, therefore, planned to assess the trends in minimum inhibitory concentration (MIC) of antifungal agents, viz itraconazole and terbinafine, and provide a template for personalized therapy to see whether the results could be translated clinically. This is an observational, single-center study. Samples comprising nasal swab, nasal and paranasal sinus tissue, brain tissue, brain abscess and orbital content, derived from 322 patients from northern India with mucormycosis, of whom 215 were male and 107 were female, were used for analysis. Cultures were identified both by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and conventional methods of identification. Antifungal susceptibility was done for amphotericin B, posaconazole, isavuconazole, itraconazole and terbinafine as per Clinical Laboratory Standard Institute M38-A2. The outcome was identification of the species of mucormycosis and susceptibility to itraconazole and terbinafine besides other primary antifungal agents. Patients or the public were not involved in the design, or conduct, or reporting or in the dissemination plans of our research. Of 322 patients, 203 were culture-positive, of whom 173 were positive by both MALDI-TOF and conventional methods of identification. Final antifungal susceptibility testing was available for 150 patients. The most common Mucorales found to cause this epidemic was Rhizopus oryzae, followed by R. microsporus Amphotericin B, posaconazole and isavuconazole had low MIC values in 98.8% of all Mucorales identified. The MIC of itraconazole was species-dependent. 97.7% of Roryzae had MIC ≤2 µg/mL. However, only 36.5% of Rmicrosporus had MIC ≤2 µg/mL. For terbinafine, 85.2% of R. microsporus had MIC ≤2 µg/mL. We conclude that identification at the species level is required as antifungal susceptibilities seem to be species-dependent. Assessment of the efficacy of itraconazole and terbinafine warrants further studies with clinical assessment and therapeutic drug monitoring as they seem to be potential candidates especially when the primary agents are not available.
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COVID-19 , Mucormicosis , Anfotericina B/farmacología , Anfotericina B/uso terapéutico , Antifúngicos/farmacología , Antifúngicos/uso terapéutico , Femenino , Humanos , Itraconazol/farmacología , Itraconazol/uso terapéutico , Masculino , Mucormicosis/tratamiento farmacológico , Mucormicosis/epidemiología , Mucormicosis/microbiología , Terbinafina/farmacología , Terbinafina/uso terapéuticoRESUMEN
The present study analysed the molecular and agro-morphological diversity in a set of 92 diverse cauliflower genotypes and two each of cabbage and broccoli. Field evaluation of the genotypes was done in randomized block design (RBD) at two locations (i.e. IARI, New Delhi and ICAR-RC-NEH Region, Barapani) during Rabi2019-20. Genotypes showed variation for all the eight observed traits at both locations and, the differences in early and snowball groups were distinct. Pusa Meghna, DC-33-8, Pusa Kartiki and CC-14 were earliest for curd initiation. Genotypes showed higher values for curd traits at Delhi. Molecular diversity was detected with 90 polymorphic simple sequence repeats (SSR). Number of alleles ranged from 1 to 9 with mean value of 2.16 and the highest polymorphic information content (PIC) value was observed for primer BoGMS0742 (0.68) with a mean value of 0.18. Cluster analysis using agro-morphological traits substantiated classification of the genotypes for maturity groups. However, SSR analysis revealed four clusters and with a composite pattern of genotype distribution. STRUCTURE analysis also supported the admixture and four subpopulations. The studyindicates for introgression of genetic fragments across the maturity groups, thereby, potential for use in further genetic improvement and heterosis breeding.
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Brassica/genética , Alelos , Botrytis/genética , Análisis por Conglomerados , Variación Genética , Genotipo , India , Polimorfismo GenéticoRESUMEN
Even before the onslaught of COVID-19 pandemic could settle, the unprecedented rise in cases with COVID-19 associated mucormycosis pushed the medical health to the fringe. Hyperglycaemia and corticosteroids appear to be the most consistent associations leading to the commonest manifestation of mucormycosis, Rhino-Orbito-Cerebral Mucormycosis. To address challenges right from categorisation and staging of the disease to the management of relentless progression, a multi-disciplinary expert committee was formed to handle the task in an evidence-based format to enforce best practices. The report of the committee on one hand attempts to succinctly present the currently available evidence while at the other also attempts to bridge the evidence-deficient gaps with the specialty-specific virtuosity of experts.
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OBJECTIVE: To assess olfactory and clinical morbidity in primary (idiopathic)-type atrophic rhinitis and its course following treatment. STUDY DESIGN: Prospective nonrandomized controlled cohort study with follow-up. SETTING: Department of Otorhinolaryngology and Head and Neck Surgery of a university hospital (tertiary heath care center). METHODS: Sixty-one patients with atrophic rhinitis underwent assessment of clinical severity with baseline olfaction with the Brief Smell Identification test, while the improvement of their status following surgical versus nonsurgical treatment was further assessed. RESULTS: Olfaction was universally deranged with bimodal age presentation and female predominance (61%). Clinical improvement was significantly associated with surgical treatment but did not reveal any relation with up-front severity of disease. A near-significant association of age with severity did not reveal significance when stratified by age group. Baseline olfaction or its change following treatment did not reveal any significance with severity of disease or clinical improvement. Radiologic atrophy also did not reveal any significant relation with severity criteria. CONCLUSIONS: Olfactory functions as compared with clinical parameters provided better reflection of underlying (systemic) pathology with environmental interaction, while later it mainly signified localized condition. Accordingly, olfaction was affected early and recovered slowly (or not at all), independent of clinical morbidity, which in turn is affected rather late but recovers early. Olfactory dysfunction at the initial stage may be a surrogate marker of potential worsening clinical condition, since bacteria often superinfect underlying susceptible nasal environment. While surgery mainly improved clinical parameters without affecting olfaction directly, a true improvement would include recovery of both.
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Chronic suppurative otitis media in almost any form can disrupt the integrity of ossicular chain. Various materials have been used for ossicular substitution or reconstruction, including both biologic and alloplastic materials. Teflon piston is now the most widely used prosthesis for reconstruction of the ossicular chain in cases of otosclerosis. The oto-surgeons are still confronted with problems of ossicular reconstruction regarding the surgical procedure to be done, type of graft to be selected especially in low and poor socioeconomic population. Thus, there is a need felt to comprehensively and holistically evaluate the outcome of ossiculoplasty using Autograft ossicle versus Allograft ossicle (Teflon). Total 64 patients of chronic suppurative otitis media with no active ear infection and air-bone-gap of more than 15 dB were admitted for surgery and divided into two groups according to material used for ossiculoplasty as group A (Autograft) and group B (Allograft). Patients were evaluated at 3 and 6 months post-operatively using audiogram. In both Group A and B, the average pre-operative AC was 40.62 dB (SD 9.65) and 39.37 (SD 10.53) respectively. In 3 months there was a change of 8.83% from 40.62 dB to 37.03 dB in Group-A (p < 0.109, not statistically significant) and 13.10% change from 39.37 dB to 34.21 dB in Group-B (p < 0.049, statistically significant) whereas at 6 months, air conduction improved by 14.22% in Group-A (p < 0.01, statistically significant) and by 21.81% in Group-B (p < 0.001, highly statistically significant). Post-operatively at 3 months, improved AB gap was 62.5% in Group-A and 68.75% in Group-B patients. Post-operative AB gap at 6 months, improvement was seen in 78.12% in Group-A while it was 81.25% in Group-B patients. Alloplastic Teflon ossicle appears to be a good alternative for ossicular reconstruction where autologous incus is not available or disease precludes its use.
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The worldwide population of diabetic patients is increasing alarmingly with India claiming number one position. It causes irreversible damage to cochlear hair cells, vestibular apparatus, visual pathway, nephrons, nerves, if not checked in time. A total of 188 patients of diabetes mellitus were included in this prospective study. The patients underwent routine anamnesis, hearing handicap inventory and dizziness handicap inventory assessment along with clinical examination for audiological, vestibular, neurological and ophthalmological (fundoscopy) status. In our study a sensorineural hearing loss, retinopathy, neuropathy, vestibulopathy was seen in diabetic patients.
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The incorporation of telemedicine and artificial intelligence for early screening and assessment of severity of life-style disorders has a great potential for better assessment in a busy outpatient clinic and thereby curtail down the related morbidities. A computer based algorithm based upon standardized questionnaire (from established assessment tools) is designed to assess the risk of obstructive sleep apnoea syndrome (OSAS). In addition the incorporation of basic screening questions of anamnesis help in suggesting a probable diagnosis of sleep related disorder as well. The overall data at our center has been analyzed to establish the existing pattern of sleep related disorders. Of 850 healthy subjects screened, prevalence of snoring was 20.47% while OSAS was seen in 4.20% (N = 25) in males and 2.64% (N = 8) in females. The parasomnia was most prevalent (14.71%), followed by insomnia (10.24%), periodic leg movement (6.59%), bruxism (1.65%) and narcolepsy (0.59%). Hypertension, laryngopharyngeal reflux and obesity were the common co-morbidities in OSAS while family history of hypertension and diabetes were common in snorers. A significant association with OSA was seen with diabetes mellitus, neck circumference and nasal obstruction, while, obesity and apnoeic episodes were more significantly associated with OSA than snorers. Increased waist to hip ratio was appreciated in both the OSAS and snorers. The algorithm based online assessment is likely to diagnose the occult clinical cases as well as assess the risk of OSAS. In routine outpatient clinic, a clinician may better assess the patient morbidity with a comprehensive availability of symptoms and moreover enhance the post-treatment compliance. In addition a smartphone based computerized assessment for general population may be designed for other lifestyle disorders as well.
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CONTEXT: Noise-induced hearing loss, one of the most common and preventable occupational hazard, occurs due to repeated and continuous exposure of loud noise, A single exposure of an impulse of noise at the level of 130--140 dB or long and repeated exposures to loud sounds to an average level of 85 dB or higher for an 8-h period can cause permanent loss of hearing. AIMS: To study and compare hearing loss over different audiometric frequencies among autorickshaw and non-commercial institutional personal car drivers. SETTINGS AND DESIGN: This was a cross-sectional comparative study conducted at a tertiary medical college, located in Lucknow during October 2017-November 2018. METHODS AND MATERIALS: The sample size was calculated using EpiInfo7. We took a sample size of 300 drivers, out of which 150 three-wheeler autorickshaw drivers (Tempo), that is, group I and 150 non-commercial car drivers, that is, group II were selected. STATISTICAL ANALYSIS USED: For statistical analysis, "Chi-square test of independence" and student's t-tests were used. RESULTS: The mean age at which drivers in group I and group II started work was 23.91 ± 7.63 years an d 23.60 ± 5.58 years, respectively. The mean hearing loss in Group I was 21.15 ± 8.65 dB and in group II it was 13.34 ± 5.79 dB. CONCLUSIONS: Autorickshaw drivers who were exposed to louder noise, that is, autorickshaw drivers in group I had more sensory neural hearing loss than the non-commercial car drivers, that is, group II.
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The evolution of the packing of postnasal space following transpalatal excision of JNA in the last 7 decades is described and a modification is presented for minimizing the immediate postoperative morbidity.
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OBJECTIVE: To assess the validity of a questionnaire (consisting of 10 items/questions) to identify hearing loss (HL) among three-wheeler tempo and noncommercial car drivers. MATERIALS AND METHODS: This was a cross-sectional study conducted in an urban area of Lucknow city. Three-wheeler tempo drivers and noncommercial car drivers were assessed for HL by audiometry. A total of 300 subjects, who fulfilled the study criteria, were selected for the interview and health assessment. The pure tone audiometry was conducted after >12 hours of the last noise exposure to avoid temporary threshold shift. RESULTS: The percentage of respondents aged between 31 and 40 years was 36%. The highest affirmative response item was "Do you have trouble hearing in noisy background?" constituting 68% and the lowest affirmative response item was "Do you have trouble understanding the speech of women and children?" constituting 33.7%. Kappa values showed that there was significantly (<0.05) mild agreement between most of the items and the gold standard for mid and high-frequency HL. The area under the curve for low, mid, and high frequency HL was 0.76% (95% CI = 0.68-0.84), 0.69 (95% CI = 0.73-0.75), and 0.67 (95% CI = 0.62-0.73), respectively. The sensitivity and specificity were reasonable for all the definition of HL at different cutoff scores. CONCLUSION: A self-reported questionnaire-based approach may be used for the assessment of HL especially when audiometry is not feasible.
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A few studies have reported incomplete resection of juvenile nasopharyngeal angiofibroma (JNA) following embolization. The likely effects of embolization, viz. shrinkage/reduced tensile strength may have increased the fragility of tumour, leaving remnants postoperatively particularly across hour-glass constriction of sphenopalatine foramina. This paper describes the likelihood of residual disease being left following embolization and hence the importance of extended surgery for complete excision.