RESUMO
The parotid gland is the largest salivary gland in the body. Pleomorphic adenomas (PA) are most common benign tumors of parotid gland. If left untreated, they can gradually attain the size which can weigh several kilograms. This paper highlights a case series of 15 cases diagnosed as giant pleomorphic adenoma arising in the parotid gland along with their management. A hospital based, observational study of 15 patients of PA of the parotid gland, > 10 cm in its widest dimension considered as giant, done at tertiary care ENT hospital over period of 9 years. The age of the patients ranged from 30 to 81 years with mean age 50.33 ± 15.30 years. There were 5(33.33%) males and 10(66.67%) females. The time duration of having tumor ranged from 5 to 20 years with mean duration of 10.4 ± 4.17 years and the largest tumor was 25 cm in its largest diameter. Mean weight of tumors was 2.72 ± 0.52 kg. One out of fifteen cases was detected as malignant in nature. All cases were treated by surgical excision without any complications. Pleomorphic adenoma of parotid gland can assume a giant proportion when timely surgical intervention is not done. We can build up confidence and hope for life in patients after complete surgical excision of giant PA.
RESUMO
To observe and compare the functional outcome in term of hearing gain in ossiculoplasty with autologous incus and Teflon made TORP/PORP in cases of chronic otitis media (COM) with ossicular disruption. 60 patients of COM between age of 11-50 years who had ossicular disruption were included in the study. They were divided into two groups of 30 patients/ group: group 1 included those patients who had mucosal COM and group 2 included those who had squamous COM. They were further subdivided into 3 subgroups each as per the ossiculoplasty material used. Pre-operative pure tone audiometry (PTA) was done. They all were followed-up at 3 months after surgery and at that time PTA was done. Pre-and post-operative hearing was compared and hearing improvement was calculated in term of air-bone gap (ABG). Out of 60 cases, 16 cases marked as failure of ossicular reconstruction as post-operative A-B gap was > 30 dB. Among these 16 cases, 7 were those patients whom ossiculoplasty was done using autologous incus and in rest 9 patients PORP/TORP was used. Success rate of ossiculoplasty using refashioned incus was 76.66% whereas Teflon TORP/PORP had success rate of 70.00%. We conclude that hearing improvement after ossiculoplasty with autologous incus is better as compare with that obtained by Teflon TORP/PORP. Also, it is a cost-effective method.
RESUMO
BACKGROUND: Diphtheria is an important vaccine preventable disease with varied outcome from mild to death. It was observed that the outcome also gets affected with status of immunization. The outcome is relatively milder in immunized children. OBJECTIVE: To find out the clinical presentation and outcome of diphtheria cases and its association with the immunization status. METHODS: A descriptive analysis of 64 diphtheria cases admitted from January 2019 to May 2020 at SMS hospital, a tertiary care referral hospital in Jaipur. RESULTS: Half of (51.56%, 33/60) patients were in the age group of 6-10 years. The peak load (48.44%) of diphtheria cases was seen in the monsoon season. Around 60% of the patients were fully immunized and around 10% partially immunized, every third case was un-immunized. The most common complication was neurological in 13 cases (20.31%), followed by cardiac complications in 11 cases (17.19%), and respiratory (7.81%). The proportion of complication was much lower (26.3%) in immunized cases as compare to partially immunized and un immunized. The proportion of myocarditis was significantly higher in un immunized cases (40%) than partially immunized (16.7%) and filly immunized group (5.3%). Similarly, Bronchopneumonia was also significantly higher (20%) in unimmunized. CONCLUSION: Our study depicted that there has been a shift of age above 5 years for diphtheria which suggests the need for the booster dose. Also high chances of complications are seen in unimmunized and partially immunized calling for public awareness regarding complete immunization.