Sociodemographic profile, work practices, and disease awareness among stone mine workers having silicosis from Central Rajasthan.

Background and Objectives: Silicosis continues to pose an important health hazard among workers having occupational exposure to stone dust. Several studies have addressed clinical presentation, radiographic and pulmonary function abnormalities in workers with silicosis. This study was planned to analyze sociodemographic profile and awareness about several aspects of silicosis among the stone mine workers visiting our centre. Methods: A questionnaire was administered in a convenient sample of eligible subjects over six years period. The questionnaire was aimed to collect sociodemographic variables, like age, gender, educational status, residential background, smoking status etc., apart from information on work-related profile including protective measures taken. Also knowledge and attitude regarding silicosis was assessed. Silicosis awareness index was also calculated as per the response received. Results: Majority of the study subjects were male (96.6%) with rural background (98.5%). 54.1% subjects were in the age group of 30 to 50 years. 81.9% mine workers were illiterate. The common addictions observed among them included smoking (60%), tobacco chewing (34%), alcohol (20%) etc., Varying duration of work exposure was observed with more than 10 years in 63.4% and more than 20 years in 32.2% workers. The commonest work exposing them to stone dust was breaking stones by chisel and hammer (51%) followed by separation of stone slab (20%) and stone drilling (15%). 80.9% subjects were not aware of the term silicosis, more than 80% were not aware of the symptoms and causes of silicosis. Only one fifth subjects were having awareness of using protection against the disease. Overall awareness about silicosis was better among literate and youngers participants. Conclusions: Stone mining industry reflects male dominance, poor literacy, long working hours for many years, financial compulsion to start and continue the job and very poor awareness regarding the disease silicosis and importance of personal protection at workplace.

Adenocarcinoma lung presenting with meningeal carcinomatosis.

Meningeal infiltration by malignant metastasis process without brain parenchymal involvement is very unusual event in patients with bronchogenic carcinoma. This manuscript describes a case of adenocarcinoma right lung in a 48-year old male having persistent headache. The cerebrospinal fluid cytology revealed the presence of metastatic deposits of adenocarcinoma lung that confirmed the diagnosis of meningeal carcinomatosis.

Influence of Life Style Factors on Oral Potentially Malignant and Malignant Disorders: A Cross Sectional Study.

The incidence of oral cancer has risen in the past decades and is usually recognised when symptomatic and at a late stage. A premalignant lesion is like smoldering volcano, which if not taken care of, may erupt, often with disastrous consequences. Early detection is therefore very important to reduce morbidity and mortality. A descriptive cross-sectional study was done to assess the prevalence, clinical presentation, and association of various addiction habits in the patients who presented with potentially malignant and malignant lesions of the oral cavity in outdoor clinics of ENT and HNS department of a tertiary care center in Jaipur (Rajasthan). 351 patients of different oral mucosal lesions were examined from August 2019 to January 2020 among which 173(49.2%) patients of potentially malignant and malignant lesions comprise the study group. Clinical findings and detailed history including addiction habits with frequency and duration were noted. Cytological and histopathological examinations were done to conclude the diagnosis. Out of 173 patients of the study group, 146(84.4%) were diagnosed with potentially malignant lesions (PMLs) and 27(15.6%) with malignant lesions (MLs). The most prevalent PML was Oral submucous fibrosis (23%) followed by leukoplakia (7.6%). The most common involved site was buccal mucosa (45.0%) followed by the tongue (26.5%). Tobacco consumption was the most prevalent addiction habit (80%) in the study group. High prevalence of tobacco abuse in patients with potentially malignant and malignant lesions suggested a strong relationship between two. It necessitates adequate awareness in the general population as well as early detection and management of these lesions by an expert Otolaryngologist.

Alteration of Smell and Taste Sensations in Covid-19 Positive Patients: A Prospective Cohort Study in Western India.

Loss/alteration of Smell and taste sensation is common in CoViD-19 infection. We conducted present study to find out the frequency, onset and severity of these lost sensations and their recovery in mild, moderate and severe COVID 19 positive patients in our setup. A questionnaire based study on 574 COVID-19 positive patients admitted in a dedicated COVID hospital between September-November, 2020 were followed up until their sensations recovered completely or maximum for two months. Fever was the most common symptom reported. Loss of smell and taste sensation is seen in 200 (34.84%) and 269 (46.86%) patients respectively; 163 (28.4%) developed both. Males were affected significantly more than females (p = 0.030 and 0.027). Approximately 1/4th patients [49 (24.5%) and 55 (20.45%)] reported loss of smell and taste sensation as their first symptom. Most common taste sensation lost was salty 191 (71.0%). Loss of smell sensation is seen maximally in mild cases and the difference among mild, moderate and severe cases is statistically significant (p = 0.00001); while the difference in loss of taste among all three grades of severity is statistically insignificant (p = 0.0770). Most of the patients [smell (142; 71%) and taste (198; 73.6%)] recovered after 2 weeks of onset of lost sensations while 96.5% (193/200) and 98.1% (264/269) patients reported complete recovery of smell and taste sensations after two months of onset. Present study shows that high percentage of COVID-19 positive patients develop loss of either one or both of smell and taste sensations but recovery is fast and complete in most of them.

Spontaneous expectoration of tumor tissue in primary adenocarcinoma lung.

Spontaneous expectoration of the tissue fragments in primary lung carcinoma is an extremely unusual event. Expectoration of tumor fragments is a significant event that should not be ignored as it serves itself as a noninvasive tool to diagnose underlying malignancy if such samples are immediately preserved and subjected to histopathological examination. More so, expectoration of a large-sized fragment may provide substantial relief from the breathlessness. Reported here is the case of a middle-aged male patient with adenocarcinoma in the right lung, and mass extended up to trachea, who spontaneously coughed out pieces of tumor tissue.

Diagnostic evaluation of mediastinal lesions: Analysis of 144 cases.

BACKGROUND: Mediastinum is a "Pandora's box" with many neoplastic and nonneoplastic lesions. The purpose of this study was to analyze our institutional experience of mediastinal lesions on fine-needle aspiration cytology (FNAC) and/or biopsy. MATERIALS AND METHODS: This study was an analysis of 144 patients who had undergone ultrasound-guided FNAC and/or core biopsy for mediastinal lesions. RESULTS: A total of 144 cases of suspected mediastinal masses were seen, and in 139 cases, tissue diagnosis was attempted. Out of 139 cases, 93 cases were neoplastic in nature (67%), 32 were nonneoplastic (23%), and 14 remained inconclusive (10%). Among neoplastic mediastinal lesions, metastatic carcinoma (37.4%) was the most common neoplastic lesion, followed by non-Hodgkin's lymphoma (12.2%), Hodgkin's lymphoma (7.1%), thymic lesions (3.5%), etc. Among nonneoplastic conditions, tuberculosis was the most common lesion (20.1%). An accurate tissue diagnosis was made in 89.9% cases by FNAC or core biopsy of mediastinal lesions in this study. Procedure-related mortality was nil. Complications were mostly minor and included chest pain in 24.5%, small pneumothorax in 13.6% requiring closed tube thoracostomy in 1.4%, and scanty hemoptysis in 9.3% cases. CONCLUSION: Neoplastic mediastinal lesions are more common than nonneoplastic lesions, with metastatic carcinoma being the most common cause followed by tuberculosis. A wide variety of lesions observed in this study stress on the importance of cytohistological diagnosis in all cases of mediastinal lesions for the final diagnosis and management planning. A guided FNAC or core biopsy is still accurate, well tolerated, and devoid of major complications.

Comparative study of clinico-bacterio-radiological profile and treatment outcome of smokers and nonsmokers suffering from pulmonary tuberculosis.

INTRODUCTION: Tuberculosis (TB) is one of the leading causes of death and disease worldwide. Tobacco smoking has been linked as a risk factor for TB. This study was aimed to affirm the strength of association between smoking and pulmonary TB. MATERIALS AND METHODS: Pulmonary TB patients aged between 18 and 65 years were enrolled and followed-up until treatment completion. Two consecutive sputum smears were examined from each patient for the presence of acid-fast bacilli (AFB) using Ziehl-Neelsen technique. Radiological severity of disease was assessed using guidelines of National TB Association of USA. Sputum smears for AFB were graded for positivity as per WHO Revised National TB Control Programme criteria. Response was determined in terms of sputum conversion at the end of intensive phase and final treatment outcomes. RESULTS: Sputum smear grading of 3+ increased from 12.5% to 68.18% and 66.66% as smoking index increased from <100 to 100-299 and >300 (P < 0.05). In nonsmokers, 79.2% patients had minimal disease while only 4.2% had advanced disease as compared to smokers where 52.4% had moderate disease, 26.2% advanced disease, and 21.4% minimal disease (P < 0.01). Smokers had significantly lower treatment success rate (69%) as against nonsmokers and former smokers (93.8% and 90.9%, respectively, P = 0.001) owing to a higher default rate among smokers (28.5%) than nonsmokers (6.3%) and former smokers (9.1%). CONCLUSION: Smokers during initial presentation, as well as at end of the treatment demonstrate more radiological findings, cavitary disease, and worse sputum AFB smear grading. Smokers also have a poorer treatment success rate largely due to high percentage of default rate thus suggesting noncompliance as a main confounder to treatment success. Focus needs to be made to reduce defaulters which are more common among smokers.

Three-dimensional echocardiographic delineation of an acquired aorto-left atrial fistula complicating native aortic valve endocarditis - "advantage of three dimensions".

Aorto-atrial fistulas are rare, but important complications resulting from aortic valve infective endocarditis, aortic valve surgery, or aortic dissection. We hereby report a case of a 20-year male, referred to us with infective endocarditis of the native aortic valve with severe aortic regurgitation and symptoms of heart failure. Detailed evaluation with two-dimensional and three-dimensional transthoracic echocardiography revealed aorto-left atrial fistula secondary to the involvement of the mitral-aortic intervalvular fibrosa (MAIVF) region. The patient underwent successful removal of the vegetations, closure of the defect along with aortic valve replacement, and mitral valve repair.

Prosthetic rehabilitation of large nasal septal defect with an intranasal stent: a clinical report.

Nasal septal perforation is a common complication of many nasal diseases such as congenital, infectious, trauma, and iatrogenic, and rarely may occur as a complication of systemic diseases, etc. The symptoms of uncorrected nasal septal perforations include crusting, epistaxis, difficulty in breathing, nasal twang in speech, postnasal discharge, foul-smelling, rhinorrhea, and hyposmia. Large nasal defects cannot be closed by hard acrylic resin nasal septal obturators because of the problems in access and path of insertion. However, obturation can be achieved by fabrication of a nasal stent that engages one of the nasal cavities. This clinical report describes prosthetic management of a patient with large nasal septal defect following septal surgery complication with an intranasal heat-processed acrylic resin stent. The stent is rendered patent for comfortable breathing, improves speech, is esthetically acceptable, dense and hygienic. These nasal stents indirectly separate the two nasal cavities with effective obturation of large nasal septal defects.