Evaluation of the Role of Circumcision in Reducing Symptomatic Urinary Tract Infection Following Vale Ablation

Aim: The aim of this single center short-term prospective study is to determine the effects of circumcision in reducing the risksof symptomatic urinary tract infection (UTI) in post posterior urethral valve (PUV) ablated patients and to compare them withtheir non-circumcised counterparts.Objective: The specific objective of this study in the group includes: a. To identify patients with PUV who develop UTI with subsequentrenal damage. b. Proportion of children with symptomatic UTI in each group. c. Relative risks of presenting with symptomatic UTIafter PUV ablution and. d. To analyze statistically when circumcision really reduces the incidence of UTI in valve ablated patients.Materials and Methods: A single institutional prospective study of patients who were admitted with PUV between April 2016and September 2017 Institutional Ethics Committee Clearance and informed consent of the parents were taken. Boys withcongenital anomalies along with hypospadias and epispadias or any other condition rendering circumcision impossible wereexcluded from the study.Results: We identified 38 patients in all of whom 23 underwent circumcision at the time of valve ablation. The mean age ofthese patients was 41.22 days on a mean follow-up period of 1 year. Only one patient (4.35%) in the circumcised group hadtwo episodes of UTI, whereas three patients (20%) who had not undergone circumcision had five episodes of UTI.Conclusion: Circumcision along with PUV ablation does protect these patients from post-ablation symptomatic UTI and thusis protective against ongoing renal damage.

Prospective Study on Effect of Submucosal Alcohol Injection in Cases of Rectal Prolapse in Infants and Children

Purpose: The purpose of the study was to study the impact of sclerosing agent in cases of rectal prolapse in infants and children.Materials and Methods: A total of 200 cases of diagnosed rectal prolapse in infants and children attending a tertiary care ofWest Bengal were included in the study for the effect of submucosal injection of alcohol from a period of August 2016 to July2018. 1.5–2 ml of alcohol was linearly injected in three sites (two laterals and one posterior).Results: All 200 cases were followed at 3 months interval for a period of 2 years. One hundred and twenty-one patients (60.5%)had a duration of prolapse for 3–6 months. Forty-six patients (23.0%) had prolapse for more than 8 months and 33 (16.5%)patients had prolapse for more than 1 year. One hundred and ninety-one (90.5%) patients responded to a single injection. Fivepatients (2.5%) required the second injection. Four (2%) patients with age more than 10 years did not respond to the treatment.Twenty-five patients had fecal soiling for a period of 10–12 days. No infectious complication and no recurrence were observed.Conclusion: 2–5 ml of ethyl alcohol (96%) is effective for the treatment of rectal prolapse. The duration of rectal prolapsehad no deleterious effect on treatment; however, patients with age more than 10 years did not respond to sclerosing agent,probably due to different etiology.

Profound Sensorineural Hearing Loss with Overlay of Middle Ear Pathology-Diagnostic Implications.

This study aimed to demonstrate the diagnosis of profound mixed hearing loss which is inappropriate to be studied vigorously to prove that at the level of profound degree of severity there is a little contribution of conductive pathology. Two groups of 15 subjects each in the age range of 18-25 years with mean age of 21 years were included. Group I consisted of pure sensorineural hearing loss of profound degree and Group II was made up of pure sensorineural hearing loss of profound degree who later reported with middle ear disorder. Pure tone measurements were conducted on all the subjects following standard procedures. Conductive hearing loss was induced with insertion of the insert ear plugs/ear moulds without sound bore for subjects in Group I and pure tone threshold measurements were repeated. Air-conduction and bone-conduction thresholds were compared for subjects in Group II prior and later to check for any middle ear pathology. Results showed that when Group I was induced with conductive hearing loss, the pure tone average did not change and for Group II, there was no change in air-conduction thresholds by later developed outer ear/middle ear pathologies. Diagnosis of profound sensorineural hearing loss with the overlay of middle ear pathology will bring insights into physiology of hearing and highlight the important issues of management of middle ear pathology, not for the purpose of improvement of absolute hearing thresholds but for the case of wearing of amplification device restricting the further growth of pathology, etc.

Effects of type 3 thyroplasty on voice quality outcomes in puberphonia

@#p style=text-align: justify;strongOBJECTIVES:/strong To assess effects of type 3 thyroplasty on outcomes of voice quality in puberphonia.METHODS:br /Design:/strong Prospective cohortbr /strongSetting:/strong Tertiary Referral Hospitalbr /strongParticipants:/strong Six patients with puberphonia who failed voice therapy, aged 16-25 years, who consulted at the ENT Outpatient department between September 2010 and September 2012, underwent type 3 thyroplasty.Pre-operative and 6-month post-operative voice analysis by voice recordings, Voice Handicap Index (VHI), GRBAS score and real time acoustic analysis (perturbation) using Dr Speech software (University version 4.0, Voice Tech Corporation, USA [Tiger Electronics] with habitual fundamental frequency (FO), jitter % and shimmer % as parameters were performed.Results: Mean pre-operative VHI and GRBAS scores were 53 and 75.67, respectively, whereas post-operative scores were 29 and 25.00, respectively. (P-value for VHI was 0.004 and that of GRBAS was 0.00). On acoustic analysis, mean pre-operative habitual fundamental frequency (FO), jitter % and shimmer % was 245.82 Hz, 0.21 and 2.34, respectively, whereas post-operative mean was 140.78 Hz (P=0.00), 0.19 (P=0.04) and 1.52 (P=0.00), respectively.Conclusion: The mainstay of treatment of puberphonia is voice therapy. Thyroplasty provides a suitable management option in those cases who fail to respond by voice therapy./p