Effects of Chemoradiation Therapy on Hearing in Patients with Malignancy of Head and Neck.

PURPOSE: To study effects of chemoradiation therapy on hearing in patients with malignancy of head and neck. METHODS AND MATERIALS: Patients receiving drugs other than cisplatin as well as those with any otology-related pathology or abnormalities were excluded from the study. Patients with primary biopsy-proven malignancy of the Nasopharynx, Oropharynx, Paranasal Sinuses, Oral Cavity, and Parotid with chemoradiation by cisplatin and different radiation modalities were all eligible. Areas of interest and OARs are indicated on CT images. All patients' hearing was assessed using pure tone audiometry at the beginning of treatment, at its conclusion, and six months later. Variations in pure tone thresholds from baseline and CTCAE - Common Terminology Criteria for Adverse Events grading are related to cochlear dose. RESULTS:  The study involves 75 patients. At cochlear dosage levels of more than 40 Gy, significant SNHL (>10 dB loss) is seen. Absolute PTA threshold values do not statistically differ from baseline to completion at any frequency. For 4000 and 8000 Hz, the absolute PTA threshold values differed from baseline to follow-up, but only for 8000 Hz was the difference statistically significant after six months of follow-up. Following treatment, 64% of patients had grade I CTCAE scoring and 16% and 12%, respectively, had otitis media with effusion and Eustachian tube dysfunction. CONCLUSION:  The inner ear may be harmed in patients receiving radiation to the head and neck. Radiation-induced SNHL typically goes unreported in routine clinical practise because of its long-term nature. In the group of head and neck tumours with high-risk locations, nearly 90% of patients with SNHL were affected. Therefore, it's critical to reduce cochlear dosage in these patient populations. More investigation is needed to distinguish between cochlear and retro-cochlear types of sensorineural hearing loss.

Development of the Sports Organization Concussion Risk Assessment Tool (SOCRAT).

OBJECTIVE: In this paper, we describe the development of a novel tool-the Sports Organization Concussion Risk Assessment Tool (SOCRAT)-to assist sport organizations in assessing the overall risk of concussion at a team level by identifying key risk factors. METHODS: We first conducted a literature review to identify risk factors of concussion using ice hockey as a model. We then developed an algorithm by combining the severity and the probability of occurrence of concussions of the identified risk factors by adapting a risk assessment tool commonly used in engineering applications. RESULTS: The following risk factors for ice hockey were identified: age, history of previous concussions, previous body checking experience, allowance of body checking, type of helmet worn and the game or practice environment. These risk factors were incorporated into the algorithm, resulting in an individual risk priority number (RPN) for each risk factor and an overall RPN that provides an estimate of the risk in the given circumstances. CONCLUSION: The SOCRAT can be used to analyse how different risk factors contribute to the overall risk of concussion. The tool may be tailored to organizations to provide: (1) an RPN for each risk factor and (2) an overall RPN that takes into account all the risk factors. Further work is needed to validate the tool based on real data.

Primary isolated nonhogkin's loymphoma of the tonsil -a case report.

Malignant lymphoma (Non-hodgkin's lymphoma) is a primary malignant tumor of lymphoid tissue composed of lymphocytic or reticulocytic derivatives of varying degree of differentiation. The tumor frequently occurs in the extranodal sites including the gastrointestinal tract and the Waldeyer's ring. Amongst the non-Hodgkin's Lymphomas, the small cell type is the relatively uncommon lymphoma (4%) whereas others include follicular type (40%) and the high grade type (40-65%). This case report is of a case of primary isolated non-Hodgkin's lymphoma of the tonsil of small cell type.

Double-blind comparison of lidocaine, tubocurarine and diazepam pretreatment in modifying intraocular pressure increases.

One hundred and sixty patients, divided randomly into four groups received normal saline (5 ml), d-tubocurarine (0.05 mg X kg-1), diazepam (0.1 mg X kg-1) or lidocaine (1 mg X kg-1) as pretreatment, in a double blind manner, five minutes before anaesthetic induction with thiopentone and succinylcholine (1 mg X kg-1). Succinylcholine caused a significant increase in IOP in all groups. However, in the lidocaine group, this increase was significantly less than that observed in the control group. The post-succinylcholine increase in IOP was further aggravated by tracheal intubation in all except the lidocaine group. A further clinical trial with higher doses of lidocaine is suggested to assess its ability to obtund the succinylcholine-induced increase in IOP. Lidocaine in a dose of 1 mg X kg-1 IV prevents the rise in IOP which follows intubation.

The use of intralesional steroids in the treatment of chalazion.

Intralesional injection of triamcinolone acetonide 5 mg/mL suspension was used in the treatment of 110 cases of chalazion; 92.3% of the cases resolved completely with one to three injections, irrespective of the duration and consistency of the chalazion. Recurrence and yellow deposits were seen at the site of injection in a minority of patients.

Osteosarcoma of the orbit.

A rare case of osteosarcoma of the orbit in a 10-year-old female child is reported.