'Shifting from anxiety to the new normal': A qualitative exploration on personal protective equipment use by otorhinolaryngology health-care professionals during COVID-19 pandemic.

Background: The novel coronavirus pandemic has influenced the working practice of health-care professionals who come across symptomatic and asymptomatic COVID patients in their day-to-day practice. Especially, among HCWs in otorhinolaryngology, with the risk of exposure being high, hence were mandated to use personal protective equipment (PPE). Materials and Methods: The change in perceptions and patterns of PPE use throughout the COVID-19 pandemic was studied in detail through interviews conducted among 15 key informants, and the data were analyzed using health belief model in our study. Results: A health belief model explains the trajectory of PPE use by otorhinolaryngology health care providers during the COVID-19 pandemic. The course of usage of PPE by otorhinolaryngology health-care professionals during the COVID-19 pandemic was explained through the health belief model. During the initial days of the COVID-19 pandemic, intense perceived severity and susceptibility to COVID infection led to PPE use, and otorhinolaryngology HCWs resorted to higher grade PPEs which gave optimal protection; but in course of time with a better understanding of the natural course of illness, minimal PPEs without compromising HCW safety were used with minimal discomfort. Perceived severity of COVID infection on self and family, health knowledge, influence of peers, and support from the institution encouraged them in using PPEs. Conclusion: We found that various aspects of health belief model such as the perceived susceptibility, perceived severity of the disease, perceived barriers and benefits in PPE use, self-efficacy, health-related knowledge, and the cues to action influence PPE use among otorhinolaryngology HCWs. The key findings can be applied in behavior change models to promote the use of PPE in the hospitals, especially during the time of pandemic.

The Clinical Utility of Vestibular Evoked Myogenic Potentials in Patients of Benign Paroxysmal Positional Vertigo.

CONTEXT: Vestibular Evoked Myogenic Potentials (VEMP) is an emerging tool to diagnose Benign Paroxysmal Positional Vertigo (BPPV). The clinical utility of VEMP has been reported only in small accord in Indian literature. AIM: To study the latency and amplitude of VEMP in patients with BPPV and compare it with that of normal subjects. SETTINGS AND DESIGN: The study included two groups. Group one (control group) were 18 normal subjects. Group two (test group) were 15 subjects with unilateral BPPV. MATERIALS AND METHODS: Those subjects who fulfilled the selection criteria based on case history and audiological assessment were taken for the VEMP recording. The VEMP response consist of positive and negative successive waves (pI-nI), with latency values in adults about 13 and 23 milliseconds respectively. STATISTICAL ANALYSIS: Data was analysed using Statistical Package for Social Sciences (SPSS) version 12 (Chicago, IL, USA). Unpaired t-test was employed to measure the statistical difference between control group and test group. RESULTS: The difference in n23 and the peak to peak amplitude between the ipsilateral and contralateral ears of the test group were statistically significant, whereas such a difference in the p13 latency turned out to be statistically insignificant. It should be noted that, out of 15 patients in the test group, five patients showed only artifact tracer recordings in both the ears which is considered as no response. The heterogeneity of the results extended from absence of VEMP to prolongation of both p13, n23; prolongation of p13 alone; and even side to side variations. CONCLUSION: Absent response from the ipsilateral ear, prolonged latency of n23 and decreased peak to peak amplitude (p13, n23), indicates the disease pathology. However, large sample size is required to draw further conclusions and to consolidate the usage of VEMP in the diagnosis of BPPV.

Rehydrated air-dried Pap smears as an alternative to wet-fixed smears.

OBJECTIVE: To assess the effect of rehydration on air-dried Pap smears and to compare them with conventional, wet-fixed smears. STUDY DESIGN: Paired cervical smears were obtained from 419 women. One set was labelled "Routine" (fixed immediately in 95% ethanol) and the other, "Rehydrated" (air-dried, rehydrated and then fixed). The latter were further subdivided into groups A-F depending on the duration of air drying. The staining quality of the smears was assessed, after adequate blinding to remove bias, and graded. The chi 2 test was performed to compare parameters in the two sets of smears. RESULTS: Of the 397 pairs found to have adequate cellularity, 6% of the Routine group and 4% of the Rehydrated were "unsatisfactory due to poor fixation." Smears rehydrated within two hours of air drying as well as those refrigerated within two hours and rehydrated after 48 hours produced a staining quality as good as that of the conventional, wet-fixed smears. Rehydration caused lysis of red blood cells in the background. CONCLUSION: Rehydration of air-dried Pap smears within two hours of preparation produces staining quality equal or superior to that of conventional, wet fixed ones. It has the added advantage of being less cumbersome for the clinical personnel involved in smear making.