Endonasal dacryocystorhinostomy in children: Our experience.

INTRODUCTION: Epiphora affects approximately 20% neonates, but most resolve spontaneously. Dacryocystorhinostomy (DCR) is indicated only when conservative management fails. OBJECTIVE: To observe clinical presentation, treatment modalities and effectiveness of endoscopic DCR in paediatric population. METHODS: It is a prospective study of 21 children done at our tertiary care hospital from 2011 to 2016. All were initially subjected to a trial of conservative management. Those that responded and didn't require surgery were excluded. RESULTS: The age group ranged from 40 days to 11.5 years. 19 underwent unilateral & 2 underwent bilateral endoscopic DCR. After a 6 month follow-up, 20 children were benefitted by surgery, 2 had an incomplete resolution and 1 required revision surgery. The overall success rate was 95.23% and failed cases were mainly due to post-traumatic distortion of the anatomy. No major complications were noted. CONCLUSION: Endoscopic DCR is safe and effective in children presenting with persistent epiphora.

Development of low calorie snack food based on intense sweeteners.

Intense sweeteners namely Aspartame, Acesulfame K and Sucralose were used in the preparation of sugar substitute sprinklers and these were used in snack food, replacing sugar. Study was conducted with an objective to develop low calorie snack food. The psychometric study showed that the threshold values for Acesulfame K, Aspartame and Sucralose were 0.012, 0.030 and 0.005 g respectively. The time intensity study revealed that among three sweeteners Aspartame had more lingering sweetness (at 60 s). The sensory evaluation of Shankarpoli prepared using refined wheat flour revealed that there was no significant difference in typical attributes of the snack; Aspartame and Acesulfame K had same sweetness intensity where as Sucralose had higher intensity of sweetness. Consumer acceptance study revealed that 53 % of the consumers liked the snack with Sucralose, which is highest compared to other two sweeteners namely Aspartame and Acesulfame K (47 %). Thus sweeteners can be used as sweetening agents in traditional food preparations.

Modified method for preparation of Halubai-an Indian traditional sweet.

Halubai, a traditional Indian sweet is conventionally prepared by soaking and grinding whole cereals/millets to a fine paste, straining it through a cloth and cooking the resultant dispersion until it starts gelatinizing. Cooking is continued further with the addition of jaggery water, stirring constantly with intermittent addition of ghee. This process involves many unit operations, which are energy and time consuming. Hence a modified method was developed which is energy efficient and time saving without compromising the quality of the product. One fine fraction (200 mesh, BS) of cereal/millet flours were used in modified method instead of whole cereals. Sensory and instrumental analysis of the samples showed that quality of Halubai prepared using modified method was comparable to that of samples from conventional method. Correlation studies on sensory data of Halubai showed positive relation for the set (r = 0.94) and smoothness (r = 0.84); and negative relation for stickiness (r = -0.94) with the overall quality. Modified method of Halubai preparation which was simple and energy efficient, resulted in products with good sensory quality.

Foreign body in tracheobronchial tree.

Foreign body inhalation into the tracheobronchial tree can prove to be a life threatening unless timely intervened and appropriate steps are being taken towards its management [1]. A review of 32 cases was done at MP Shah Medical College Jamnagar over a period of 2 years. Children were most susceptible to aspiration of foreign bodies. All the cases were selected on the basis of detailed clinical history, clinical features, and radiological findings. The cases which had a strong index of suspicion without any positive clinical history were also subjected to rigid bronchoscopy under general anesthesia. Maximum number of cases was in the age group of 1 to 3 years (62.5%). The minimum age group ranging from 6 months to maximum 8 years. The time of presentation of the patients varied from within 24 hours to upto 6 months. Only four patients presented within 24 hours. The maximum presenting period was within 1 week. Organic foreign bodies were most common presentation (groundnut). Other foreign bodies were grains, seeds, ball pen cap, stones and slate pencil. Definite history of inhalation was available only in 19 cases with symptoms of choking, breathlessness, cough and recurrent upper respiratory tract infection. Right main bronchus was found to be most common site of impaction (52%) followed by left main bronchus (32%) and tracheal foreign body (16%).

Extended anterior nasal packing in juvenile nasopharyngeal angiofibroma.

This is the case study of 16 patients in which postoperatively after complete removal of tumors, the bleeding did not stop with anterior and posterior nasal packing. In all those cases extended anterior nasal pack was applied during the surgery after the complete removal of tumor and bleeding stopped effectively.