Menopause and its Effect on Voice.

Abstract: This study was designed to study the impact of menopause on voice quality. Cross-sectional Observational study with a total of 100 subjects. All subjects underwent biochemical analysis which included thyroid function tests, estrogen levels, progesterone levels and underwent voice analysis using the VAUGHMI voice analyser software. 50 postmenopausal females as cases and 50 premenopausal females as controls were taken for the study. The females were of the age group 35-55 yrs in order to remove age as confounding factor. The primary outcome measure was Total score, calculated based on harshness, hoarseness and breathiness. The postmenopausal females had a poorer voice quality than the premenopausal females (Total score 1.62 vs 2.48, p < 0.001). There was a significant difference between the fundamental frequency and pitch and perturbation in frequency of the postmenopausal females as compared to premenopausal females. The difference in the perturbation in the intensity of the voice was not significant. No linear correlation could be established between the voice quality and oestrogen or progesterone levels but the intergroup variation of the two parameters was significant. The premenopausal females have better voice quality than postmenopausal females. The relationship between hormonal level and voice quality couldn't be established. Further studies are required to assess the relation of hormone levels & voice quality with the possibility of exploring voice cosmesis. Level of Evidence: Level 3.

Acinic cell carcinoma of the parotid gland with neuroendocrine differentiation.

Acinic cell carcinoma (ACC) is a malignant salivary gland tumor characterized by tumor cells displaying acinar features. Usually presenting as a slow-growing tumor, ACC, however, may show dedifferentiation to a higher grade including neuroendocrine carcinoma. In addition, ACC may rarely show focal neuroendocrine differentiation without any frank evidence of neuroendocrine carcinoma. We describe such a case of ACC of the parotid gland in a 65-year-old female, which showed neuroendocrine differentiation. The diagnostic clues, immunohistochemistry panel, and prognostic and treatment aspects are also presented.

Unusual Presentation of Chordoma in Nose.

Chordomas are uncommon tumors of the bone representing 1-4 % of all primary bone tumors. These typically involve axial skeleton. Primary nasal presentation of chordoma is a rare occurrence and is usually misdiagnosed till the histopathological confirmation. We present a case of chordoma in nasal cavity treated by wide local resection and also present a review of literature discussing various facets in its presentation and management.

Pachyonychia Congenita Type 1: Case Report and Review of the Literature.

The case of an 8-year-old boy is hereby reported, who presented with nail dystrophy, subungual hyperkeratosis, oral leukokeratosis, and numerous follicular papules all over the body. The features were consistent with a diagnosis of pachyonychia congenita type 1. The case is being reported for its rarity. We also discuss in a nutshell, the literature till date.

Clinico-Mycological Study of Onychomycosis and Pattern of Drug Resistance

Introduction: Onychomycosis is a fungal infection of thetoenails or fingernails that may involve any component of thenail unit, including the matrix, bed, or plate. Onychomycosisis caused by dermatophyte fungi, non dermatophyte mouldsand yeasts. Prevalence rates for OM varying from 3 to 5%have been found in most studies; however, a few reportssuggest a higher prevalence of even up to 26% in the generalpopulation. Hence through this study an attempt was made toidentify the various clinical patterns of onychomycosis and toidentify pattern of drug resistance in onychomycosis.Material and methods: The proposed study was carriedout in Outpatient Department of Dermatology Venereologyand Leprosy, Rohilkhand Medical College and Hospital,Bareilly, a tertiary care hospital in western Uttar Pradeshfor one year (November 2017- October 2018) on patientshowing nail changes suggestive of onychomycosis, usingdirect microscopy using potassium hydroxide. The culturemedium SDA with chloramphenicol was used. Sensitivity toTerbinafine, Fluconazole, Itraconazole and Griseofulvine wasstudied.Result: The most common pattern of onychomycosis seenwas distal lateral subungual onychomycosis. Pattern of drugresistance is maximum with Griseofulvin (49%) and least withTerbinafine (20%).Conclusion: A total of 104 patients were enrolled, withmean age 35.93 years. Males were more commonly involvedcompared to females. The culture results were positive among55 patients and negative in 49 patients. The most commoncausative agent isolated was dermatophyte moulds followedby non-dermatophytes and yeasts.

Level of Awareness and Attitude towards Topical Steroids among Medical Interns.

Topical steroids are the most commonly prescribed drugs in dermatological setting, and they are also one of the most abused ones, as these drugs are very cheap, easily available over the counter, and provide quick relief in symptoms. This study aims to find the level of awareness and attitude regarding topical steroids among medical interns. MethodsThis was a cross sectional questionnaire-based study conducted among medical interns of 2014 batch of Rohilkhand Medical College in the Department of Dermatology, Venereology and Leprosy. The study was conducted with the help of a questionnaire that was modified from the study, Verma P, et al. This was followed by a presentation on topical steroids use, misuse and what steps can be taken to prevent their rampant misuse. Finally, a feedback was taken on importance of the study. ResultsTotal 69 medical interns were included in the study. Fifty-two interns had previously prescribed or used topical corticosteroids. Steroids (clobetasol, betamethasone, mometasone) in combination with either tretinoin & hydroquinone or antimicrobials were commonly abused. The commonest indication for which they were used were infections of which tinea was the most common followed by dark spots or as a fairness cream, acne, eczema, and other conditions such as pruritus, insect bite, burn, etc. ConclusionsThis study shows significant knowledge gap among medical interns regarding topical steroids. Thus, knowledge regarding topical corticosteroids is very essential and should be emphasized more during the MBBS period. More studies are required to study regarding their awareness and misuse.