NCD Burden and the role of nutritionChronic diseases, often known as non-communicable diseases (N... more NCD Burden and the role of nutritionChronic diseases, often known as non-communicable diseases (NCDs), pose a significant threat to worldwide public health. As per World Health Organisation (WHO), NCDs account for 74% of all fatalities worldwide, with cardiovascular disease, cancer, respiratory disease, and diabetes being the leading causes.[1] Inadequate nutrition, including diets heavy in sugar, salt, saturated and trans fats, and deficient in fruits, vegetables, whole grains, and lean protein sources, is a significant risk factor for NCDs. The World Health Organization suggests a diet rich in fruits, vegetables, whole grains, nuts, and seeds and low in processed foods, sugar, saturated and trans fats.[2]
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery
Sinonasal squamous cell carcinoma (SCC) is a rare form of head-and-neck malignancy, with an incid... more Sinonasal squamous cell carcinoma (SCC) is a rare form of head-and-neck malignancy, with an incidence of 3%, while SCC of the ethmoid sinus is even more infrequent with relatively few cases cited in the literature. Management of anterior skull base tumors is complex due to the anatomic detail of the region and the variety of tumors that occur in this area. Currently, the “gold standard” for surgery is the anterior craniofacial resection. A 61-year-old man with a locally advanced SCC of the ethmoid sinus involving orbit with intracranial extradural extension was surgically treated performing anterior craniofacial resection followed by adjuvant intensity-modulated radiation therapy to the tumor bed. Currently, the “gold standard” for ethmoid carcinoma with intracranial extension is the anterior craniofacial approach. It allows wide exposure of the complex anatomical structures at the base of the skull permitting monobloc tumor resection. A multidisplinary team approach involving an otolaryngologist, neurosurgeon, plastic surgeon, pathologist, and radiologist is required for effective management of these tumors.
Objectives: The objective of this study is to review various biomaterials or implants used in ENT... more Objectives: The objective of this study is to review various biomaterials or implants used in ENT and their adverse effects on events that were noticed from the initial days to the present era. Methods: Relevant articles were searched from the databases. PubMed, Scopus, Web of Science, and Google were used to search for the data. Results: Cochlear implant (CI) adequacy depends on biocompatibility, anti-inflammatory treatment, and reduction of fibrosis. Silicone is used in the otologic field, and its allergy is a rare cause of CI extrusion. Nitinol pistons are used in stapedotomy, and polyethylene (Teflon) grafts are used in partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP). Their complications include graft extrusion and residual perforation. Chronic sphenoid sinusitis is associated with Medpor porous polyethylene implants used for sellar reconstruction in skull-based surgeries. In vocal cord paralysis, injectable collagen preparations ...
Poor nations are already facing the heat of double burden of communicable and non-communicable di... more Poor nations are already facing the heat of double burden of communicable and non-communicable diseases (NCDs), often known as chronic illnesses, which are characterized by a protracted course and are multifactorial in causation. In addition to this, neglected non-communicable diseases (NNCD) in the form of gout, sickle cell disease, accidents and many more are likely to be one of the biggest public health challenges soon. Nearly three-quarters (31.4 million) of all NCD-related fatalities occur in developing nations. In terms of morbidity and mortality, the “BIG FOUR” NCDs—diabetes, cancer, chronic respiratory diseases, and cardiovascular diseases—are widely acknowledged as the main contributors to global health loss. However, other NCDs account for 55% of the global burden of NCDs and are frequently neglected in terms of premature death, increased Disability Adjusted Life Years (DALY), and decreased Quality-Adjusted Life Year (QALY). We have briefly discussed the disease burden of ...
IntroductionBreast cancer is one of the most common cancer among Indian women, with an incidence ... more IntroductionBreast cancer is one of the most common cancer among Indian women, with an incidence of 25.8 per 100,000 women according to the Ministry of Health and Family Welfare. Late detection is responsible for poor quality of life (QOL), and it is the leading cause of death. In metropolitan regions, one in every 22 women will have breast cancer over their lifetime; but in rural areas, one in every 60 women will develop breast cancer as per estimates.Aim and objectiveThis paper aims to describe the various AI based breast screening technologies which are used in breast cancer screening in India.MethodologyThe literature search was done using “Pub Med,” “Google scholar,” and “Scopus” databases for the key terms “technology,” “cancer research,” “artificial intelligence,” “mammography”, “breast cancer,” “cancer,” and/or “neoplasia in breast.” All the relevant articles were included to support this mini review.ResultsWe found that emerging artificial intelligent technologies namely “N...
Introduction: Manuka honey has been used in chronic diabetic ulcers and traumatic wounds. We have... more Introduction: Manuka honey has been used in chronic diabetic ulcers and traumatic wounds. We have used Manuka honey in cases of otitis externa because of its antibacterial and anti-inflammatory properties. Objectives: The objective was to study the efficacy of topical applications of Manuka honey in the patients of acute otitis externa. Materials and Methods: Patients with acute otitis externa without any prior ear complaint or intervention were selected for the study after informed and written consent. All patients selected for the study were packed with Manuka honey-impregnated umbilical tape and pain scores; canal wall edema was recorded on days 0, 1, 3, and 7. Results: A total of 20 patients were included in our study. Twenty patients followed us on day 1, 15 patients on day 3, and seven patients followed us till day 7. The mean pain score for day 0 was 5.35, and the mean pain score decreased to 2.95 on day 1, and the difference was statistically significant. Conclusion: Manuka honey appears to be an effective therapeutic agent in the management of otitis externa.
Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which... more Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which is frequently misinterpreted as sarcoma, both clinically and microscopically. It is a reactive lesion composed of fibroblasts/myofibroblasts and most commonly found in extremities and trunk. NF has been described in the head and neck region in 10-20% of cases. Many pathologists do not consider NF in the differential diagnosis of soft tissue masses arising in the Head neck region. NF that occurs in otherwise healthy individuals usually presents with a history of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. It has a confirmed perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is the treatment of choice. A case of NF over the neck in a 05-year-old female not associated with trauma who presented w...
Embryology of stapes has long been a topic of controversy. There are theories stating a single so... more Embryology of stapes has long been a topic of controversy. There are theories stating a single source to the dual origin of stapes. Chronic otitis media is also known to cause various acquired bony ossicular fixations. We present a case of an 11-year-old female with right chronic otitis media, active squamosal with cerebellar abscess who underwent drainage of cerebellar abscess followed by tympanomastoidectomy as a two-staged procedure. Intraoperatively, there were stapes suprastructure fusion to the fallopian canal and one crural attachment to the promontory. There are no clear criteria to differentiate bony fixation of congenital origin from acquired causes. This case also highlights the need to add a new subclass in the classification of minor middle ear anomalies given by Cremer, and our findings also support the dual origin for stapes development.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Unilateral Sensorineural Hearing Loss (USNHL) can present with varying symptoms apart from hearin... more Unilateral Sensorineural Hearing Loss (USNHL) can present with varying symptoms apart from hearing loss, such as dizziness and tinnitus. Impaired sound localization, inability to identify speech in noise and decreased temporal summation can significantly impair the daily activities of an individual. This along with dizziness and tinnitus affects the physical, mental and social health as well. The purpose of this study is to assess and correlate the spectrum of handicap faced by USNHL patients. Validated questionnaires were used to evaluate handicap in 42 USNHL patients due to hearing loss (Hearing Handicap Inventory for Adults–HHIA), dizziness (Dizziness Handicap Inventory–DHI) and tinnitus (Tinnitus Handicap Inventory–THI). These handicaps were then correlated with each other using Spearman’s correlation coefficient. Statistically significant strong positive correlation of HHIA was seen with DHI (rho = 0.60, p ≤ 0.001) and THI (rho = 0.74, p ≤ 0.001). Similarly, strong positive correlation was seen between emotional subscales of HHIA and DHI (rho = 0.73, p ≤ 0.001). USNHL can lead to significant emotional and social handicap which is compounded in the presence of hearing loss, dizziness and tinnitus. These handicaps are strongly correlated to one another. Hence, a holistic approach is needed for USNHL rehabilitation. There exists a need to develop a comprehensive measure to assess and grade the handicap faced by these patients.
Supplemental Digital Content is available in the text Objective: Evaluate a new autologous mushro... more Supplemental Digital Content is available in the text Objective: Evaluate a new autologous mushroom-shaped cortical bone partial ossicular replacement prosthesis (MPORP) for cost-effective and sustainable hearing results. Study Design: Prospective study. Setting: Tertiary care center. Patients: Forty-two patients suffering from chronic otitis media with intact superstructure of the stapes and partially or completely eroded incus. Interventions: Group-1 (n = 24) underwent only tympanoplasty with MPORP; group-2 (n = 18) underwent intact canal wall mastoidectomy (ICW) with MPORP. Main Outcome Measures: Hearing results were evaluated using a four frequency average (measured at 0.5, 1, 2, 3 kHz) pure tone air conduction (PTA), air-bone gap (ABG), and word recognition scores (WRS) after 3, 6, and 12 months and compared with preoperative results. Results: Overall, successful rehabilitation of ABG to 20 dB or less was achieved in 92% of patients. Mean postoperative ABG was 15.35 ± 4.18 dB showing mean improvement of 23.89 ± 5.95 dB. In group-1, mean postoperative ABG was 18.47 ± 3.65 dB, showing an improvement of 25.92 ± 5.3 dB. In group-2, mean postoperative ABG was 18.47 ± 3.65 dB showing an improvement of 20.14 ± 4.96 dB. Hearing improvement in all the cases together and both the groups checked separately was statistically significant (paired t test, p < 0.001). Group 1 had, on average, 5 dB better hearing than group 2 (unpaired t test, p > 0.05). Conclusion: The MPORP is obtainable from the local site, easily constructed, bio-compatible, cost-effective, less bulky, adequately rigid for sound transmission, magnetic resonance imaging (MRI) compatible, and provides sustainable hearing gain because it has better chances of integration with the head of stapes.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2020
Deafmutism affects communication and wholesome development of an individual. India has a signific... more Deafmutism affects communication and wholesome development of an individual. India has a significant burden of deafness in the country. Even fourteen years after the launch of a National Program for Prevention and Control of Deafness in year 2006, we lack detailed data about the disability from most regions of the country. This study aims at finding out the prevalence, clinical history-examination and audiological profile of deaf-mute patients visiting the Out Patient Department (OPD) of a tertiary care institute in Uttarakhand, and compare the results with similar studies published during last 20 years from India to generate a literature review. Out of 46,049 patients that visited OPD of the institute during the given period of 24 months, 73 cases were short-listed clinically to be enrolled in the study. However, only 55 (75%) of them completed the questionnaire and audiological testing. All information was extracted from the patients/relatives with the help of a questionnaire in the Hindi language. The prevalence of deafmutism in patient presenting in our OPD in the study period was 0.3%. The history of pre-, peri- and post-natal risk factors was present in high percentage (58.2%, 78.2% and 34.5% respectively) of patients. This warrants review of our maternal and child healthcare strategies. The literature review revealed lack of uniform and standardized tool in conducting and reporting of studies on deafmutism. The questionnaire used in this study can be further improved and modified in the future as per the requirements of data collection.
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery, 2019
Congenital hypofibrinogenemia is a rare condition which can present as spontaneous hemorrhage. We... more Congenital hypofibrinogenemia is a rare condition which can present as spontaneous hemorrhage. We present a case of a 7-year-old male who presented with complaints of sudden swelling over the cheek and neck after an episode of fever and upper respiratory tract infection. The diagnosis was delayed as the initial diagnosis of deep neck space infection was suspected, and the patient was treated in that line. The diagnosis was suspected when the child developed swelling in the knee joint and workup was done for hypofibrinogenemia. The child was transfused with cryoprecipitate and he has complete recovery by day 7.
Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rar... more Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rarer. We have not come across any such case in the English literature of the dual presentation of tuberculosis to the best of our knowledge so far. Early diagnosis and prompt management are the key to reduce the disease burden and also to avoid life-threatening complications.
NCD Burden and the role of nutritionChronic diseases, often known as non-communicable diseases (N... more NCD Burden and the role of nutritionChronic diseases, often known as non-communicable diseases (NCDs), pose a significant threat to worldwide public health. As per World Health Organisation (WHO), NCDs account for 74% of all fatalities worldwide, with cardiovascular disease, cancer, respiratory disease, and diabetes being the leading causes.[1] Inadequate nutrition, including diets heavy in sugar, salt, saturated and trans fats, and deficient in fruits, vegetables, whole grains, and lean protein sources, is a significant risk factor for NCDs. The World Health Organization suggests a diet rich in fruits, vegetables, whole grains, nuts, and seeds and low in processed foods, sugar, saturated and trans fats.[2]
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery
Sinonasal squamous cell carcinoma (SCC) is a rare form of head-and-neck malignancy, with an incid... more Sinonasal squamous cell carcinoma (SCC) is a rare form of head-and-neck malignancy, with an incidence of 3%, while SCC of the ethmoid sinus is even more infrequent with relatively few cases cited in the literature. Management of anterior skull base tumors is complex due to the anatomic detail of the region and the variety of tumors that occur in this area. Currently, the “gold standard” for surgery is the anterior craniofacial resection. A 61-year-old man with a locally advanced SCC of the ethmoid sinus involving orbit with intracranial extradural extension was surgically treated performing anterior craniofacial resection followed by adjuvant intensity-modulated radiation therapy to the tumor bed. Currently, the “gold standard” for ethmoid carcinoma with intracranial extension is the anterior craniofacial approach. It allows wide exposure of the complex anatomical structures at the base of the skull permitting monobloc tumor resection. A multidisplinary team approach involving an otolaryngologist, neurosurgeon, plastic surgeon, pathologist, and radiologist is required for effective management of these tumors.
Objectives: The objective of this study is to review various biomaterials or implants used in ENT... more Objectives: The objective of this study is to review various biomaterials or implants used in ENT and their adverse effects on events that were noticed from the initial days to the present era. Methods: Relevant articles were searched from the databases. PubMed, Scopus, Web of Science, and Google were used to search for the data. Results: Cochlear implant (CI) adequacy depends on biocompatibility, anti-inflammatory treatment, and reduction of fibrosis. Silicone is used in the otologic field, and its allergy is a rare cause of CI extrusion. Nitinol pistons are used in stapedotomy, and polyethylene (Teflon) grafts are used in partial ossicular replacement prosthesis (PORP) or total ossicular replacement prosthesis (TORP). Their complications include graft extrusion and residual perforation. Chronic sphenoid sinusitis is associated with Medpor porous polyethylene implants used for sellar reconstruction in skull-based surgeries. In vocal cord paralysis, injectable collagen preparations ...
Poor nations are already facing the heat of double burden of communicable and non-communicable di... more Poor nations are already facing the heat of double burden of communicable and non-communicable diseases (NCDs), often known as chronic illnesses, which are characterized by a protracted course and are multifactorial in causation. In addition to this, neglected non-communicable diseases (NNCD) in the form of gout, sickle cell disease, accidents and many more are likely to be one of the biggest public health challenges soon. Nearly three-quarters (31.4 million) of all NCD-related fatalities occur in developing nations. In terms of morbidity and mortality, the “BIG FOUR” NCDs—diabetes, cancer, chronic respiratory diseases, and cardiovascular diseases—are widely acknowledged as the main contributors to global health loss. However, other NCDs account for 55% of the global burden of NCDs and are frequently neglected in terms of premature death, increased Disability Adjusted Life Years (DALY), and decreased Quality-Adjusted Life Year (QALY). We have briefly discussed the disease burden of ...
IntroductionBreast cancer is one of the most common cancer among Indian women, with an incidence ... more IntroductionBreast cancer is one of the most common cancer among Indian women, with an incidence of 25.8 per 100,000 women according to the Ministry of Health and Family Welfare. Late detection is responsible for poor quality of life (QOL), and it is the leading cause of death. In metropolitan regions, one in every 22 women will have breast cancer over their lifetime; but in rural areas, one in every 60 women will develop breast cancer as per estimates.Aim and objectiveThis paper aims to describe the various AI based breast screening technologies which are used in breast cancer screening in India.MethodologyThe literature search was done using “Pub Med,” “Google scholar,” and “Scopus” databases for the key terms “technology,” “cancer research,” “artificial intelligence,” “mammography”, “breast cancer,” “cancer,” and/or “neoplasia in breast.” All the relevant articles were included to support this mini review.ResultsWe found that emerging artificial intelligent technologies namely “N...
Introduction: Manuka honey has been used in chronic diabetic ulcers and traumatic wounds. We have... more Introduction: Manuka honey has been used in chronic diabetic ulcers and traumatic wounds. We have used Manuka honey in cases of otitis externa because of its antibacterial and anti-inflammatory properties. Objectives: The objective was to study the efficacy of topical applications of Manuka honey in the patients of acute otitis externa. Materials and Methods: Patients with acute otitis externa without any prior ear complaint or intervention were selected for the study after informed and written consent. All patients selected for the study were packed with Manuka honey-impregnated umbilical tape and pain scores; canal wall edema was recorded on days 0, 1, 3, and 7. Results: A total of 20 patients were included in our study. Twenty patients followed us on day 1, 15 patients on day 3, and seven patients followed us till day 7. The mean pain score for day 0 was 5.35, and the mean pain score decreased to 2.95 on day 1, and the difference was statistically significant. Conclusion: Manuka honey appears to be an effective therapeutic agent in the management of otitis externa.
Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which... more Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which is frequently misinterpreted as sarcoma, both clinically and microscopically. It is a reactive lesion composed of fibroblasts/myofibroblasts and most commonly found in extremities and trunk. NF has been described in the head and neck region in 10-20% of cases. Many pathologists do not consider NF in the differential diagnosis of soft tissue masses arising in the Head neck region. NF that occurs in otherwise healthy individuals usually presents with a history of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. It has a confirmed perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is the treatment of choice. A case of NF over the neck in a 05-year-old female not associated with trauma who presented w...
Embryology of stapes has long been a topic of controversy. There are theories stating a single so... more Embryology of stapes has long been a topic of controversy. There are theories stating a single source to the dual origin of stapes. Chronic otitis media is also known to cause various acquired bony ossicular fixations. We present a case of an 11-year-old female with right chronic otitis media, active squamosal with cerebellar abscess who underwent drainage of cerebellar abscess followed by tympanomastoidectomy as a two-staged procedure. Intraoperatively, there were stapes suprastructure fusion to the fallopian canal and one crural attachment to the promontory. There are no clear criteria to differentiate bony fixation of congenital origin from acquired causes. This case also highlights the need to add a new subclass in the classification of minor middle ear anomalies given by Cremer, and our findings also support the dual origin for stapes development.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2021
Unilateral Sensorineural Hearing Loss (USNHL) can present with varying symptoms apart from hearin... more Unilateral Sensorineural Hearing Loss (USNHL) can present with varying symptoms apart from hearing loss, such as dizziness and tinnitus. Impaired sound localization, inability to identify speech in noise and decreased temporal summation can significantly impair the daily activities of an individual. This along with dizziness and tinnitus affects the physical, mental and social health as well. The purpose of this study is to assess and correlate the spectrum of handicap faced by USNHL patients. Validated questionnaires were used to evaluate handicap in 42 USNHL patients due to hearing loss (Hearing Handicap Inventory for Adults–HHIA), dizziness (Dizziness Handicap Inventory–DHI) and tinnitus (Tinnitus Handicap Inventory–THI). These handicaps were then correlated with each other using Spearman’s correlation coefficient. Statistically significant strong positive correlation of HHIA was seen with DHI (rho = 0.60, p ≤ 0.001) and THI (rho = 0.74, p ≤ 0.001). Similarly, strong positive correlation was seen between emotional subscales of HHIA and DHI (rho = 0.73, p ≤ 0.001). USNHL can lead to significant emotional and social handicap which is compounded in the presence of hearing loss, dizziness and tinnitus. These handicaps are strongly correlated to one another. Hence, a holistic approach is needed for USNHL rehabilitation. There exists a need to develop a comprehensive measure to assess and grade the handicap faced by these patients.
Supplemental Digital Content is available in the text Objective: Evaluate a new autologous mushro... more Supplemental Digital Content is available in the text Objective: Evaluate a new autologous mushroom-shaped cortical bone partial ossicular replacement prosthesis (MPORP) for cost-effective and sustainable hearing results. Study Design: Prospective study. Setting: Tertiary care center. Patients: Forty-two patients suffering from chronic otitis media with intact superstructure of the stapes and partially or completely eroded incus. Interventions: Group-1 (n = 24) underwent only tympanoplasty with MPORP; group-2 (n = 18) underwent intact canal wall mastoidectomy (ICW) with MPORP. Main Outcome Measures: Hearing results were evaluated using a four frequency average (measured at 0.5, 1, 2, 3 kHz) pure tone air conduction (PTA), air-bone gap (ABG), and word recognition scores (WRS) after 3, 6, and 12 months and compared with preoperative results. Results: Overall, successful rehabilitation of ABG to 20 dB or less was achieved in 92% of patients. Mean postoperative ABG was 15.35 ± 4.18 dB showing mean improvement of 23.89 ± 5.95 dB. In group-1, mean postoperative ABG was 18.47 ± 3.65 dB, showing an improvement of 25.92 ± 5.3 dB. In group-2, mean postoperative ABG was 18.47 ± 3.65 dB showing an improvement of 20.14 ± 4.96 dB. Hearing improvement in all the cases together and both the groups checked separately was statistically significant (paired t test, p < 0.001). Group 1 had, on average, 5 dB better hearing than group 2 (unpaired t test, p > 0.05). Conclusion: The MPORP is obtainable from the local site, easily constructed, bio-compatible, cost-effective, less bulky, adequately rigid for sound transmission, magnetic resonance imaging (MRI) compatible, and provides sustainable hearing gain because it has better chances of integration with the head of stapes.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2020
Deafmutism affects communication and wholesome development of an individual. India has a signific... more Deafmutism affects communication and wholesome development of an individual. India has a significant burden of deafness in the country. Even fourteen years after the launch of a National Program for Prevention and Control of Deafness in year 2006, we lack detailed data about the disability from most regions of the country. This study aims at finding out the prevalence, clinical history-examination and audiological profile of deaf-mute patients visiting the Out Patient Department (OPD) of a tertiary care institute in Uttarakhand, and compare the results with similar studies published during last 20 years from India to generate a literature review. Out of 46,049 patients that visited OPD of the institute during the given period of 24 months, 73 cases were short-listed clinically to be enrolled in the study. However, only 55 (75%) of them completed the questionnaire and audiological testing. All information was extracted from the patients/relatives with the help of a questionnaire in the Hindi language. The prevalence of deafmutism in patient presenting in our OPD in the study period was 0.3%. The history of pre-, peri- and post-natal risk factors was present in high percentage (58.2%, 78.2% and 34.5% respectively) of patients. This warrants review of our maternal and child healthcare strategies. The literature review revealed lack of uniform and standardized tool in conducting and reporting of studies on deafmutism. The questionnaire used in this study can be further improved and modified in the future as per the requirements of data collection.
Annals of Indian Academy of Otorhinolaryngology Head and Neck Surgery, 2019
Congenital hypofibrinogenemia is a rare condition which can present as spontaneous hemorrhage. We... more Congenital hypofibrinogenemia is a rare condition which can present as spontaneous hemorrhage. We present a case of a 7-year-old male who presented with complaints of sudden swelling over the cheek and neck after an episode of fever and upper respiratory tract infection. The diagnosis was delayed as the initial diagnosis of deep neck space infection was suspected, and the patient was treated in that line. The diagnosis was suspected when the child developed swelling in the knee joint and workup was done for hypofibrinogenemia. The child was transfused with cryoprecipitate and he has complete recovery by day 7.
Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rar... more Tubercular otitis media is a rare disease and its association with retropharyngeal abscess is rarer. We have not come across any such case in the English literature of the dual presentation of tuberculosis to the best of our knowledge so far. Early diagnosis and prompt management are the key to reduce the disease burden and also to avoid life-threatening complications.
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