With the use of prophylactic antibiotics in surgical procedures, the rate of wound infection has ... more With the use of prophylactic antibiotics in surgical procedures, the rate of wound infection has been decreased significantly compared to the pre antibiotic era. However, there is no consensus about the duration of antibiotic usage in different part of the world. Prolonged antibiotic usage may not only incur extra expenditure on the patient, along with the prolonged hospital stay, it also can be a potential risk for developing antibiotic resistance. This is a study, attempted to emphasize the optimal usage of antibiotic prophylaxis, by comparing a single day regimen versus a five day regimen.
Journal of Dr. NTR University of Health Sciences, 2017
Pleomorphic adenoma (PA) is the most common benign neoplasm affecting the major salivary glands. ... more Pleomorphic adenoma (PA) is the most common benign neoplasm affecting the major salivary glands. It is more common in parotid gland and sometimes occurs in submandibular and other minor salivary glands. Carcinoma ex-pleomorphic adenoma (CXPA) is the malignant transformation of a primary or recurrent PA. Here, we report a case of CXPA of submandibular salivary gland with metastasis in the cervical lymph nodes. He was treated with excision of the mass with radical neck dissection, followed by adjuvant radiotherapy.
OBJECTIVES The aim of the study was to compare lecture-based teaching and simulation-based hybrid... more OBJECTIVES The aim of the study was to compare lecture-based teaching and simulation-based hybrid training for ENT induction and objectively assess the performance of trainees in a simulated environment. METHODS This is a prospective interventional study that included 60 interns in their rotatory internship with no prior exposure to ENT emergencies. The interns came in batches of 5‒6 for their 15-days ENT postings. On the first day, a pre-test questionnaire, lecture-based teaching on three scenarios and then allocation into one of the three simulation groups- Group A (Tracheostomy group), Group B (Nasogastric tube group), and Group C (Epistaxis group) was done. Hands-on simulation training was given only to the assigned group. At the end of 15-days, post-test questionnaire and an objective assessment of the three scenarios in a simulated environment was conducted. The same training was repeated for each batch of participants who attended the posting. RESULTS The participants had significant improvement in the post-test scores in all three scenarios (p < 0.05), and these improvements were marked in those who had received simulated training. On comparing simulation scores, the participants who received hands-on training on a particular scenario outperformed other (p < 0.05). CONCLUSION Simulation-based training improves cognition and overall confidence in managing ENT skills and emergencies. In simulation training, objective and standardized assessment is the key to achieve specific learning objectives to improve the psychomotor and cognitive skill. LEVEL OF EVIDENCE II.
Medical Journal of Dr. D.Y. Patil University, 2016
Objectives: Adult adenoid hypertrophy is not common. More number of cases of adult adenoid hypert... more Objectives: Adult adenoid hypertrophy is not common. More number of cases of adult adenoid hypertrophy is detected in recent years due to the free availability of endoscopes. The aim of this study is to know the etiopathology of adenoid hypertrophy in adults. Materials and Methods: Twenty-five cases of adult adenoid hypertrophy who underwent adenoidectomy were studied in our institution over a period of 5 years from 2008 to 2013. All the patients underwent diagnostic nasal endoscopy, and associated sinus and nasal pathology were studied. Results: Of 25 cases, 12 were males and 13 were females. In our study adult adenoid hypertrophy was more common in second and third decade. Nasal obstruction was main symptom in 80% of our cases. Allergic symptoms were seen in 28%, headache in 24%, and repeated throat infection in 20%. Adenoidectomy with tonsillectomy was done in 5 cases, adenoidectomy with septoplasty in 5 cases, septoplasty with turbinectomy along with adenoidectomy in 7 cases, functional endoscopic sinus surgery with adenoidectomy in 3 cases, adenoidectomy with tympanoplasty in 2 cases, myringotomy with grommet insertion in 2 patients, and isolated adenoidectomy in 1 patient. Conclusion: Since highest number of cases in our study is in early adulthood, we believe that adenoid hypertrophy is persistence of childhood hypertrophy.
Introduction Allergic rhinitis (AR) is a common IgE -mediated inflammatory condition characterise... more Introduction Allergic rhinitis (AR) is a common IgE -mediated inflammatory condition characterised by sneezing, nasal congestion, itching and rhinorrhoea. Nasal allergy is a strong risk factor for the onset of asthma in adults. Bronchial hyper-responsiveness (BHR) is a distinct feature of pathophysiology in asthma. Spirometric parameters like Forced Expiratory Volume in first second [FEV1] and Forced Expiratory Flow [FEF 25–75%] are known to be impaired in patients with allergic rhinitis. We studied these parameters in subjects of AR who have never experienced any chest symptoms. It is well known that, subjects with allergic rhinitis are at greater risk of developing overt bronchial asthma in future. Methods All patients presented with symptoms of allergic rhinitis without history of bronchial asthma were included. Patients those who were clinically diagnosed with allergic rhinitis were evaluated with absolute eosinophilic count, serum IgE and Spirometric assessment. In spirometry, post bronchodilator FEV1 reversibility and post bronchodilator FEF 25–75% values were used to assess lower airway abnormalities. Results Among 61 subjects, 32 were males and 29 were females. The maximum numbers [28] of patients were in 21–35 age group. Absolute eosinophil count was elevated in 38% of patients. 33% of patients showed elevated IgE values above 1000. 43% of patients showed FEV1 reversibility which is a sign of Bronchial hyperreactivity. 5% of patients showed impaired post bronchodilator FEF 25–75% which indicates presence of small airway disease. There was significant correlation between FEV1 reversibility and elevated IgE. Conclusion Impaired spirometric parameters indicate coexistence of bronchial impairment and hence predisposition to progression from allergic rhinitis alone to overt asthma in future. Thus careful evaluation of lower airway has to be done to rule out coexisting subclinical asthma.
Objectives: The objective of the study is to know the presence of biofilm-producing organisms in ... more Objectives: The objective of the study is to know the presence of biofilm-producing organisms in the middle ear mucosa in chronic otitis media (COM) mucosal disease and their antibiotic sensitivity. Materials and Methods: This was a prospective comparative study conducted on 100 patients who underwent tympanoplasty. They were divided into two groups: Group 1 included mucosal active disease (50) and Group 2 included mucosal inactive (50). During surgery, a biopsy from the middle ear mucosa was taken and sent for culture and sensitivity and tested for their biofilm-forming capability using tissue culture plate method. Results: In Group 1, 17 cultures were biofilm-producing organisms and 14 were non/weak biofilm-producing organisms. In Group 2, 14 were biofilm producing and 8 were non/weak biofilm producing. Piperacillin-tazobactam was the most sensitive drug for Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus epidermidis irrespective of their biofilm-producing capabi...
Peanut or groundnut is considered as nutritious food, as it is rich in many essential nutrients w... more Peanut or groundnut is considered as nutritious food, as it is rich in many essential nutrients which include calories, protein, vitamins, and dietary minerals [1]. Peanuts also contain polyphenols, polyunsaturated and monounsaturated fats, phytosterols and dietary fibers [2]. They are indeed a good source of nutrition, especially for children. On the other hand, peanut is also a common cause of food allergy, which sometimes can be fatal. The incidence of peanut allergy was on the increase, in spite of avoiding peanuts for children with high risk of peanut allergy. National Institute of Allergy and Infectious Diseases while issuing the guidelines for diagnosis and management of food allergies, recommend feed peanuts as early as four to six months for an infant with a high risk of peanut allergy [3]. They observed that early exposure to peanut would lead to desensitization, and reducing the severity of peanut allergy in such infants, citing dual allergen exposure hypothesis which sta...
International Education and Research Journal, Mar 15, 2016
Medical education needs periodic reforms to cope up with the developing technologies in the field... more Medical education needs periodic reforms to cope up with the developing technologies in the field of medicine which cannot be assessed with conventional methods. Apart from the knowledge, skill and attitude also need to be assessed. Objective structured clinical examination (OSCE) is considered as a suitable method for assessment of all theses aspects, in many countries. However in India, this method of assessment is still not very popular. We conducted a study to understand the experience of undertaking OSCE and to know the effectiveness of OSCE in the assessment of medical students. Medical education needs periodic reforms to cope up with the developing technologies in the field of medicine which cannot be assessed with conventional methods. Apart from the knowledge, skill and attitude also need to be assessed. Objective structured clinical examination (OSCE) is considered as a suitable method for assessment of all theses aspects, in many countries. However in India, this method of assessment is still not very popular. We conducted a study to understand the experience of undertaking OSCE and to know the effectiveness of OSCE in the assessment of medical students.
Oral cavity and the oropharynx are the two most common sites of cancer in the head and neck regio... more Oral cavity and the oropharynx are the two most common sites of cancer in the head and neck region. The exposure of mucosal surface of the oral cavity and entire oropharynx to alcohol and tobacco-related carcinogens increases the risk for developing premalignant or malignant lesions. The purpose of this study is to assess the serum levels of total antioxidant capacity, vitamin C and malondialdehyde in confirmed cases of oral and oropharyngeal squamous cell carcinoma and their correlation in healthy subjects.
With the use of prophylactic antibiotics in surgical procedures, the rate of wound infection has ... more With the use of prophylactic antibiotics in surgical procedures, the rate of wound infection has been decreased significantly compared to the pre antibiotic era. However, there is no consensus about the duration of antibiotic usage in different part of the world. Prolonged antibiotic usage may not only incur extra expenditure on the patient, along with the prolonged hospital stay, it also can be a potential risk for developing antibiotic resistance. This is a study, attempted to emphasize the optimal usage of antibiotic prophylaxis, by comparing a single day regimen versus a five day regimen.
Journal of Dr. NTR University of Health Sciences, 2017
Pleomorphic adenoma (PA) is the most common benign neoplasm affecting the major salivary glands. ... more Pleomorphic adenoma (PA) is the most common benign neoplasm affecting the major salivary glands. It is more common in parotid gland and sometimes occurs in submandibular and other minor salivary glands. Carcinoma ex-pleomorphic adenoma (CXPA) is the malignant transformation of a primary or recurrent PA. Here, we report a case of CXPA of submandibular salivary gland with metastasis in the cervical lymph nodes. He was treated with excision of the mass with radical neck dissection, followed by adjuvant radiotherapy.
OBJECTIVES The aim of the study was to compare lecture-based teaching and simulation-based hybrid... more OBJECTIVES The aim of the study was to compare lecture-based teaching and simulation-based hybrid training for ENT induction and objectively assess the performance of trainees in a simulated environment. METHODS This is a prospective interventional study that included 60 interns in their rotatory internship with no prior exposure to ENT emergencies. The interns came in batches of 5‒6 for their 15-days ENT postings. On the first day, a pre-test questionnaire, lecture-based teaching on three scenarios and then allocation into one of the three simulation groups- Group A (Tracheostomy group), Group B (Nasogastric tube group), and Group C (Epistaxis group) was done. Hands-on simulation training was given only to the assigned group. At the end of 15-days, post-test questionnaire and an objective assessment of the three scenarios in a simulated environment was conducted. The same training was repeated for each batch of participants who attended the posting. RESULTS The participants had significant improvement in the post-test scores in all three scenarios (p < 0.05), and these improvements were marked in those who had received simulated training. On comparing simulation scores, the participants who received hands-on training on a particular scenario outperformed other (p < 0.05). CONCLUSION Simulation-based training improves cognition and overall confidence in managing ENT skills and emergencies. In simulation training, objective and standardized assessment is the key to achieve specific learning objectives to improve the psychomotor and cognitive skill. LEVEL OF EVIDENCE II.
Medical Journal of Dr. D.Y. Patil University, 2016
Objectives: Adult adenoid hypertrophy is not common. More number of cases of adult adenoid hypert... more Objectives: Adult adenoid hypertrophy is not common. More number of cases of adult adenoid hypertrophy is detected in recent years due to the free availability of endoscopes. The aim of this study is to know the etiopathology of adenoid hypertrophy in adults. Materials and Methods: Twenty-five cases of adult adenoid hypertrophy who underwent adenoidectomy were studied in our institution over a period of 5 years from 2008 to 2013. All the patients underwent diagnostic nasal endoscopy, and associated sinus and nasal pathology were studied. Results: Of 25 cases, 12 were males and 13 were females. In our study adult adenoid hypertrophy was more common in second and third decade. Nasal obstruction was main symptom in 80% of our cases. Allergic symptoms were seen in 28%, headache in 24%, and repeated throat infection in 20%. Adenoidectomy with tonsillectomy was done in 5 cases, adenoidectomy with septoplasty in 5 cases, septoplasty with turbinectomy along with adenoidectomy in 7 cases, functional endoscopic sinus surgery with adenoidectomy in 3 cases, adenoidectomy with tympanoplasty in 2 cases, myringotomy with grommet insertion in 2 patients, and isolated adenoidectomy in 1 patient. Conclusion: Since highest number of cases in our study is in early adulthood, we believe that adenoid hypertrophy is persistence of childhood hypertrophy.
Introduction Allergic rhinitis (AR) is a common IgE -mediated inflammatory condition characterise... more Introduction Allergic rhinitis (AR) is a common IgE -mediated inflammatory condition characterised by sneezing, nasal congestion, itching and rhinorrhoea. Nasal allergy is a strong risk factor for the onset of asthma in adults. Bronchial hyper-responsiveness (BHR) is a distinct feature of pathophysiology in asthma. Spirometric parameters like Forced Expiratory Volume in first second [FEV1] and Forced Expiratory Flow [FEF 25–75%] are known to be impaired in patients with allergic rhinitis. We studied these parameters in subjects of AR who have never experienced any chest symptoms. It is well known that, subjects with allergic rhinitis are at greater risk of developing overt bronchial asthma in future. Methods All patients presented with symptoms of allergic rhinitis without history of bronchial asthma were included. Patients those who were clinically diagnosed with allergic rhinitis were evaluated with absolute eosinophilic count, serum IgE and Spirometric assessment. In spirometry, post bronchodilator FEV1 reversibility and post bronchodilator FEF 25–75% values were used to assess lower airway abnormalities. Results Among 61 subjects, 32 were males and 29 were females. The maximum numbers [28] of patients were in 21–35 age group. Absolute eosinophil count was elevated in 38% of patients. 33% of patients showed elevated IgE values above 1000. 43% of patients showed FEV1 reversibility which is a sign of Bronchial hyperreactivity. 5% of patients showed impaired post bronchodilator FEF 25–75% which indicates presence of small airway disease. There was significant correlation between FEV1 reversibility and elevated IgE. Conclusion Impaired spirometric parameters indicate coexistence of bronchial impairment and hence predisposition to progression from allergic rhinitis alone to overt asthma in future. Thus careful evaluation of lower airway has to be done to rule out coexisting subclinical asthma.
Objectives: The objective of the study is to know the presence of biofilm-producing organisms in ... more Objectives: The objective of the study is to know the presence of biofilm-producing organisms in the middle ear mucosa in chronic otitis media (COM) mucosal disease and their antibiotic sensitivity. Materials and Methods: This was a prospective comparative study conducted on 100 patients who underwent tympanoplasty. They were divided into two groups: Group 1 included mucosal active disease (50) and Group 2 included mucosal inactive (50). During surgery, a biopsy from the middle ear mucosa was taken and sent for culture and sensitivity and tested for their biofilm-forming capability using tissue culture plate method. Results: In Group 1, 17 cultures were biofilm-producing organisms and 14 were non/weak biofilm-producing organisms. In Group 2, 14 were biofilm producing and 8 were non/weak biofilm producing. Piperacillin-tazobactam was the most sensitive drug for Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus epidermidis irrespective of their biofilm-producing capabi...
Peanut or groundnut is considered as nutritious food, as it is rich in many essential nutrients w... more Peanut or groundnut is considered as nutritious food, as it is rich in many essential nutrients which include calories, protein, vitamins, and dietary minerals [1]. Peanuts also contain polyphenols, polyunsaturated and monounsaturated fats, phytosterols and dietary fibers [2]. They are indeed a good source of nutrition, especially for children. On the other hand, peanut is also a common cause of food allergy, which sometimes can be fatal. The incidence of peanut allergy was on the increase, in spite of avoiding peanuts for children with high risk of peanut allergy. National Institute of Allergy and Infectious Diseases while issuing the guidelines for diagnosis and management of food allergies, recommend feed peanuts as early as four to six months for an infant with a high risk of peanut allergy [3]. They observed that early exposure to peanut would lead to desensitization, and reducing the severity of peanut allergy in such infants, citing dual allergen exposure hypothesis which sta...
International Education and Research Journal, Mar 15, 2016
Medical education needs periodic reforms to cope up with the developing technologies in the field... more Medical education needs periodic reforms to cope up with the developing technologies in the field of medicine which cannot be assessed with conventional methods. Apart from the knowledge, skill and attitude also need to be assessed. Objective structured clinical examination (OSCE) is considered as a suitable method for assessment of all theses aspects, in many countries. However in India, this method of assessment is still not very popular. We conducted a study to understand the experience of undertaking OSCE and to know the effectiveness of OSCE in the assessment of medical students. Medical education needs periodic reforms to cope up with the developing technologies in the field of medicine which cannot be assessed with conventional methods. Apart from the knowledge, skill and attitude also need to be assessed. Objective structured clinical examination (OSCE) is considered as a suitable method for assessment of all theses aspects, in many countries. However in India, this method of assessment is still not very popular. We conducted a study to understand the experience of undertaking OSCE and to know the effectiveness of OSCE in the assessment of medical students.
Oral cavity and the oropharynx are the two most common sites of cancer in the head and neck regio... more Oral cavity and the oropharynx are the two most common sites of cancer in the head and neck region. The exposure of mucosal surface of the oral cavity and entire oropharynx to alcohol and tobacco-related carcinogens increases the risk for developing premalignant or malignant lesions. The purpose of this study is to assess the serum levels of total antioxidant capacity, vitamin C and malondialdehyde in confirmed cases of oral and oropharyngeal squamous cell carcinoma and their correlation in healthy subjects.
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