Endoscopic Repair of Spontaneous CSF Rhinorrhoea: Results from 21 Cases

Introduction Surgery to close the skull base defect is the treatment of choice in persistent spontaneous cerebrospinal fluid rhinorrhoea with endoscopic endonasal repair being the method of choice.  This study analysed the demographics of presentation, optimal diagnostic and localisation strategies and the effectiveness of transnasal endoscopic treatment strategies  with post-operative follow-up of CSF rhinorrhoea patients in a tertiary care institution   . Materials and Methods  A prospective longitudinal study was conducted on 21 CSF rhinorrhoea patients operated on between August 2014 and August 2018 and results documented. Results CSF rhinorrhoea was found most commonly in middle aged female patients in our study. HRCT PNS was capable of identifying a leak site in 66% of the cases. All patients were operated endoscopically with no major intra-operative or post-operative complications. Resolution of CSF leak occurred in 85% of cases. Conclusion CSF rhinorrhoea can be diagnosed and endoscopic repair can be effectively performed in our existing tertiary care set-ups with good results

Synthetic Studies in Phytochrome Chemistry

An account is given of the author’s several approaches to the synthesis of the parent chromophore of phytochrome (1), a protein-bound linear tetrapyrrole derivative that controls photomorphogenesis in higher plants. These studies culminated in enantioselective syntheses of both (2R)- and (2S)-phytochromobilin (4), as well as several 13C-labeled derivatives designed to probe the site of Z,E-isomerization during photoexcitation. When reacted in vitro, synthetic 2R-4 and recombinant-derived phytochrome apoprotein N-C produced a protein-bound chromophore with identical difference spectra to naturally occurring 1

Endoscopic Skull Base Surgery: Our Initial Experience

Introduction Patients with lesions of the skull base form a minor but very important subgroup of patients presenting to the ENT surgeon or are referred from other departments with complaints such as headache, nasal discharge and nasal obstruction. This study was done to study the clinical presentation of the patients with lesions of the skull base, assess intra operative findings and complications, and to document post operative clinical course and histopathological reports. Materials and Methods A prospective study was conducted on 10 patients with skull base lesions, who were operated on at our institution between August 2014 and August 2015. Patients with clinically and radiologically documented skull base lesions operated by endoscopic methods were included, while those operated on with open methods or those having involvement of the cavernous sinuses and the internal carotid arteries were excluded. Results All patients in the group were successfully operated on with no major intra operative or post operative complications encountered. Adequate tissue was obtained for biopsy with adequate sellar decompression and plugging of CSF leaks was done as required. Conclusion Endoscopic interventions for the skull base lesions can be safely performed in tertiary care set ups with minimal intra operative and post operative morbidity and have a better prognosis than other open procedures

Serum magnesium and stable asthma: Is there a link?

Background: Although magnesium is used through intravenous and inhalation route in the management of asthma, actual prevalence of hypomagnesemia in asthma is not known. We conducted this study: 1) to detect the prevalence of hypomagnesemia in stable asthma and 2) to assess the significance of hypomagnesemia in these patients. Design: Prospective clinical study. Setting: Department of Respiratory Medicine, Calcutta National Medical College, Kolkata. Period of Study: Four months from January, 2007, to April, 2007. Materials and Methods: Fifty patients attending outpatients department of respiratory medicine with stable asthma were randomly selected. They were assessed clinically and their serum magnesium levels were measured. This was compared with the serum magnesium values of 45 nonasthmatic healthy controls. Results: Out of 50 patients, 14 had hypomagnesemia. Possible relationship of hypomagnesemia with tachycardia, tachypnoea, severity of asthma, medication use, and previous and future exacerbations were analyzed. Conclusion: There was statistically significant association of hypomagnesemia with tachypnoea, severe asthma, use of long-acting b2 -agonist, inhaled corticosteroids, theophylline, use of ≥ 3 medications, previous and future exacerbations but not with tachycardia or use of short-acting β2 -agonist or montelukast

Kimura's Disease: A Rare Cause of Postauricular Swelling

Introduction Kimura’s Disease is a chronic inflammatory disorder of lymph node which is very rare in Indian population. Case Report A 15 year old boy with multiple postauricular swelling for 18 months presenting in OPD and diagnosed having eosinophilia. Then excision biopsy was taken, which indicates Kimura’s Disease. Patient was treated with high dose of corticosteroid. Conclusion Kimura’s disease, though rare should be kept in mind for treating a patient with lymphadenopathy with eosinophilia or high IgE level, because it can spare the patient unnecessary invasive procedure