Obesity and glycated hemoglobin: is there a relation with oxygen saturation in type 2 diabetes mellitus?

Background: Diabetics and obese persons are highly susceptible to cardiovascular diseases (CVD). Obesity causes hypoxemia and glycated hemoglobin (HbA1c) also is known to lower the oxygen-carrying capacity and related systemic vascular vasodilatory adaptations and responses. Aim was to assess the effect of obesity and glycosylated hemoglobin on oxygen saturation in patients of type 2 diabetes mellitus (T2DM).Methods: HbA1c level and oxygen saturation (SpO2) were measured in 100 adult, obese (Body mass index>30) T2DM patients.Results: Mean HbA1C and SpO2 values were 8.69±2.41% and 95.24±3.23% respectively. P value for correlation between SpO2 and BMI was 0.3. On the other hand, p-value for correlation between SpO2 and HbA1c was 0.679Conclusions: There was no significant effect of obesity and HbA1c on oxygen saturation in T2DM patients

Use of lignocaine nebulization in post bronchoscopy patients: a study of 150 cases

Background: To see the role of lignocaine nebulisation and to compare its role with use of steroids and bronchodilators alone in post bronchoscopy patients.Methods: In the present study, 150 patients, who underwent rigid bronchoscopy for removal of foreign body, were taken into consideration. Immediately after the rigid bronchoscopy, 100 patients were given nebulization and 50 patients were not nebulized. Out of 100 patients, 50 patients were given nebulization with steroids (budesonide) and bronchodilators (salbutamol) and 50 patients received nebulization with lignocaine 4%, steroids (budesonide) and bronchodilator (salbutamol).Results: In the present study, 38 patients (25.3%) were having complications like laryngobronchial spasm, laryngeal edema, cardiac arrest and respiratory arrest. Out of the 38 patients, 15 patients (39.5%) were having laryngobronchial spasm and 23 patients (60.5%) were having laryngeal edema. Out of 15 patients who had laryngobronchial spasm only 2 (13.3%) patients, who were nebulised developed this complication, while 86.7% cases of laryngobronchial spasm developed in non-nebulised patients. Out of 23 patients who developed laryngeal oedema, only 6 (26%) patients who were nebulised developed this complication, while 74% cases of laryngeal oedema developed in non-nebulised patients.Conclusions: In the present study it is concluded that both morbidity and mortality can be reduced by the use of nebulisation in the postoperative period after rigid bronchoscopy. Addition of lignocaine in nebulisation along with steroids and bronchodilators further reduces the morbidity and mortality in the postoperative period

Thyroglossal duct cyst variation in presentation: our experience of 3 years

Background: The prime objective of the present study was, to learn incidence of thyroglossal duct cyst in different age and sex groups and variation in its presentation.Methods: The present retrospective study was carried out in department of otorhinolaryngology and head and neck surgery, GMC Jammu from June 2017 to May 2020. In this retrospective study clinical records, medical records and histopathological records were thoroughly reviewed and studied. 20 patients diagnosed as thyroglossal duct cyst were included in the present study.Results: Out of 20 patients, 14 were paediatric patients and 6 were adults. 15 patients presented with cystic swelling while 5 patients presented with fistula. Out of 20 patients, 5 patients had suprahyoid presentation, 4 patients had cyst at the level of hyoid and 11 had infrahyoid presentation. 16 patients underwent sistrunk operation while 4 patients underwent simple excision. Out of 4 patients who had undergone simple excision, 2 patients developed recurrence.Conclusions: In the present study it is concluded that paediatric age group presents most commonly with thyroglossal cyst as a midline, painless swelling. The most common site observed is infrahyoid region. After proper investigations and diagnosis, thyroglossal duct cyst should be excised preferably by sistrunk operation

Use of topical nasal steroid spray in the treatment of non-specific chronic pharyngitis- our experience

Background: The present study was done to find the effectiveness of nasal steroid spray in the treatment of non-specific chronic pharyngitis.Methods: The present prospective study was carried out in department of Otorhinolaryngology and Head and Neck surgery, Government Medical College Jammu from July 2017 to March 2020. Patients were selected randomly from the ENT OPD, a detailed history was taken, thorough clinical examination was done to confirm the diagnosis and exclude all other existing illnesses and associated problems. Fluticasone nasal spray was used to see the relief of symptoms. Persistent relief was central to be considered proof of effectiveness of the treatment.Results: 40 patients were taken up for the present study, out of which only 32 patients showed relief in symptoms. 25 patients showed relief of symptoms with only 1-2 sprays. 8 patients did not report any relief of symptoms even after continues use of steroid nasal spray for 3-4 weeks. No significant side effect was noticed in any patient.Conclusions: In the present study, it is concluded that use of steroid (fluticasone) nasal spray in well selected cases of non-specific chronic pharyngitis is very effective, safe and cheap

Pattern of Noise Induced Hearing Loss and its Relation with Duration of Exposure in Traffic Police Personnel

Background: Occupational noise exposure is a major and preventable cause of hearing loss. Traffic policemen are constantly exposed to noise pollution. Noise induced hearing loss (NIHL) denotes a selective 4000 Hz hearing loss (unilateral or bilateral). Objective: To assess the prevalence pattern of NIHL and its relation with duration of exposure to noise in traffic policemen. Material and methods: Otoscopy, tuning fork tests and Pure Tone Audiometry (PTA) were performed in 150 apparently healthy police personnel. Results: Rinne’s and Weber’s test were normal in all the subjects. Schwabach’s test showed normal bone conduction in normal subjects as well as those with NIHL. PTA revealed that 33 (22% of sample) subjects were suffering from NIHL; 8 (5.3%) had sensorineural hearing loss whereas 109 (72.7%) performed normally in the test. None of the subjects with sensorineural hearing loss showed the characteristic notch at 4 kHz. Majority of the subjects (69.7%) with NIHL had mild to moderate grades of hearing loss in both ears. No subject had profound hearing loss. Significant association was observed between NIHL and duration of exposure. Steps need to be taken at the level of employers as well as individuals to counter occupational noise threat

Socializing One Health: an innovative strategy to investigate social and behavioral risks of emerging viral threats

In an effort to strengthen global capacity to prevent, detect, and control infectious diseases in animals and people, the United States Agency for International Development’s (USAID) Emerging Pandemic Threats (EPT) PREDICT project funded development of regional, national, and local One Health capacities for early disease detection, rapid response, disease control, and risk reduction. From the outset, the EPT approach was inclusive of social science research methods designed to understand the contexts and behaviors of communities living and working at human-animal-environment interfaces considered high-risk for virus emergence. Using qualitative and quantitative approaches, PREDICT behavioral research aimed to identify and assess a range of socio-cultural behaviors that could be influential in zoonotic disease emergence, amplification, and transmission. This broad approach to behavioral risk characterization enabled us to identify and characterize human activities that could be linked to the transmission dynamics of new and emerging viruses. This paper provides a discussion of implementation of a social science approach within a zoonotic surveillance framework. We conducted in-depth ethnographic interviews and focus groups to better understand the individual- and community-level knowledge, attitudes, and practices that potentially put participants at risk for zoonotic disease transmission from the animals they live and work with, across 6 interface domains. When we asked highly-exposed individuals (ie. bushmeat hunters, wildlife or guano farmers) about the risk they perceived in their occupational activities, most did not perceive it to be risky, whether because it was normalized by years (or generations) of doing such an activity, or due to lack of information about potential risks. Integrating the social sciences allows investigations of the specific human activities that are hypothesized to drive disease emergence, amplification, and transmission, in order to better substantiate behavioral disease drivers, along with the social dimensions of infection and transmission dynamics. Understanding these dynamics is critical to achieving health security--the protection from threats to health-- which requires investments in both collective and individual health security. Involving behavioral sciences into zoonotic disease surveillance allowed us to push toward fuller community integration and engagement and toward dialogue and implementation of recommendations for disease prevention and improved health security

Evaluation of quality of life after septorhinoplasty using Rhinoplasty Outcome Evaluation questionnaire

Abstract Background To assess satisfaction level of patients undergoing septorhinoplasty pre- and post-operatively using Rhinoplasty Outcome Evaluation (ROE) questionnaire. Methods The present prospective study, after approval by Institutional Ethics Committee, was conducted in the Department of ENT, SMGS Hospital, from March 2021 to November 2022 on 83 patients who underwent septorhinoplasty. Demographic and clinical characteristics (age, gender, education, technique of surgery) of all participants were recorded. All patients were asked to answer the Rhinoplasty Outcome Evaluation (ROE) questionnaire 1 day prior to surgery. Postoperative ROE questionnaire was asked at the 6th month in ENT OPD by the same researcher. Results In our study, the mean preoperative total ROE score was 32.17 ± 5.38, and the mean postoperative total ROE score was 87.11 ± 5.39, the difference being statistically significant (p = 0.0039). Higher post-operative satisfaction score (89.7 ± 5.64) was seen in patients aged more than 35 years, as compared to younger patients (78.4 ± 5.8). In our study, upon gender-wise comparison, there was more statistically significant satisfaction in male patients than female patients postoperatively (p = 0.0022). Better postoperative ROE score was seen in lower literacy group (88.9 ± 6.73) than higher literacy group (83.3 ± 5.63). However, both open and closed techniques showed statistically insignificant difference in postoperative ROE score (p = 0.388). Conclusion Based on the Rhinoplasty Outcome Evaluation (ROE) questionnaire, our study showed that septorhinoplasty significantly improved quality of life in majority of our study subjects in terms of both aesthetic as well as functional parameters

Pattern of Noise Induced Hearing Loss and its Relation with Duration of Exposure in Traffic Police Personnel

Background: Occupational noise exposure is a major and preventable cause of hearing loss. Traffic policemen are constantly exposed to noise pollution. Noise induced hearing loss (NIHL) denotes a selective 4000 Hz hearing loss (unilateral or bilateral). Objective: To assess the prevalence pattern of NIHL and its relation with duration of exposure to noise in traffic policemen. Material and methods: Otoscopy, tuning fork tests and Pure Tone Audiometry (PTA) were performed in 150 apparently healthy police personnel. Results: Rinne’s and Weber’s test were normal in all the subjects. Schwabach’s test showed normal bone conduction in normal subjects as well as those with NIHL. PTA revealed that 33 (22% of sample) subjects were suffering from NIHL; 8 (5.3%) had sensorineural hearing loss whereas 109 (72.7%) performed normally in the test. None of the subjects with sensorineural hearing loss showed the characteristic notch at 4 kHz. Majority of the subjects (69.7%) with NIHL had mild to moderate grades of hearing loss in both ears. No subject had profound hearing loss. Significant association was observed between NIHL and duration of exposure. Steps need to be taken at the level of employers as well as individuals to counter occupational noise threat

Halitosis: Its Aetiology and Psychosocial Impact- A Hospital Based Study

Introduction Halitosis means bad or unpleasant odour from oral cavity. It causes embarrassment to the patients and affects their social life and communication. This study aims to find the causes of halitosis and to assess its psychosocial impact. Materials and Methods A prospective study was conducted in the department of Otorhinolaryngology and Head Neck Surgery in a tertiary care hospital. It included 165 patients, presenting to the ENT OPD with chief complains of oral malodour for at least 3 months. The patients in the age above 15 years and below 75 years, irrespective of gender, were included in the study. Results The age of the patients ranged from 15 to 75 years with a mean age of 52.24 ± 15.67 with male: female ratio of 7:10. The most common cause of halitosis in the present study included chronic rhinosinusitis (38.7%), gingivitis/periodontitis (19.39%), tonsillitis (4.84%), laryngopharyngeal reflux (2%), deep neck space infections (1.2%). In 23.56%, the halitosis was a symptom of an underlying malignancy. Conclusion Halitosis from an extra oral origin can be the sign of an underlying systemic disease or malignancy. The consultation should be done with the periodontist, ENT specialist and a physician

Postoperative continuous positive airway pressure to prevent pneumonia, re-intubation, and death after major abdominal surgery (PRISM): a multicentre, open-label, randomised, phase 3 trial

Background: Respiratory complications are an important cause of postoperative morbidity. We aimed to investigate whether continuous positive airway pressure (CPAP) administered immediately after major abdominal surgery could prevent postoperative morbidity. Methods: PRISM was an open-label, randomised, phase 3 trial done at 70 hospitals across six countries. Patients aged 50 years or older who were undergoing elective major open abdominal surgery were randomly assigned (1:1) to receive CPAP within 4 h of the end of surgery or usual postoperative care. Patients were randomly assigned using a computer-generated minimisation algorithm with inbuilt concealment. The primary outcome was a composite of pneumonia, endotracheal re-intubation, or death within 30 days after randomisation, assessed in the intention-to-treat population. Safety was assessed in all patients who received CPAP. The trial is registered with the ISRCTN registry, ISRCTN56012545. Findings: Between Feb 8, 2016, and Nov 11, 2019, 4806 patients were randomly assigned (2405 to the CPAP group and 2401 to the usual care group), of whom 4793 were included in the primary analysis (2396 in the CPAP group and 2397 in the usual care group). 195 (8\ub71%) of 2396 patients in the CPAP group and 197 (8\ub72%) of 2397 patients in the usual care group met the composite primary outcome (adjusted odds ratio 1\ub701 [95% CI 0\ub781-1\ub724]; p=0\ub795). 200 (8\ub79%) of 2241 patients in the CPAP group had adverse events. The most common adverse events were claustrophobia (78 [3\ub75%] of 2241 patients), oronasal dryness (43 [1\ub79%]), excessive air leak (36 [1\ub76%]), vomiting (26 [1\ub72%]), and pain (24 [1\ub71%]). There were two serious adverse events: one patient had significant hearing loss and one patient had obstruction of their venous catheter caused by a CPAP hood, which resulted in transient haemodynamic instability. Interpretation: In this large clinical effectiveness trial, CPAP did not reduce the incidence of pneumonia, endotracheal re-intubation, or death after major abdominal surgery. Although CPAP has an important role in the treatment of respiratory failure after surgery, routine use of prophylactic post-operative CPAP is not recommended