Macrocalcification in thyroid nodule

Background: The thyroid is one of the largest endocrine organs. The prevalence of palpable thyroid nodules increases with age and is 4-7% in a middle-aged population. Objective of present study was to understand if thyroid malignancy is associated with macrocalcification.Methods: 34 cases were with thyroid nodules were evaluated initially with sonography and then with FNAC, the results of which were given on the basis of Bethesda system.Results: On USG, 23 (67.6%) nodules had macrocalcifications, 5 (14.7%) had microcalcifications and 6 (17.6%) had both micro as well as macrocalcifications. Cytology of 23 nodules with macrocalcification were non-diagnostic in 8.7%, benign 73.9%, suspicious for malignancy in 8.7 % and malignant in 8.7%. Only 2 lesions with macrocalcification and 1 with both macro and microcalcification came out to be non-diagnostic. 17 lesions with macrocalification were diagnosed as benign, 2 as suspicious for malignancy and 2 as malignant. While 3 lesions with microcalcification were diagnosed as malignant on FNAC and 2 as benign.Conclusions: Macrocalcification is not a good indicator for malignancy

Prevalence and etiology of hearing impairment in urban area of Shimla, Himachal Pradesh, India: a cross sectional observational study

Background: The ear is a marvelously complex and sensitive organ. Disease of the ear have profound effect on the health and quality of life of millions of people around the globe. Data regarding the magnitude of hearing impairment in our country is limited and the literature search revealed that no such studies have been conducted in this region.Methods: A community based cross sectional observational study was carried out among the 306 individuals in urban area of Shimla, Himachal Pradesh, India. Information was obtained by a structured questionnaire, clinical ENT examination and audiological tests after obtaining informed consent.Results: The study group had 48.4% males and 51.6% females. Maximum 29.4% of individuals were in the age group of 31-45 years. Mean age was 32.22±20.15. The prevalence of hearing impairment was 13.1%. Among individuals with hearing loss, maximum 57.5% were in the age group of ≥60 years. Sensorineural hearing loss was found in 70%, maximum 55% had mild hearing loss. Among majority of individuals with hearing loss cause was presbyacusis 57.5% followed by infectious ear disease 27.5%. Among majority of individuals with hearing loss 37.5% required no further action at the time of study.Conclusions: In the present study, prevalence of hearing loss was found to be 13.1% and predominantly mild sensorineural or conductive type of hearing loss. An early intervention and quality patient education was necessary for prevention of hearing impairment in majority of cases

Tonsillectomy and its effect on ASO titre

Background: Acute tonsillitis is one of the most common manifestations of the upper respiratory tract infections. It is common in children and accounts for an incidence of about 32 per 1000 patients per year. The objective of this study was to determine the effect of tonsillectomy on ASO titre and to evaluate the sensitivity and specificity of throat swab culture.Methods: Present study performed a prospective study, a total number of 50 children were screened, out which 25 patients under the age of 15 years (16 male and 9 female), were included in the study, who were having chronic tonsillitis with raised anti-streptolysin O titre (>200IU/ml). All the patient underwent tonsillectomy and serological estimation of ASO titre was done at the end of first, second and third month post-surgery. Throat swab culture was performed prior to tonsillectomy and at the third month of follow up.Results: Twelve children (48%), twenty children (80%) and twenty-two children (88%) became serologically negative for ASO antibody at the end of first, second and third month respectively, with a statistically significant p value of 0.0001. The sensitivity and specificity of throat swab culture was 16% and 100% respectively.Conclusions: Tonsillectomy has a significant role in reducing the serological levels of anti-streptolysin O antibody and its reactivation, thereby decreasing the rate of complications associated with Group A-beta haemolytic streptococci

Pleomorphic adenoma of minor salivary gland with therapeutic misadventure: a rare case report

<p>Abstract</p> <p>Background</p> <p>The benign tumors of nasopharynx are least encountered tumors in otolaryngology, as nasopharynx is considered one of notorious anatomical site for the malignant tumors. Pleomorphic adenoma of the minor salivary gland of nasopharynx and parapharyngeal space is rare. We present a pleomorphic adenoma of minor salivary gland which was mismanaged.</p> <p>Case presentation</p> <p>An adult male presented with left nostril obstruction for five months. The examination found big mass extending from nasopharynx to oropharynx. On CT scan, this tumor was quite big and extending to the parapharyngeal space. The FNAB found it a carcinoma but it did not respond to radiotherapy. The excision biopsy of tumor revealed it as pleomorphic adenoma. We found only five published reports on this tumor arising from nasopharynx.</p> <p>Discussion and conclusion</p> <p>Although, in this case report exact origin of the tumor could not be ascertained as it also appeared to be a parapharyngeal tumor but we kept the possibility of a nasopharyngeal tumor on the basis of clinical features. The pleomorphic adenoma of nasopharynx is rare. It can be misdiagnosed as malignant epithelial tumor on histopathology. The differentiation from its malignant variant is also difficult. A possibility of benign tumor should always be kept in nasopharyngeal growth with no evidence of metastasis, and histopathological diagnosis of growth should be available before any definitive treatment.</p