Burden of congenital heart diseases in a tertiary cardiac care institute of high altitude area

Background: Congenital heart disease is one of the major causes of mortality and morbidity in the paediatric population of both the developing and developed countries. Variability in incidence and prevalence of CHD from various countries of Indian subcontinent and rest of the world could be because of genetic, cultural, and environmental factors.  The objective of the study was to find the prevalence and pattern of CHD in a tertiary care hospital in Kashmir (Jammu and Kashmir).Methods: All children admitted at territary care hospital with age 0-15 years were screened for congenital heart disease. The study was conducted for period of one year to ascertain the prevalence and spectrum of CHDs.Results: A total of 232 patients out of 23000, were found having CHDs measuring a prevalence of 10.5/1000. About 170 (73%) were the acyanotics, and 62 (27%) were cyanotic heart patients. Among the acyanotic heart diseases ventricular septal defect was the most frequent lesion seen in 54 (23%), followed by patent ductus arteriosus in 50 (22%) children. Among the cyanotic heart diseases tetralogy of Fallot was the most frequent cyanotic heart disease seen in 15 (6.4%) patients.Conclusions: Authors observed high prevalence of CHD in our population. The pattern and spectrum of CHD were comparable to national and international data

Aerodynamic measurement-Maximum Phonation Time in young patients with benign vocal fold lesions and with normal voice: a comparative analysis

Background: Clinicians use Maximum Phonatory Time (MPT) as one of tool to verify the glottic efficiency objectively. Impairment of vocal fold mucosa integrity due to lesions results in alteration in MPT. The aim of current study was to compare MPT in young adults with vocal fold lesions and age and sex matched normal subjects.Methods: This study was conducted in the Department of ENT & Head and Neck surgery of Government Medical College Srinagar on 41 adult patients with benign vocal fold lesions and 41 healthy subjects matched for age and sex for a period of 2 years from April 2017- April 2019. The aerodynamic measure was measured as maximum phonation time in seconds and the results were analysed statistically. Both patients and controls were explained the procedure. Results: Mean MPT in seconds in males with vocal fold lesion was 14.42 seconds with SD of 5.62 seconds and in females was 10.81 seconds with SD of 3.44 seconds. Coefficients of variation (CV) was 0.35 and 0.21 respectively. In control group it was 18.15 seconds with SD of 5.88 in males and in females it was 15.72 seconds with a SD of 6.21. Mean difference between patients and controls in males and females was 3.8 and 4.9 respectively. P-Value in males and females was 0.053 and 0.003 respectively.Conclusion: Vocal cord lesions decrease MPT in both sexes even in young adults

Medical Image Large Hemangiopericytoma of the Tongue

These pictures are of a 45 -year old male patient with a swelling on the tip of tongue from the last one year. The swelling increased progressively in the last one year with a recent onset of mild discomfort. He has never shown to any physician before and once swelling reached to a large size he reported to us. MRI revealed a solid mass with isodense contrast in T1

Medical Image Large Hemangiopericytoma of the Tongue

These pictures are of a 45 -year old male patient with a swelling on the tip of tongue from the last one year. The swelling increased progressively in the last one year with a recent onset of mild discomfort. He has never shown to any physician before and once swelling reached to a large size he reported to us. MRI revealed a solid mass with isodense contrast in T1.</p

Angina Bullosa Hemorrhagica – A Case Series

Angina bullosa hemorrhagica (ABH) is an oral subepithelial blood blister with poorly understood etiopathogenesis, which is not attributable to blood dyscrasias or vesiculobullous disorders. These hemorrhagic bullae spontaneously rupture within minutes to hours, resulting in ragged, often painless, superficial erosions that heal spontaneously within 1 week without scarring. The lesions are usually solitary, and sometimes cause extreme anxiety in patients. Treatment is generally symptomatic. We report a series of four such patients. No treatment was given, except for reassurance and anxiolytics

Lincoln ’S Highway - A Forgotten Abscess.

ABSTRACT Introduction: Carotid space is a deep neck space within the carotid sheath. .Mosher called carotid sheath as the Lincoln Highway of the neck. Abscess in this space is rare to be seen by young Ear, Nose and Throat (ENT) surgeons in this era of early diagnosis and good antibiotics. We are reporting a case of isolated carotid space abscess in a 20 year old male to familiarize young surgeons with this abscess. Case report: A 20 year old young boy came to our Outpatient Department (OPD) with complaints of fever, painful neck swelling, progressive diffi culty in swallowing from the last 7 days. Contrast Enhanced Computed Tomography (CECT) was done which revealed abscess located adjacent to carotid artery in the carotid sheath. Incision and drainage was done and carotid sheath was opened and pus drained .Patient was discharged after few days on oral antibiotics. Conclusion: Carotid space abscesses are rarely seen in developed countries. Tender and fl uctuating swelling over the carotid artery area points towards it. CECT is the investigation of choice. Needle aspiration should be avoided especially by less trained persons. Small abscesses may respond to intravenous antibiotics but when frank and large abscess is formed, incision and drainage is the treatment of choice

Paediatric acute retropharyngeal abscesses: An experience

Background: To describe our experience of paediatric patients with acute retropharyngeal abscess in terms of clinical presentation, diagnosis, management and complications. Materials and Methods: A prospective study was done for a period of 4 years (Jan 2009 to Jan 2013) on paediatric patients (< 15 years) with acute retropharyngeal abscess at two tertiary hospitals in Srinagar. Diagnosis was made on the basis of X-ray, CECT scan findings and confirmed on incision and drainage. Pus was aspirated from all patients and sent for culture and sensitivity. Data for clinical presentation, X-ray, CECT scan findings, causes, complications, bacteriology and management were collected. Thirty-five abscesses were drained while 5 with small abscesses on CECT were managed conservatively. Results: A total of 40 patients were diagnosed as acute retropharyngeal abscesses. Males were commonly affected, and most of the patients were less than 6 years of age. Most common symptom at presentation was fever (35) followed by neck pain (30) Dysphagia/odynophagia (22), swelling in neck (19). Most common clinical sign observed was oropharyngeal swelling and limitation of neck movements (30), cervical swelling/lymphadenopathy in 22 patients. Torticollosis and drooling were seen in 15 patients. Complications were seen in 8 patients. Most common X-ray finding was pre-vertebral thickening. Success rate with primary surgical drainage was 95% while 3 patients in conservative group failed. Conclusion: Children with RPA most commonly present with restricted neck movements, fever and cervical lymphadenopathy, and rarely with respiratory distress or stridor. Surgical intervention is necessary for most of these patients