Anterior Ethmoidal Nerve Syndrome - An Under-diagnosed Cause of Headache

Introduction The anterior ethmoidal nerve syndrome is a group of symptoms resulting from irritation of the terminal branches of the anterior ethmoidal nerve.  Middle turbinate compression against the septum or the lateral nasal wall may cause a neuropathic facial pain syndrome which is often confused with sinogenic headache or other causes of headache. The diagnosis of anterior ethmoidal nerve syndrome is based on clinical and radiologic findings and needs a high index of suspicion. Our objective is to determine the nasal cause of headache and to create awareness among young ENT surgeons about various local causes of craniofacial pain. Materials and Methods A retrospective observational study carried out in a tertiary care hospital of North India. 30 patients who fulfilled the clinical diagnostic criteria were selected for the study. Results All the patients were analysed, managed accordingly by conservative and surgical management and outcome analysed. All patients were managed with medical and surgical management. Out of 30 patients, 28 (93.33%) patients improved in which 2 patients improve by medical management and 26 patients by surgical management. Conclusion The diagnosis requires a strong clinical suspicion and appropriate evaluation including nasal endoscopy, scan and anesthesia of the suspected point of contact

Combating the COVID-19 pandemic in a resource-constrained setting: insights from initial response in India

The low-and-middle-income country (LMIC) context is volatile, uncertain and resource-constrained. India, an LMIC, has put up a complex response to the COVID-19 pandemic. Using an analytic approach, we have described India’s response to combat the pandemic during the initial months (from 17 January to 20 April 2020). India issued travel advisories and implemented graded international border controls between January and March 2020. By early March, cases started to surge. States scaled up movement restrictions. On 25 March, India went into a nationwide lockdown to ramp up preparedness. The lockdown uncovered contextual vulnerabilities and stimulated countermeasures. India leveraged existing legal frameworks, institutional mechanisms and administrative provisions to respond to the pandemic. Nevertheless, the cross-sectoral impact of the initial combat was intense and is potentially long-lasting. The country could have further benefited from evidence-based policy and planning attuned to local needs and vulnerabilities. Experience from India offers insights to nations, especially LMICs, on the need to have contextualised pandemic response plans