Ingestion of honey improves the symptoms of allergic rhinitis: Evidence from a randomized placebo-controlled trial in the East Coast of Peninsular Malaysia

BACKGROUND AND OBJECTIVES: The role of honey in the treatment of allergic rhinitis (AR) is controversial. We studied the complementary effect of ingestion of a high dose of honey, in addition to standard medications, on AR. DESIGN AND SETTINGS: Prospective randomized placebo-controlled study. Subjects were recruited from an otolaryngology clinic in 2 tertiary referral centers in the East coast of Peninsular Malaysia. The study period ranged from April 2010-April 2011. METHODS: Forty AR patients were divided equally into a case group and a control group. All the subjects received a daily dose of 10 mg of loratadine for 4 weeks. The case group ingested 1 g/kg body weight of honey daily in separate doses for the 4-week period. The control group ingested the same dose of honey-flavored corn syrup as placebo. AR symptoms were scored at the start, week 4, and week 8 of the study. RESULTS: There were no significant differences between the mean total symptom score of the case and the control groups at the start of the study. At week 4, both groups showed progressive improvement in the symptoms; at week 8, only the case group showed a continuous improvement in the symptom score. Only the group that ingested honey showed a significant improvement in individual AR symptoms. The improvement persisted for a month after the cessation of the treatment. CONCLUSION: Honey ingestion at a high dose improves the overall and individual symptoms of AR, and it could serve as a complementary therapy for AR

Habitual non-traumatic cricothyroid joint dislocation: a rare case of rotated larynx

A case of a 21 year old gentleman is described, with no history of preceding trauma, presenting with intermittent dysphagia to solids and fluids for 4 years. Neck examination at rest was normal. However on deep inspiration, the right thyroid lamina protrudes or becomes more prominent. The patient is able to return the larynx to its normal position with manual manipulation. Laryngeal examination with fibreoptic scope during rest and deep breath shows gross rotation of the laryngeal structures for more than 60° on deep breath, with the vocal cords axis rotated to the left side. Management was conservative

Combined use of maxillomandibular swing approach and neurosurgical ultrasonic aspirator in the management of extensive clival chordoma: A case report

<p>Abstract</p> <p>Introduction</p> <p>Chordoma is a rare malignant tumour with an incidence of metastasis of less than 10 percent. Usually arising from clivus its posterior extension may involve the brainstem before presenting as nasal mass and obstruction. Surgery is the main mode of treatment with adjuvant radiotherapy. However surgery is rarely possible for a large intracranial lesion.</p> <p>Case presentation</p> <p>We report the case of an adolescent patient with a chordoma extending posteriorly to the brainstem and anteriorly to the nasopharynx and managed by the combination of resection using a maxillomandibular swing approach and the use of a neurosurgical ultrasonic aspirator.</p> <p>Conclusion</p> <p>Maxillomandibular swing approach provides good access for large nasopharyngeal tumour extending brainstem area.</p

The accuracy of stereolithography medical model of sinonasal anatomical structures compare to 3D CT scan measurement

Introduction Stereolithography is a relatively new tool in medicine. It has been used to produce many anatomical models in various fields. The accuracy of stereo lithography is thus essential to provide real replacement and time saving procedure. Objectives The objectives of this study are to develop stereolithography model for sinonasal region for ENT and craniofacial teaching and to assess the accuracy of stereo lithography model produced by our stereolithographic apparatus. It is also to evaluate the suitability of stereolithography model to be used as pre surgical planning for endoscopic sinus surgery together with an Image Guided System. If appropriate the model also will be used for surgical training for resident. Methodology Data with normal paranasal sinus was collected from USM craniofacial CT scan database. The images were processed with a specific procedure using MIMIC software. A stereolithography model was produced using the data. The model was compared with 3D CT scan image using specific landmark. The landmarks were divided into general craniofacial measurements and sinonasal measurements. The model was tried for simulated endoscopic sinus surgery using Image Guided System. Results The stereolithography model shows an accuracy of 99.82% for general craniofacial measurement and 99.68% for sinonasal measurement. Lamina papyracea thickness produces the largest error of28.71%. There is no pattern to indicate internal measurement group is opposite to the value of external measurement group. The stereolithography model is not suitable to be used as planning of endoscopic sinus surgery, since the anatomy requirement is very critical in the related area. Conclusion Stereolithography model is accurate in the dimensions that were measured. The model is suitable for planning in craniofacial surgery. However to be used as presurgical planning in endoscopic sinus surgery, it is still not detail enough. Further improvement in material used in stereolithography is needed before it can be utilised as presurgical model for endoscopic sinus surgery

Emergency Thyroidectomy for a Bleeding Multinodular Goitre

Goitre is a slow-growing thyroid mass, rarely presenting as an emergency. However, a superimposed infection or acute intralesional bleeding can cause the mass to increase rapidly in size. We report a patient with long-standing multinodular goitre who presented with bleeding from the left thyroid mass. Despite all appropriate measures, the continuous bleeding finally stopped upon thyroidectomy