Base of Tongue Tuberculosis: A Case Report

We report a rare case of base of tongue tuberculosis following pulmonary tuberculosis. Patient presented to us with chief complaints of sore throat and pain on swallowing for period of 3 months. On examination with 70 degree telescope, we observed an ulcer on right side of base of tongue. The edges of the ulcer appeared to be undermined with whitish slough at the centre of the ulcer. Examination of neck showed a multiple small palpable middle deep cervical lymph nodes on right side of neck. Biopsy of the ulcer was taken, which showed granulomatous inflammation, suggestive of tuberculosis. Laboratory investigations revealed a raise in erythrocyte sedimentation rate, sputum for acid fast bacilli was strongly positive. Chest X ray was performed for patient showed multiple areas of consolidation. Patient was referred to chest clinic for further management of tuberculosis and was started on anti-tuberculous drugs. In conclusion tuberculosis of oral cavity is rare, but should be considered among one of the differential diagnosis of the oral lesions and biopsy is necessary to confirm the diagnosis

Distinctive histological features of non-eosinophilic CRSwNP patients.

<p><b>(A)</b> Comparison of the proportion of total NP tissue area occupied by pseudocysts in different endotypes of CRSwNP and representative hematoxylin/eosin staining images of a pseudocyst (red arrow) within the epithelial layer from non-eosinophilic NP tissues (40×) <b>(B)</b> Comparison of a yellowish spot in NP tissue between non-eosinophilic and eosinophilic CRSwNP patients and representative images of a yellowish spot (red arrow) found on endoscopy in a non-eosinophilic CRSwNP patient. (*<i>p</i><0.05, **<i>p</i><0.01, and ***<i>p</i><0.001). Data represent medians. E-NP, eosinophilic nasal polyp; NE-NP, non-eosinophilic nasal polyp.</p

Correlation of the ratio of ethmoidal to maxillary CT scores with inflammatory markers in different endotypes of CRSwNP, including (A) IL–4 mRNA, (B) IL–5 mRNA, (C) IFN-γ mRNA, (D) total IgE homogenate, and (E) periostin mRNA.

<p>Correlation of the ratio of ethmoidal to maxillary CT scores with inflammatory markers in different endotypes of CRSwNP, including (A) IL–4 mRNA, (B) IL–5 mRNA, (C) IFN-γ mRNA, (D) total IgE homogenate, and (E) periostin mRNA.</p

Comparison of clinical CT findings and correlation between Lund-MacKay CT score/clinical CT findings in different endotypes of CRSwNP, including (A) subtraction of CT scores, (B) olfactory opacification scores, and (C) ethmoidal scores and maxillary scores (*<i>p</i><0.05, **<i>p</i><0.01, and ***<i>p</i><0.001).

<p>Data represent medians (IQR). E-NP, eosinophilic nasal polyp; NE-NP, non-eosinophilic nasal polyp.</p

Patient characteristics and methods used.

<p>N/A: Not applicable</p><p>Patient characteristics and methods used.</p

Non-Eosinophilic Nasal Polyps Shows Increased Epithelial Proliferation and Localized Disease Pattern in the Early Stage - Fig 1

<p><b>(A)</b> Comparison of total inflammatory cells, EMBP⁺ cells, and HNE⁺ cell were performed in NP tissues between non-eosinophilic and eosinophilic CRSwNP patients <b>(B)</b> Expression of Ki–67 in NP tissues from non-eosinophilic and eosinophilic CRSwNP patients. Number of Ki-67-positive epithelial cells per 100 cells, averaged from three different areas of epithelium (*<i>p</i><0.05, **<i>p</i><0.01, and ***<i>p</i><0.001). Data represent means (SD). E-NP, eosinophilic nasal polyp; NE-NP, non-eosinophilic nasal polyp.</p

Selecting optimal second-generation antihistamines for allergic rhinitis and urticaria in Asia

Abstract Background Allergic diseases are on the rise in many parts of the world, including the Asia–Pacific (APAC) region. Second-generation antihistamines are the first-line treatment option in the management of allergic rhinitis and urticaria. International guidelines describe the management of these conditions; however, clinicians perceive the additional need to tailor treatment according to patient profiles. This study serves as a consensus of experts from several countries in APAC (Hong Kong, Malaysia, the Philippines, Singapore, Thailand, Vietnam), which aims to describe the unmet needs, practical considerations, challenges, and key decision factors when determining optimal second-generation antihistamines for patients with allergic rhinitis and/or urticaria. Methods Specialists from allergology, dermatology, and otorhinolaryngology were surveyed on practical considerations and key decision points when treating patients with allergic rhinitis and/or urticaria. Results Clinicians felt the need for additional tools for diagnosis of these diseases and a single drug with all preferred features of an antihistamine. Challenges in treatment include lack of clinician and patient awareness and compliance, financial constraints, and treatment for special patient populations such as those with concomitant disease. Selection of optimal second-generation antihistamines depends on many factors, particularly drug safety and efficacy, impact on psychomotor abilities, and sedation. Country-specific considerations include drug availability and cost-effectiveness. Survey results reveal bilastine as a preferred choice due to its high efficacy and safety, suitability for special patient populations, and the lack of sedative effects. Conclusions Compliance to the international guidelines is present among allergists, dermatologists and otorhinolaryngologists; however, this is lower amongst general practitioners (GPs). To increase awareness, allergy education programs targeted at GPs and patients may be beneficial. Updates to the existing international guidelines are suggested in APAC to reflect appropriate management for different patient profiles and varying symptoms of allergic rhinitis and urticaria