scholarly journals An overview of endoscopic stapedotomy in a tertiary care centre

Author(s):  
Atish B. Gujrathi ◽  
Siddharth A. Shroff ◽  
Nishikant Gadpayale ◽  
Naman Agarwal

<p class="abstract"><strong>Background:</strong> Stapedotomy is now one of the most popular and common surgeries done worldwide. Otosclerosis remains the most common single cause of conducting hearing loss in adult population. Females are more frequently affected than males with an approximate 2:1 ratio.</p><p class="abstract"><strong>Methods:</strong> This study consists of 30 patients who underwent stapedotomy for otosclerosis. This study was conducted at Dr Shankarrao Chavan Government Medical College, Nanded, during the period of 2 years (2017-2019). Patients were evaluated and operated. The various anatomical variations, diagnostic dilemmas, intraoperative complications, its management and follow-up were done systematically.  </p><p class="abstract"><strong>Results:</strong> Age of patients included in this study ranged from 15 to 50 years. Youngest patient was a 17-year-old male. Age of presentation was most commonly seen in third decade of life. Male to female ratio was 1:2. The most common symptom was hard of hearing followed by tinnitus. In this study, 76.67% of the patient’s had bilateral disease. 66.66% of patients had hearing loss between 41-55 dB with mean pre-operative pure tone average was 51.16 dB. About 80% of patients had successful air bone closure between 0-10 dB after the surgery.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic stapedotomy seems a feasible and relatively safe surgical technique in limited case series. Cosmetically this procedure was more compliant by the patients however endoscopic stapedotomy requires a significant learning curve and an extreme expertise.</p>

2021 ◽  
Vol 71 (Suppl-1) ◽  
pp. S130-35
Author(s):  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz Bhalli ◽  
Wasif Siddique ◽  
Attique Ahmed ◽  
Maryam Khan ◽  
...  

Objective: To describe the resultant Otologic morbidity and report on the early outcomes following blasts occurring in twin cities of Quetta and Peshawar. Study Design: Case series. Place and Duration of Study: ENT department Tertiary Care Centre Quetta and Tertiary Care Hospital Peshawar. Study period was, from Jan 2013 to Dec 2013. Methodology: All bomb blast patients brought to the hospitals were included in study. Participants completed Symptom Assessment Forms followed by detailed ENT examination and Pure Tone Audiograms on arrival and after 6 weeks. Results: A total of 504 patients were included initially of which 80% of the patients were male. About 57.8% of the patients complained of ear injury, 21.6% of the total patients had tympanic membrane perforation on initial presentation. Chances of spontaneous closure of perforation were 20.9% in our study. Chances of hearing improvement were 17.9% in our study at the end of the study period. Conclusion: Blast related otologic injuries constituted a major source of morbidity The most common type of hearing loss following a blast trauma was mild to moderate conductive type. Chances of recovery of hearing following blast do exist (17.9%). Suspected patients should be regularly assessed and followed up. Much work needs to be done to study the impact of blast trauma on hearing in our country.


2021 ◽  
Vol 8 (22) ◽  
pp. 1831-1834
Author(s):  
Sathish Obalanarasimhaiah ◽  
Nagesh Nayakarahalli Swamygowda ◽  
Balakrishna Nanjundappa Setty ◽  
Kasturi Thirumangalam Subramani

BACKGROUND Solid pseudopapillary neoplasm (SPN) of pancreas is a rare epithelial tumour of low malignant potential. SPN accounts for less than 1 to 2 % of exocrine pancreatic tumours. It mainly affects women between the second and third decade of life, and its management is not well defined. The aim of this study was to report clinicopathological characteristics of SPN and its outcome. METHODS A retrospective study was conducted in a tertiary care centre from January 2015 to December 2019. All patients who were diagnosed and treated as SPN of pancreas in our institute were retrospectively reviewed. A data of the characteristics of these patients was developed, including age, gender, size, location of tumour, treatment, histopathological and immunohistochemical features. RESULTS Six patients were diagnosed as having SPN of pancreas, during the 5-year period. All 6 patients were female. Youngest age of occurrence was 15 years. Maximum age was 41 years. Average age was 25 years. All patients were symptomatic and the most common symptom was dull aching upper abdominal pain. Contrast enhanced computed tomography (CECT) was done for all patients. 3 patients had typical features of SPN. Endoscopic ultrasound (EUS) was done for 4 patients and EUS fine needle aspiration cytology (FNAC) was done for 3 patients. Patients were provided with procedure details and informed consent was taken. All patients were subjected to surgical treatment. Out of six patients, two underwent laparoscopic spleen preserving distal pancreatectomy, two patients underwent classical Whipple’s procedure and two patients had undergone median pancreatectomy. CONCLUSIONS SPN are rare neoplasms, typically affecting young females without clear histogenesis and with a malignant potential. Appearance from imaging studies can be adequate to guide surgical resection without pre-operative pathological assessment. But in unclear cases, EUS-FNAC with immunohistochemistry helps in establishing a pre-operative diagnosis. Surgical resection should be offered when feasible. Prognosis of SPN of the pancreas is good due to its favourable biological features, even in the presence of distal metastasis. KEYWORDS Solid Pseudopapillary Neoplasm (SPN)


2015 ◽  
Vol 100 (8) ◽  
pp. 742-747 ◽  
Author(s):  
Camille Aupiais ◽  
Brice Ilharreborde ◽  
Catherine Doit ◽  
Audrey Blachier ◽  
Marie Desmarest ◽  
...  

Background and objectiveArthritis in children has many causes and includes septic and viral arthritis, reactive arthritis and juvenile idiopathic arthritis (JIA). We aimed to describe the different types of arthritis among children hospitalised for a first episode of arthritis.DesignRetrospective, descriptive case series study.SettingA French tertiary care centre.PatientsChildren under 16 years of age hospitalised for an arthritis episode between 1 January 2008 and 31 December 2009.Main outcome measuresDemographic and clinical features were compared with χ2 or Fisher's exact tests and non-parametric tests.Results173 children were hospitalised for a first episode of arthritis during the study period, with a male/female ratio of 1.14. The most frequent cause of hospitalisation was septic arthritis (43.4% of cases, 69.3% of which were due to Kingella kingae and 10.7% to Staphylococcus aureus). JIA was responsible for 8.1% of cases and arthritis without any definitive diagnosis for 40.4%. Median age at diagnosis was 2.7 years (IQR 0.3–14.6) and was lower in the septic arthritis group (1.5 years; 1.1–3.4) than in the JIA group (4.7 years; 2.5–10.9) (p<0.01). Septic arthritis involved a single joint in 97.3% of cases, while JIA involved four joints in 14.3% of cases and two to four joints in 28.6% of cases (p<0.01).ConclusionsSeptic arthritis was the most frequent cause of arthritis in hospitalised children. Despite the increasing application of microbiological molecular methods to synovial fluid analysis, further measures are required to improve the diagnosis of arthritis of unknown cause.


2021 ◽  
pp. 73-76
Author(s):  
Uday S. Mohite ◽  
Aayushi Anil Agrawal

Background: In India,Cataract is the leading cause of avoidable blindness.2 and cataract surgery forms the major workload of most ophthalmic units in the country. An estimated 4 million people become blind because of cataract every year,3 which is added to a backlog of 10 million operable cataracts in India, whereas only 5 million cataract surgeries are performed annually in the country.4 Thus, a technique of cataract surgery that is not only safe and effective but also economical and easy for the majority of ophthalmologists. It is estimated that about 25% of poor outcomes of cataract operations performed in developing countries annually are due to surgical complications.19 Minimizing intraoperative complications of cataract surgery is an important step towards eliminating visual impairment caused by such complications. Aim & Objective:1. To study intra-operative complications of manual small incision cataract surgery. 2. To study the visual outcome in patients of intra-operative complications following its management. Methods: Prospective cross sectional study, Study setting: Ophthalmology Department of tertiary care centre Study Duration: 2 years (October 2018 to December 2020).Study population: All patients with cataract requiring surgery admitted in tertiary care center Sample Size: 700 Results: Majority of study subjects belongs to age group 41 -40 years contributing 511 cases (73%) followed by age group 65 yrs and more 133 (19%),16-40 age group 35 (5%) and 15 years or less 21 (3%) respectively. males contributing 390 cases (55.71%) followed by females 310 cases (44.29%).Male: Female ratio is 1.25: 1. preoperative visual acuity in operated eye is in the range of < 3 /60 - Perception to light (PLPR) in majority of subjects contributing 497 cases (71%) followed by 161 cases (23%) in between < 6/ 60 - 3 /60 group, 35 cases (5%) in < 6 /18 to 6 /60 group and 7 cases (1 %) in 6 /18 or better group respectively. most common intraoperative complication was posterior capsular rent contributing 19 cases (2.71%) followed by iris prolapse 14 cases (2%), premature entry 10(1.43%), Descemet's membrane stripping 10 (1.43%), intraoperative hyphaema 8 (1.14%), capsular extension in 7 cases(1%) Iridodialysis in 5 (0.71%) and zonular dialysis in 5(0.57%) respectively Conclusions: Rate of complication was higher in hypermature type of cataract .There was no statistical signicant association between age and intraoperative complications.


2019 ◽  
Vol 6 (2) ◽  
pp. 455
Author(s):  
Ashok Kumar Gudagunti ◽  
Ishwar Hasabi ◽  
Arathy S.

Background: Chronic pulmonary obstructive disease (COPD) has been responsible for the decreased quality of life as well as increased morbidity and mortality. Globally it has been estimated that nearly three million die yearly due to COPD and more likely to occupy the third place of mortality by 2030. The objective of the present endeavour was to study clinical profile of patients with chronic pulmonary obstructive disease at a tertiary care centre.Methods: A hospital based cross sectional study was carried out among 200 cases of COPD. Their detailed history, thorough clinical examination and parameters like hemoglobin, serum creatinine, protein etc were investigated. The presence of co-morbidities was noted.Results: As the age increased the prevalence of the COPD increased and highest was found out to be in the age group of above 60 years of age. Males were more affected with COPD as compared with females. The male to female ratio was found out to be 2.4:1. The smokers were more compared to the non smokers. The prevalence of smoking among COPD was noted to be 66% compared to 34% as non smokers. Least proportion of patients of the COPD had fever i.e. in 22% of the cases. Cough was found in 83% of the cases. Breathlessness was found out to be in 98% of the cases. 15% of the cases of the COPD had diabetes only as the co-morbidity along with COPD and no other co-morbidity.Conclusions: Breathlessness was the most common symptom at presentation and diabetes and hypertension were the most common co-morbidities found.


Author(s):  
S. S. Doddamani ◽  
Yasha C.

<p class="abstract"><strong>Background:</strong> Chronic otitis media with cholesteatoma is associated with hearing loss. Cholesteatoma causes bone erosion leading to ossicular chain defects. These ossicular lesions are only detected intraoperatively. If the ossicular status could be detected preoperatively by audiometric parameters, it would aid in better information to the patient, surgeon and preparation for the surgery. The aim of this study is to describe the intraoperative ossicular status, preoperative hearing status and to correlate them in patients with cholesteatoma.</p><p class="abstract"><strong>Methods:</strong> This is a retrospective case series study conducted in a tertiary care centre. Data was collected from inpatient files of 47 patients who underwent surgery for cholesteatoma from January 2016 to December 2017. Air and bone conduction thresholds, air- bone gaps from pure tone audiometry (PTA) reports were collected. The status of the ossicles was collected from the operative notes.  </p><p class="abstract"><strong>Results:</strong> PTA revealed hearing loss in all the patients, predominantly conductive loss (83%). Ossicular defects were noted in 87% with incus most frequently involved (78.7%). Ossicular lesions were significantly associated with worse air conduction, bone conduction thresholds and air bone gap.</p><p><strong>Conclusions:</strong> Cholesteatoma is frequently associated with ossicular defects. PTA shows worse parameters in ossicular defects. But, it doesn’t reflect the status of ossicle involved or the number of ossicles involved.</p>


2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Saroj Kumar Bhagat ◽  
Shrey Sidhant ◽  
Mukesh Bhatta ◽  
Ashish Ghimire ◽  
Bhupendra Shah

Introduction. Guillain-Barre syndrome is the most common cause of acute flaccid paralysis in the adult population. It occurs at the rate of 0.34 to 4 per 100000 individuals. This study was conducted to determine the clinicoepidemiological profile and outcome of the patients with Guillain-Barre syndrome. Materials and Methods. We conducted a retrospective study of patients with Guillain-Barre syndrome, presented at B.P. Koirala Institute of Health Sciences, a tertiary care centre in eastern Nepal, from January 2013 to December 2017. All patients diagnosed with Guillain-Barre syndrome were included in this study. The handwritten case record files of the study population were retrieved from medical record section of the institute. Results. Of 31 patients with Guillain-Barre syndrome, the mean age of patients was 17±12 years. The most common presenting symptom of study population was ascending paralysis (93.5%). Respiratory failure requiring mechanical ventilation occurred in 16.1%. The common variants are AIDP and AMAN. Respiratory tract infection (29%) was the most common antecedent event. The in-hospital mortality of Guillain-Barre syndrome was 6.45%. Conclusion. Guillain-Barre syndrome is commonly seen in the young population. The most common symptom of Guillain-Barre syndrome was ascending paralysis. The in-hospital mortality rate of patients with GBS was 6.45%.


Author(s):  
Deepak A. V. ◽  
K. J. Jacob ◽  
Sumi P. Maria

Background: Peripartum hysterectomy is a life-saving procedure resorted to when conservative measures fail to control obstetric haemorrhage. Several predisposing factors, suboptimal care and lack of infrastructure may lead to this emergency procedure. We wanted to find out factors associated with peripartum hysterectomy and the adverse maternal outcomes at our centre.Methods: A retrospective case series analysis of 40 cases of peripartum hysterectomy performed over a period of 5 years from January 2010 to December 2014 at Government Medical College Hospital, Thrissur, Kerala was done.Results: The incidence of peripartum hysterectomy was 0.29%. The most common indication for peripartum hysterectomy was hysterectomy was uterine atony (50%). Thirty-five women (88%) were between 20 and 35 years. Most of the subjects were unbooked. There were two maternal deaths (case fatality rate of 5%) following peripartum hysterectomy during this period. All the subjects required blood transfusion.Conclusions: Prompt performance hysterectomy before the patient’s clinical condition deteriorates is the key to success. The incidence of adherent placenta is increasing, so every effort should be taken to reduce the caesarean section rates globally. 


2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P127-P128
Author(s):  
Robert L Harris ◽  
Grundy Alan ◽  
Tunde A Odutoye

Objectives Radiological balloon dilatation of lower oesophageal strictures is common practice. Other than some early reports from our own centre, there is little published regarding radiological dilatation of pharyngeal and upper oesophageal strictures and less still on radiological balloon dilatation of post-total laryngectomy and pharyngolaryngectomy neo-pharyngeal strictures. Standard practise is bouginage under general anaesthaesia. The objective of this study is to assess the efficacy of radiological balloon dilatation for the treatment of dysphagia secondary to neopharyngeal strictures in patients who have undergone laryngectomy. Methods A tertiary care centre case series of 20 consecutive patients (17 males and 3 females aged 40 to 84) with pharyngeal stricture and dysphagia post-total laryngectomy or pharyngolaryngectomy who underwent balloon dilatation of the stricture under radiological guidance. Maintenance of swallowing was the main outcome measure. Results 5 patients gained relief of their dysphagia with 1 balloon dilatation only. 9 patients required more than 1 dilatation to maintain swallowing. 2 patients had balloon dilatation procedures and stent insertion for palliative relief of dysphagia from known recurrent malignant disease. 3 patients failed to maintain swallowing with repeat dilatations. No patients suffered any significant complications such as perforation. Conclusions Balloon dilatation is minimally invasive and less traumatic than rigid pharyngoscopy with bouginage dilatation. It is well tolerated. It may be repeated frequently and can successfully relieve strictures of the pharynx in patients who have undergone total laryngectomy or pharyngolaryngectomy.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Paola López Del-Tejo ◽  
Nadia Cubas-Vega ◽  
Cecilia Caraballo-Guerra ◽  
Bernardo Maia da Silva ◽  
Jefferson da Silva Valente ◽  
...  

Abstract Background Malaria and HIV are two important public health issues. However, evidence on HIV-Plasmodium vivax co-infection (HIV/PvCo) is scarce, with most of the available information related to Plasmodium falciparum on the African continent. It is unclear whether HIV can change the clinical course of vivax malaria and increase the risk of complications. In this study, a systematic review of HIV/PvCo studies was performed, and recent cases from the Brazilian Amazon were included. Methods Medical records from a tertiary care centre in the Western Brazilian Amazon (2009–2018) were reviewed to identify HIV/PvCo hospitalized patients. Demographic, clinical and laboratory characteristics and outcomes are reported. Also, a systematic review of published studies on HIV/PvCo was conducted. Metadata, number of HIV/PvCo cases, demographic, clinical, and outcome data were extracted. Results A total of 1,048 vivax malaria patients were hospitalized in the 10-year period; 21 (2.0%) were HIV/PvCo cases, of which 9 (42.9%) had AIDS-defining illnesses. This was the first malaria episode in 11 (52.4%) patients. Seven (33.3%) patients were unaware of their HIV status and were diagnosed on hospitalization. Severe malaria was diagnosed in 5 (23.8%) patients. One patient died. The systematic review search provided 17 articles (12 cross-sectional or longitudinal studies and 5 case report studies). A higher prevalence of studies involved cases in African and Asian countries (35.3 and 29.4%, respectively), and the prevalence of reported co-infections ranged from 0.1 to 60%. Conclusion Reports of HIV/PvCo are scarce in the literature, with only a few studies describing clinical and laboratory outcomes. Systematic screening for both co-infections is not routinely performed, and therefore the real prevalence of HIV/PvCo is unknown. This study showed a low prevalence of HIV/PvCo despite the high prevalence of malaria and HIV locally. Even though relatively small, this is the largest case series to describe HIV/PvCo.


Sign in / Sign up

Export Citation Format

Share Document