bluuebunny/crossref_metadata_2025 huggingface dataset:
Knowledge, Attitude and Practice of Preventive Dentistry Among Private Dental Practitioners in Vadodara, India
Authors: Ramya R , Thanveer K , Ajithkrishnan CG
Published: July 2019

Background

Private dentists’ knowledge and attitude on preventive dentistry may influence their practice and contribute to oral health of individuals and community. The objective of the study was to investigate the preventive orientation of private dental practitioners in Vadodara (India) through a questionnaire study.

Methodology

A cross-sectional self-administered questionnaire survey was conducted among Indian Dental Association-enrolled private dentists in Vadodara. The 37-item pre-tested questionnaire included questions about personal and professional characteristics and items to assess knowledge, attitude, practice and barriers related to preventive dentistry. Statistical methods included descriptive statistics and chi-square and correlation analysis using Pearson's Correlation coefficient.

Results

82 of 140 eligible respondents filled the questionnaire (response rate: 58.57%). Majority were BDS degree holders (64.63%). Most dentists had solo-practice (65.85%) and had a work experience of 1-10 years (56.10%). 75% reported reading national and/or international dental journals. 62.20% claimed to have attended Continuing Dental Education programmes within the last year and interest was expressed by 89.02%. Majority (80.49%) possessed above average knowledge. Knowledge was higher among least experienced groups compared to the most experienced groups and it was statistically significant. 48.78% of respondents exhibited highly favourable attitude. Frequently rendered preventive measures were oral hygiene instructions, anti-tobacco advice and dietary advices practiced by 86.59%, 80.49% and 43.90% of dentists respectively. Oral cancer screening, fluoride and sealants were done by most dentists on risk basis. Lead protection was ignored by 43.90%. Most dentists perceived patient-related barriers as most impeding to preventive care. No correlation was observed between knowledge and attitude.

Conclusion

Preventive orientation of private dentists in Vadodara was encouraging with scope for improvement.
Assessment Of Effectiveness Of 'Anti-Tobacco Compaign’ In Sangli District Of Maharastra, India - An Epidemiological Survey
Authors: Adaki S , Karagir A , Shah K , Marathe K
Published: July 2019

Background

India has highest rates of oral cancer in the world and rates are still increasing. Oral cancer accounts for one-third of the total cancer cases and 90% of the patients are tobacco chewers. The Govt. of India initiated and enacted the national tobacco-control legislation namely, “The Cigarettes and other Tobacco Products (Prohibition of Advertisement and Regulation of Trade and Commerce, Production, Supply and Distribution) Act 2003”; on 18 May, 2003. Still there is persistence of more number of people with tobacco habits. So, an epidemiological survey for Sangli district was conducted in Bharati Vidyapeeth Deemed University Dental College and Hospital to know the effectiveness of 'Anti - tobacco campaign’

Materials & Methods Of Survey

A questionnaire based survey was conducted among tobacco consumers in all age groups for the period of one year. The information was collected from the tobacco consumers and filled up by investigators on the pre-structured pre-tested proforma consisting of questions (QUESTIONNAIRE) related with the identification data, age, sex, occupation, marital status, education, socioeconomic status, type, source & reason of tobacco use, awareness about health hazards due to tobacco use and its source of information.

Results

Information was collected from 573 patients, among them 91.4% were male, 85.1% consumed in smokeless form, 81.3% were literate, 78.8% knew about ill effects of tobacco, 49.1% people had information about anti-tobacco programmes.

Conclusion

In the present study only 49.1% people know about the anti-tobacco campaign among them 86% are literates and 40-60 and above 60 years age group of people are less aware of such programs. So campaign should be designed in such a way that more number of adults, illiterates and literates know about ill-effects of tobacco and also to provide guidance to quit the tobacco.
Diagnostic and Management Challenges in Mikulicz Syndrome
Authors: Bhattacharjee Abhinandan , Uddin S , Prakash Rudra , Rathor Aakansha , Kalita Sanchita
Published: July 2019

Mikulicz disease (MD) is a disorder characterized by multiple lymphoepithelial lesions involving lacrimal and salivary glands. It is an uncommon condition, and very few cases are reported in the literature. It is a variant of Sjögren syndrome (SS) with patients presenting with clinical features over a wide range of spectrum. It is important to differentiate on which side of the disease spectrum the patient is presenting, i.e., either primary SS or secondary SS, because management can vary.

The purpose of mentioning these two cases and its importance lie in the fact that the patients presented at two ends of the spectrum of SS – the first patient belonging to secondary SS and the second patient belonging to primary SS – which changes the line management for both patients, conservative and surgical respectively. The purpose of reporting these two cases is to emphasize the importance of identifying disease symptoms and signs early, which can help stratify the patient as a variant of primary SS or secondary SS and thus decide on the appropriate line of management, saving precious time and discomfort to the patient.

Here we are mentioning two case reports of MD belonging to diagonally opposite spectrums of SS and their management with successful remission.

How to cite this article

Bhattacharjee A, Uddin S, Prakash R, Rathor A, Kalita S. Diagnostic and Management Challenges in Mikulicz Syndrome. Int J Head Neck Surg 2015;6(4): 139-145.
Postoperative Complications of Thyroid Surgery: A Corroborative Study with an Overview of Evolution of Thyroid Surgery
Authors: Bansal Chetan , Bhardwaj Aparna , Rathi Sonam , Agrahari Alok , Singh Virendra P
Published: July 2019

Background

To study the frequency of postoperative complications after thyroid surgery indicated for various benign and malignant lesions and to corroborate the results in relation to the extent of surgery and a clinical overview of evolution of thyroid surgery.

Materials and methods

An analytical study was carried out at a tertiary care center over a period of 3 years from January 2011 to December 2013. Data were collected from 80 patients who underwent thyroidectomies for various thyroid diseases at this center.

Results

Hemithyroidectomy, isthmusectomy, subtotal, neartotal, and total thyroidectomies were performed in 36 (45%), 6 (7.5%), 8 (10%), 10 (12.5%), and 20 (25%) cases respectively. The overall postoperative complication rate was 20%. Postoperative hypocalcemia and recurrent laryngeal nerve injury were the most common complications. Permanent hypocalcemia and permanent recurrent laryngeal nerve injury were observed in 3.75 and 2.5% of all operated cases respectively. The less common complications were wound hematoma, seroma formation, and superior laryngeal nerve injury. There was no mortality observed in our series.

Conclusion

The overall complication rate can be minimized by operating in a bloodless field, doing a meticulous dissection, and correctly identifying and preserving recurrent and superior laryngeal nerves along with parathyroid glands, if feasible.

How to cite this article

Pandey AK, Maithani T, Agrahari A, Varma A, Bansal C, Bhardwaj A, Singh VP, Rathi S. Postoperative Complications of Thyroid Surgery: A Corroborative Study with an Overview of Evolution of Thyroid Surgery. Int J Head Neck Surg 2015;6(4):149-154.
Drug-induced Airway Hematoma
Authors: Dahiya Vijeyta , Ramachandran K , Divya GM , Muhammed Faisal
Published: July 2019

Drug-induced airway hematoma is a very rare condition. The incidence of hemorrhage with anticoagulants is 6.8%. We hereby present the case reports of two such cases. Both patients presented with dysphagia and throat pain. One was on warfarin and the other was on aspirin. Examination revealed laryngeal and retropharyngeal hematoma respectively. Discontinuation of drugs and reversal of anticoagulation improved the symptoms. In the second case, retropharyngeal hematoma was drained. These cases highlight the importance of suspecting this entity in patients on drugs, especially anticoagulants who present with upper aerodigestive tract symptoms. Timely intervention and reversal of coagulopathy can save the patients.

How to cite this article

Divya GM, Dahiya V, Ramachandran K, Muhammed F. Drug-induced Airway Hematoma. Int J Head Neck Surg 2015;6(4):187-189.
Monophasic Synovial Sarcoma of the Lower Eyelid: Rare Tumor involving Rare Site
Authors: Suresh TN , Sagayaraj A , Harshita TR , Mohiyuddin Azeem
Published: July 2019

Aim

Synovial sarcoma of eyelid is extremely rare. We are reporting a case of massive synovial sarcoma of lower eyelid extending to soft tissues over the anterior wall of maxilla.

Case report

A 58-year-old male patient presented with a large mass involving the left lower eyelid and extending over the soft tissues of the anterior wall of the maxilla since 15 years. Clinical examination showed a firm soft tissue mass measuring 16 × 8 × 6 cm involving the left lower eyelid and extending to soft tissues over the maxilla. The mass showed ulceration and was bleeding on touch.

Computed tomography scan showed an exophytic lobulated heterogeneously enhancing mass lesion with intense enhancing capsule measuring 14 × 9.3 × 8.4 cm with few internal areas of necrosis arising from left preseptal region. The lesion was causing erosion at the medial wall and floor of left orbit.

It was clinically diagnosed as hemangiopericytoma. The patient was taken up for surgery and wide excision of the tumor and medial maxillectomy was done. The defect was reconstructed with a glabellar flap.

How to cite this article

Mohiyuddin A, Sagayaraj A, Harshita TR, Suresh TN. Monophasic Synovial Sarcoma of the Lower Eyelid: Rare Tumor involving Rare Site. Int J Head Neck Surg 2015;6(4):190-192.
Frontal Sinus Surgery: The State of the Art
Authors: Marino Michael J , McCoul Edward D
Published: July 2019

Aim:

Review and describe the essential components of modern frontal sinus surgery.

Background

Frontal sinus surgery has evolved considerably over the last century, and advances in imaging, optics, and instrumentation have contributed to contemporary treatment paradigms. Outcomes assessment has had an important role in identifying indications for surgery and future areas of research.

Review results

Numerous advancements are part of modern frontal sinus surgery and the treatment of frontal sinusitis. Anatomic studies have revealed variations that are associated with disease and pose challenges for surgery. Open approaches remain relevant in situations of difficult disease or as part of combined approaches. Endoscopic surgery, however, is central to contemporary surgical management of frontal sinus disease. Evolving instrumentation and the development of new implantable devices are increasingly relevant in the endoscopic era. Outcomes research has refined indications for surgery and identifies areas for ongoing research.

Conclusion

State-of-the-art frontal sinus surgery is the product of significant evolution and advancement. Modern surgery is reflective of improved optics and new instrumentation, and the central role of endoscopic approaches in treating frontal sinus disease. Outcomes research has been essential for developing an evidenced-based approach to frontal sinus surgery.

Clinical significance

A review of the essential components of state-of-the-art frontal sinus surgery for the practicing otolaryngologist.

How to cite this article

Marino MJ, McCoul ED. Frontal Sinus Surgery: The State of the Art. Int J Head Neck Surg 2016;7(1): 5-12.
Deep Neck Space Infections in Children: Has Anything changed?
Authors: Kavanagh Katherine R , Valdez Tulio A
Published: July 2019

The diagnosis and management of pediatric deep neck infections (DNIs) has changed over the last three decades. Improvements in imaging techniques, antibiotics and airway management have resulted in a significant decrease in the overall morbidity and mortality.

Knowledge of clinical features of DNIs in children is important because these uncommon infections may be associated with airway compromise or complications due to involvement of contiguous vital structures. Most often, these infections are due to Gram-positive organisms but polymicrobial infections are also well described. There is no consensus on management, with some authors advocating an aggressive surgical approach and others favoring a trial of medical management prior to surgical intervention. Surgical management is often indicated in young children, large abscesses, or those complicated by extension to critical structures. Once the source of the abscess or DNI is controlled and purulent collections drained, antibiotic therapy can often be transitioned to an oral agent, provided there is evidence of clinical improvement.

How to cite this article

Kavanagh KR, Valdez TA. Deep Neck Space Infections in Children: Has Anything changed? Int J Head Neck Surg 2016;7(2):77-82.
Obstructive Sleep Apnea in Children: Controversies in Diagnosis and Management
Authors: Ingram David G , Friedman Norman R
Published: July 2019

Aim:

To discuss commonly encountered diagnostic and therapeutic dilemmas in pediatric obstructive sleep apnea (OSA).

Background

Pediatric OSA is a fairly common childhood disorder, affecting 1 to 5% of all children and much larger proportions of children with selected comorbidities. Untreated OSA is associated with deleterious effects on neurobehavioral outcomes, cardiovascular health, and growth.

Results

We discuss several important diagnostic dilemmas, including when to obtain a preoperative polysomnogram (PSG), the relationship between OSA and sleep-disordered breathing, and limitations of conventional PSG-derived metrics. Management challenges commonly encountered in clinical practice include defining surgical cure and providing reliable estimates for families preoperatively, issues related to the use of positive airway pressure, and emerging alternative and complementary therapeutic modalities.

Conclusion

While recently published clinical practice guidelines have provided important standards for the diagnosis and management of pediatric OSA, many areas of uncertainty remain.

Clinical significance

We provide a review of current diagnostic and therapeutic controversies relevant to the practicing clinician.

How to cite this article

Ingram DG, Friedman NR. Obstructive Sleep Apnea in Children: Controversies in Diagnosis and Management. Int J Head Neck Surg 2016;7(2):83-88.
Imaging of Pediatric Neck Masses
Authors: Sajedi Payam , Shet Narendra
Published: July 2019

Pediatric neck masses comprise a wide spectrum of entities, benign and malignant. The role of imaging is to characterize these lesions, in order to better determine which can be expectantly managed and which require immediate intervention. An important consideration in the pediatric population is ionizing radiation; while X-ray and CT can be useful, radiation can have harmful effects, particularly in children. In this article, we review imaging feature of common pediatric neck masses, with emphasis on radiation sparing modalities (ultrasound and MRI) when possible.

How to cite this article

Sajedi P, Shet N. Imaging of Pediatric Neck Masses. Int J Head Neck Surg 2016;7(2):89-96.
A Clinical Approach to the Parapharyngeal Space
Authors: Shivakumar AM , Shivanandappa Praveen D , Doddamane Veena P , Munish KS , Yogeesha BS
Published: July 2019

Aim

To present the clinicopathological profile, surgical management, and the outcome of parapharyngeal space (PPS) neoplasms in 14 patients.

Materials and methods

This is a retrospective review of the clinical records of 14 patients treated for PPS tumors. The age of patients ranged from 24 to 54 years, with female to male ratio of 1.3:1. The commonest clinical presentation was a slowgrowing, painless neck swelling. The preoperative protocol was based on: (1) imaging study to establish site, size, and anatomical relationships. (2) Fine-needle aspiration cytology (FNAC) was performed to determine the nature of the mass. Details of the management, morbidity, and outcome of these patients are presented.

Results

A total of 85.7% of the PPS neoplasms were benign and 14.2% were malignant. Majority of the benign tumors were of neurogenic origin. The histocytopathology confirmed 12 (85.7%) of these diagnoses (2 patients were with “nondiagnostic” result). The positive predictive value of the FNAC was 83.3% for benign tumors and 100% for malignant tumors. In 6 patients (60%), a transcervical surgery was performed. Three patients (30%) underwent transparotid–transcervical surgery for a pleomorphic adenoma of the deep lobe of the parotid gland in the prestyloid space and transcervical–transmandibular approach was taken in 1 case (10%). Postoperative complications occurred in 3 out of 10 patients (33.3%).

Conclusion

The results of our study are in agreement with other studies reported in the literature and confirm the need to follow a careful preoperative diagnostic protocol that must take advantage of imaging studies (computed tomography, magnetic resonance imaging) and of cytology FNAC, in order to plan surgical treatment with a safe approach and that reduces complications, esthetic and functional damage, and the risk of recurrence.

How to cite this article

Shivanandappa PD, Doddamane VP, Munish KS, Yogeesha BS, Shivakumar AM. A Clinical Approach to the Parapharyngeal Space. Int J Head Neck Surg 2017;8(1):1-4.
The Aggressive Anaplastic Thyroid Carcinoma: A Case Report and Institutional Review
Authors: NG Sze-How , Hadi Imisairi Ab
Published: July 2019

To report a case of anaplastic thyroid carcinoma (ATC) with huge ulcer and to review our experience with these aggressive tumors in our hospital. We retrospectively reviewed the presentation, treatment and survival of all the patients who were diagnosed with ATC at Hospital Raja Perempuan Zainab II (HRPZ II), Kota Bharu, Malaysia from 2004 to 2010. A 63-year-old woman presented to outpatient clinic with history of anterior neck swelling for more than 10 years. She complained of rapid increase in size with huge ulcer and associated with hoarseness of voice and shortness of breath over 1 month period. She was investigated and the diagnosis of ATC was established. However, she refused for any surgical intervention and eventually succumbed during the palliative treatment 5 months later. ATC is a very rare thyroid cancer and usually presents at a very late stage with significant morbidity and mortality. Early detection, new therapeutic strategies and more studies especially based on molecular approaches may probably more helpful for better survival results in the future.

How to cite this article

Sze-How NG, Imisairi AH. The Aggressive Anaplastic Thyroid Carcinoma: A Case Report and Institutional Review. World J Endocr Surg 2012;4(1):20-22.
Pheochromocytomas, MEN 2A and Pregnancy: A Case Report with Review of the Literature
Authors: Thompson Geoffrey B , Dy Benzon M , Podgaetz Eitan , Young William F
Published: July 2019

Pheochromocytoma in pregnancy is a rare condition with an estimated incidence of one in 54,000 pregnancies. Pheochromocytoma in the setting of multiple endocrine neoplasia (MEN) type 2A develops in approximately 40% of the patients with this germline mutation. MEN 2A patients with pheochromocytoma are often asymptomatic compared to those with nonsyndromic pheochromocytoma. We present a 28-year-old pregnant woman with a known MEN 2A mutation who was incidentally found to have a pheochromocytoma. She underwent an uncomplicated laparoscopic right adrenalectomy after proper α- and α-adrenergic blockade. Her serum fractionated metanephrines normalized prior to discharge from the hospital. The remainder of her pregnancy was uneventful and she delivered a health baby at term. Pheochromocytoma in pregnancy requires careful management to assure the well being of both the mother and the fetus. In pregnancy, laparoscopic surgical removal of the pheochromocytoma is feasible with excellent results when performed in the second trimester. In late pregnancy, medical management with close monitoring of the mother and fetus is recommended until fetal maturity is achieved. In the third trimester, cesarean section followed by open adrenalectomy is the preferred operation. An integrated and multidisciplinary approach with close communication among the endocrinologist, surgeon and perinatal services is paramount to achieve excellent outcomes for both patients. Women with MEN 2 should be advised to refrain from pregnancy until updated biochemical and imaging studies have ruled out pheochromocytoma.

How to cite this article

Dy BM, Podgaetz E, Young WF, Thompson GB. Pheochromocytomas, MEN 2A and Pregnancy: A Case Report with Review of the Literature. World J Endocr Surg 2012;4(1):29-32.
An Unusual Cause of Hot Spot on Parathyroid Imaging
Authors: Singaporewalla Reyaz M , Negi Anuradha , Seow Dominique YB , Chinchure Dinesh
Published: July 2019

Background and aim

Radiological imaging is routinely used in patients with primary hyperparathyroidism to localize the abnormal adenoma and to plan surgical approach. We report an unusual cause of false-positive localization on parathyroid sestamibi scan, i.e., not previously described in the literature.

Case report

A 66-year-old man with primary hyperparathyroidism showed a discrete persistent focus in the left infraclavicular area during localization using sestamibi scan. Ultrasound of the neck was negative showing only small bilateral thyroid nodules. Single-photon emission and four-dimensional computed tomography (CT) scans showed an intense focus of the tracer uptake and a 1-cm lesion near the left subclavian vein (SCV), corresponding to the infraclavicular hot spot. Initial infraclavicular exploration showed the lesion to be a collapsible saccular varix of the left SCV. Bilateral neck exploration led to the discovery of the actual right parathyroid adenoma beneath an exophytic thyroid nodule. The patient made an uneventful recovery and remains normocalcemic at 1-year follow up.

Conclusion and clinical significance

Hot spot on parathyroid imaging outside the line of embryological descent should be interpreted with caution. Vascular retention of injected isotope within a saccular varix of the neck vein can give rise to falsepositive results on sestamibi scans. Bilateral neck exploration remains the “gold standard” procedure when localization scans either are negative or turn out to have false-positive findings.

How to cite this article

Singaporewalla RM, Negi A, Seow DYB, Chinchure D. An Unusual Cause of Hot Spot on Parathyroid Imaging. World J Endoc Surg 2016;8(2):164-167.
A Rare Case of Solitary Parathyroid Adenoma presenting with Recurrent Pancreatitis detected by Dual-phase Single-isotope Imaging (Technetium Sestamibi and Technetium Thyroid Scan) with SPECT-CT
Authors: Sharma Amit , John Arun R , Jain Anurag , Vishnoi Madan G , Paliwal Dharmesh , Dubey Indra P
Published: July 2019

Primary hyperparathyroidism is a rare cause of acute pancreatitis with a rather uncommon association according to existing literature. We present a rare case of recurrent pancreatitis with primary hyperparathyroidism resulting from a solitary parathyroid adenoma detected by a dual-phase singleisotope imaging protocol using technetium pertechnetate and technetium sestamibi followed by a single-photon emission computed tomography (SPECT)-CT. The case demonstrates the requirement of a high index of suspicion of primary hyperparathyroidism as one of the etiologies in patients presenting with recurrent pancreatitis. This case highlights the role of dualphase single-isotope imaging (technetium pertechnetate and technetium sestamibi scan) along with SPECT-CT for precise anatomical localization of a parathyroid adenoma, which is of paramount importance to the surgeon for meticulous planning and execution of the surgical procedure.

How to cite this article

John AR, Jain A, Vishnoi MG, Paliwal D, Sharma A, Kumar N, Dubey IP. A Rare Case of Solitary Parathyroid Adenoma presenting with Recurrent Pancreatitis detected by Dual-phase Single-isotope Imaging (Technetium Sestamibi and Technetium Thyroid Scan) with SPECT-CT. World J Endoc Surg 2016;8(2):175-178.
Flap Selection in Head and Neck Cancer Reconstruction
Authors: Gupta Arunesh , Baliarsing Amresh S , Thorat Tushar S , Bhat Uday , Garg Sanchit , Bhattacharyya Diptarka
Published: July 2019

Advances in head and neck reconstruction techniques have improved the results in function and the aesthetic outcome. Several flaps with different composition are available for specific reconstruction to achieve optimum result. Sensate free tissue transfer, dental rehabilitation and epiphyseal transfer for pediatric mandible are also now possible to achieve better function. The specific choice of the flap according to the region of defect and important keypoints in harvesting and reconstruction strategy for head and neck cancer are based on our experience in the last two decades.

How to cite this article

Baliarsing AS, Thorat TS, Gupta A, Bhat U, Garg S, Bhattacharyya D. Flap Selection in Head and Neck Cancer Reconstruction. Int J Otorhinolaryngol Clin 2013;5(2):63-76.
A Study of Primary Parapharyngeal Space Tumors in a Tertiary Care Center
Authors: Shirazi Nadia , Bist SS , Agarwal Vinish , Kumar Lovneesh , Luthra Mahima
Published: July 2019

Objectives

This study was conducted to evaluate the demographic profile, clinicopathological features, and surgical approaches used to treat primary parapharyngeal space tumors.

Materials and methods

This was a retrospective study of the primary parapharyngeal space tumors treated surgically from April 2012 to March 2015 in a tertiary care teaching center. The study population included 16 cases. The inflammatory lesions and secondary metastasis in parapharyngeal space were excluded. The clinicopathological features, surgical management, and outcome of all the cases were analyzed.

Observations

The gender distribution was 56.2% males and 43.7% females. The median age was 38 years with range from 16 to 62 years. The most common presenting symptom was neck swelling in 87.5% cases, and oropharyngeal bulge was the most common examination finding in 100% cases. Magnetic resonance image was done in 87.5% cases and contrast computed tomography (CT) scan in 31.25% cases, while 25% cases underwent both. The tumor was in the pre-styloid compartment in 62.5% cases and post-styloid in 31.25% cases. In 75% cases, cytology was done directly, while in 25% cases, CT–guided cytology was performed. Cytological diagnosis was histologically correlated in 81.2% cases while changed in 18.7% cases. On histology, 87.5% cases were benign and 12.5% were malignant. The most common histological variant was pleomorphic adenoma in 56.25% cases. The most common surgical approach used was transcervical in 75% cases. Mean tumor size was 7 cm. Complications occurred in 12.5% cases.

Conclusion

Imaging modalities in combination with fine needle aspiration cytology are a very good diagnostic tool before planning for intervention. The transcervical approach is an excellent technique to deal with small to moderate-size tumors and even for large well-defined tumors.

How to cite this article

Bist SS, Kumar L, Agarwal V, Shirazi N, Luthra M. A Study of Primary Parapharyngeal Space Tumors in a Tertiary Care Center. Int J Otorhinolaryngol Clin 2016;8(1):13-17.
Mucopyocele of Concha Bullosa: A Rare Presentation as Orbital Swelling
Authors: Singh Hitendra Prakash , Hajela Anupriya , Agarwal Satya P
Published: July 2019

Whenever there is pneumatization of either turbinate, it is known as concha bullosa (CB). In the case of middle turbinate, it is the most common anatomical aberration. A mucopyocele of CB is very rarely seen. A 13-year-old male presented with the complaints of gradually progressive swelling on medial aspect of right eye with nasal obstruction, nasal discharge, and facial heaviness for 3 years. Computed tomography (CT) scan of the paranasal sinuses showed a well-defined cystic lesion of thick fluid attenuation with thin shell in the periphery located at the medial canthus of right eye involving the lacrimal sac region with stranding of adjacent periorbital fat plane. Lesion is seen causing erosion of lamina papyracea. After complete hematological and preanesthetic assessment, surgery was planned for the patient under general anesthesia. The lateral lamella and inferior part of CB was excised to drain out the pus and prevent recurrences. Patient remained symptom free in the follow-up period.

How to cite this article

Singh HP, Kumar S, Hajela A, Agarwal SP. Mucopyocele of Concha Bullosa: A Rare Presentation as Orbital Swelling. Int J Otorhinolaryngol Clin 2016;8(2):53-55.
Kikuchi's Disease: A Rare Clinical Entity of Cervical Lymphadenopathy with Review of Literature
Authors: Naik Sudhir , Kumar BL Yatish , Ravishankara S , Shashikumar T , Navya R , Sathya P
Published: July 2019

Background and objectives

Kikuchi disease is an uncommon, idiopathic, generally self-limited cause of lymphadenitis. The disease runs a self-limiting course usually resolving in 6 to 8 months of occurrence, with the usual clinical manifestations being cervical lymphadenopathy, with or without systemic manifestations.

Materials and methods

A retrospective study was done in three cases of Kikuchi disease reported over 2 years. All three females had cervical lymphadenopathy not responding to empirical treatment. All had excision of the lymph nodes with immunohistochemistry, which suggested the necrotizing lymphadenopathy. Other similar diagnoses, like systemic lupus erythematosus, non-Hodgkin's lymphoma, Kawasaki, tuberculous, metastatic lymphadenopathy, were excluded.

Conclusion

The rare possibility of cervical lymphadenopathy being Kikuchi's disease should be thought if empirical therapy fails. So, a meticulous effort by the pathologist and surgeon helps in diagnosing the self-limiting, little understood disease of Kikuchi in young patients with cervical lymphadenopathy and fever.

How to cite this article

Naik SM, Kumar BLY, Ravishankara S, Shashikumar T, Navya R, Sathya P. Kikuchi's Disease: A Rare Clinical Entity of Cervical Lymphadenopathy with Review of Literature. Int J Otorhinolaryngol Clin 2016;8(3):101-105.
Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy
Authors: Dawood Mohammed R , Khammas Ammar H
Published: July 2019

Aim

To clarify the diagnostic accuracy of the lateral X-ray of nasopharynx, and the flexible nasopharyngoscopy in the assessment of adenoid hypertrophy, with the preoperative rigid nasal endoscopic observation, as it was considered as a reference standard guide.

Materials and methods

This is a prospective observational study that included 80 children who planned to undergo adenoidectomy due to the symptoms found related to adenoid hypertrophy. All the children underwent a relevant clinical history and full ear, nose, and throat (ENT) examination, and the grading of adenoid hypertrophy was done preoperatively with the lateral X-ray of the nasopharynx and the flexible nasopharyngoscopy. These findings were analyzed and compared with the peroperative rigid nasal endoscopic assessment of adenoid hypertrophy, which was considered as a reference guide.

Results

There were 44 boys (55%) and 36 girls (45%), with mean age of 5.176 (±1.873) years, and the highest frequency of adenoid hypertrophy was found in the age group of 4 to 6 years (62.45%); the most common grade of the adenoid size in all the types of the assessment was grade 3. The assessment of adenoid grading by both flexible and peroperative rigid nasal endoscopy versus radiology was statistically significant, with p value of 0.0001, while the adenoid grading between flexible and peroperative rigid nasal endoscopic assessment was almost comparable, as no significant difference was found, with p value of 0.46.

Conclusion

Flexible nasopharyngoscopy was a more reliable diagnostic tool in the assessment of the adenoid size than lateral nasopharyngeal X-ray, as it correlates well with peroperative rigid nasal endoscopic finding.

How to cite this article

Dawood MR, Khammas AH. Diagnostic Accuracy of Radiology and Endoscopy in the Assessment of Adenoid Hypertrophy. Int J Otorhinolaryngol Clin 2017;9(1):6-9.
Relapsing Polychondritis: An Otolaryngologist's Perspective
Authors: Naina P , John Sheeja S , Syed Kamran A
Published: July 2019

Relapsing polychondritis (RP) is an uncommon autoimmune disease with varying clinical presentations. Relapsing polychondritis frequently involves the ear, nose, and throat cartilages, often causing subtle and episodic symptoms that can pose a diagnostic challenge to the otolaryngologist. A high index of suspicion is needed to identify these subtle signs leading to early diagnosis. Here, we report a case of RP presenting with hoarseness of voice; we reviewed the literature and clinical signs discussed from an otolaryngologist's perspective. Greater awareness about its episodic and myriad presentation is needed for early diagnosis and management of this uncommon clinical condition.

How to cite this article

Syed KA, Naina P, John SS, Varghese AM. Relapsing Polychondritis: An Otolaryngologist's Perspective. Int J Otorhinolaryngol Clin 2017;9(1):17-20.
Open Safety Pin in Larynx: A Case Report and Review of Literature
Authors: Hota Ashutosh , Baliarsingh Diptiman
Published: July 2019

A foreign body in the respiratory tract is a serious event, and it needs urgent attention. It is important to know the type of foreign body with careful history taking. Usually, such cases come in pediatric age group due to accidental ingestion or inhalation. We present a case of 12-year-old female who presented with an impacted open safety pin lodged in the larynx. Its sharp end was upward in position and penetrated the subglottis and anterior commissure. A tracheotomy was done for securing airway, and the foreign body was removed with the help of rigid endoscope. The child had an uneventful recovery.

How to cite this article

Baliarsingh D, Rath A, Hota A, Panigrahi R. Open Safety Pin in Larynx: A Case Report and Review of Literature. Int J Otorhinolaryngol Clin 2017;9(1):21-24.
Vaccine-preventable Diseases
Authors: Prakash Prashant
Published: July 2019

How to cite this article

Malhotra J, Garg R, Prakash P, Bansal M. Vaccine-preventable Diseases. J South Asian Feder Obst Gynae 2016;8(2):85-89.
A Study of Cardiotocography in Hypertensive Disorders of Pregnancy and Its Correlation with the Neonatal Outcome
Authors: Raghuvanshi Pratibha , Tiwari Rajesh
Published: July 2019

Aim

To study the effect of antepartum and intrapartum surveillance with cardiotocography (CTG) on the neonatal morbidity and survival in cases of hypertensive disorders of pregnancy in a rural medical college hospital in Jabalpur.

Materials and methods

A total of 200 cases of hypertensive disorders > 32 weeks of gestation were subjected to antepartum and intrapartum surveillance with CTG. The neonatal outcome was recorded. This was compared with the records of 200 matched controls who had delivered in the department when CTG was not available. Statistical analysis was done in Statistical Package for the Social Sciences (SPSS) software with x2 test in 2 × 2 tables, and p-value < 0.05 was set as the value of a significant result.

Results

Cardiotocography led to a significantly higher number of induced labors (p < 0.05) and cesarean sections (p < 0.001). There was a significant reduction in neonatal mortality in the study group (p < 0.001).

Conclusion

Surveillance with CTG leads to improved neonatal survival, at the same time increasing the cesarean rates in cases of hypertensive disorders in pregnancy. Further methods such as fetal scalp blood sampling may have to be applied to reduce the high cesarean rate with CTG.

How to cite this article

Tiwari P, Sahu B, Raghuvanshi P, Tiwari R. A Study of Cardiotocography in Hypertensive Disorders of Pregnancy and Its Correlation with the Neonatal Outcome. J South Asian Feder Obst Gynae 2016;8(2):149-153.
Hepatitis B in Pregnancy
Authors: Prakash Prashant , Kumari S Shantha , Agarwal Prabhat
Published: July 2019

Antiviral therapy with lamivudine, tenofovir, or telbivudine in the 3rd trimester can decrease mother-to-child transmission (MTCT) to < 5% and should be used in women with high viral loads in the 3rd trimester. Postpartum flares of liver disease are common, and therefore, careful monitoring is warranted in women who stop therapy. The decision to breastfeed while on antiviral therapy should be individualized, but current evidence suggests that it is safe.

How to cite this article

Kumari SS, Prakash P, Garg R, Agarwal P. Hepatitis B in Pregnancy. J South Asian Feder Obst Gynae 2016;8(3):167-170.
Screening and Analysis of Asymptomatic Bacteriuria during Pregnancy
Authors: Hoodbhoy Zahra , Javed Arshia , Wali Aisha S
Published: July 2019

Aim

Asymptomatic bacteriuria (ASB) is a common condition in pregnancy. The aim of our study is to estimate the rate of ASB, causative organisms, and antibiotic sensitivity in a secondary care hospital.

Materials and methods

Midstream clean catch urinary sample was collected from 149 women between 12 and 28 weeks of gestation. Those with urinary symptoms, diagnosed for urinary tract infection (UTI), with vaginal bleeding or vaginal discharge, and who had given antibiotics within 7 days preceding sample collection were excluded. Data were collected from medical records, and statistical analysis was done using Statistical Package for the Social Sciences (SPSS) version 19.

Results

Asymptomatic bacteriuria was seen in 26% (n = 39) of the women. No association of age, parity, gestational age, body mass index (BMI), and diabetes was found with ASB. The most common pathogen isolated was Escherichia coli (46%) followed by Streptococcus (17.9%) and Staphylococcus aureus (10.3%). Fosfomycin with 94.4% sensitivity and nitrofurantoin with 89% sensitivity were seen as first- and second-line antibiotics for treatment of E. coli. Overall sensitivity of all isolates was 69.20% for fosfomycin, 66.6% for ceftriaxone, and 61% for augmentin. The three most common antibiotics (i.e., penicillin, pipemidic acid, and ampicillin) used in pregnancy showed highest overall resistance for all isolates.

Conclusion

Incidence of ASB was significantly high. The most common bacteria isolated was E. coli.

Clinical significance

Due to large variance in prevalence worldwide, incidences should be studied in local population and antibiotics should be prescribed according to culture and sensitivity to address the issue of multidrug resistance.

How to cite this article

Javed A, Wali AS, Hoodbhoy Z. Screening and Analysis of Asymptomatic Bacteriuria during Pregnancy. J South Asian Feder Obst Gynae 2016;8(3):171-174.
Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test
Authors: Kapadia Shital N , Bansal Komal R , Parmar Kartikeya , Panot Himanshu , Bandi Femida
Published: July 2019

Objectives

The aim of this article is to assess fetomaternal hemorrhage (FMH) and determine its volume and also to study the relation of the amount of FMH to various factors.

Materials and methods

This was a prospective study carried out at Ahmedabad Civil Hospital from October 2012 to March 2013. A total of 75 blood samples were collected from RhDnegative mothers during the postnatal period. Sixteen samples were excluded because the fetus blood group was either Rh negative or unknown. The acid elution or Kleihauer—Betke quantitative test was used to measure the amount of FMH. The data were analyzed using Epi Info version 7.

Results

With Kleihauer—Betke/acid elution test (KBT), 45.76% of women had fetal whole blood in their blood circulation during a postnatal period varying from 1.2 to 9.6 mL. The test was negative (i.e., no fetal cells were identified) in 54.24% of women. The majority of women had hemorrhage less than 4 mL. None of them had a large FMH.

Conclusion

Most of the FMH calculated was <10 mL, which could have been neutralized by lower doses of anti-D immunoglobulin, which have incurred lower costs than the 300-μg dosage. Thus, developing optimized testing and accessing dosing protocols is needed in health care facilities. In the present study, we found no significant relation between the amount of FMH and parity or type of delivery.

How to cite this article

Kapadia SN, Bansal KR, Parmar K, Panot H, Bandi F. Assessment of Fetomaternal Hemorrhage in Rhesus D-negative Postpartum Women by Kleihauer—Betke Test. J South Asian Feder Obst Gynae 2016;8(3):181-184.
Management of Hematometra in Single Horn of Didelphic Uterus with Obstructed Hemivagina and Ipsilateral Renal Agenesis Syndrome: A Case Report with Brief Review of Literature
Authors: Agarwal Ritu
Published: July 2019

The triad of uterus didelphys with obstructed hemivagina and ipsilateral renal agenesis (OHVIRA) syndrome is a rare entity. These cases are difficult to diagnose due to heterogeneous presentation and rarity of the condition. Ultrasonography and magnetic resonance imaging are important for initial diagnosis; however, laparoscopy is required for the confirmation of the diagnosis. Early and accurate diagnosis of this condition followed by prompt surgical therapy is essential to prevent complications and to preserve future fertility. Here we report a case of uterus didelphys with hemivagina and ipsilateral renal agenesis with hematometra and hematosalpinx in a young girl.

How to cite this article

Mishra VV, Agarwal R, Bandwal P, Choudhary S, Gandhi K. Management of Hematometra in Single Horn of Didelphic Uterus with Obstructed Hemivagina and Ipsilateral Renal Agenesis Syndrome: A Case Report with Brief Review of Literature. J South Asian Feder Obst Gynae 2016;8(3):231-235.
Unusual Complication of Intrauterine Contraceptive Device
Authors: Agarwal Namita , Agarwal Brijesh K
Published: July 2019

Intrauterine foreign bodies have been used in animals as a contraceptive since times immemorial. The use of pebbles in camels as a contraceptive has been reported in Arabs.

Intrauterine contraceptive devices (IUCDs) have been used since 1962 when the first International Conference of Population Council, New York reported encouraging data on Margulies coil and Lippes loop as IUCDs. According to the World Health Organization, IUCDs are the second most widely used reversible contraceptive method after voluntary female sterilization.

Intrauterine contraceptive devices have undergone extensive evolution from Grafenberg ring to Ota ring, Margulies coil, Lippes loop, Birnberg bows, Saf T-coil followed by Cu T 200, Cu 7, Multiload Cu 250/375, Cu T 380 Ag, Cu T 380 S [slimline]. Hormonereleasing IUCDs were developed in 1973. Ombrelle 250/380 and FlexiGard are the latest in this series.

The common complications encountered with IUCD insertion are pelvic infections, infertility, the risk of both intrauterine and extrauterine pregnancy, pain, altered bleeding pattern, expulsion of the device, and its migration. Migration of IUCD into the bladder has been rarely reported in the literature. The authors report an unusual case of a secondary vesical calculus formed around a migrated IUCD.

How to cite this article

Agarwal N, Agarwal BK. Unusual Complication of Intrauterine Contraceptive Device. J South Asian Feder Obst Gynae 2016;8(3):243-245.
Obstetric Outcome in a Patient with Aplastic Anemia
Authors: Nanda Anuja , Gupta Vineeta , Maheshwari Prachi , Tandon Archna
Published: July 2019

Aplastic anemia is a rare disease caused by destruction of pluripotent stem cells in bone marrow. The etiology may be radiation exposure, chemotherapy, environmental toxins or it could be autoimmune. During pregnancy it can be life threatening for both mother and child. Treatment options are erythrocytes and platelet transfusions and immune suppressive therapy. We report a series of obstetric events in the life of a woman whose pregnancy was complicated due to aplastic anemia but her subsequent obstetric outcome improved after successful bone marrow transplantation.

How to cite this article

Gupta V, Maheshwari P, Tandon A, Nanda A. Obstetric Outcome in a Patient with Aplastic Anemia. J South Asian Feder Obst Gynae 2017;9(2):121-122.
Postpartum Ultrasound
Authors: Mulic-Lutvica Ajlana
Published: July 2019

This article describes uterine and uterine cavity changes throughout the normal and pathological puerperium, as revealed by various ultrasound modalities. A gray scale ultrasound, color and pulsed Doppler ultrasound and 3D ultrasound were used. It is based on results of several prospective longitudinal studies, which were designed so that every woman was examined at six occasions during the puerperium, namely on postpartum days 1, 3, 7, 14, 28 and 56. The first four examinations were performed transabdominally and the last two transvaginally. The same design was used in all studies. The involution process of the uterus was assessed by measuring the anteroposterior diameter of the uterus and uterine cavity. Morphological findings were recorded. The influence on the involution process of parity, breastfeeding, maternal smoking and infant's birth weight were also evaluated. Besides conventional ultrasound, Doppler technology was used to study hemodynamic events occurring during the normal puerperium. The pulsatility (PI) and resistance (RI) indices in the uterine arteries were measured, and the presence or absence of early diastolic notches was recorded. A hypervascular area in myometrium was assessed by color and power Doppler. Normal involution process was also described by means of 3D ultrasound. The volume of the uterus and uterine cavity after normal vaginal delivery were measured using virtual organ computer-aided analysis (VOCAL) using six adjacent planes and a 30° rotation method. Reference values from uncomplicated puerperium were used when pathological conditions were studied.

Results from these studies, which shed light on normal and pathological changes during the puerperium, are summarized in this chapter.

How to cite this article

Mulic-Lutvica A. Postpartum Ultrasound. Donald School J Ultrasound Obstet Gynecol 2012; 6(1):76-92.
Three-dimensional Ultrasound in Detection of Fetal Anomalies
Authors: Pooh Ritsuko K
Published: July 2019

In the history of 3D/4D ultrasound technology, the great achievement was high definition (HD) live technology. This technology is a novel ultrasound technique that improves the 3D/4D images. HDlive ultrasound has resulted in remarkable progress in visualization of early embryos and fetuses and in the development of sonoembryology. HDlive uses an adjustable light source and software that calculates the propagation of light through surface structures in relation to the light direction. The virtual light source produces selective illumination, and the respective shadows are created by the structures where the light is reflected. This combination of light and shadows increases depth perception and produces remarkable images that are more natural than those obtained with classic three-dimensional (3D) ultrasound. The virtual light can be placed in the front, back, or lateral sides, where viewing is desired until the best image is achieved. A great advantage is that the soft can be applied to all images stored in the machine's memory. With HDlive ultrasound, both structural and functional developments can be assessed from early pregnancy more objectively and reliably and, indeed, the new technology has moved embryology from postmortem studies to the in vivo environment. Practically, in obstetrical ultrasound, HDlive could be used during all three trimesters of pregnancy.

How to cite this article

Pooh RK, Kurjak A. Three-dimensional Ultrasound in Detection of Fetal Anomalies. Donald School J Ultrasound Obstet Gynecol 2016;10(3):214-234.