This study aims to evaluate the effect of septal correction on the blood pressure (BP) of patients with symptomatic nasal septal deviation and to assess whether a positive association exists between deviated nasal septum and hypertension. A prospective observational clinical study was conducted at Kempegowda Institute of Medical Sciences, Bangalore. Hundred adults, aged 18-40 years, with symptomatic nasal septal deviation, newly detected untreated hypertension (mean BP C140/90 mmHg), undergoing submucosal resection of the septum and submucosal diathermy of hypertrophied inferior turbinate (when present), were included. Postoperative follow up for ENT examination and BP measurement was done at 1, 6 and 12 months. Seventy five males and 25 females met the inclusion criteria. 48 % were aged 31-35 years (mean = 31.83 ± 5.19 years). 71 % had anterior septal deviation, 13 % posterior deviation and 16 % a combination of both. Preoperatively, mean systolic blood pressure was 141.82 ± 1.70 mmHg and mean diastolic blood pressure was 91.04 ± 1.21 mmHg, which postoperatively decreased by 10-12 mmHg and 4-5 mmHg respectively. 79 % showed a significant (P \ 0.001) decrease in BP postoperatively. 13 % showed no change in BP, of which 53.8 % had posterior deviation, demonstrating a significant association (P \ 0.001) between type of deviation and response to surgery. In 8 %, a rise in BP over the follow up period was seen; of these, 62.5 % were aged 36-40 years, indicating a significant association (P \ 0.001) between age and BP. Surgical correction of septal deviation is thus effective in controlling the BP of patients with anterior deviation, aged \35 years.

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Context: Key to successful awake direct laryngoscopy is establishing reliable local anesthesia. Lidocaine spray was reported to be effective in laryngoscopic procedure with less hemodynamic and cardiovascular disturbances. Novel formulation of lidocaine as lozenges was developed to avoid problems of throat irritation and bitter taste associated with spray. Aims: The aim of the following study is to compare the effi cacy and safety of lidocaine lozenges versus lidocaine spray in patients undergoing awake diagnostic direct laryngoscopy. Design: A prospective, randomized, open label, active controlled, multicentric study. Subjects and Methods: Patients of either sex, aged between 18 to 80 years and undergoing awake diagnostic direct laryngoscopy were enrolled after screening for eligibility criteria. Enrolled patients were randomized to one of the two treatment; lidocaine lozenges 200 mg and lidocaine spray 200 mg to be applied as a single dose before laryngoscopy. Immediately after the procedure, effi cacy, and safety was assessed. Statistical Analysis: Between groups comparison was done using appropriate parametric or nonparametric tests. Results: Investigator experienced signifi cantly lesser procedural diffi culty and reduced gag refl ex during the procedure with lidocaine lozenges compared to spray. Lesser number of patients experienced aversive symptoms (especially nausea, vomiting, cough, and pain) during and after the procedure and signifi cantly more number of patients preferred to have a repeat procedure with lidocaine lozenges compared to spray. The global assessments by the patient and investigator favored lidocaine lozenges over spray. Conclusion: Lidocaine lozenges given before direct awake laryngoscopy provide a signifi cant benefi t by offering a more effective, safe, and convenient anesthesia compared to spray.

<p class="abstract"><strong>Background:</strong> Nasal polyps are associated with chronic inflammation of the nasal cavity and sinus mucosa. Steroids are the main stay of medical treatment. FESS is indicated when medical treatment fails. Bleeding during surgery can impair the surgical field during operation and increase the time duration and risks of complications. Pre-operative corticosteroids help reduce bleeding during surgery. The objectives of the study was to study and compare the effects of pre operative intra nasal steroid spray and oral steroid on intra-operative bleed in FESS for nasal polyposis.</p><p class="abstract"><strong>Methods: </strong>60 patients diagnosed with nasal polyposis were sequentially divided into 2 groups. Group A received intranasal steroid spray and Group B received oral steroid each for 7 days. Patients of both groups underwent FESS under general anaesthesia. Bleeding volume and quality of surgical field were assessed during the procedure to evaluate the effect of pre operative steroids in bleeding in FESS.</p><p class="abstract"><strong>Results: </strong>Majority of our study patients of both the groups had moderate bleed. 33.3% of Group B patients showed the best outcome of surgery with just slight bleeding while 33.3% patients of Group B had moderate to severe bleed. Majority of our study patients (53.3%) had a blood loss of about 50-100 ml, of which 66.7% patients belonged to Group B.</p><p class="abstract"><strong>Conclusions: </strong>Preoperative steroids are truly beneficial. Oral steroids has been found to be relatively better than intra nasal steroid spray in improving symptoms, reducing intra operative bleeding, and in providing better quality of surgical field.  </p><p class="abstract"> </p>

Rhinitis is inflammation of nasal mucosa which characteristically presents as running nose, blocked nose, itching on nose or sneezing. Allergic rhinitis is more common than non-allergic rhinitis. Anti-histamines are the mainstay of SAR treatment. Desloratadine, rupatadine and ketotifen are the commonly prescribed anti histamines in our region. In this study, we have compared efficacy and tolerability of desloratadine, rupatadine and ketotifen in SAR. This was a prospective, randomized, three arm, open label comparative study of desloratadine, rupatadine and ketotifen in SAR, conducted at Department of ENT, Kempegowda Institute of Medical Sciences, Bangalore; between January 2014 and December 2014. Patients’ severity of SAR symptoms were assessed by TNSS, QoL was measured using Medical Outcomes Study questionnaire (SF-12). SF-12 was administered at the start of study and then at the end of study. Adverse effects were monitored during clinical examination at each visit. Study subjects were systemically randomized into three groups – desloratadine (DES), rupatadine (RUP) and ketotifen (KET). Based on the assigned group; desloratadine was given orally in dose of 10mg OD, rupatadine orally 10 mg OD and ketotifen orally 1mg BD. All medications were given for 4 weeks. Follow up was done for all patients every week during treatment period of 4 weeks. The primary outcome measure was change in mean TNSS from baseline; secondary outcome measures were changes in the individual nasal symptom scores, change in the quality of life and tolerability to the study medications. Total 150 patients were recruited for this study, divided into 3 groups. DES and RUP were equally effective but significantly better than KET in improving rhinorrhea, nasal congestion, TNSS and AEC. (p=0.05). All the drugs were equally effective with no statistically significant intergroup difference in improving sneezing, nasal itching and QoL. RUP appeared to have better tolerability as the total number of adverse events were marginally less. DES and RUP are comparatively more effective and faster acting than KET. All the study medications were well tolerated with few mild, self-limiting, transient adverse events requiring no intervention.