There have been a variety of complications reported during and post- COVID infection. Recently, there has been an increase in sporadic cases of paranasal sinus mucormycosis in COVID- 19 patients. We report a case of COVID- 19 patient diagnosed to have orbital apex syndrome secondary to mucormycosis of nose and paranasal sinus requiring emergency endoscopic sinus surgery. Appropriate use of personal protective equipment and safety precautions taken by health care workers prevented the spread of the virus during surgery.
Objective Clinical symptoms of otitis media with effusion are rarely brought forward to the guardians of young children who the disease is most prevalent in. This often leads to poor scholastic performances and difficult social interactions. The objective of this study was to identify asymptomatic cases of otitis media with effusion present in individuals with adenoid hypertrophy. Material and Methods In a cross sectional study advocated in Justice K.S.Hegde Hospital, Karnataka India we evaluated one hundred patients above the age of three from August 2016 to December 2017. Candidates who presented with an adenoid nasopharyngeal ratio of more than 0.5 were selected for the study. Individuals who complained of otological symptoms were not considered for the study. Patients cleared of other pathological otological conditions were underwent audiological evaluation with pure tone audiometry and tympanometry for evaluating the middle ear status and hearing loss. Results The study showed a total of 36% of patients evaluated presented with asymptomatic otitis media with effusion. In candidates who presented with a bilateral B tympanogram, 40% had significant conductive hearing loss of more than 25dB. Conclusion An objective test such as impedance audiometry in all patients with adenoid hypertrophy would aid in the diagnosis of fluid in the middle ear, so that timely intervention can be done and possible complications be averted.
<p class="abstract"><strong>Background:</strong> The objectives of the study were to document the presentation of laryngeal tuberculosis, response to anti-tubercular treatment and objective evaluation of larynx during and post anti-tubercular treatment.</p><p class="abstract"><strong>Methods:</strong> A before and after treatment study including 15 subjects with laryngeal tuberculosis treated in our tertiary health care centre during a three year study period. Clinical presentation, management, subjective self-assessment of voice and objective assessment of larynx by videostroboscopy at the beginning, at two months and at six months of anti-tubercular treatment were documented. </p><p class="abstract"><strong>Results:</strong> Two patients had primary laryngeal tuberculosis and thirteen patients had laryngeal tuberculosis associated with pulmonary tuberculosis. Only one patient was immuno-compromised. Most common presenting symptom was hoarseness (93%). Ulcerative lesions were the most common clinical finding (87%) with the vocal cords being the commonest site involved (80%). All patients responded well to anti-tubercular treatment. Videostroboscopy showed an improvement in vocal cord lesions during treatment. Subjective assessment of voice after two months of anti-tubercular treatment showed marked improvement in voice. At completion of treatment, voice was better but all patients had complaints of residual hoarseness.</p><p><strong>Conclusions:</strong> Primary laryngeal tuberculosis is less common in comparison to laryngeal tuberculosis secondary to pulmonary tuberculosis. With early diagnosis, the response to treatment is satisfactory. Videostroboscopy can be used as an effective tool in monitoring vocal cord changes during the follow- up period.</p>
Carcinogenesis concerns several changes that eventually result in the inactivation of tumor suppressor genes and activation of protooncogenes, leading to loss of cell cycle control. Inactivation of p16 seems to be an early event in this process and occurs in approximately 80% of squamous cell carcinoma cases. The aims of this study were to evaluate the immunohistochemical expression of p16 protein in oral and oropharyngeal squamous cell carcinoma cases, with both the tumoral area itself and its surgical margin being analyzed (dysplastic areas and histologically normal epithelium adjacent to carcinoma), and to verify the presence of human papillomavirus (HPV) and its relation to p16 expression. Paraffin-embedded biopsy tissues from 26 patients, 13 with oral squamous cell carcinoma and 13 with oropharyngeal squamous cell carcinoma, comprised the analyzed samples. To detect HPV, a nested polymerase chain reaction test using PGMY 09/11 and GP5*/GP6* primers and visualization of the product on a 2% agarose gel was performed. Demographic data were obtained from medical records. The results showed low expression of p16 in the tumor area (38.46%), compared with surgical margins in the histologically normal epithelium (84.6%) and dysplastic areas (57.7%). These findings indicate the inactivation of p16 in the process of malignant transformation. The association described in the literature between expression of p16 and presence of HPV could not be verified in this study, because none of the cases was HPV positive.
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