Background: Coronavirus disease 2019 (COVID-19) disproportionately affects individuals with various comorbidities. Among these, chronic kidney disease (CKD) has been shown to be strongly associated with the progression to severe disease. This study aimed to assess the severity and disease outcomes in patients with COVID-19 infection and CKD. Methods: This is a retrospective study conducted at a tertiary care hospital from July 2021 to September 2021. The case records of patients with CKD and COVID-19 were studied. They were compared with age and gender-matched controls equally. The presenting symptoms, clinical course, severity of illness, laboratory markers, need for ventilator support, and mortality outcomes were studied. Results: In total, 40 CKD and 40 non-CKD patients with COVID-19 were included in the study. It was also observed that among the patients with CKD, more patients had fever, breathlessness, and diarrhea. The requirement for noninvasive ventilation, ventilator, and inotropes was on the higher average for patients with CKD. Overall mortality was 27.5% in the CKD group and 2.5% in the non-CKD group, which was statistically significant (p = 0.002). Conclusions: COVID-19 patients with CKD had more severe illnesses with a requirement of ventilator support and had higher mortality than the patients without CKD. Patients with CKD are a key subset of patients with COVID-19 for whom more aggressive early treatment and stricter preventive measures may be beneficial.
Objectives Lingual thyroid (LT) is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen cecum to its normal eutopic prelaryngeal site. Lingual thyroid is the most frequent ectopic location of the thyroid gland. Its clinical incidence varies between 1:4000 and 1:10000. The purpose of this case series was to discuss a series of cases of LT gland its incidence, clinical presentation, sex ratio, age group, endocrine status, radiological features and appropriate surgical approaches. Materials and methods Six patients of LT were diagnosed who presented to our institution in a period of 6 months out of 225 thyroid cases, out of 14539 outpatient department (OPD) patients. The LT is often asymptomatic but may cause dysphagia, dysphonia with stomatolalia, upper airway obstruction and hemorrhage, often with hypothyroidism. Treatment of a LT depends on the severity of symptoms, the age of the patient, any precipitating factors, such as puberty or pregnancy. Result Relevant demographic, clinic-pathological and radiological data were recorded. Four of six were treated conservatively. One underwent complete surgical excision and one pregnant lady in first trimester kept under observation and regular follow-up. Conclusion We found female predominance than male with ratio of 5:1. Our study had high prevalence of LT of 1:2400. Thyroid scintigraphy plays the most important role in diagnosing LT, but ultrasonography contributes as well. In cases of symptomatic disease, surgery is the treatment of choice, followed by radioiodine ablation and levothyroxine suppression therapy in more refractory cases. How to cite this article Patil YS, Rajashekhar RP, Karodpati NS, Thomas J. Lingual Thyroid: A Case Series of Six Lingual Thy-roid with Incidence and Different Treatment Modalities. Int J Head Neck Surg 2015;6(3):103-108.
<p class="abstract"><strong>Background:</strong> Adenoid Hypertrophy is the commonest disorder in children. The size of adenoids varies from child to child and also in the same individual as he grows and attains maximum size between age of 3 to 7 years. Adenoid hypertrophy plays a significant role in the pathogenesis of otitis media with effusion. Our objective was to study the tympanogram changes following adenoidectomy. i.e to find out the effect of adenoidectomy on Otitis Media with Effusion.</p><p class="abstract"><strong>Methods:</strong> Patients showing >50% of airway obstruction by the adenoids were included in the study. 20 patients with adenoid hypertrophy underwent adenoidectomy. Pre-operative and postoperative tympanograms of 40 ears were studied. </p><p class="abstract"><strong>Results:</strong> Type A curve (normal) was found in 12 ears. Type B Flat tympanogram – 12 ears s/o Gross Serous Otitis Media. Type C tympanogram – 8 ears s/o uncomplicated eustachian tube obstruction. 5 ears showed tympanogram s/o Eustachian tube block without significant collection of middle ear fluid. 3 ears showed tympanogram s/o uncomplicated eustachian tube obstruction. Post adenoidectomy, 32 ears showed normal tympanogram. 8 ears showed tympanogram s/o negative middle ear pressure with normal compliance.</p><p class="abstract"><strong>Conclusions:</strong> Our study shows high prevalence of Otitis Media with Effusion in patients with adenoid hypertrophy. Otitis Media with Effusion is treated by adenoidectomy in most of the patients which is confirmed by post adenoidectomy tympanogram. Also, problem of decreased attention in school due to reduced hearing secondary to OME can be corrected by adenoidectomy. Hence, all patients should undergo pre and post-adenoidectomy tympanometry to know the compliance and pressure changes in the middle ear.</p>
<p class="abstract"><strong>Background:</strong> Cholesteatoma term was coined by Johannes Muller in 1838. Cholesteatomas are the last stage of squamous epithelial retraction comprising either the pars tensa or flaccida that are not self-cleansing, which retain epithelial debris and elicit a secondary, inflammatory reaction. Active squamosal epithelial disease is a retraction pocket which is filled with keratinous debris.</p><p class="abstract"><strong>Methods:</strong> 50 patients were selected presenting with active squamosal chronic otitis media (COM). For all cases a detailed history was taken, otoscopic and otomicroscopic examination along with tuning fork test were performed to know the status of tympanic membrane and status of air and bone conduction of sound waves. Audiological assessment was done by pure tone audiometry. X-ray mastoid and high-resolution computed tomography (HRCT) temporal bone was done for analysis. Pre anaesthetic fitness was taken and patients were posted for tympanomastoid exploration. </p><p class="abstract"><strong>Results:</strong> Most common presentation was of foul smelling otorrhoea in 40 patients, reduced hearing in 40 patients. 8 patients presented with vertigo and 2 presented with facial nerve paresis. Most common otoscopic finding was pf postero-superior retraction pocket in 26 patients. After clinical and radiological assessment 30 patients were posted for canal wall down mastoidectomy.</p><p class="abstract"><strong>Conclusions:</strong> Primary acquired cholesteatomacan affect all age group with significant effect on hearing and quality of life.</p>
<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Labyrinthine fistula (LF) is the most common intra-temporal complication of squamosal chronic otitis media represents an erosive loss of endochondral bone overlying the semicircular canals without loss of perilymph. Main treatment of LF is surgical. The aim of our study is to discuss its incidence and sex ratio. The main objective is to describe the audio-vestibular results after closure of labyrinthine fistula by our technique using surdille flap. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">234 patients with squamosal chronic otitis media presented to our institution in a period of 24 months. Out of 234 patients, 22 patients were having labyrinthine fistula. Eleven patients had fistula test positive. Rest eleven patients were found to have LF intra-operatively. All patients underwent canal wall down modified radical mastoidectomy (MRM). Treatment of LF was done surgically by using surdille flap in all the cases. Post operatively Audio-vestibular results of labyrinthine fistula surgery by our technique were studied. </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">The results show that the cholesteatoma matrix can be removed from the fistula. Removal of the fistula generally improves the vestibular symptoms. In all patients canal wall down procedure was done with surdille flap seal over LF. In our study, incidence of LF was 9.40% and none of the patients ended up with postoperative deafness. Hearing improved in 36.40% patients whereas it remained unchanged in rest of the cases. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Labyrinthine fistula, very commonly seen in the lateral semicircular canal has incidence of 5-10% reported in many studies. We demonstrated that open technique with removal of matrix and sealing with three layers may be a valuable choice for the surgical treatment of LF with little risk for cochlea-vestibular functions. Advantage of using surdille flap (sealing the fistula with three layers) is that it decreases the possibility of postoperative vertigo.</span></p>
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