A high prevalence of osteoporosis was observed in elderly Indian subjects. pDXA has high negative predictive value, making it a useful tool in population screening for osteoporosis.

Nitric oxide (NO) is a biological messenger produced by mammalian cells serving various functions including regulation of blood flow, platelet function, immunity, and neurotransmission. The paranasal sinuses and nasal mucosa are a major source of exhaled NO. The aim of the study is to compare the nasal NO (nNO) levels in patients with chronic rhinosinusitis with those of common cold patients and controls and to correlate CT scores with nNO levels. The nasal concentration of NO was measured by electroluminescence in 13 healthy volunteers, in 13 patients suffering from common cold and 13 patients with chronic rhinosinusitis. The concentration of NO was correlated with symptom scores, endoscopic findings and CT findings. The measured levels of NO did not differ between healthy volunteers and common cold patients, but they were significantly lower in patients suffering from chronic rhinosinusitis. As NO is a regulator of mucociliary activity and has bacteriostatic and antiviral effects, the decreased concentration of nNO in patients suffering from sinusitis suggests that lack of NO may contribute to the pathogenesis of this disease. Thus, nNO, which is easily measured, provides a valuable non-invasive objective measure of chronic rhinosinusitis.

The WHO has designed a safe surgery checklist to enhance communication and awareness of patient safety during surgery and to minimise complications. WHO recommends that the check-list be evaluated and customised by end users as a tool to promote safe surgery. The aim of present study was to evaluate the impact of WHO safety checklist on patient safety awareness in otorhinolaryngology and to customise it for the speciality. A prospective structured questionnaire based study was done in ENT operating room for duration of 1 month each for cases, before and after implementation of safe surgery checklist. The feedback from respondents (surgeons, nurses and anaesthetists) was used to arrive at a customised checklist for otolaryngology as per WHO guidelines. The checklist significantly improved team member's awareness of patient's identity (from 17 to 86%) and each other's identity and roles (from 46 to 94%) and improved team communication (from 73 to 92%) in operation theatre. There was a significant improvement in preoperative check of equipment and critical events were discussed more frequently. The checklist could be effectively customised to suit otolaryngology needs as per WHO guidelines. The modified checklist needs to be validated by otolaryngology associations. We conclude from our study that the WHO Surgical safety check-list has a favourable impact on patient safety awareness, team-work and communication of operating team and can be customised for otolaryngology setting.

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Importance; The use of endoscope for the ear has opened up new approaches to treat cholesteatoma surgically and reduce residuals. The endoscope can be used as an adjunct to the microscope or by itself. Aims and objectives:1. To evaluate the use of endoscopy in identifying the cholesteatoma remnant at the time of primary surgery with the operating microscope.2. To evaluate the effectiveness of endoscopy in assessing limited disease during cholesteatoma surgery.Design: A hospital-based, interventional, non-randomized, non-comparative and prospective study was done in 116 ears with acquired cholesteatoma. At the time of the surgery, the endoscope was used to study and identify the extent of the disease. After completion of the surgery by the standard inside-out technique using microscope and drill, the endoscope was used to identify the cholesteatoma remnants if any.Setting: This study was done in a tertiary care hospital.Participants: 116 patients with acquired cholesteatoma that were operated on. Main outcome measure:The proportion of residual disease identified with the help of endoscope at the end of standard surgery using microscope and drill. Secondary outcome measure was the proportion of cases in which endoscope was useful in decision making intra-operatively. Results:Out of 116 patients operated with the microscope, 13 had a cholesteatoma remnant at the end of surgery which was missed by the microscope but identified with the oto-endoscope. The sinus tympani was the commonest site of cholesteatoma remnant. Also in 7 cases, the endoscope helped in limiting the dissection by better identification of the extent of disease as compared to microscope during surgery. Conclusion and relevance:Endoscope is a useful adjunct to the operating microscope in cholesteatoma surgeries. It is useful in not only identifying residual disease but also in decision making by identifying the extent of the disease intra-operatively.