Ovarian pregnancy is a rare event occurring in 1-3% of all ectopic pregnancies. Increased reporting might be due to the wider use of intra-uterine devices, ovulatory drugs and assisted reproductive techniques. Though ovarian pregnancy has a distinct pathology, it can be a source of clinical and intraoperative diagnostic difficulty. We report two cases of ovarian pregnancy - one primary and one secondary - that came to our notice within six months span. Unlike tubal ectopic and secondary ovarian pregnancies, patients with primary ovarian pregnancy are likely to experience success in future intra-uterine conception and negligible risk.

Our aim was to find out the association between nasal smear eosinophil count and allergic rhinitis (AR) and to determine a cutoff value that is significant for a diagnosis of AR. We also wanted to determine whether this count is related to the predominant symptoms, duration, or type and severity of AR, or to the presence of coexisting asthma. We selected 100 patients with a clinical diagnosis of allergic rhinitis across all age groups and an equal number of age-and sex-matched controls for the study. Their nasal smear eosinophil counts were recorded in terms of the number of eosinophils per high-power field (HPF). All patients were then clinically assessed for asthma and underwent spirometry. The data were recorded and appropriate statistical analysis done. The difference in the mean eosinophil counts of patients with AR and controls was found to be statistically significant (p = 0.000). A nasal smear eosinophil count of >0.3 per HPF had a 100% specificity and a 100% positive predictive value for AR. Asthma was associated with allergic rhinitis in 40% of patients; an association was not found between nasal smear eosinophil count and the symptoms, duration, type, and severity of allergic rhinitis or coexistent asthma. We conclude that an eosinophil count of >0.3 per HPF in nasal smears is a highly specific criterion for the diagnosis of AR. However, nasal smear eosinophil counts are poor indicators of the degree, duration, or type of upper or associated lower airway inflammation due to allergy.

A fourth branchial pouch sinus often manifests quite late in life as a recurrent neck abscess, suppurative thyroiditis, or pseudothyroiditis. Demonstration of the sinus opening in the piriform fossa by hypopharyngoscopy in combination with ultrasonography of the neck provides adequate information to justify proceeding to surgery. The sinus tract usually courses through the thyroid cartilage. The most effective treatment is surgical excision of the tract up to the piriform fossa through the cartilage. This procedure is associated with very low complication and recurrence rates. A fourth branchial pouch sinus is an uncommon condition. Even so, it is still underdiagnosed as a result of poor awareness of its existence by medical practitioners, including otolaryngologists. Part of the reason is a lack of adequate coverage of this topic in otolaryngology and surgery textbooks. In this article, we add to the literature by describing our experience with 7 patients—4 males and 3 females, aged 5 to 45 years (mean: 25.6)—who were diagnosed with a fourth branchial pouch sinus over a 6-year period. The diagnosis was confirmed by identifying the sinus opening at the apex of the piriform sinus during hypopharyngoscopy. Definitive treatment consisted of surgical exploration of the neck and excision of the tract.

Introduction: Smoking is the major risk factor for the development of chronic lung disease and airway malignancy. The development of biomarkers for disease onset and early progression is hindered by the accessibility of the primary tissue in the lungs, so there is a need to evaluate alternative sites for surrogate biomarkers. The harmful effects seen in the lower and distal airways are also mirrored in the nasal epithelium as one airway and one disease. Objective: To study the correlation between nasal mucosal cytology, mucociliary function, nasal airflow and lung function among the current smokers, never smokers, and former smokers. Methods: Cross sectional, observational study from a tertiary care hospital.105 subjects were randomly distributed on the basis of smoking pattern into 3 groups, never smoker, current smoker and former smoker. Nasal mucosal cytology and function were assessed by saccharin transit time test (STT), peak nasal inspiratory flow(PNIF) and nasal ciliated cells & goblet cell ratio. The lower airway was assessed by spirometry. Results: The increase in saccharin transit time was statistically significant (p <.001) in current smokers and former smokers compared to never smokers. The lower mean goblet cell count of the former smoker group was statistically significant when compared to the never smoker and current smoker groups, (p.023) while the change in ciliated cell/ goblet cell ratio remained statistically insignificant. The decrease in FEV1/FVC is statistically significant (p 0.036) in former smokers compared to both never smokers and current smokers. Conclusion: Nasal mucociliary function is reduced in smokers and this reduction is permanent as cessation of smoking does not improve the mucociliary function. Lay Summary: The study is focused to find out whether harmful effects seen in the lower and distal airways are also mirrored in the nasal epithelium as one airway and one disease in current smokers, never smokers and former smokers and thus to find out an early predictor of chronic lung disease so that intervention may be initiated to counsel and help the smokers taking part in the study to quit smoking. It was a Cross sectional, observational study from a tertiary care hospital.105 subjects were randomly distributed on the basis of smoking pattern into 3 groups, never smoker, current smoker and former smoker. Nasal mucosal cytology and function were assessed by saccharin transit time test (STT), peak nasal inspiratory flow (PNIF) and nasal ciliated cells & goblet cell ratio (CC/GC). Lower airway was assessed by spirometry.The increase in saccharin transit time is statistically significant (p <.001) in current smoker and former smoker compared to never smoker which implied that nasal mucociliary function is reduced in smokers. The lower mean goblet cell count of the former smoker group was statistically significant when compared to the never smoker and current smoker groups. (p.023) while the changes in ciliated cell and goblet cell ratio remained statistically insignificant. The decrease in FEV1/FVC is statistically significant (p 0.036) in former smokers compared to both never smokers and current smoker which lead us to the conclusion that  this reduction is permanent and cessation of smoking does not improve the mucociliary function.