<p class="abstract"><strong>Background:</strong> Nasal douching is a best effective and simple treatment procedure for chronic rhinosinusitis. This study compares the efficacy of nasal douching with isotonic saline solution versus ringer lactate solution in patients suffering from chronic rhinosinusitis.</p><p class="abstract"><strong>Methods:</strong> This randomized control trial was conducted among the patients with chronic rhinosinusitis who were attending the outpatient department of Otorhinolaryngology in Chettinad Hospital and Research Institute, Chennai, during the study period from June 2019 to December 2019. After randomization group A and B includes thirty cases of chronic rhinosinusitis each and they received nasal douching with saline and Ringer lactate two times a day for a period of three weeks and assessed using sino-nasal outcome test (SNOT) 20 during pre-treatment and post treatment. Data was entered in Microsoft excel and data analysis was done using SPSS version 17.  </p><p class="abstract"><strong>Results:</strong> On assessing the overall SNOT 20 mean score, in both group A and group B, there was statistically significant improvement post treatment score when compare to pre-treatment scores. But the differences in improvement between the two groups were not found to be significant.</p><p class="abstract"><strong>Conclusions:</strong> Though isotonic saline and ringer lactate solution showed significant improvement after treatment both these are same with respect to efficacy in the treatment of douching for chronic rhinosinusitis with no difference in outcome.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background:</strong> Nasal polyposis is a multifactorial disease. Despite the presence of numerous theories proposed towards the aetiology of nasal polyp, inflammation is the main causative factor. Fungi can impair the local immune system and bring about an inflammatory response causing polyp formation. The aim and objective of the research was to know the prevalence of fungal infection in nasal polyposis and to assess the microbiological and pathological features of fungi in nasal polyposis.</p><p class="abstract"><strong>Methods:</strong> A total of 100 patients operated for nasal polyposis were included in the study excluding immune-compromised patients. All the nasal polyposis cases were subjected to clinical examination, diagnostic nasal endoscopy and medical treatment before undergoing surgical treatment. Polyps removed were subjected to histopathological examination (HPE) and potassium hydroxide (KOH) wet mount examination under microscope.  </p><p class="abstract"><strong>Results:</strong> Out of the 100 patients studied 66 patients (66%) were in the age group between 31 to 60 years. 85 patients had bilateral polyps, in which fungal element was isolated in 11 patients and among 15 patients with antrochoanal polyp 1 patient had fungal isolates. Of the 17 patients who had previous history of surgery, fungi were isolated in 4 patients and the rest were from patient who got operated for the first time. 3 out of the 8 patients, who had recurrence, were positive for fungal infection.</p><p class="abstract"><strong>Conclusions:</strong> Fungi are found to be more prevalent in nasal polyps and fungi can be considered as one of the main causative factor for formation of nasal polyposis and its recurrence after surgery. Anti-fungal agents could be a helping hand in the management of nasal polyposis to prevent its recurrence.</p><p> </p>

Endotracheal intubation has achieved widespread use and refinement in standard treatment for respiratory failure.The aim of the study is to observe the most common structures that get injured in prolonged intubation and to assess the structural changes in the larynx after prolonged intubation in patientswho are admitted at Chettinad Hospital and Research institute. 58 patients were included in this study that were admitted to the hospital or attended the ENT outpatient department. The study was conducted from November 2017 to May 2019. Structural changes in the larynx were assessed in the patients who were intubated for more than 48 hours using video laryngoscopy. The findings were documented and subjected to statistical analysis. In the study, based on the data collected from 58 patients who were under intubation for more than 48 hours, underwent video laryngoscopy to assess the anatomical changes in larynx. It is concluded that -As the number of days of intubation increased in our study group, the prevalence of structural changes in larynx also increased. Hence, it is ideal to keep the patients under intubation for not more than 48 hours. If the patient needs continuous ventilatory support, it is better to shift to other modes of assisted ventilation.

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