Objective: To evaluate association between depth of invasion and neck node metastasis. Methods:Aprospective observational study was carried at Department of ENT, Sawai Man Singh Medical College over a period of one year in which 102 patients of oral carcinoma were included that underwent wide local excision with neck dissection. Results:The mean depth of invasion was 10.59 with 7.44 standard deviation (range 2-45 mm). Lymph node metastasis was present in 3 out of 27 patients with a DOI < 5mm (11%), in 13 out of 39 with a DOI 5.1-10 mm (34%) and in 8 out of 36 with DOI >10mm (22%). Chi square value was 30.79 and the p-value was<0.001. Conclusion: The risk of lymph node metastasis increased with increased depth of invasion.
Background: India was furiously hit by the second wave of COVID-19 that peaked during the months of April and May 2021. It led to an unprecedented number of rhino-orbital-cerebral mucormycosis cases that came as a bitter surprise. Several parameters were found to be consistently elevated in the patients like serum ferritin, D-dimer, and HbA1C. Methods: A cross-sectional observational study was conducted at the SMS medical college that included 120 patients presenting with post-COVID mucormycosis from 1st May to 31st May 2021. HbA1c, D-dimer, serum ferritin levels were measured at the time of admission. Results: Our study showed a mean range of serum ferritin of 539.6±484.9, mean D-dimer range was 636.3±303.5, both of which were higher than normal. In the present study 94.1% of the patients had diabetes mellitus. Among them 60.80% of the patients had newly detected diabetes and 33.30% were known cases of diabetes with mean HbA1c 9.7±2.3. The p value was less than 0.001 which was statistically significant. Conclusions: Timely detection and categorization of the patients based on severity of the above parameters can not only help in executing the existing institutional resources but can also help in saving valuable lives, and preventing radical surgical procedures like orbital exenteration and maxillectomy.
Invasive fungal rhinosinusitis was seen to rise to epidemic levels after the 2nd wave of ongoing Covid pandemic, especially in tropical countries, maximally in India. A similar trend is being observed for cases who have recently recovered from dengue virus infection. Post dengue invasive fungal infection is a new presentation and any associations between it and Covid pandemic need to be studied in detail to help prepare for any complications. 3 patients presented to the out-patient department of E.N.T at a tertiary level teaching hospital in East India with complains similar to rhinosinusitis. These patients were then evaluated and diagnosed to be infected from Mucormycosis and Aspergillosis fungal sinusitis after which they were managed with surgical debridement and systemic antifungal therapy. All had a recent history of recovery from Dengue virus infection and a possible association could be suspected. 3 patients presented with complains of pain over upper jaw with orbital swelling and loss of vision developing over a period of 24 days. Two of them had ulceration of hard palate. They were then subjected to Contrast MRI along with CT scan of the Paranasal sinuses which depicted pansinus involvement with intracranial extension in two patients. These were then planned for diagnostic nasal endoscopies along with biopsies which turned out to be Invasive fungal sinusitis in the form of Aspergillosis and Mucormycosis. All the 3 patients had recent history of recovery from Dengue virus infection and did not have any other co-morbidities. Covid Associated Mucormycosis (CAM) is a well-known entity now but no reports of Dengue associated Invasive fungal sinusitis are yet reported. Whether this new phenomenon has anything to do with the interactions between dengue virus and coronavirus is not known at present and needs to be studied in detail so appropriate management protocols can be formulated.
<p><strong>Background:</strong> Chronic otitis media (COM) is a recurrent infection of the middle ear and/or mastoid air cells affecting 2-3% of global population. Mastoidectomy is the mainstay of the treatment of COM. Bone drilling during mastoidectomy procedure exposes both the ears to acoustic trauma leading to sensorineural hearing loss. The present study was conducted to assess the possible deleterious effect of drilling on hearing of contralateral normal ear by monitoring pre-operative and post-operative pure tone audibility (PTA) and otoacoustic emissions (OAE). Aims and objectives were to evaluate the effect of drill- generated noise on hearing in non-operated ear during mastoidectomy in terms of hearing loss, its nature and duration and recovery of hearing loss.</p><p><strong>Methods:</strong> An observational study was carried out in ENT department at SMS medical college and hospital, Jaipur. Total 40 patients were studied. Pre-operative and post-operative PTA and OAE were studied and compared. Mean drilling time during mastoid surgery was also studied.</p><p><strong>Results:</strong> Out of 40 subjects, maximum patients were 11-20 years of age group (37.5%) with female preponderance (57.5%). All had undergone mastiodectomy. Only 6 (15%) subjects had transient sensorineural hearing loss of contralateral normal ear as determined by comparing pre-operative and post-operative PTA and OAE. The mean recovery time was 2-3 days. The study had shown significant effect of drill generated noise on hearing of contralateral healthy ear following mastoidectomy.</p><p><strong>Conclusions</strong>: Drill-generated noise can’t be lowered to a great extent therefore drilling time should be minimized during mastoid surgeries.</p>
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