Though Tuberculosis is one of the most common causes of ill health and death worldwide, people with diabetes have 2 -3 times higher risk of tuberculosis when compared with people without diabetes. Though tuberculosis can affect any part of the body, oral and oropharyngeal tuberculosis is rare, but reported. And it's association with diabetes mellitus because of the decreased host mechanism, is still rare, but reported. A 50-year-old female diabetic who was on insulin therapy came to OPD of MGM hospital, Kakatiya Medical College, Warangal with complaints of severe pain in throat for the last 6 months. On examination, right tonsil was enlarged with granular surface. Left tonsil and rest of the oropharynx were normal. Examination of chest was normal and there was no evidence of pulmonary tuberculosis. Punch biopsy revealed tuberculosis of tonsil. Isolated cases of primary tuberculosis of tonsil without evidence of pulmonary tuberculosis are rare. Presence of diabetes mellitus makes patients 2 -3 times more vulnerable for tubercular infection.

Post-operative restlessness is observed commonly among children following Ear Nose Throat surgeries. This post anesthetic problem is also termed as Emergence Agitation (EA) which interferes with patient's recovery, presenting a challenging task to the anesthetist in terms of assessment and convincing the parents. Many factors play a role singly or in combination in producing EA. EA consist of restlessness, excessive crying and spells of breath holding, head banging and incoherent speech. In this prospective clinical study the incidence of post-operative recovery restlessness EA in children aged between 3 to 12 years, enumeration of the causes, and prediction of EA in Indian population. MATERIALS AND METHODS: 246 Children undergoing elective surgeries of Ear Nose and throat are selected and their demographic data, socioeconomic back ground and emotional attachment with parents were elicited. Parents of the children were interviewed prior to surgery using a questionnaire enquiring of their children's personality, and emotional attachment and meekness. Their preoperative clinical data are documented. Their post-operative general condition, behavior, time taken for awakening, period of total recovery and treatment factors are recorded and analyzed. RESULTS: The incidence of EA was found in 23.6% of the children. EA lasted between 21 minutes to 52 minutes with a mean period of 28.4±9.5 minutes. 67% of the children required medication with sedatives, analgesics and anti-emetics. Post-operative stay in the Surgical ICU ranged between Hrs. 3.12±0.36mts to Hrs. 8.39±2.10mts in the children showing restlessness, compared to those not showing agitation. CONCLUSIONS: The factors associated with EA were, age, emotional attachment, meekness, adaptability, previous surgery, analgesics, sedatives, dose of pentothal sodium for induction, time taken for awakening and duration of surgery. Shorter was the time of awakening, longer the period of recovery restlessness noticed in the present study.

BACKGROUND Deep neck space infections are bacterial infections of the fascial planes and potential spaces of the head and neck. DNSIs are seen across all age groups depending on the primary cause. The primary causes of DNSI include odontogenic infections, tonsillar and peritonsillar infections, malignancies and foreign body ingestion. The advent of antibiotics has reduced the incidence of DNSI, b ut DNSI poses a challenge due its propensity to cause life-threatening complications and decompensates a well looking patient very rapidly. Treatment of DNSI includes prompt surgical drainage and administering appropriate antibiotics with or without airway support based on the alert signs like respiratory distress, stridor and neck stiffness. This study aims to investigate and understand the patterns of DNSI across all ages and gender with its presentation, signs, sites involved, bacteriology, management and complications. MATERIALS AND METHODS This is a retrospective descriptive study of 94 patients with DNSI admitted in the ENT Department from February 2015 to October 2016. Patients of all age groups and gender were included. All clinical parameters were included in the study including comorbidities, clinical presentation, site, causative organism, complications, treatment and management across all age groups with mean age being 45 years. RESULTS In our report, there were 55 male patients and 25 female patients. Diabetes was found as a comorbid condition in 19 cases (23.7%). The mean age was 45 years. Our study found out that the most frequent causes of DNSI were odontogenic conditions (27.5%). Neck and/ or facial oedema in all patients with local pain in 79 patients (98.75%) were the most common symptoms of DNSI. The most commonly isolated bacterium was Staphylococcus aureus in 30 patients (37.5%) followed by Group G Streptococcus in 20 patients (25%). Among complications, the presence of septic shock and mediastinitis were statistically significant variables associated with the demise group. Surgery was done in 78 patients (97.5%), of which 55 patients underwent neck drainage only. CONCLUSION DNSI carries significant risks of life-threatening complications including death. This necessitates the need for accurate diagnosis and prompt management to provide a cure without complications, and to always promptly identify alert signs such as stridor and neck stiffness. Management of DNSI traditionally is based on antibiotic treatment with prompt surgical drainage of abscess. T he study brings to light the importance of prompt diagnosis and treatment of DNSI and the importance of oral hygiene, especially in developing countries.

BACKGROUNDTympanic membrane traumatic perforation may be either due to direct or indirect source. The aim of the study is to evaluate the various aetiologies of TM perforation at MGM Hospital, Warangal. Tympanic membrane is much more traumatized than middle or inner ear. The incidence has been estimated at 6.80/1000 persons. We wanted to evaluate the various aetiologies of TM perforations, their prognosis and outcome with regard to various means (Conservative and Myringoplasty) of management.