Purpose: To assess the correlation between the comorbidities, such as hypertension, diabetes, thyroid disorders, hearing loss, hyperlipidemia, and vitamin D deficiency and benign paroxysmal positional vertigo (BPPV) and to determine the high-risk groups for recurrence of symptoms. Design: Descriptive analytical study. Materials and Methods: Patients who met the inclusion criteria underwent complete ear, nose, and throat examination, including Dix-Hallpike test and roll-over test and blood pressure recording. Investigations included pure tone audiometry, random blood sugar/fasting blood sugar, serum thyroid-stimulating hormone, fasting serum total cholesterol, and serum vitamin D levels. Patients were followed up for a period of 6 months to 1 year. Results: Older age-group has an increased risk of BPPV and recurrence of symptoms. About 45.1% of the patients with BPPV who were detected to have symptoms of hypertension were also more common with hypertensive. Diabetes mellitus was found to have an increased risk of BPPV and its recurrence. The presence of other comorbidities, such as abnormal thyroid function test (9%), sensorineural hearing loss (14%), hypercholesterolemia (46%), and vitamin D deficiency (79%) didn’t show any significant risk for recurrence. Conclusion: The presence of comorbidities worsens the status of BPPV, causing more frequent otolith detachment. Hence, it increases the risk of recurrence even after successful repositioning maneuver. Patients presenting with BPPV should therefore be evaluated and treated for these comorbidities along with the repositioning maneuvers.
<p class="abstract"><strong>Background:</strong> The objectives of the study were to document the presentation of laryngeal tuberculosis, response to anti-tubercular treatment and objective evaluation of larynx during and post anti-tubercular treatment.</p><p class="abstract"><strong>Methods:</strong> A before and after treatment study including 15 subjects with laryngeal tuberculosis treated in our tertiary health care centre during a three year study period. Clinical presentation, management, subjective self-assessment of voice and objective assessment of larynx by videostroboscopy at the beginning, at two months and at six months of anti-tubercular treatment were documented. </p><p class="abstract"><strong>Results:</strong> Two patients had primary laryngeal tuberculosis and thirteen patients had laryngeal tuberculosis associated with pulmonary tuberculosis. Only one patient was immuno-compromised. Most common presenting symptom was hoarseness (93%). Ulcerative lesions were the most common clinical finding (87%) with the vocal cords being the commonest site involved (80%). All patients responded well to anti-tubercular treatment. Videostroboscopy showed an improvement in vocal cord lesions during treatment. Subjective assessment of voice after two months of anti-tubercular treatment showed marked improvement in voice. At completion of treatment, voice was better but all patients had complaints of residual hoarseness.</p><p><strong>Conclusions:</strong> Primary laryngeal tuberculosis is less common in comparison to laryngeal tuberculosis secondary to pulmonary tuberculosis. With early diagnosis, the response to treatment is satisfactory. Videostroboscopy can be used as an effective tool in monitoring vocal cord changes during the follow- up period.</p>
<p class="abstract">Thyroglossal duct remnants and branchial arch anomalies are the most common congenital neck masses. These anomalies typically present in childhood or early adulthood as cysts, sinuses or cartilaginous remnants, but may rarely present in late adulthood. Although both thyroglossal duct remnants and branchial cysts may be encountered individually, these anomalies are rarely encountered together in the same individual. We report the third such case of co-existing branchial cyst and thyroglossal cyst occurring in the same individual with review of embryological development of thyroglossal duct cysts and second branchial arch anomalies.</p>
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