A. K. Mishra

Plant growth-promoting rhizobacterial strain-mediated induced systemic resistance in tea (Camellia sinensis (L.) O. Kuntze) through defense-related enzymes against brown root rot and charcoal stump rot.

Induction of systemic resistance in host plants through microbes and their bioactive metabolites are attaining popularity in modern agricultural practices. In this regard, individual application of two strains of Pseudomonas, RRLJ 134 and RRLJ 04, exhibited development of induced systemic resistance in tea plants against brown root rot and charcoal stump rot under split root experiments. The experimental findings also confirmed that the cuttings treated with fungal test pathogen and plant growth-promoting rhizobacteria (PGPR) strains survived longer as compared with pathogen–alone-treated cuttings. The enzyme level studies revealed that the presence of PGPR strains reduced the viscosity loss of cellulose and pectin by both the pathogens to a significant level. The activity of defense-related enzymes like l-phenylalanine ammonia lyase, peroxidase, and polyphenol oxidase were also recorded higher in tea cuttings treated with PGPR strains in presence of pathogen. Crude bioactive metabolites isolated from these strains also showed in vitro antagonism against the test pathogens besides reducing the number of diseased plants under gnotobiotic conditions. These findings confirm the utilization of these two strains for induction of systemic resistance against two major root diseases in tea plants under plantation conditions.

Contact Endoscopy of mucosal lesions of oral cavity – Preliminary experience

BACKGROUNDnContact Endoscopy is a non invasive tool to visualise alterations in cell architecture inxa0vivo. In this study we investigated the diagnostic accuracy of Contact Endoscopy in detecting malignancy in oral mucosal lesions.nnnMETHODSn76 patients with oral mucosal lesions requiring biopsy were included. Contact Endoscopy was performed by Otolaryngologist before biopsy and findings recorded. The lesion was then biopsied and sent for histopathological examination by Pathologist who was blinded to Contact Endoscopy findings. Findings of Contact Endoscopy were compared with histopathological findings taking the latter as the gold standard. Two biopsies were reported as inconclusive on histopathological examination and hence excluded from the final analysis. Data of the remaining 74 patients is presented here.nnnRESULTSnClinically lesions were diagnosed as ulcero-proliferative lesions in 34 patients, Leukoplakia in 19, Erythroplakia in 9, Lichen planus in 5 and Submucous fibrosis in 7 patients. Histopathological examination revealed presence of malignancy in 97.06% of ulcero-proliferative mucosal lesions, 10.53% of leukoplakia and 33.33% of erythroplakia while corresponding figures on Contact Endoscopy were 94.12%, 5.26% and 11.11% respectively. No malignancy was detected in lichen planus and submucous fibrosis by either technique. When compared with histopathological examination, CE showed sensitivity of 84.21%, specificity of 94.44% and accuracy of 89.19%. No adverse effects on the patients were seen due to the procedure or stain.nnnCONCLUSIONnContact Endoscopy may be useful in determining cellular structure inxa0vivo without biopsy to detect oral malignancy early. Further studies are suggested.

Sentinel Lymph Node Localization Using 1 % Isosulfan Blue Dye in Cases of Early Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

To study the use of 1xa0% isosulfan blue dye in identifying sentinel node, sensitivity and specificity of frozen section and predictive value of sentinel node in predicting other nodal status in the cases of oral cavity and oropharyngeal squamous cell carcinoma. 15 patients of oral cavity and oropharyngeal SCC with clinically N0 neck, who required WLE of the primary lesion as well as neck dissection as per recommended treatment protocol, were selected from OPD. 1xa0% Isosulfan dye was injected peritumorally intraoperatively after the induction of general anaesthesia. Neck dissection was performed and first node taking up the blue dye was identified, dissected, removed and was sent for frozen section. In two of the 15 cases a sentinel node was identified (sensitivity of the technique—13xa0%). Both the sentinel nodes were positive for presence of metastasis on final histopathology (specificity—100xa0%). However, five cases had nodal metastasis on final histopathological examination of the neck dissection specimen (sensitivity of sentinel lymph node biopsy—40xa0%). Frozen section examination had a sensitivity and specificity of 100xa0%. All data was analyzed using SPSS 16 software. Use of 1xa0% Isosulfan Dye for identification of sentinel node is a simple and cheap technique, however, it has low sensitivity as compared to the use of triple diagnostic procedure consisting of lymphoscintigraphy, per op gamma probe localization and using isosulfan dye for sentinel node identification. Sentinel lymph node is representative of nodal status and correlates well with the final histopathological examination of the dissected neck nodes.

Herpes simplex laryngitis following primary genital herpes

Primary genital herpes is associated with involvement of extragenital sites like thighs, buttocks, fingers and pharynx. This involvement occurs due to autoinoculation, orogenital exposure from the source and also seeding due to viremia in the initial period. Involvement of larynx in a case of primary genital herpes is extremely rare prompting us to report this case.

Contact Endoscopy - A promising tool for evaluation of laryngeal mucosal lesions

Early diagnosis of laryngeal cancer is important for favourable treatment outcome. Due to morbidity and difficulties associated with surgical biopsy, a need has always been felt for an easy, non invasive yet accurate tool for knowing histopathological nature of mucosal lesions. Contact Endoscopy (CE) is one such technique which is capable of providing real time and magnified images of cellular structure of superficial layers of various mucosal surfaces with obvious advantages and potential for wide clinical application. In this review, a summary of role and efficacy of CE in diagnosis, treatment and follow up of various laryngeal mucosal lesions is presented. We searched Pubmed, Medline, Cochrane and Google scholar for articles on CE for mucosal lesions of larynx. For better understanding of the technique, articles on CE of other non-laryngeal sites of head and neck were also reviewed. Article selection was limited to human studies without restriction to language and year of publication. Reference lists from identified articles were also searched. Six prospective original articles, three descriptive studies and one review article on CE of laryngeal lesions are included in this review and their findings summarized. Common findings on examination of cellular architecture and vascular patterns described by various authors are also tabulated. The literature revealed high sensitivity (90-94.7%), specificity (81-100%) and accuracy (88-94%) of CE in diagnosis of laryngeal lesions across the published studies. CE is a promising non invasive tool for evaluation of laryngeal mucosal lesions. However, further prospective, randomized, double blinded studies as well as research to improve the technique to overcome the existing limitations are required before defining its precise role in clinical practice.

Blast injury to the ear: management and long term follow up at a tertiary care hospital in a terrorism affected area of North India

Background: A large proportion of blast victims suffers ear injuries; however, these injuries are often overlooked. Methods: We assessed 411 blast victims to detect ear injury employing detailed history, otological examination, pure tone audiometry, auditory steady state response and distortion product otoacoustic emissions. TM perforations were managed by thorough cleaning of ear by suctioning, edges approximation and gelfoam splinting in group A and only suctioning in group B. Prednisolone in tapering doses was prescribed for managing hearing loss in all except those in whom it was contraindicated. Results: Out of 411 blast victims, 228 (55.47%) had aural trauma. All cases were males (being serving soldiers) between ages of 21 and 57 years. (Mean 37.77 years, SD 10.38). 285 ears had a perforated TM. Of these, 145 were assigned to group A while 140 were in group B. There was no significant difference in spontaneous healing of perforation between the two groups but at 5 years’ follow up group A had significantly higher number of unscarred, healthy TMs than group B (Z score=2.2111, p=0.0271). Mean pure tone average was 51.16 dB (SD 8.79 dB) at presentation and 38.91 dB (SD 7.86 dB) at 5 years. Recovery of SNHL component was significantly better in steroid treated patients. Conclusions: Edges approximation and gelfoam splinting helped in reducing scarring of TM on healing, on long follow up. Steroid treated group showed better recovery of hearing loss.

Post Temporal Bone Fracture Facial Paralysis: Strategies in Decision Making and Analysis of Efficacy of Surgical Treatment

Management of traumatic facial nerve injuries after temporal bone fractures is both challenging and controversial. The dilemma is whether to operate or not and if operating, when to operate and how much of the nerve to decompress. The aim of this study is to review our criteria for decision making in management of patients with temporal bone fracture induced facial nerve palsy, and analyze outcome of patients selected for surgical management. Review of 28 cases of temporal bone fracture between 2012 and 2016 was carried out. Patient assessment included clinical, audiological, computer tomography scans and electromyography (EMG) examinations. All 28 cases were initially started on conservative medical treatment. Based on criteria of complete clinical paralysis at onset, no improvement with conservative treatment and fibrillation potential in EMG, 10 cases underwent surgical decompression through the transmastoid approach. Among the 10 surgically-treated patients, lesions were predominantly found in geniculate ganglion area. Analysis of results after 12xa0months revealed 70% of cases who underwent surgery had House Brackmann (HB) Grade I–II recovery. Good recovery was achieved in all 18 medically treated patients (HB Grade I–II). Candidate selection based on accurate clinical judgment and judicious use of electrodiagnostic tests plays a vital role in outcomes in the treatment of post traumatic facial injury. Early surgical intervention gave better results in our study.

Comparison of balloon dacryocystorhinostomy with conventional endonasal endoscopic dacryocystorhinostomy for relief of acquired distal nasolacrimal drainage obstruction and its impact on quality of life: A prospective, randomized, controlled study

BackgroundnWe compared balloon dacryocystorhinostomy with conventional endoscopic dacryocystorhinostomy for the management of acquired distal nasolacrimal obstruction and the quality of life post procedure.nnnMethodsn98 patients, aged 10-73 years, were recruited and randomized into 2 groups of 49 each who underwent conventional endoscopic dacryocystorhinostomy (group 1) and 9xa0mm balloon assisted endoscopic dacryocystorhinostomy (group 2). Follow-up sessions were conducted at 3, 6 and 12 months post-op.nnnResultsnGroup 2 showed significantly shorter mean operative time (25.10xa0min versus 29.82; pxa0<xa00.001), lesser pain in the post-op evening (mean 2.12 versus 2.9 on NRS-11 pain scale; pxa0<xa00.001) as well as on first post-op day (mean 1.08 versus 1.73; pxa0<xa00.001). Success was achieved in 89.79% in group 1 and 93.87% in group 2 at 3 months (pxa0=xa00.46) which declined due to recurrences to 85.71% and 87.75% respectively at 12 months (pxa0=xa00.76). Complications occurred in 14 cases in group 1 and in 10 cases in group 2 (pxa0=xa00.34). All were minor. Mean GBI scores (for quality of life assessment) at 12 months follow-up were 27.20 and 28.38 respectively (pxa0=xa00.08).nnnConclusionnThe efficacy, safety and quality of life of balloon dacryocystorhinostomy and conventional endoscopic dacryocystorhinostomy were comparable. In addition, balloon dacryocystorhinostomy had significantly shorter operative time and lesser post-op pain.

Therapeutic interventions by speech language pathologist in managing adult dysphagia: An evidence based review

The speech and language pathologist provides nonsurgical, nonpharmacological treatment to patients with oropharyngeal dysphagia. There is a notable lack of knowledge or awareness among the professionals in managing dysphagia using this therapeutic intervention. The present article, therefore, reviews the therapeutic interventions offered by speech and language pathologist in managing adult dysphagia and its efficacy data. Literature was searched and all the therapeutic interventions offered were included and studies were quoted mentioning their efficacy. In general, positive therapy effects were found.

Knowledge Needs and Online Knowledge Seeking Behaviour of Stakeholders in the Indian Rice Sector

There is a tremendous potential for agricultural stakeholder to harness information and communication technologies (ICTs) through access to online learning resources and repositories. Most of the online sources of agricultural knowledge lack credible, contextualised and local language knowledge that could be readily applicable among the extension professionals and other stakeholders. Hence, there is a need to understand knowledge needs and online knowledge-seeking behaviours of agricultural stakeholders. It is essential to develop and deploy a sound methodology to analyse the online sources of agricultural knowledge for the benefit of extension organisations. This study focuses on the Indian rice sector and comes out with empirical evidences on knowledge needs and online knowledge-seeking behaviour of various stakeholders. The paper also recommends sound strategies for developing online agricultural repositories.