Jagat Singh

Nasal mucociliary clearance in adenotonsillar hypertrophy

The nasal mucociliary clearance time was studied using Andersen saccharin method in 50 normal children and 50 age and sex matched patients of adenotonsillar hypertrophy, which was repeated one month after adenotonsillectomy. The normal mucociliary clearance time in healthy children was found to be 8.55±2.11 minutes. A significant impairment in nasal mucociliary clearance time was noted in children suffering with adenotonsillar hypertrophy which was 16.97±3.1 minutes, and early adenotonsillectomy restored the mucociliary clearance to a normal 8.7±2.14 minutes.

Nasal mucociliary clearance in healthy children in a tropical country

INTRODUCTION Nasal mucociliary clearance is an important physiological function of nasal cavity that helps in protecting the lower respiratory tract from undesirable organic and inorganic matter including the micro organisms. The study was designed to establish normal mucociliary clearance time in healthy children in a tropical environment. MATERIAL AND METHODS The study was carried out in 100 randomly selected normal school children aged 4--15 years using saccharin method. The diseases that are known to affect the nasal mucociliary clearance were excluded. The study variables were age and sex. RESULTS Mean nasal mucociliary clearance time was 5.7+/-2.59 min with no significant difference between males and females. The clearance time was found to be impaired in groups A and B including children of 4--7 and 8--11 years of age respectively. CONCLUSION Nasal mucociliary clearance is impaired in children of either sex between 4 and 11 years probably due to subclinical adenoiditis. However clearance returns to normal level at the time of puberty, which coincides with adenoids involution.

Oesophageal foreign body in four month old infant.

A 4 month old male infant was brought with only strong suspicion of foreign body ingestion without any symptomatology. X-ray examination revealed foreign body at cricopharyngeus, which was managed successfully emphasizing the fact that a strong suspicion and relevant radiography is the key to early and successful management.

Nasal mucociliary clearance in patients with tracheostomy.

Nasal mucociliary clearance (NMC) time was estimated in 30 tracheostomized patients (24 males & 6 females) in the age group of 13–55 years which was 7.04±0.38 minutes: The patients suffering from nose and paranasal sinus disorders; taking drugs like bromhexine; undergoing radiotherapy and smokers were excluded from the study. The nasal mucociliary clearance in 30 age & sex matched healthy controls was 9.16±0.62 minutes. The NMC was found to he significantly lowered in patients with tracheostomy (p<0.01). This decrease in NMC tune was significant in tracheostimized patients of more than 3 weeks duration (p<0.01), whereas, it was not found significantly lowered in patients with tracheostomy of less than 3 weeks duration (p>0.1).

Secretory otitis media: A school health survey.

The present study was carried out to find out prevalence of secretory otitis media in 200 school going children between the age group of 5–7 years by impedance audiometry besides clinical evaluation. 100 children were taken from two different schools catering to higher and lower socioeconomic strata of society. The overall prevalence of secretory otitis media came out to be 20.75%. It was 28.5% in lower socioeconomic group and, 13% in the other group. This high prevalence warrants routine screening for secretory otitis media. Further impedance audiometry was found to be very good method of screening secretory otitis media.

Oesophageal candiasis in AIDS.

With the explosion in the number of AIDS patients, many of these are likely to consult to otolaryngologists the head & neck is a rather common site to be affected. Sometimes only oesophageal candidiasis is the presenting feature as in the present case which is being reported show typical radiological appearance. the differential diagnosis and treatment of nesophageal candidiasis is briefly discussed

Multiple papilloma larynx

Multiple papilloma of larynx is caused by human papilloma virus. We treated sixteen such cases (10 males and six females) in the last 10 years. All presented with hoarseness while six presented with difficulty in respiration. Three patients needed tracheostomy, all had difficult decanulation, and one developed laryngotracheal stenosis and could not be decanulated. All were treated by surgical excision; ten had recurrence. Four patients were treated with post operative Acyclovir with no recurrence in three cases.

To Evaluate the Pre and Post Shunt Sensorineural Hearing Loss in Hydrocephalus Patients

Hydrocephalus means watery head and defined as disturbance of formation, flow, or absorption of cerebrospinal fluid. The clinical presentation of hydrocephalus includes hearing loss especially sensorineural hearing loss (SNHL). Ventriculoperitoneal (VP) shunting is the most commonly performed procedure in these patients. Pure tone audiogram, impedence and BAEPs, were done for preoperative hearing assessment in 20 hydrocephalus patients. Out of 20 patients, 12 cases (60%) had SNHL while, rest 8 (40%) patients had mixed hearing loss. Post VP shunting hearing improvement was observed in 14 patients (70%) whereas it worsened in 30% of patients. The result is even better if shunt is placed at early age.

To Evaluate the Effect of Nasal Packing on Blood Oxygen Saturation

Objective: To study the effect of nasal packing on blood oxygen saturation. Materials and methods: Study was conducted on 30 patients of deviated nasal septum, who underwent septoplasty under local anesthesia followed by anterior nasal packing. The pulse oximetry was carried out three times on each patient to record the blood oxygen saturation (SpO2) by using digital pulse oximeter. The first reading of SpO2 was taken before nasal packing, second after 24 hours of nasal packing and third 3 weeks after surgery. Statistical analysis was done by Chi-square test and paired t-test. Results: A total of 33.3% patients were below 20 years of age, whereas 60% were between 20 and 30 years of age and 6.7% were above 30 years. Males were 80%. It was observed that preoperative mean SpO2 was 98.3 ± 0.794%, after 24 hours of nasal packing was 97.17 ± 1.744% and 3 weeks after surgery was 98.87 ± 0.629%. On statistical analysis, the difference in SpO2 was highly significant (p < 0.001). Conclusion: The application of nasal packs can be risky in old patients, more so having cardiopulmonary disease. The use of packs with airflow is recommended in these patients who should ideally be monitored with pulse oximetry.

Comrarative study of infiltration and surface application of bupivacaine in post tonsillectomy pain

The concept of preamptive analgesia using bupivacaine to minimize post operative pain is a well established fact in surgery today. But the role ol bupivacaine to control post operative pain in tonsillectomy is still viewed with some degree of suspicion. The review of medical literature gives us conflicting views regarding its use. We present a randomised double blind study of 80 cases in which bupivacaine was used in the form of infilteration (preoperatively and packs (postoperatively) to minimize post tonsillectomy pain. The results were statistically analysed using ‘t’ test and bupivacaine was found to be highly effective in minimizing post operative tonsillectomy pain. But the superiority of one method of application over the other could not be established.