P. Karthikeyan

Incidence and Presentation of Fungal Sinusitis in Patient Diagnosed with Chronic Rhinosinusitis

Significant number of patients diagnosed with chronic rhino sinusitis often tend to have a final diagnosis of fungal sinusitis. We wanted to find out (a) The incidence of patients with fungal sinusitis in those patients who were initially diagnosed as chronic rhinosinusitis. (b) The presentation of fungal sinusitis patients who were initially diagnosed as CRS. Retrospective chart review of 242 patients diagnosed as CRS from May 2006 to April 2009. The various symptoms and signs of those diagnosed initially as CRS, who were then diagnosed as fungal sinusitis were tabulated. Radiological and serological investigations were then analyzed. The microbiology of various species that were cultured in those identified as fungal sinusitis were also presented. Out of 242 patients diagnosed with CRS, 67 patients had clinical and radiological evidence of fungal sinusitis but only 24 of these patients had fungal organisms identified. Majority of them were Aspergillus fumigatus. Clinical suspicion of fungal sinusitis should be made in those patients presenting with CRS with the following signs and symptoms of nasal obstruction, discharge and polyps. Most of those fungus were Aspergillus fumigatus and responded well to treatment.

Evaluation of Eustachian tube function in chronic suppurative otitis media (tubotympanic type) with reference to its treatment outcome

Aims and Objectives: To assess the eustachian tube function (ETF) and to evaluate the treatment outcome of chronic suppurative otitis media (CSOMtubotympanic type) in relation to eustachian tube dysfunction. Materials and Methods: Prospective study for a period of 2 years; the study comprises of 100 patients diagnosed to have CSOM (tubotympanic type). ETF was assessed by Toynbees test. Patients with normal ETF were taken up for myringoplasty. Patients with totally impaired ETF irrespective of middle ear mucosal status (dry or wet) were taken up for cortical mastoidectomy with tympanoplasty. Patients with partially impaired ETF, with dry middle ear mucosa were taken up for myringoplasty and those with wet middle ear were taken up for cortical mastoidectomy with tympanoplasty. Results and Analysis: The ETF in these patients was analyzed and graft uptake was assessed clinically in reference to ETF status. The results are tabulated and analyzed using Chi-square test using number cruncher statistical system (NCSS) software. In our study, preoperative ETF had a highly significant P value = 0.0005. Conclusion: Methodology of treatment adapted for CSOM patients based on ETF proves that the eustachian tube plays a major role in the uptake of graft.

A Retrospective Epidemiological Study of Rhinosporidiosis in a Rural Tertiary Care Centre in Pondicherry.

INTRODUCTION Rhinosporidiosis is an age old endemic scourge which has affected various parts of the world, most notably India and Sri Lanka. Although a large body of literature exists regarding this problem, postoperative recurrence rates continue to vary, and the effect of public health education in the eradication of this disease has not been taken into account. AIM The aim of this study was to find out the site, presentation and postoperative recurrence rate in patients with rhinosporidiosis. MATERIALS AND METHODS This was a retrospective study involving operated cases of rhinosporidiosis in the Department of Ear, Nose and Throat of a rural tertiary care referral centre over a period of 3 years. The behavioural pattern of the disease, its epidemiology, rate of recurrence and outcomes of surgical management were analysed. RESULTS A statistically significant correlation could be found between male gender and rural residential status and incidence of rhinosporidiosis. Bathing in rivers and ponds were found to be strongly associated with rhinosporidiosis (p=0.005). Almost all patients were found to be of low socioeconomic status. Nasal obstruction and epistaxis were the most common presenting complaints. CONCLUSION Rhinosporidiosis is strongly associated with male gender, young and middle aged adults, agricultural occupations, rural residential status, a history of bathing in ponds and rivers and a low socioeconomic status. Post-surgical recurrence of rhinosporidial masses can be avoided with careful and complete clearance of the mass and cauterization of the base. Appropriate and consistent public health education helps to reduce the incidence of rhinosporidiosis in endemic communities.

Hearing evaluation in mobile phone users at a tertiary care hospital

Introduction: Mobile phone usage is over 5.6 billion worldwide. India holds second position with about 885 million users, that is, 74% of Indian population (November 2011). The advanced mobiles with the fancy multipurpose gadgets make mobiles a part of us. Chronic exposure to sound of more than 90 dB can result in permanent hearing loss. Mobile phone may not produce a sound as loud in a fraction, but there is possibility of sound exposure for a long-term. Materials and Methods: Hundred subjects were selected randomly from students of a medical college, based upon criteria of the preliminary questionnaire and subjected to clinical examination, to rule out other possible causes of hearing loss and categorized into two groups. (Group 1: Users for 2 h/day). The following noninvasive procedures were done to assess the hearing status: Pure tone audiometry (PTA), distortion product otoacoustic emissions (DPOAE), and brainstem evoked response audiometry (BERA). Results: A variable degree of hearing loss has been found in the mobile phone users in DPOAE and BERA. Further, on gross comparison individuals of Group 1 ( 2 h/day), loss was found in both; but the proportion is noted to be more in Group 2. Conclusion: Here, most of the study population (73%) was found to use mobile phone at least for 30 min or more for every call and they were assessed having a hearing loss (mild/asymptomatic). Thus, intensity of hearing loss is found to be directly proportional to the duration of usage and sound exposure of more than that regulated as safe.