Utility of Point-of-Care Ultrasound in Differentiating Causes of Shock in Resource-Limited Setup.

Background: Delivering early diagnosis of shock in resource-limited setting is challenging, especially with limited availability of point-of-care laboratory and radiological diagnostic facilities. There is growing urgency to provide point-of-care diagnosis and treatment for time-sensitive condition like shock.

Aims: We tried to evaluate the application of point-of-care ultrasound (Rapid Ultrasound for Shock and Hypertension [RUSH] protocol) considering different disease cohort and practice realities in our setup.

Endolymphatic duct papillary tumour: captured undercover of complicated chronic otitis media.

Endolymphatic sac tumor is a rare invasive benign neoplasm occurring sporadically or in Von Hippel-Lindau disease. This case mimics clinically to a complicated chronic otitis media with left ear discharge and facial weakness with sudden onset headache, vomiting, vertigo.

Sudden sensorineural hearing loss: an otologic emergency.

The study purpose was to determine the efficacy of steroids, volume expanders and antivirals in the management of idiopathic sudden sensory neural hearing loss and to establish importance of early medical intervention. In this prospective study, thirty-four patients presenting with idiopathic sudden hearing loss of 30 db or more were enrolled in study group between 2005 and 2009. Patient variables as they related to recovery were studied and include patient age, time to onset of therapy, status of contralateral ear, presence of diabetes, severity of hearing loss, pattern of hearing loss in audiogram and presence of associated symptoms, (tinnitus, vertigo).

Bone conduction improvement after surgery for conductive hearing loss.

The objective is to evaluate change in post-operative bone conduction in patients who underwent surgery for conductive/mixed hearing loss due to various reasons. The study design is of retrospective case review and tertiary referral center setting. Five-hundred patients with unilateral conductive/mixed hearing loss were divided into five equal groups (each representing different causes for pre-operative hearing loss), who underwent appropriate surgical correction and had a follow-up audiogram available.

Evaluation of auditory brainstem responses for hearing screening of high-risk infants.

Auditory brainstem responses (ABR) were recorded in 30 normal and 60 high-risk neonates with gestational age between 30 and 45 weeks. The normative data of normal group as regard to age, sex and various parameters of ABR were compared with high-risk group. ABR parameters especially wave V and interwave V-I intervals were significantly prolonged in high-risk infants.

Use of autogenic and allogenic malleus in tympanic membrane to footplate assembly - long-term results.

The objective of this study was to assess the functional performance and long-term stability of autogenic and allogenic malleus used for ossiculoplasty as tympanic membrane to footplate assembly. A retrospective study of 119 patients who underwent such ossiculoplasty in closed cavity mastoidectomy from 1989-2004 was carried out. There was no extrusion in any of our cases.

Modified intact canal wall mastoidectomy - long term results in hearing and healing.

Introduction: The classic intact canal wall (ICW) mastoidectomy with tympanoplasty (combined approach tympanoplasty) [1, 2] has anatomic constraints for clearance of disease from the anterior attic and sinus tympani leading to high recidivism. Farrior [3, 4] described the modification of this technique and senior author (AM) has been using it with further modifications since 1973.

Materials And Methods: We report our long-term experience in hearing and healing in 126 cases with special reference to the age (pediatric versus adults), ossicle status (presence or absence of stapes suprastructure) and type of cholesteatoma (Attic versus posterior-superior versus secondary acquired cholesteatoma).

Is surgical vestibular ablation necessary in disabling peripheral vertigo?

The use of intratympanic gentamicin is an easily performed office procedure for the conservative treatment of the Meniere's disease patient who has failed medical therapy. The procedure provides excellent control for the symptom of vertigo and is one of the most successful methods in the treatment of vertigo due to inner ear disorders. Surgical ablation is no longer necessary for adequate control of vestibular symptoms and that chemical ablation/alteration may replace the need for surgical vestibular ablation in cases of disabling Meniere's disease and other inner ear causes for peripheral vertigo.

Reparative granuloma following stapes surgery.

Reparative granuloma of the oval window is an uncommon complication of stapes surgery, which usually develops within one to six weeks after operation and causes a sudden hearing loss and disturbance of balance. We report 2 cases of post-stapedectomy reparative granuloma that developed during the tenure of senior surgeon (AM).

Transfacial nasal approach to paranasal sinuses, nasopharynx and anterior skull base.

There are different surgical approaches to remove lesion involving the large central lesions of nasal cavity, sinus and nasopharynx with anterior skull base and retromaxillary extension depending on the site extent and the type of tumor. In this paper, we are describing a method that is rhinological and is a direct approach for removal of such lesions in 6 patients.

Rehabilitation of the tympanomastoid cavity in Canal Wall Down procedures.

During 1980 to 2004, 1602 Canal Wall Down (CWD) procedures was performed of which 978 had primary surgery and 624 were revision cases. We have highlighted various methods for total clearance of disease process from the tympanomastoid area, making of a smooth cavity, augmentation of middle ear space for better functional results, inlay temporalis fascia grafting, ossiculoplasty with live tissue grafts, natural obliteration of the cavity and meatoplasty.Healing of cavity and tympanic membrane (TM) graft was achieved in 1548 (94.

Surgical management of glomus tympanicum tumor.

Glomus tympanicum tumor (also known as paraganglioma or chemodectoma) is the most benign tumor of temporal bone. Treatment may be palliative or curative. Palliative therapy includes watchful observation or radiotherapy and curative treatment is surgical.

Value of ultrasonography in laryngeal and laryngopharyngeal cancers.

High-resolution sonography has improved in the past few years and has become a very valuable tool in the diagnosis of diseases of the head and neck. Ultrasonography (US) is commonly the first imaging modality after clinical examination. It is inexpensive, noninvasive and is easily tolerated by patients.

Proliferative fascitis of nose.

Rapidly growing soft- tissue lesions in the oral and maxillofacial region can represent a variety of diagnoses involving radically different treatment modalities. Accurate diagnosis is important to avoid unnecessary and often mutilating surgery. Nodular fascitis is a rapidly proliferating fibroblastic lesion that presents as a tumour- like mass.

Can alzheimer's disease and dementias with Lewy bodies be distinguished clinically?

To determine if Alzheimer's disease (AD), its Lewy body (LB) variant (LBV), and diffuse LB disease (DLBD) are distinguishable at initial clinical evaluation, data from autopsy-confirmed AD, LBV, and DLBD were examined. No significant differences were found in age at onset, age at death, total duration of illness, duration of illness before initial visit, duration of illness from initial visit to death, or severity of illness at initial evaluation. Hallucinations and delusions were significantly more frequent for LBV and DLBD, respectively, than for AD, and falls were more frequent for DLBD than for AD.