Faecal immunochemical tests for patients with symptoms suggestive of colorectal cancer: An updated systematic review and multiple-threshold meta-analysis of diagnostic test accuracy studies.

Aim: Extending faecal immunochemical tests for haemoglobin (FIT) to all primary care patients with symptoms suggestive of colorectal cancer (CRC) could identify people who are likely to benefit from colonoscopy and facilitate earlier treatment. The aim of this work was to investigate the diagnostic accuracy of FIT across different analysers at different thresholds, as a single test or in duplicate (dual FIT).

Method: This systematic review and meta-analysis searched 10 sources (December 2022).

Impact of cardiopulmonary resuscitation duration on functional outcome, level of independence, and survival among patients with in-hospital cardiac arrests: A pilot study.

Background: Cardiovascular diseases (CVDs) are the leading cause of cardiac arrest (CA), which are presented as sudden cardiac arrest (SCA) and sudden cardiac death (SCD). To assess the impact of CPR duration on the functional outcome, level of independence, and survival among patients with in-hospital cardiac arrest (IHCA).

Material And Methods: This prospective longitudinal pilot study was conducted at a tertiary care hospital in South India.

Successful Pediatric Cochlear Implantation In Persistent Stapedial Artery: First Reported Case In India With Literature Review And Relevance of Preoperative Imaging Checklist.

We report the first successful pediatric cochlear implantation in bilateral persistent stapedial artery (pSA) in India. Another child with unilateral pSA, the contralateral side was initially implanted. Both children were preoperatively diagnosed.

Barriers and facilitators to faecal immunochemical testing in symptomatic populations: A rapid systematic scoping review and gap analysis.

Aim: Faecal immunochemical testing (FIT) is used to triage people with signs or symptoms of a colorectal cancer (CRC). Recent guidelines have recommended further research to improve access, uptake and return of FIT. This systematic scoping review aims to understand the barriers and facilitators to FIT testing in symptomatic patients.

Competency Based Medical Education (CBME) in India: Clinicians' Multifaceted Challenges.

In the recent past, in order to achieve our national goal of 'health for all', National Medical Commission and Government of India made competency based medical education (CBME) mandatory in all Indian medical colleges. By undergoing CBME, the Indian Medical Graduate is expected to achieve the five roles of Clinician, Communicator, Leader and Member of the health care, Professional and Lifelong learner. This article is an overview of CBME, its relevant terminologies and knowledge-gaps.

Surgical Intervention in Allergic Rhinitis: Stuffy Versus Sneezy Runny Nose.

To detect proportion and surgical outcome of adult patients with allergic rhinitis non-responsive to medical treatment. To identify clinical candidacy for submucous turbinoplasty of inferior turbinate resection or soft tissue reduction. A prospective descriptive study of adults with clinical allergic rhinitis was done.

Mucosal-Type Chronic Otitis Media: Clinical Predictors of Postoperative Success.

Objectives: Chronic otitis media (COM) remains a global disease, a burden, and a challenge. Predicting its treatment's postoperative success based on clinical presentation has not been reported, particularly for the mucosal (tubotympanic/safe) type.

Methods:  A prospective descriptive study of patients with mucosal-type COM was done to identify clinical predictors of improved postoperative hearing outcomes and successful graft uptakes.

Interventions for Managing Late Gastrointestinal Symptoms Following Pelvic Radiotherapy: a Systematic Review and Meta-analysis.

Aims: Pelvic radiotherapy can induce gastrointestinal injury and symptoms, which can affect quality of life. We assessed interventions for managing these symptoms.

Materials And Methods: A review of randomised controlled trials published between January 1990 and June 2023 from databases including MEDLINE, EMBASE, CENTRAL, CINAHL, clinicaltrials.

Rejection of Fecal Immunochemical Tests Within the Lower Gastrointestinal Diagnostic Pathway: A Cohort Study.

Introduction/objectives: The fecal immunochemical test (FIT) helps triage primary care patients at risk of colorectal cancer (CRC). Improving FIT returns has received recent attention, however uncertainty exists regarding the accurate completion of samples provided for laboratory analysis. This study aims to identify the rejection rate of returned FIT samples and determine rejection causes.

Adenoidectomy: Anatomical Versus Clinical Success.

Endoscopic adenoidectomy with powered instruments,a challenge in resource-constraint developing countries, has been on the rise. To evaluate conventional curettage as compared to endoscopic assisted adenoidectomy in the successful management of adenoid enlargement. A randomized controlled double-blinded study among children undergoing adenoidectomywas done.

Otolaryngologists' Initiative for Collaborative Tracheostomy Care: Knowledge, Attitude and Skill in Tracheostomy Care Among Nurses - An Interventional Study from India.

Unlabelled: Tracheostomy-related adverse events are a global problem, requiring coordinated approach for care of tracheostomised patients. The concept of 'collaborative tracheostomy care' was introduced by Global Tracheostomy Collaborative in 2012. For successful post tracheostomy outcome, nursing care is vital.

Surgical Candidacy for Management of Laryngomalacia: A Proposed Scoring System.

Introduction: Identifying surgical candidacy for the management of laryngomalacia is a challenge.

Objective: To develop a simple scoring system for surgical candidacy in laryngomalacia.

Methods: Eighteen years retrospective observational study of children with laryngomalacia (LM) clinically categorized into mild, moderate and severe LM and were analyzed for surgical candidacy.

Bilateral Puffy Orbits in a toddler: Therapeutic Challenges.

We report a rare case of bilateral paediatric sinus related orbital infection (SROI) in a toddler who initially presented with unilateral lid oedema, worsening bilaterally in spite of parenteral antibiotics requiring multiple surgical interventions. Challenges in management of life threatening intracranial sequelae of SROIs including visual loss are discussed.

Fecal Immunochemical Testing in Patients With Low-Risk Symptoms of Colorectal Cancer: A Diagnostic Accuracy Study.

Background: The fecal immunochemical test (FIT) is recommended for triaging primary care patients in England with low-risk symptoms of colorectal cancer (CRC). The evidence underpinning recommendations by the National Institute for Health and Care Excellence had limitations, with a paucity of primary care evidence. This study examines the diagnostic accuracy of FIT in a defined low-risk symptom primary care population.

Otological Manifestations in Head Injury: Experience from a Tertiary Academic Centre.

Head injuries are most commonly associated with serious otolaryngological involvement. This study was done to identify the otological manifestations and its sequelae among patients with head injury. A prospective study conducted in a tertiary care centre, among patients attending the Emergency medicine, Otorhinolaryngology and Neurosurgery departments from August 2017-July 2018 with head injury and associated otological manifestations.

Challenges of Universal Newborn Hearing Screening in a Developing Country-a Double-Edged Sword.

Objective to implement Universal Neonatal Hearing Screening (UNHS) in a tertiary academic hospital and identify associated risk factors. Prospective study. Screening tests with Otoacoustic Emissions (OAE) were done among newborns, prior to hospital discharge.

Prioritisation of lower gastrointestinal endoscopy during the COVID-19 pandemic: outcomes of a novel triage pathway.

Objective: The 2-week-wait (2ww) referral pathway is used in England to fast-track patients with suspected colorectal cancer (CRC). A two-stage triage pathway was used to prioritise lower gastrointestinal (LGI) endoscopy for suspected CRC during the COVID-19 pandemic.

Method: All patients referred for an LGI endoscopy via a 2ww referral pathway between March 2020 and July 2020 were assessed.

Ultrasound Probe Positions for Internal Jugular Vein Cannulation: A Prospective Study of Different Techniques.

Objective: We compared sonoanatomy of the internal jugular vein (IJV) the high (HA), conventional (CA) and the medial oblique approach (MA) to identify the best approach and head position for IJV cannulation.

Materials & Methods: Total of 45 volunteers aged 18-65 years were included in this study. The degree of overlap in percentage, depth of IJV from skin, antero-posterior (AP) and transverse diameters (TD) of IJV were measured in real time with ultrasound (US).

Laryngopharyngeal Reflux: Symptoms, Signs, and Presence of Pepsin in Saliva - A Reliable Diagnostic Triad.

 Twenty-four-hour multichannel intraluminal impedance with double probe pH monitoring (MII-pH), though considered the most sensitive tool for the diagnosis of gastroesophageal reflux disease (GERD), is invasive, time consuming, not widely available, and unable to detect non-acid reflux. In contrast, the presence of pepsin in the saliva would act as a marker for reflux, considering that pepsin is only produced in the stomach.  To evaluate the predictive value of salivary pepsin in diagnosing laryngopharyngeal reflux (LPR) as suggested by the results of reflux symptom index (RSI > 13), reflux finding score (RFS > 7), and positive response to treatment with a 4-week course of proton-pump inhibitors.

Increased psychological distress and somatization in patients with irritable bowel syndrome compared with functional diarrhea or functional constipation, based on Rome IV criteria.

Background: The Rome IV criteria for disorders of gut-brain interaction define irritable bowel syndrome (IBS) as a functional bowel disorder associated with frequent abdominal pain of at least 1 day per week. In contrast, functional diarrhea (FD) and functional constipation (FC) are relatively painless. We compared differences in mood and somatization between Rome IV IBS and FC/FD.

Meet the Lacrimal Sac: Endoscopic Surgeons' Road Map.

Knowledge of lateral nasal wall landmarks in relation to lacrimal apparatus is essential for successful endoscopic dacryocystorhinostomy. This descriptive study of right and left sagittally sectioned ten adult cadaver head specimens was done measuring various lateral nasal wall anatomical landmarks including lacrimal apparatus with digital calipers. Maxillary line was identified in 75%, majority overlapping lacrimal sac.

A Three Point Assessment Protocol for Tympanoplasty Outcomes: A Retrospective Analysis.

 The surgical outcome of chronic otitis media (COM) of the mucosal type in the pediatric population with high rates of recurrent tympanic membrane perforation is indeed a concern for the attending surgeon.  The present study was done to evaluate the outcome of tympanoplasty in children with chronic otitis media mucosal type.  A retrospective analysis of the medical records of all children, aged < 16 years old, who underwent tympanoplasty for COM of the mucosal type was performed.

High prevalence of primary bile acid diarrhoea in patients with functional diarrhoea and irritable bowel syndrome-diarrhoea, based on Rome III and Rome IV criteria.

Background: A high prevalence of primary bile acid diarrhoea (BAD) has been reported for Rome III defined irritable bowel syndrome (IBS)-diarrhoea and functional diarrhoea. We determined whether this still applies under the contemporaneous Rome IV criteria, given that the latter characterises IBS-diarrhoea as having more frequent abdominal pain compared with previous iterations, whilst no longer recognising abdominal discomfort.

Methods: Patients referred for a SeHCAT test completed a baseline questionnaire comprising, i) demographic data, ii) risk factors for BAD (inflammatory bowel disease, bowel resection, cholecystectomy, microscopic colitis, celiac disease, abdominal-pelvic radiotherapy), iii) the Rome III and IV bowel disorder questionnaire, and iv) mood and somatisation scores.

Diagnostic Yield of Colonoscopy in Patients With Symptoms Compatible With Rome IV Functional Bowel Disorders.

Background & Aims: There is little data on the diagnostic yield of colonoscopy in patients with symptoms compatible with functional bowel disorders (FBDs). Previous studies have only focused on diagnostic outcomes of colonoscopy in those with suspected irritable bowel syndrome using historic Rome I-III criteria, whilst having partially assessed for alarm features and shown markedly conflicting results. There is also no colonoscopy outcome data for other FBDs, such as functional constipation or functional diarrhea.

To PEG or not to PEG that is the question.

Nutrition support involves the use of oral supplements, enteral tube feeding or parenteral nutrition. These interventions are considered when oral intake alone fails to meet nutritional requirements. Special diets and oral supplements are usually the first approach to managing malnutrition; however, their role becomes limited when oral intake is restricted or if swallowing is unsafe.