Global Strategy on Digital Health.

Digital technology has been a revolutionary foray in education, industry, research and recently, healthcare. Digital health encompasses various aspects of technology like information and communication, mobile health, data-recording and telemedicine. There has been an exponential and unregulated increase in digital health services in last few years which have raised concerns over data privacy, ethical standards and quality of services.

Endoscopic visualisation of the round window during cochlear implantation.

Background: Endoscopes provide a magnified view of the middle ear and visualisation of hidden areas. Otoendoscopes facilitate excellent visualisation of the round window niche during cochlear implantation.

Objective: To compare microscopic and endoscopic visualisation of the round window membrane during cochlear implantation in 20 patients.

Changes in Lung Function Parameters after Total Intravenous Anaesthesia and Balanced Anaesthesia with Desflurane: A Prospective Randomised Study.

Objective: Following anaesthesia, there is a decrease in pulmonary function. Unlike volatile anaesthetics, propofol decreases the upper airway tone, and total intravenous anaesthesia (TIVA) with propofol may decrease coughing on emergence. Coughing may reduce postoperative atelectasis.

Infection associated relapses in children with nephrotic syndrome: A short-term outcome study.

Children with nephrotic syndrome (NS) encounter multiple episodes of relapses associated/triggered by an episode of infection. The primary objective of this study was to find the proportion of infection associated relapses that resolve on the treatment of acute infection over an observation period of two weeks in children with NS. This prospective observational study enrolled 45 children with steroid-sensitive NS presenting with an infection associated relapse during the study period (February 2015 to February 2016).

Future therapies in melasma: What lies ahead?

Melasma is a common, acquired, symmetrical hypermelanosis. It negatively impacts the patient's quality of life and responds poorly to treatment. Although earlier classified as epidermal and dermal, melasma is now thought to be a complex interaction between epidermal melanocytes, keratinocytes, dermal fibroblasts, mast cells, and vascular endothelial cells.

Ectopic Cervical Thymus in an Infant with Normal Orthotopic Thymus: Role of Imaging in Diagnosis and Management.

Ectopic cervical thymus (ECT) is a rare cause of solid cervical mass in the pediatric age group. The location of the mass along the path of thymic descent (thymopharyngeal duct), sonographic echo pattern and MR signal intensity identical to that of normal orthotopic thymus in the anterior mediastinum help us in making a confident diagnosis. To the best of our knowledge only nine cases have been reported in infants in the literature.

Predicting Outcome in Neonates with Possible Clinical Sepsis by Estimating an Early Score for Neonatal Acute Physiology-II (SNAP-II).

Objectives: To determine role of Score for Neonatal Acute Physiology-II (SNAP-II) and its individual parameters assessed within 12 h of suspicion of neonatal sepsis in predicting outcomes; study its distribution across gestational ages and determine its relation with survival duration among expired neonates.

Methods: This prospective observational study conducted in a newborn unit of a tertiary care teaching hospital over 1 year included intramural neonates with birth weight ≥1000 g and gestation ≥28 weeks suspected with sepsis and assigned SNAP-II score within 12 h of suspicion. On day 14 of enrollment, they were categorized into three outcome groups: death (D), survival with organ dysfunction (SOD) and survival without organ dysfunction (SWOD).

Testing Modalities for Inborn Errors of Metabolism - What a Clinician Needs to Know?

The present century is being hailed as the century for genetic therapies, and inborn errors of metabolism is leading the way. As we gear ourselves for treating children with genetic and metabolic disorders, the key is to recognize them early and accurately for best outcomes. In these changing times with advent of technology, clinicians are now more aware, exposed and well equipped with the armamentarium of diagnostic modalities.

The 3-Question Approach: A Simplified Framework for Selecting Study Designs.

Conventional algorithms for selecting study designs are difficult to use for a novice researcher, especially the postgraduate students. An inherent limitation of using the existing algorithms is the requirement of a priori knowledge of the characteristics of various study designs. We propose a simple and novel 3-question approach to select study designs.

Comparative evaluation of round window niche accessibility pre-operatively on high-resolution computed tomography of the temporal bone with intra-operative findings.

Objective: To compare round window niche visibility as seen endoscopically during cochlear implant surgery with pre-operative high-resolution computed tomography of the temporal bone.

Methods: Nineteen patients scheduled for cochlear implantation, aged 2-20 years, were referred for computed tomography from October 2016 to March 2018. Angles were measured between the lines passing through the mid-sagittal plane and cochlear basal turn on the scans.

Internal Carotid Artery Bleed: A Rare Complication of Invasive Sphenoidal Aspergillosis.

Background: Invasive sinonasal aspergillosis is rarely seen in immunocompetent individuals. It may involve adjacent intracranial and intraorbital structures causing high morbidity and mortality.

Case Description: We report a rare case of invasive Aspergillus sinusitis in a young, immunocompetent woman causing headache and vision loss.

Giant De Novo Pleomorphic Adenoma of Parapharyngeal Space, Can It Cause Spinal Deformity? A Case Report.

Study Design: Case report.

Introduction: De novo giant pleomorphic adenoma is a rare tumor of the parapharyngeal space (PPS). Tumors of the PPS can grow to a large size, compromising the space of the upper aerodigestive tract.

Endoscopic assisted powered adenoidectomy versus conventional adenoidectomy - a randomised controlled trial.

Objective: To compare endoscopic assisted powered adenoidectomy with conventional curettage adenoidectomy.

Methods: A randomised controlled trial was conducted at a tertiary care teaching hospital. Fifty patients with a symptom complex pertaining to adenoid hypertrophy and requiring adenoidectomy were chosen and divided into 2 groups of 25 each.

Mutational spectrum and identification of five novel mutations in G6PC1 gene from a cohort of Glycogen Storage Disease Type 1a.

Background: Glycogen storage disease type-1a is an inherited, autosomal recessive disorder caused by mutations in G6PC1 gene leading to deficiency of glucose-6-phosphatase-α specifically in the liver/kidney/intestine.

Patients And Methods: DNA of six unrelated Indian GSD-1a patients were screened for mutations in the entire coding region of G6PC1 gene followed by direct DNA sequencing and functional was tested using glucose-6-phosphatase assay.

Results: Mutational screening of GSD-1a patients identified five novel mutations, viz.

Identifying Pathways Mediating Obstructive Sleep Apnea and Obesity in Indian Children.

Objective: Overweight and obesity in children is associated with several metabolic and cardiovascular impairments, including obstructive sleep apnea (OSA). However, the causal pathway from OSA to obesity is not fully known yet. The aim of this study was to explore the association between OSA and obesity-related metabolic outcomes in obese Indian children.

Inhaled Foreign Body Impaction: A Review of Literature in Malaysian Children.

Foreign body aspiration in children is a problem that can lead to several complications, including death. In this retrospective publication review from 1970 to 2015, there were altogether 42 Malaysian children below the age of 15 y reported with foreign body (FB) ingestion. There were 31 boys and 11 girls between 2 and 177 mo of age.

Is Acoustic Radiation Force Impulse (ARFI) Ultrasound Elastography Valuable in the Assessment of Cervical Lymphadenopathy?

Cervical lymphadenopathy frequently poses a diagnostic challenge as neither clinical nor imaging assessment can reliably differentiate between benign and malignant lymphadenopathy. Non-invasive differentiation between the two may help to reduce the number of FNAC or biopsy. The purpose of this study was to evaluate whether the new ARFI technique (Virtual Touch Quantification), in conjunction with gray scale sonography and Doppler, can help in the characterization and differentiation of benign from malignant cervical lymphadenopathy.

Autism Spectrum Disorders and Celiac Disease: Is there an Association?

We included 150 children aged 2-12 years with Autism Spectrum Disorders and normal serum total IgA levels, and screened them for celiac disease using anti-tissue transglutaminase IgA levels. All the children were screen negative, suggesting lack of positive association between Autism Spectrum Disorders and Celiac disease.