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Introduction: Chronic suppurative otitis media is associated with ossicular necrosis. Both safe and unsafe CSOM have incidence of ossicular necrosis. This study will provide the much-needed insight, into the factors which can act as significant predictors for the intra operative ossicular status, and help in better preparing the patient before the surgery and need for ossiculoplasty. Furthermore, narrowing down to the most significantly related predictors, it may also be»possib1eto reduce the financial burden on the patient, something which is of prime importance in a resource limited country like ours. Objectives: pre-operative predictors of intra operative ossicular status in chronic suppurative otitis media and effect of duration of disease on hearing threshold and ossicular-status. Material and methods: A descriptive observational study was done in a Tertiary care referral center. A total number of 124 patients with the clinical diagnosis of CSOM were selected from outpatient department and admitted. All patients were subjected to otoendoscopy, X-raymastt), 1d (Schiller’s view) and pure tone audiometry. All patients underwent tympanomastoidectomy. Preoperative findings on the basis of history, examination and investigations were noted along with findings of intraoperative ossicular status. Findings were tabulated and statistical test were applied to determine significant preoperative predictors of iv intraoperative ossicular status. Results: Intraoperative ossicular necrosis was seen in a total number of 43 patients. On; univariate analysis, blood-stained discharge (P<0.0001), purulent consistency of ear discharge (0<0.0()01), associated symptoms of vertigo (p=0.0047), otalgia (p=0.0019), size(p=0.0042) and f site(p=0.004l), severity of hearing loss (p=0.004), sclerotic mastoid air cell (p=0.0001) had significant association with ossicular necrosis. The duration of disease and hearing threshold did not have statistically significant association (p=0.227). Conclusion: Ossicular necrosis is best indicated by the presence blood-stained and purulent discharge, vertigo, otalgia, total perforation, severe degree of hearing loss and sclerosed mastoid. Incus was the most common necrosed ossicle followed by malleus followed by stapes, Duration of disease did not have a significant connotation with hearing threshold. [ABSTRACT FROM AUTHOR]

Diphtheria is an acute, potentially fatal, and highly communicable bacterial infection caused by Corynebacterium diphtheriae. In India and the developing world, 100% immunisation is claimed against diphtheria through diphtheria, pertussis, and tetanus (DPT) vaccination. Only a negligible number of cases are seen in the western world. In India, a few outbreaks of diphtheria has been reported among children. But it is rarely diagnosed in Indian adults. Diphtheria has high morbidity due to nerve damage and high mortality because of respiratory obstruction or myocardial complications. PubMed data base was searched for case reports in last 10 years for respiratory diphtheria in adults. Here we are presenting our case and a review on laryngopharyngeal diphtheria in adults. [ABSTRACT FROM AUTHOR]

Objective: Hearing loss as a complication of diabetes is a debatable issue with a handful of contradictory studies. The objective of the present study was to evaluate the status of hearing in patients with type 2 diabetes mellitus and to correlate the severity of hearing loss with the duration of diabetes mellitus. Methods: This is an observational cross-sectional study which was done at a tertiary care teaching hospital over a period of 12 months. Two hundred consecutive type 2 diabetic patients in the age group between 18 and 60 years were enrolled. Patients were subjected to blood sugar levels, glycosylated hemoglobin, and pure tone audiometry. Possible confounders for hearing loss were excluded. The chi-square test was applied and P < .05 was considered significant. Results: The average age of the patients was 47.18±8.65 years with a male to female ratio of 1.19: 1. The mean duration of diabetes was 5.60±4.15 years. Out of 200 patients, hearing loss was observed in 55%. The prevalence of sensorineural hearing loss was 50%. Higher frequencies (4 kHz-8 kHz) were most affected. The association of fasting blood sugar and HbA1c levels with hearing loss was significant while no association was observed between the duration of diabetes and hearing loss. Conclusion: The study confirmed hearing loss in almost half of the diabetic patients while no association was observed between the duration of diabetes and hearing loss. It is recommended that the audiological screening must be included in the initial evaluation of the diabetic patient to detect and prevent further hearing loss. [ABSTRACT FROM AUTHOR]

Introduction: Ultrasonography (USG) is considered as the primary imaging modality for confirmation of ovarian mass and to differentiate them in to benign or malignant. Aim: The present study was conducted with the aim to evaluate accuracy of B- mode USG and Doppler scan (Colour Doppler + Spectral Doppler) for ovarian lesions. Materials and Methods: The patients included in the study were from those referred with either palpable adnexal mass or incidentally detected adnexal masses. Total 250 women were evaluated by USG, Doppler scan. Only fifty patients who had true ovarian mass intraoperatively and on histopathology were included in study, rest masses were excluded. Study parameters were morphological indexing on B- Mode USG, flow study, vessel arrangement, and vessel morphology and vessel location in Colour Doppler and resistive index and pulsatility index in spectral Doppler. Results: Total 50 women were included in present study. Out of these 46% were pre-menopausal while 54% were menopaused women, 66.7% of post-menopausal women had malignant ovarian masses compared to 8.7% of premenopausal. Sensitivity, specificity, positive predictive value and negative predictive value of B-Mode USG for ovarian masses were 94.44%, 48.15%, 54.84% and 92.86% respectively, with p-value = 0.007, while sensitivity, specificity, positive predictive value and negative predictive value of Doppler scan were 85%, 90%, 85% and 90% respectively, with p-value = 0.0001. Conclusion: USG and its different techniques are accepted as the primary imaging modality for early stage diagnosis of an ovarian malignancy. Statistical analysis suggests that Doppler Scan (Colour + Spectral) was more accurate (88%) than B-Mode USG (67%), but author is in view that both of these modalities should be used in conjunction to screen the ovarian lesions. [ABSTRACT FROM AUTHOR]