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Tuberculous infection of the oral cavity is an exceedingly rare clinical entity and it generally occurs secondary to pulmonary tuberculosis, with the gingival involvement as its only primary finding. Due to its rarity and atypical presentation this condition often gets misdiagnosed. We report here a case of secondary oral tuberculosis in a 44 year old male patient who presented with gingival involvement. The diagnosis was based on sputum examination, radiology of chest, montaux test and histopathology. Early diagnosis and prompt treatment is important for management of this clinical condition.

Background: Transcanal endoscopic ear surgery (TEES) permits wide-angle vision, high resolution, and magnification as well as the direct visualization of hidden areas of the middle ear cavity. The aim of the study was to determine the anatomic and functional results of endoscopic composite cartilage tympanoplasty in chronic otitis media cases with safe central perforation.Methods: This prospective study was conducted on 50 chronic otitis media cases with safe central perforation (small/medium) between February 2020 to July 2021 in a tertiary care center. All the patients were selected as per the described inclusion and exclusion criteria. All cases underwent endoscopic composite cartilage graft tympanoplasty (type-I) under general anesthesia. Audiological outcomes were assessed by comparing mean pure tone average pre-and post-operatively and morphological results (successful graft uptake) were evaluated at 6 months. Results: The result of this study showed that out of 50 cases 47 had successful graft uptake (94%) while 3 cases were found to have a residual perforation. The pre-operative air conduction threshold (ACT) was 42.82±7.33 dB whereas postoperative ACT was 31.26±7.48 dB, and the difference between the preoperative and postoperative values was found to be statistically significant. Conclusions: This study concluded that endoscopic composite cartilage tympanoplasty in chronic otitis media cases with dry central perforations is an effective surgical modality with good audiological and morphological outcomes and negligible post-operative complications.

The diagnosis and management of deep neck space infections remain a challenging task for otolaryngologists. A retrospective observational analysis of 137 cases of deep neck infections at a tertiary care centre was reviewed. We present 137 treated cases of DNSIs in a retrospective 5 years clinical study conducted in the department of otolaryngology at a tertiary care center from January 2012 to December 2016. Demographic information, Socio-economic data, etiopathogenesis, clinical presentation, spaces involved, diagnosis, and treatment strategies, associated morbidities, course and complications were analysed and compared with past experiences. Odontogenic and salivary gland infections causes were the most common source of DNIs. Major complication observed was skin defect. In this study, submandibular space infection was found to be the most common space involved in DNSI. Pain (100%) was the most common clinical complaint followed by neck swelling (65.69%). Staphylococcus aureus (38 cases) was the most common micro-organism isolated. Surgical intervention was the main modality of treatment and there was one mortality. DNSIs are fairly common challenging and potentially lethal entities which can lead to severe complications in a very short time, should there be delay in its prompt diagnosis and management. Computerized Tomography Scan (CT scan) with contrast is the investigation of choice in diagnosing DNSIs. Assessment of airway control must take precedence.

The aim of this analytical study was to assess the reduction in intra- and post-operative complications of parotid surgeries for benign lesions following simple surgical steps and to compare the outcome with the literature. A retrospective study of 77 patients requiring parotidectomy surgery for benign parotid lesions was conducted in Department of Otorhinolaryngology, Sri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun from the period of January 2011 to January 2016. Patients were followed up for 1–5 years and serial evaluation was done for all cases who developed any of intra- or post-operative complications in their disease course. The ages of presentation varied from 1.5 to 70 years. There were 51 males and 26 female patients. Majority cases were of pleomorphic adenoma followed by warthins tumor. Superficial parotidectomy was done in 69 patients; 4 cases required near total parotidectomy while total conservative parotidectomy was done in 4 cases. The commonest complication was altered sensations around the ear which was seen in 10 cases followed by temporary facial nerve paresis and sialocele formation which occurred in 3 cases each. This study advocates the importance of detailed anatomical knowledge, behavior of various benign pathologies, experience of surgeon and his fine dissection techniques to ensure minimum risks of injury to important structures in surgical field.

The field experiment entitled, “Influence of stage of harvesting and zinc application on yield and zinc uptake in cluster bean (Cyamopsis tetragonoloba L.)” was conducted during Kharif 2016 at Forage Research Farm, Agronomy Section, ICAR-National Dairy Research Institute, Karnal, Haryana. The experiment was laid out in split plot design with three replications. The main plot treatments comprised of four stages of harvesting [50, 60, 70 and 80 DAS] and under sub plot treatments four levels of Zinc application (Control, 10 kg ZnSO4, 20 kg ZnSO4 and 0.5 % Zinc spray at 30 DAS) were taken. The soil of the experimental field was sandy clay loam in texture with neutral pH, low in available nitrogen and zinc, medium in available phosphorus and higher in available potassium. The growth parameters viz. plant height, leaf length, number of leaves, stem girth and leaf: stem ratio were significantly higher at 80 DAS over other harvesting stages. In sub plot treatments application of zinc through zinc sulphate @ 20 kgha-1 significantly improved all growth parameters except stem girth over other treatments. Positive interaction effect was recorded between Stage of harvesting and zinc application for stem girth and plant height. Highest plant height was recorded under treatment combination of 80 DAS and zinc application @ 20 kg ha-1over other harvesting date and zinc level combinations. A significant increase in green fodder yield (GFY) and dry matter yield (DMY) was obtainedup to harvest at 80 DAS and zinc application @ 20 kg ha-1whereas significantly highest OM content was recorded at 50 DAS (Day after sowing). Maximum zinc uptake was noticed at 80 DAS stage and application rate of 20 kg ZnSO4ha-1 among other treatments.

Background: Coronavirus disease of 2019 (COVID-19) has made an imperishable haunting mark worldwide, and has changed in many aspects the way medicine had been practiced till now. This study is intended to highlight the approach that was followed in the department of ear, nose, and throat (ENT) learning from the existing available guidelines to provide safe routine and emergency ENT care to all the patients irrespective of the COVID status. Objectives of the study were to highlight the changes, challenges, triage and safety recommendations associated with patient management during the ongoing pandemic.Methods: This study conducted between 25th March 2020 to 15th September 2020 constitutes of following points covering various aspects of patient management such as education about personal protective equipment, the 3-station triage system starting from the patient’s entry in the hospital, general working and precautions at the ENT outpatient department (OPD) registration counter, medical consultation with otorhinolaryngologist in OPD or in ER, general precautions in endoscopy room/voice lab, and operation theatre, patient transport, and postoperative care. Results: A total of 8930 patients were seen from 25th March 2020 to 15th September 2020. 7885 patients were seen in ENT outpatient department, 561 in emergency room, and 484 patients were seen as referrals sent from other departments. 297 patients were advised admission for various surgical procedures whereas 22 patients were admitted for conservative management.Conclusions: Through this study, we suggest a paradigm consisting of safety and triage recommendations to be followed while dealing with patients in a way to minimise the cross transmission of virus.

Background: To highlight the changes, challenges, and safety recommendations associated with surgical management of a patient which were practiced effectively at our institute during the pandemic and share our experience.Methods: This retrospective observational descriptive study conducted between 25th March 2020 and 31st October 2020 constitutes of following points covering various aspects of surgical management of patient such as- general precautions followed by otrorhinolaryngologist while doing OPD surgical procedures, while doing endoscopy, in every major operative elective or emergency surgical procedure. This study also mentions focussed considerations for specialised surgical procedures like otology surgeries, endoscopic sinus and skull base surgeries, airway surgeries, tracheostomy, head and neck carcinoma etc. Results: Of the 342 cases operated between 25th March 2020 and 31st October 2020 during this pandemic, 69 nasal surgeries, 83 ear surgeries, 37 throat surgeries, 37 head and neck surgeries, 26 oesophagoscopies, 17 bronchoscopies, 63 tracheostomies, and 10 cases of maxillofacial trauma were performed. 983 patients were taken up for endoscopic examination of the mucosa of the head and neck in OPD as an office-based procedure.Conclusions: Through this study, we suggest a safety and recommendations procedural framework to be followed while managing surgical patients in a way to minimise the cross transmission of virus.

Background: The main objective of the study was to assess the anatomical and functional results of cartilage tympanoplasty using full thickness cartilage graft (with or without perichondrium) reinforced with fascia in high risk situations.Methods: This prospective non-controlled, non-randomized study included 124 cases of chronic otitis media who underwent cartilage (reinforcement) tympanoplasty (underlay) and ossicular reconstruction with or without mastoidectomy in following seven groups: revision cases, atelectatic cases, subtotal perforation (dry), larger anterior perforations (dry), tympanosclerosis, cholesteatomatous ear, and wet (discharging) ears . Graft success was accepted labelled as an intact graft at the end of six month postoperatively. At the same time, hearing results were also assessed by comparing pre- and post-operative pure tone average air-bone gap (PTA-ABG) of each group using Student “t” test and pResults: Anatomical success rate in this series was 94.36%. The overall mean pre- and post- operative pure tone average air-bone gap (PTA-ABG) were 31.33±10.41 dB and 19.55±12.04 dB, respectively and the difference was statistically significant (pConclusions: This study discusses the results of cartilage tympanoplasty in specifically indicated seven situation and reveals good anatomic results in each group (minimum success rate was 86.66% in wet ears) and statistically significant differences in mean pre- and post op PTA-ABG in groups except cholesteatoma and wet ear group.

Background: Tuberculous otitis media (TOM), a rare cause of chronic otitis media, is easily confused with nonspecific chronic otitis media owing to its unexpectedly changing and variable presentation, low suspicion and low prevalence which causes difficulty in its early diagnosis. The purpose of this study was to analyze its changing clinical pattern and to formulate an acceptable management protocol.Methods: This retrospective observational, descriptive study included 457 cases of Chronic otitis media who were operated between January 2017 to July 2020 in a tertiary care center. Histo-pathological examination of tissue from the middle ear and mastoid were sent and positive results were corroborated retrospectively to the clinical findings.Results: Diagnosis of TOM was established post-operatively in five cases (1.09%) with a positive histopathology report in four out of five cases and by polymerase chain reaction (PCR) in one case. Three cases (60%) presented with facial palsy and one with profound hearing loss (20%). All cases received 6 months course of anti-tubercular therapy postoperatively and were in regular follow up.Conclusions: Tuberculosis of the middle ear can present unexpectedly either as a complication or completely as a non-specific chronic otitis media. The extent of pathological findings might not be in commensuration with the clinical features. In operated chronic otitis media cases, specimen for histopathological examination must be sent in all cases and further specific microbiological investigations may as well be advised accordingly.

Aims and objectives Vocal cord palsy (VCP) can be definitely depicted on computed tomograpy (CT) scan by identifying key points at the level of true vocal cords and aryepiglottic folds. There are various VCP mimics and imaging shortcomings, and these can usually be circumvented by thoughtfully assessing the scan plan and level, and a diligent search for additional characteristics. Materials and methods This retrospective study consisted of 10 cases of unilateral VCP, who all had been clinically diagnosed of VCP and further evaluated by CT. Pre- and postcontrast enhanced axial CT from skull base to aorto-pulmonary window were done and multiplanar three-dimensional reconstruction of images in coronal and sagittal planes along with volume-rendered imaging was done. Results Most consistent findings in VCP were thickening of ipsilateral aryepiglottic fold and medialization of ipsilateral aryepiglottic fold (100%), followed by dilation of ipsilateral pyriform sinus (90%) and dilatation of ipsilateral laryngeal ventricle (80%). Etiologic causes were ascertained in three cases: Thyroid malignancy, tuberculosis, and pyriform sinus malignancy. The last etiology was probably a VCP mimic. Conclusion Radiologic evaluation is inarguably useful for determining the etiology of VCP, particularly for lesions within neck and thoracic cavity. Most crucial objective in assessing a case of VCP is to exclude the presence of a life-threatening primary lesion as the cause of VCP. How to cite this article Pandey AK, Gangrade S, Malhotra A, Varma A, Maithani T. Computerized Tomographic Assessment of Vocal Cord Palsy: Otolaryngologist's Purview. Int J Phonosurg Laryngol 2016;6(2):57-63.

Aim Palpable masses in the head and neck region can arise from various structures, such as lymph node, thyroid gland, major and minor salivary glands, soft tissues, blood vessels, and neural structures. Fine needle aspiration cytology (FNAC) is a simple, quick, inexpensive first-line method to evaluate such swellings and thus confirm the diagnosis. This study correlates aspiration cytology as an indispensable tool in diagnosing various head and neck swellings and their prevalence with respect to age, sex, site of origin, and nature of those masses. Materials and methods This study was done from January 2007 to December 2013 in the Department of Otorhinolaryngology and Department of Pathology. All the patients presenting with various head and neck swellings underwent FNAC, and the results were correlated with anatomical sites and frequency of occurrence and categorized into various clinicopathological groups. Results This study included 1,272 cases who were evaluated by FNAC for head and neck swellings. In this study, 32 patients presented with frank abscesses, 36 cases with submandibular region swellings, seven cases with submental swellings, 70 cases with various swellings in the neck and postauricular area, 47 cases with various facial and scalp swellings, two cases from oral cavity, 74 cases with parotid masses, 680 cases with lymphadenopathy, and 324 cases with thyroid lesions. Conclusion Fine needle aspiration cytology is a useful, reliable, cost-effective, and valuable diagnostic tool for the initial evaluation and diagnostic categorization of all superficial and deep-seated lesions in the head and neck region as it is a fairly sensitive and specific procedure in addition to being simple, rapid, accurate, and without any significant complications and above all without affecting the underlying tissue morphology altogether How to cite this article Pandey AK, Bhardwaj A, Maithani T, Kishore S, Singh VP. Distributive Analysis of Head and Neck Swellings with Their Cytopathological Correlation. Int J Otorhinolaryngol Clin 2016;8(3):89-96.

Objectives To evaluate the predictability of aditus patency in mucosal chronic otitis media (COM) with sclerosed mastoid using clinical and radiological tests. Study design Prospective study. Materials and methods Thirty-five cases of mucosal COM with sclerosed mastoid were taken for antrotomy with tympanoplasty. The preoperative evaluation of aditus patency was done using clinical examination, inflation deflation test for Eustachian tube function and high-resolution computed tomography (HRCT) temporal bone. The intraoperative patency was tested by water test. Results This study shows that there is statistically insignificant correlation between duration of discharge, tympanosclerosis and Eustachian tube function with aditus patency. There is statistically significant relationship between HRCT temporal bone and aditus patency (p < 0.0001). Conclusion High-resolution computed tomography temporal bone is a reliable predictor for aditus patency and we recommend routine use in sclerosed mastoid before all tympanoplasties for best results. How to cite this article Varma A, Maithani T, Agrahari AK, Pandey AK, Singh VP. Clinical and Radiological Predictability of Aditus Patency in Mucosal COM with Sclerosed Mastoid: An Analytical Study. Int J Otorhinolaryngol Clin 2015;7(3):121-124.

The present investigation was carried out to screen the dolichos bean genotypes for aluminium tolerance. The experiment was laid out in a factorial completely randomized design with 2 factors (20 genotypes with four aluminium concentration of 0, 15, 30, 45 mg of Al/kg soil) with three replications. Main effect and interaction effects were studied for vine length, root length, root tolerance index, root dry matter, shoot dry matter, leaf dry matter, total dry matter and extractable aluminium in soil at 4th week after sowing whereas the pod weight, pod length and yield were observed at harvesting stage. The genotypes and aluminium treatment showed significant difference for all the studied parameters. The interaction effect was also found to be significant for all the characters except for vine length. From the present study it was concluded that genotypes Pusa Sem 3, G2 and G4 were tolerant to aluminium toxicity upto 45 mg Al/kg as well as high yielding.

Thirty genotypes of chilli were evaluated in RBD with three replications at vegetable research farm, CHF, CAU, Pasighat, Arunachal Pradesh, India during kharif, 2011. Variability, correlation and path analysis were carried out to study the character association and contribution, respectively. Analysis of variance revealed significant differences among the genotypes for all traits. High PCV and GCV, heritability, genetic advance were observed for days to first flowering, plant height, number of seed per fruit, number of fruit per plant, ascorbic acid and fruit yield per plant. Correlation indicated that fruit yield per plant was positively and significantly correlated with number of branch per plant, number of fruit per plant and chlorophyll content while negative and significant association was established with ascorbic acid content. Maximum positive direct effect on fruit yield per plant was imposed by fruit weight, number of fruit per plant, number of seed per fruit and capsaicin content. DOI: http://dx.doi.org/10.3329/bjb.v43i3.21600 Bangladesh J. Bot. 43(3): 283-291, 2014 (December)

Kartagener’s syndrome is a rare congenital disorder consisting of sinusitis, bronchiectasis with situs inversus and is associated with infertility. It is the subgroup of disorder called primary ciliary dyskinesia in which well defined morphological or functional abnormalities of cilia result in sinopulmonary involvement with varying severity. Clinical manifestations involve chronic and/or recurrent respiratory infections with much heterogeneity in multisystem involvement. Early diagnosis and management of this condition help to prevent irreversible lung damage and prevent chronic lifelong sequelae.

Present study was carried out to screen the cowpea genotypes and to determine the effect of different level of aluminium on morpho-physiological, growth, yield and quality attributes. Twenty cowpea genotypes with four aluminium levels i.e. 0, 20, 40, 60 ppm in three replications was investigated in factorial complete randomized block design. Individual main effect and their interaction effects were studied for plant height at weekly interval, biomass, number of nodule per plant, root length, shoot length, dry matter of root, shoot, leaf, total dry matter, number of pod per plant, pod weight, yield and seed protein content. Cowpea genotypes exhibited significant differences for all 13 observed traits. Aluminium treatment expressed significant differences for all the attributes under study except biomass per plant. However, interaction effect was found to be significant for all studied characters except plant height at all stages. Among the aluminium treatments; observed traits were performing better at 20 ppm of Al, whereas, pod yield and protein content were best under the control.

Aim To report a rare case of unilateral parotid agenesis with ipsilateral type I first branchial cleft anomaly. Material and methods A case study with special emphasis on the embryology, outlining the complex developmental process of parotid and branchial arches and highlighting the probable reason for development of such anomalies. Results The literature states that unilateral parotid agenesis is a rare entity with few reported cases occurring solely or in conjunction with other head and neck anomalies. In our attempts to find its association with first branchial cleft anomalies we found a single reported case of parotid agenesis with type II first branchial cleft anomaly; thus to the best of our knowledge this is first case of unilateral parotid agenesis with ipsilateral type I first branchial cleft anomaly. Conclusions Unilateral parotid agenesis is usually asymptomatic and is generally diagnosed when it occurs along with other head and neck conditions.

Aim: The aim of this study is to see the different functional gradings of Eustachian tube ventilatory function as assessed by Bortnick-Miller (B-M) apparatus in chronically diseased middle ears (dry cases) planned to undergo tympanoplasty and to correlate the results with the past experiences. Materials and Methods: This study consisted of 29 cases of chronic suppurative otitis media, inactive stage having central perforation. Tubal function was evaluated by B-M apparatus based on ability of tube assimilating the applied positive and negative pressure. Tubal opening pressure was noted after applying positive pressure while residual intratympanic pressure after 10 swallows was recorded after applying negative pressure. Results: This study revealed that results of tubal manometry in diseased ears cover a wide spectrum of normal function to partial/non-function. 51.72% of cases were able to equalize applied negative pressure, 41.39% partially equalizing, while 6.89% of cases were completely unable to equalize applied negative pressure. Conclusion: Our results of aspiration method with the help of BM apparatus explicitly suggest that tubal function in chronically diseased ears deviates from that of normal ears. It perpetually reflects that varied results of middle ear reconstructive surgeries could be anticipated in accordance with different tubal function gradings.

Aim : Pathophysiology of Eustachian tube significantly affects the result of middle ear reconstructive surgery. The aim of this study is to ascertain the relevance of preoperative assessment of tubal function on the results of myringoplasty and to correlate the outcome of surgery with the tubal function gradings. Materials and Methods : A total of 58 cases of dry central perforation of tympanic membrane were divided into two groups. In control group A, pre-operative Eustachian tube function was not checked. In Test group B, pre-operative Eustachian tube function was checked by modified inflation-deflation test using impedance audiometer. Results : Success was assessed at 4th month postoperatively on the basis of intact drum. The results between both groups were compared using Chi-square test. There was no statistically significant difference (P< 0.05) between the control and the test group. Conclusion : The capability to reduce an applied negative pressure correlates well with the successful result of a tympanic membrane graft. However, failure to equilibrate negative pressure does not discriminate between success and failure of this operative procedure.