Search

Siddhartha Dutta,1 Rimple Jeet Kaur,2 Pankaj Bhardwaj,3 Jaykaran Charan,1 Sunil Kumar Singh Bist,4 Mohan Dan Detha,5 Tanuj Kanchan,6 Praveen Sharma,7 Sanjeev Misra8 1Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India; 2Department of Pharmacology, S. N. Medical College, Jodhpur, Rajasthan, India; 3Department of Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India; 4Medical and Health, Jodhpur Zone and COVID 19 Nodal Officer, Jodhpur District, Rajasthan, India; 5Block CMHO, Luni, Jodhpur and Medical Officer in Charge, COVID Care Centre, Boranada, Jodhpur, Rajasthan, India; 6Department of Forensic Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India; 7Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India; 8All India Institute of Medical Sciences, Jodhpur, Rajasthan, IndiaCorrespondence: Jaykaran CharanDepartment of Pharmacology, AIIMS, Jodhpur, Rajasthan, IndiaTel +919825219196Email dr.jaykaran78@gmail.comIntroduction: The COVID-19 pandemic has brought the entire world to a standstill. The disease is rapidly transmitting in the community. Imposed lockdowns due to the COVID-19 pandemic have effectively delayed the transmission in the community but the transmissibility in households needs to be explored. The aim of this study was to estimate the household transmission of COVID-19 and assess the factors affecting transmission.Patients and Methods: A cross-sectional study where the data were collected from a single isolation center, was conducted. Patients were contacted by phone. Information regarding number of COVID-19-positive cases in the family, their demographic details, along with number of rooms in their household was collected.Results: A total of 369 families of COVID-19-positive patients were contacted. Nineteen families with a single member were excluded. Out of 350 families with a total 2126 members, 480 (22.5%) were COVID-19 positive. Mean age was 30.12 years (± 14.39) and majority of them were males (68.9%). Majority of the cases (67.3%) were in the age group (19– 49 years). Mean rooms per person were 0.51± 0.20 (0.14 to 1.50). Mild negative correlation was seen between number of positive COVID-19 cases and rooms per person (r= − 0.138, p=0.008) while moderate negative correlation with number of family members and proportion of family members being COVID-19 positive (r= − 0.542, p≤ 0.0001).Conclusion: One in four family members got infected with COVID-19, they were majority males and in the working age group. Negative correlation of positive cases with number of family members and mild negative correlation between rooms per person and proportion of family member affected indicates some other factors may be responsible for household transmission than these factors.Keywords: COVID-19, household transmission, SARS-CoV-2, coronavirus, isolation

Nodular fasciitis, is a benign, pseudo sarcomatous proliferative lesion of the soft tissue, which is frequently misinterpreted as sarcoma, both clinically and microscopically. It is a reactive lesion composed of fibroblasts/myofibroblasts and most commonly found in extremities and trunk. NF has been described in the head and neck region in 10-20% of cases. Many pathologists do not consider NF in the differential diagnosis of soft tissue masses arising in the Head neck region. NF that occurs in otherwise healthy individuals usually presents with a history of rapid growth, and is commonly found in the upper extremities and on the chest and trunk. The importance of otolaryngologists being aware of the existence of this entity in this area of the body is stressed. It has a confirmed perfectly benign clinical course, and simple excision, as tissue-sparing as possible, is the treatment of choice. A case of NF over the neck in a 05-year-old female not associated with trauma who presented with a localized mass over her left neck is presented.

Aggressive fibromatosis (AF) is a locally aggressive infiltrative low-grade benign tumor that accounts for approximately less than 3% of all soft tissue tumors. In the head and neck region this tumor tends to be more aggressive and associated with significant morbidity. Aggressive surgery is a viable management option and may be successfully used as a single modality treatment, or in combination with radiotherapy. We report a rare case of AF in a 38 year old female, who presented with a painless mass over the left supraclavicular fossa, extending inferiorly into the thoracic inlet, which was excised successfully in toto with the help of cardiothoracic vascular surgeon (CTVS).

Adenoid cystic carcinoma is extremely rare tumour that accounts for approximately 5% of primary malignancy of external auditory canal. These tumours are related with a high risk of recurrences and significant morbidities from surgical management and adjuvant radiotherapy. Despite the aggressive management for these tumours, many patients succumb to distant metastasis, making overall prognosis of these tumours poor. Although ACC of EAC has been reported in 5th decade, but its occurrence in young patient is very rare. We report a rare case of ACC in a young 22 years old female, who presented with ear canal mass and ear pain. Biopsy suggested mass to be ACC. Patient underwent wide local excision followed by adjuvant radiotherapy.

Craniopharyngiomas are slow growing tumours arising from remnants of the craniopharyngeal duct and occupy the sellar region. The patients may remain asymptomatic for long duration or present with headache or visual disturbances. Surgery is the mainstay of the treatment. Traditionally these tumours have been removed by neurosurgeons through the cranial approach but the advent of nasal endoscopes has opened new avenues for ENT surgeons to treat such patients. We hereby present a case of craniopharyngioma who was successfully treated by Trans-nasal Hypophysectomy.

Malignant melanoma is one of the rare and highly aggressive diseases of the sinonasal cavity. High index of suspicion is required for diagnosis as the patient usually presents with non specific signs and symptoms. In the natural course of the disease, higher rate of loco regional recurrences and distant metastasis are seen making the overall prognosis of disease very poor. In reviewing the various treatment modalities used in the past, surgical resection of the tumour with postoperative radiotherapy is preferred one. Advances in surgery, radiotherapy and chemotherapy don’t have any impact on improved survival, which remains poor in this disease. We report two cases of malignant melanoma, which were treated at our institute.

Primary non-Hodgkin’s lymphomas (NHL) of the sinonasal tract are rather uncommon entities. Morphologically and radiographically, sinonasal lymphomas are difficult to distinguish from other malignant neoplasms or non- neoplastic processes. They have a variable presentation from fulminant destructive manifestations to chronic indolent type of disease and may mimic as carcinomas and invasive fungal infection respectively. We report a case of primary NHL involving sinonasal tract in elderly female, which was clinically and radiologically mimicking as sinonasal malignany and was proven as NHL on histological examination and confirmed by immunohistochemistry. A high index of suspicion, appropriate histopathological examination and immunohistochemistry is necessary to differentiate sinonasal lymphomas from other possibilities. Failure to do so may miss the diagnosis and delay appropriate treatment

Rhinolith is an uncommon nasal mass in children and adolescents. We report a 8 years old boy with a history of long standing foul smelling right sided nasal discharge, progressive nasal obstruction and recurrent epistaxis, which was clinically suspected as being due to the presence of a long standing foreign body. Rhinolith in the right nasal cavity was diagnosed on rigid endoscopic examination. Rhinolith was removed by using a 00 rigid nasal endoscope.

Nasopharynx is an exceptionally rare anatomical location for foreign body impaction. We present a rare case of nasopharyngeal foreign body (NFB) in a 7 years old child. The diagnosis was confirmed by nasal endoscopy. Immediate removal of foreign body (FB) in the nasopharynx was performed under general anesthesia. This rare situation is potentially dangerous, since its dislodgment may cause fatal airway obstruction. Therefore, in all cases with missing foreign bodies in the aerodigestive system, nasopharyngeal impaction should be kept in mind and endoscopic examination of the region should be considered

People may be more likely to exercise if they have self-efficacy for exercise (SEE). We conducted an exploratory analysis of SEE using data from a clinical trial designed to increase physical activity (N = 340). We evaluated correlates of baseline SEE and the relationship between baseline SEE and physical activity. Low SEE at baseline was correlated with lower well-being, physical activity, and higher depression at baseline. Participants with high (vs. low) baseline SEE had higher physical activity (but no differential change in activity) over time. These data highlight the potential role of SEE in psychological health and physical activity.

Discharging sinus in upper eyelid is one of rare manifestations of tuberculosis. The present report describes the youngest case of tubercular dacryoadenitis in an otherwise healthy child. A 4 year old male patient presented with discharging sinus in upper eyelid that developed after a spontaneously burst abscess in upper eyelid. Pus culture was sterile and the child did not improve with antibiotics. The child subsequently developed superotemporal orbital swelling and along with discharging sinus. Debridement and curettage of the necrotic tissue and sequestrum were done, histopathology showed the chronic granulomatous inflammation consistent with tuberculosis. The patient was managed with anti-tubercular therapy for 6 months. Atypical presentations of tuberculosis like discharging sinus in eyelid pose a difficult problem in diagnosis particularly in a young child. Spread of tubercular bacilli to the lacrimal gland is more commonly hematogenous or may occur directly from conjunctival tuberculosis and rarely from direct inoculation during trauma. This case report presents unusual development of tuberculosis with no other local or systemic focus of tubercular infection and any direct trauma. Tuberculosis should be kept as a possible differential diagnosis in cases of painless lid swelling, especially in a country like India where tuberculosis is endemic.

Histoplasmosis is a rare tropical disease caused by Yeast-like dimorphic fungus Histoplasma capsulatum.Granulomatous diseases caused by infectious agents are being encounted more frequently nowadays. Infection by histoplasma capsulatum is one such granulomatous disease. In non-endemic areas, histoplasmosis poses a diagnostic challenge, especially since the presenting lesions can mimic carcinoma. The clinician should keep in mind histoplasmosis as a differential diagnosis when dealing with granulomatous lesions of oral cavity, oropharynx and larynx in both immunocompetent and immunocomparised patients. The histopathologist must be informed about the possibility of histoplasmosis, because special dyes have to be used to confirm this diagnosis. The treatment is mainly medical with Amphotericin B which remains the gold standard for treatment of this disease. The rarity of this disease in this part of country and variable clinical presentation prompted the authors to report this case.