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ABSTRACT Objective Methods Results Conclusions The purpose of this work is to synthesize the latest developments in diagnosis and management of acute and late dysphagia and dysphonia in oral cavity cancer.A literature search was conducted using PubMed, Web of Science, Embase and Google Scholar in May 2024 of articles published between 2021 and 2024. Keywords in the search terms included oral cavity cancer, dysphagia, dysphonia, deglutition, swallowing, voice, oral cavity cancer treatment, oral cavity radiation, chemotherapy, dysgeusia, xerostomia, swallow preservation.Twenty‐seven pertinent studies fit the inclusion criteria. The most common dysphagic complaints following head and neck cancer are trismus, xerostomia, mucositis and dysphagia. Dysphonia, change in voice is reported by half of head and neck cancer survivors. Fibrosis and neuropathy following radiation therapy to the oral cavity, tongue, oropharynx and its surrounding structures is the most common etiology of post‐treatment dysphonia.Oral cavity cancers cause speech and swallowing dysfunction due to both anatomic and post‐treatment changes. These sequalae can be detrimental to the quality of life of the head and neck cancer survivor. For both dysphagia and dysphonia after head and neck cancer early speech and swallow therapy with a Speech Language Pathologist are essential to restoring and maintaining function. [ABSTRACT FROM AUTHOR]

Background and Aims: Anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines have the potential to alter several biological systems concurrently with remolding the immune system, most of which are related to immunization, while some others are known as adverse effects. This review aims to explore the potential effects of vaccination on the oral microenvironment and classifies them as good, bad, or ugly, with a brief review of facial diseases following coronavirus disease 2019 (COVID‐19) vaccination. Methods: This study was a comprehensive review conducted through searching related articles in Medline, Scopus, and Google Scholar databases. Results: On one side, the "Good" impacts of vaccination on the oro‐nasal mucosa are explained as if the mucosal immune responses followed by SARS‐CoV‐2 vaccines are enough to provide immunity. On the other side, the possible "Bad" and "Ugly" effects of the vaccine, which manifest as orofacial adverse events and autoimmune reactivations, respectively, should be noted. Exacerbation of pre‐existing autoimmune conditions such as lichen planus, pemphigus vulgaris, bullous pemphigoid, and Stevens‐Johnson syndrome have been reported. Conclusion: COVID‐19 vaccines could affect different biological systems alongside stimulating the immune system, and some of these effects are referred to as adverse effects. Nonetheless, these adverse effects are treatable, and healthcare professionals should not prevent patients from taking the first available vaccination. [ABSTRACT FROM AUTHOR]

Abstract Background and Aims Anti‐severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) vaccines have the potential to alter several biological systems concurrently with remolding the immune system, most of which are related to immunization, while some others are known as adverse effects. This review aims to explore the potential effects of vaccination on the oral microenvironment and classifies them as good, bad, or ugly, with a brief review of facial diseases following coronavirus disease 2019 (COVID‐19) vaccination. Methods This study was a comprehensive review conducted through searching related articles in Medline, Scopus, and Google Scholar databases. Results On one side, the “Good” impacts of vaccination on the oro‐nasal mucosa are explained as if the mucosal immune responses followed by SARS‐CoV‐2 vaccines are enough to provide immunity. On the other side, the possible “Bad” and “Ugly” effects of the vaccine, which manifest as orofacial adverse events and autoimmune reactivations, respectively, should be noted. Exacerbation of pre‐existing autoimmune conditions such as lichen planus, pemphigus vulgaris, bullous pemphigoid, and Stevens‐Johnson syndrome have been reported. Conclusion COVID‐19 vaccines could affect different biological systems alongside stimulating the immune system, and some of these effects are referred to as adverse effects. Nonetheless, these adverse effects are treatable, and healthcare professionals should not prevent patients from taking the first available vaccination.

The nature of association between chronic otitis media (COM)-mucosal disease and sensorineural hearing loss is controversial. Identifying the risk factors which influence the bone conduction threshold in these patients can help the clinician in counselling the patients for surgery at the earliest to achieve optimum hearing outcomes. The present study was undertaken to determine the association between COM-mucosal disease and cochlear dysfunction. The study also aimed at identifying the determinants and their influence on the bone conduction thresholds of the diseased ear. In this study, 72 patients with unilateral chronic otitis media—mucosal disease were enrolled consecutively. All patients were enquired in detail about their presenting ear symptoms. All the patients underwent a pure tone audiogram in a sound treated room. Patients were categorised into two groups according to the presence of conductive hearing loss only or with a sensorineural component. The bone conduction thresholds were calculated and compared for frequencies at 0.5, 1, 2 and 4 kHz. The average hearing threshold for air conduction and bone conduction were calculated across 0.5, 1 and 2 kHz. Bone conduction threshold more than 20 decibels (dB) in any of the frequencies were considered significant and indicative of having sensorineural hearing loss component. The contralateral healthy ear served as control to cancel out the confounding factors such as presbyacusis, noise induced hearing loss, congenital hearing loss, etc. Multivariate linear regression models were used to evaluate the relationships between bone conduction thresholds and chronic otitis media-mucosal disease. In the present study, 18.05% of participants had a sensorineural component. The difference between the bone conduction threshold in the diseased ear and normal ear ranged from 5.41 dB at 0.5 kHz to 3.77 dB at 4 kHz (p < 0.001). Bone conduction thresholds at 4 kHz were greater than that for speech frequencies (p < 0.5). 84.6% of participants with sensorineural component had a disease duration of less than 5 years and the remaining 15.4% had a duration of greater than 15 years. There was no statistically significant difference in the incidence of sensorineural component based on the site of the perforation (p = 0.341). 21.9% of participants who used topical antibiotic drops developed a sensorineural component, while 15% of participants who did not use antibiotic ear drop preparation developed a sensorineural component. Multivariate linear regression analysis revealed that increasing age was the only factor associated with increase in bone conduction thresholds of the diseased ear (p = 0.002). Chronic otitis media- mucosal disease appears to be associated with higher bone conduction thresholds, signifying cochlear dysfunction. A statistically significant higher bone conduction thresholds are seen across 0.5 to 4 kHz in the diseased ears compared to the normal ears, signifying the vulnerability of the inner ear against chronic otitis media. In our analysis increasing age is the most significant predisposing factor associated with higher bone conduction thresholds. Higher frequencies are more affected than lower speech frequencies. Sensorineural hearing loss can occur early in the disease process and early surgical intervention in COM—mucosal disease is recommended to prevent increase in bone conduction thresholds and achieve optimum hearing outcomes. [ABSTRACT FROM AUTHOR]

Sensorineural hearing loss is relatively well established in the squamosal chronic otitis media. However, its association with mucosal COM is still debated. The present study aimed at evaluating the prevalence of sensorineural hearing loss in unilateral mucosal COM. The study was conducted at a tertiary care hospital in New Delhi, and 60 patients with unilateral mucosal chronic otitis media were recruited. Pure tone thresholds were ascertained for air and bone conduction in an acoustically treated room and matched against certain patient and disease characteristics. In this study, the combined prevalence of SNHL/Mixed Hearing loss in mucosal COM was found to be 8.3%. A statistically significant association between SNHL/Mixed HL was seen in the 40–50-year age group (p-0.004). Prevalence with a disease duration of more than 10 years was 33% (p-0.019). All the patients who presented with SNHL/Mixed HL had an actively discharging ear. 80% of the patients who presented with SNHL/Mixed HL had large perforations. SNHL/Mixed HL prevalence of 28.6% was found in smokers, compared to 5.7% in non-smokers (p-0.039). The risk of developing SNHL/Mixed HL increased with increasing patients' age, disease duration, and size of the perforation and smokers. [ABSTRACT FROM AUTHOR]

Lichen planus (LP) can affect multiple body sites including skin, mucosae, scalp and nails, causing considerable impact on patients' quality of life. Currently, there are no LP patient-reported outcome measures (PROMs) that address all body sites potentially affected by LP. We developed a LP Quality of Life Questionnaire (LPQoL), informed by an expert consortium and patient survey study, to address this gap. The study was approved by our institution's Institutional Review Board. First, a 22-item LPQoL was designed with input from LP experts at our institution. The tool was then optimized by garnering input from patients recently diagnosed with LP, who were asked to complete the LPQoL, as well as the Dermatology Life Quality Index (DLQI) and a feedback form about the LPQoL. Fifty-eight of 150 patients (39% response rate) returned the questionnaire. Mean DLQI score was 4.9 ± 5.6 SD (range 0–25) and mean LPQoL score was 13.6 ± 10.4 SD (range 0–54). LPQoL score was positively correlated with DLQI score (r = 0.79; p < 0.001). Forty-nine out of 56 (88%) and 6/56 (11%) rated the LPQoL as 'very easy' or 'fairly easy' to complete, respectively. Based on participants' feedback, we increased the recall period from one week to one month and added questions on esophageal involvement. With iterative input from LP experts and patients, we developed a LPQoL to address the gap in a multi-site PROM specific to LP. This is a pilot study and there is ongoing validation studies; therefore, this measure should not be used in clinical practice or research until validated. [ABSTRACT FROM AUTHOR]

Background: Chronic otitis media is a condition commonly presenting with tympanic membrane perforation and resulting in conductive hearing loss. The aim of the study was to assess the relationship between the site and size of tympanic membrane perforation with the degree of hearing impairment in patients with inactive chronic otitis media of mucosal type. Methods: Hospital based cross sectional study of 174 patients with tympanic membrane perforation at government medical college, Alappuzha from November 2017 to March 2019. Patients were enrolled based on history and clinical examination findings. Images obtained by otoendoscopy were analyzed by measuring the percentage area of membrane perforation in relation to total area of the tympanic membrane using adobe acrobat area tool. Degree of hearing loss was calculated by pure tone audiometry test and calculating the average hearing thresholds at frequencies of 500Hz, 1000Hz, 2000Hz and 4000Hz. Results: The age distribution of patients ranged from 14 to 72 years with a mean age of 41.78years. Male to female ratio was 1.59:1. The degree of hearing loss increased as the size of the perforation increased which was statistically significant (p

COVID-19 vaccination, although is a promising tool to overcome the pandemic, has side effects. There are increasing reports of oral lesions after COVID-19 vaccination. The aim of this review is to identify the occurrence of some oral lesions after COVID-19 vaccination, and highlight the underlying immune mechanisms involved. A narrative literature review was performed by searching electronic databases including PubMed, Scopus and Web of Science to investigate the oral lesions after COVID-19 vaccination. The inclusion criteria were original studies, including the case reports, case series, letter to the editor, and cross-sectional studies. The exclusion criteria included the studies which examined the oral lesions caused by COVID-19 infection. The information, including the number of participant(s) receiving vaccine, type of vaccine, dose number, side effect(s), time of onset following vaccination, healing time, treatment strategies for the existing lesions, and related mechanisms were then summarized in a data extraction sheet. The results of this review showed that some vaccines had side effects with oral involvement such as pemphigus vulgaris, bullous pemphigoid, herpes zoster, lichen planus, Stevens-Johnson syndrome and Behçet's disease. Future research needs to elucidate the physiopathology of oral manifestations after the COVID-19 vaccination, and better understand the risk factors associated with such responses. Sometimes vaccine's side effects may be due to the nocebo effect, which means that the person expects some adverse events to occur following the vaccine administration.

This report describes a fatal case of mucosal disease in a two-year-old bull. For causal agent detection, scab, whole blood, and feces samples were tested by RT-PCR, PCR, ELISA, and viral isolation. RT-PCR positive amplification was obtained in blood samples for bovine viral diarrhea virus (BVDV). Viral isolation from the scab samples confirmed BVDV as the causative agent of the clinical manifestations. Subsequently, genetic characterization based on phylogenetic analysis of three partial sequences revealed the presence of BVDV subgenotype lb in analyzed samples. Due to the development of clinical manifestation named mucosal disease, these findings suggest the detection of BVDV persistently infected (Pl) bull; therefore, these results demonstrate the importance of establishing BVDV control programs that rely on testing the presence of PI in cattle from Mexico. [ABSTRACT FROM AUTHOR]

Abstract Objective Investigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)‐infected children undergoing highly active antiretroviral therapy (HAART). Materials and Methods Cross‐sectional study of 66 HIV seropositive children, comprised of 28 (42.4%) females and 38 (57.6%) males (average age of 6 years). Study participants all required data regarding CD4+ T‐helper cell counts and the viral load. All participants underwent an orofacial clinical examination by calibrated clinicians. Associations between the presence of oral mucosal lesions, CD4+ cell counts, and viral load were analyzed using Poisson regression. Results The prevalence of oral manifestations was detected in 21 children (31.8%). Oral lesions were detected in 16 children with viral load copies 500 cells/mm3. Predominant lesions identified included angular cheilitis (36.7%), candidiasis (13.3%) and atypical oral ulcers (13.3%). The presence of one lesion was the most prevalent represented by 19 children. Oral lesions in relation to the CD4+ counts >500 resulted in; 14 children with one oral lesion, 5 with two lesions and 3 with three oral mucosal lesions. The other half of this CD4+ count patient group presented with no oral mucosal lesions. Oral lesions in relation Viral load copies

Chronic otitis media is a disease developing due to Eustachian tube dysfunction secondary to any insult in nasopharynx which is likely to be bilateral with different stages of disease in both ear. The objective of this study was to examine contralateral ear through otoscopic, radiological and audiological study. Study was conducted between December 2018 and July 2020 in Otorhinolaryngology and Head and Neck Suregery Department. The Contralateral ear was defined as the ear with no tympanic membrane perforation and with no symptoms in patients of unilateral chronic otitis media. Otoscopy, Pure tone audiometry and HRCT temporal bone were done. Results were recorded and analysed. Descriptive stastical analysis was done using SPSS software version 22 of Windows 7. Grade1 pars tensa retraction which is most common abnormal finding in contralateral ear on otoscopy in both unilateral mucosal and squamosal COM patients. On otoscopy of contralateral ear 71.43% squamosal COM patients were having abnormal tympanic membrane. Hearing loss was seen in 25.71% patients of mucosal COM and 22.9% patients of squamosal COM patients. 17.1% patients of mucosal COM and 20% patients of squamosal COM show mastoid sclerosis of contralateral ear on HRCT temporal bone. Majority of patients with unilateral COM have initial findings of pathogenesis of COM in contalateral ear. These findings in contralateral ear are more common in patients with squamosal COM than patients with mucosal COM [ABSTRACT FROM AUTHOR]

Natural infections with HoBi‐like pestivirus (HoBiPeV) have been detected in cattle in South America, Europe and Asia with a range of clinical manifestations including fatal mucosal disease (MD). In India, although HoBiPeV in cattle has been reported, there is no information on currently circulating HoBiPeV strains and associated severe clinical disease. Between September 2018 and December 2019, suspected cases of bovine viral diarrhoea with severe disease in cattle were noticed in farmers' small holdings in Tamil Nadu State. To determine the extent of pestivirus infection, blood, serum, nasal or oral swab samples of 46 cattle from 18 villages were tested. Based on the real‐time RT‐PCR, antigen ELISA and nucleotide sequencing results, pestivirus was detected in nine cattle from eight villages in two districts and all pestiviruses were identified as HoBiPeV. All nine HoBiPeV‐infected cattle displayed clinical signs resembling MD and HoBiPeV isolates (n = 9) obtained were characterized at genetic and antigenic level. Phylogenetic analyses based on 5′‐untranslated regions (5′‐UTR), Npro and combined 5′‐UTR‐Npro gene sequences revealed that eight HoBiPeV isolates clustered into a clade, distinct from all reported HoBiPeV clades (a–d), whereas one belonged to HoBiPeV‐d clade, thus providing evidence of emergence of a novel HoBiPeV clade (e). This was also supported by HoBiPeV‐e clade‐specific amino acid substitutions in Npro and the antigenic reactivity patterns. The study demonstrates the existence and independent evolution of five HoBiPeV clades (four main clades) globally and surprisingly three exclusive to India. Also we confirm first HoBiPeV occurrence in southern India with predominant prevalence of HoBiPeV‐e strains. Besides demonstrating increased HoBiPeV genetic diversity, here we show association of HoBiPeV with severe clinical disease involving fatalities highlighting impact of HoBiPeV on cattle health. The emergence of a novel HoBiPeV lineage provides new insights on global HoBiPeV epidemiology and genetic diversity reiterating the need for continuous monitoring of HoBiPeV in India. [ABSTRACT FROM AUTHOR]

Objective: Investigation of the prevalence of oral mucosal lesions in human immunodeficiency virus (HIV)‐infected children undergoing highly active antiretroviral therapy (HAART). Materials and Methods: Cross‐sectional study of 66 HIV seropositive children, comprised of 28 (42.4%) females and 38 (57.6%) males (average age of 6 years). Study participants all required data regarding CD4+ T‐helper cell counts and the viral load. All participants underwent an orofacial clinical examination by calibrated clinicians. Associations between the presence of oral mucosal lesions, CD4+ cell counts, and viral load were analyzed using Poisson regression. Results: The prevalence of oral manifestations was detected in 21 children (31.8%). Oral lesions were detected in 16 children with viral load copies <50 cells/mm3 and 22 children with CD4+ counts >500 cells/mm3. Predominant lesions identified included angular cheilitis (36.7%), candidiasis (13.3%) and atypical oral ulcers (13.3%). The presence of one lesion was the most prevalent represented by 19 children. Oral lesions in relation to the CD4+ counts >500 resulted in; 14 children with one oral lesion, 5 with two lesions and 3 with three oral mucosal lesions. The other half of this CD4+ count patient group presented with no oral mucosal lesions. Oral lesions in relation Viral load copies <50 resulted in; 9 children with one oral lesion, 3 with two oral mucosal lesions and 4 with three oral mucosal lesions. The other half of this Viral load patient group presented with no oral mucosal lesions. No significant correlations were established between the presence of oral mucosal lesions and low CD4+ counts (p = 0.715) nor with high viral load counts (p = 0.638). Conclusion: HIV‐related oral mucosal lesions still presented in the participants despite management with HAART. Based on the results, CD4+ counts and viral load does not appear to be suitable markers of orofacial involvement in children. [ABSTRACT FROM AUTHOR]

Objective: To evaluate sinonasal anatomic variations on the paranasal computed tomography (CT) scans and to investigate association with sinonasal inflammatory mucosal disease. Materials and Methods: Between January 2019 and December 2019, paranasal CT scans of 279 adult patients were retrospectively analyzed. Patients data were obtained from medical and imaging records. On CT examinations, each anatomic variation was evaluated with respect to side and bilaterality. We investigated statistically coexistence between anatomic variations and presence of sinonasal inflammatory mucosal disease. Results: Our results showed high prevalence of sinonasal anatomic variations. The most common anatomic variation was nasal septal deviation (65.2 %), followed by concha bullosa (41.6 %)and septal spur (28.7 %). We found a statistically significant relationship between concha bullosa and sinonasal inflammatory mucosal disease (p=0.009) which was observed especially in bulbous (p=0.048) and extensive types(p=0.017). No significant association was noted with the other anatomic variations. Conclusion: Concha bullosa, particularly bulbous and extensive types have a tendency to cause sinonasal inflammatory mucosal disease. Key words: Sinonasal cavity, anatomic variation, computed tomography, mucosal disease, rhinosinusitis

Sensori-neural hearing loss (SNHL) results from inner ear damage or injury to the neural pathways that relay signals from the inner ear to the brain. A serious sequelae of COM is damage to the inner ear. This study aimed at finding the occurrence of SNHL in unilateral mucosal COM. One Hundred patients who had unilateral mucosal COM were enrolled in the study and underwent pure tone audiometry using Audio 4002 system in acoustically treated room. Bone conduction (BC) threshold less than 20 dB was taken as normal. Significant SNHL of 23% was seen in mucosal COM. Unilateral mucosal COM leads to significant impact on BC thresholds. The risk of SNHL increases with larger perforation size and increasing duration and active stage of disease. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to evaluate the relationship between personality traits and perceived treatment success in oral lichen planus. Material and methods: A total of 53 patients with diagnosed oral lichen planus were evaluated at the time of diagnosis and along the course of their treatment. The visual analogue scale (VAS) was used for evaluating pain and burning sensation, along with an evaluation of the oral health-related quality of life (OHIP) and the clinical severity. In order to determine the personality trait, the NEO-FFI questionnaire was applied. Data were assessed with the statistical software Stata by a multiple linear regression. Results: A significant relationship between the two personality traits: "conscientiousness" and "extraversion" and a perceived improvement in oral lichen planus could be observed. The higher the "conscientiousness," the better the perceived oral health-related quality of life. Furthermore, "extraversion" had a significant influence on the improvement in clinical severity index (P < 0.05). Conclusions: Personality traits, especially conscientiousness and extraversion, have a significant impact on the perception of therapeutic intervention in oral lichen planus. Clinical relevance: As personalized patient management is gaining importance and psychosocial factors play a significant role in mucosal diseases, the patient's psychological profile should be considered in the oral lichen planus management. [ABSTRACT FROM AUTHOR]

Summary: As our understanding of mycology progresses, the impact of fungal microbes on human health has become increasingly evident. Candida albicans is a common commensal fungus that gives rise to local and systemic infections, particularly in immunocompromised patients where it can result in mortality. However, C. albicans has also been quietly linked with a variety of inflammatory disorders, to which it has traditionally been considered incidental; recent studies may now provide new aspects of these relationships for further consideration. This review provides a novel perspective on the impact of C. albicans and its peptide toxin, candidalysin, on human health, exploring their contributions to pathology within a variety of diseases. [ABSTRACT FROM AUTHOR]

Background: We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC). Methods: The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as "high risk," those with one parameter higher were coded as "moderate risk", those with both parameters lower than the cutoff values were coded as "low-risk" patients. Results: The mean NLR and PLR values in the endoscopically active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p< 0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p< 0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease. Conclusions: This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC.

Background and Objectives: Prescription of acid supressive therapy (AST) for prophylaxis of stress-related mucosal disease (SRMD) in hospitalized patients is inappropriate in many cases. Therefore, this study was designed to determine the role of clinical pharmacist in optimizing prescription of these therapies. Materials and Methods: This quasi-experimental study was conducted on 101 patients admitted to the Nephrology Ward in Shafa Hospital affiliated to Kerman University of Medical Sciences. All patients with a length of hospital stay of more than 24 hours were included. In the pre-intervention phase, each patient was evaluated regarding the risk of SRMD and receiving or not receiving SRMD prophylaxis. In the second phase, the clinical pharmacist actively intervened for discontinuation of AST in patients at low risk of SRMD and initiation of AST in patients who were at high risk of SRMD but did not receive any medication. Finally, in each phase of the study, the number of patients who appropriately or inappropriately received prophylactic drug was reported. Chi square test was used to analyze data. Results: Fifty-seven and 44 patients were evaluated in the pre-intervention and intervention phases, respectively. The number of patients who inappropriately received prophylactic drugs significantly decreased from 37 patients (77%) in the pre-intervention phase to 6 patients (31.6%) in the intervention phase (p<0.001). Conclusion: Considering the effective role of the clinical pharmacist in this study, consultation with a clinical pharmacist for optimizing rational prescription of drugs for prophylaxis of SRMD in hospitalized patients is recommended. [ABSTRACT FROM AUTHOR]

Objectives: The objective of the study is to know the presence of biofilm-producing organisms in the middle ear mucosa in chronic otitis media (COM) mucosal disease and their antibiotic sensitivity. Materials and Methods: This was a prospective comparative study conducted on 100 patients who underwent tympanoplasty. They were divided into two groups: Group 1 included mucosal active disease (50) and Group 2 included mucosal inactive (50). During surgery, a biopsy from the middle ear mucosa was taken and sent for culture and sensitivity and tested for their biofilm-forming capability using tissue culture plate method. Results: In Group 1, 17 cultures were biofilm-producing organisms and 14 were non/weak biofilm-producing organisms. In Group 2, 14 were biofilm producing and 8 were non/weak biofilm producing. Piperacillin-tazobactam was the most sensitive drug for Pseudomonas aeruginosa, Klebsiella pneumoniae, and Staphylococcus epidermidis irrespective of their biofilm-producing capability. Linezolid had showed 100% sensitivity for Staphylococcus aureus. Ciprofloxacin was the most resistant drug irrespective of organisms and their biofilm-forming capability.Conclusion: P. aeruginosa and S. aureus are the common organisms present in the mucosa of the middle ear in COM. Piperacillin-tazobactam is the most sensitive drug for middle ear infection. The most resistant drug is ciprofloxacin. [ABSTRACT FROM AUTHOR]

The aim of the present study was to access success rate of tympanoplasty and complications with interlay technique of tympanoplasty. This Longitudinal Prospective study was carried out in the Department of Otorhinolaryngology and Head and Neck Surgery, Era's Lucknow Medical College, Lucknow. 50 patients aged between 10 and 50 years of chronic otitis media mucosal type disease with dry ears were selected. Otomicroscopic, tunning fork test, pure tone audiometry were done in all patients. All patients underwent interlay tympanoplasty. Patients were followed up regularly for a minimum period of 1.5 years. Successful graft uptake was noted in 48 (96%) cases. Interlay tympanoplasty results in excellent graft uptake and good post operative Air Bone Gap closure. [ABSTRACT FROM AUTHOR]

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Bovine viral diarrhea virus 1, reclassified as Pestivirus A, causes an economically important cattle disease that is distributed worldwide. Pestivirus A may cause persistent infection in that calves excrete the virus throughout their lives, spreading the infection in the herd. Many persistently infected (PI) calves die in the first 2 years of life from mucosal disease (MD) or secondary infections, probably as a consequence of virus-induced immune depression. Here, high-throughput sequencing (HTS) was applied for evaluation of the total virome in sera of (i) PI calves displaying clinically apparent MD (n = 8); (ii) PI calves with no signs of MD (n = 8); and (iii) control, Pestivirus A-free calves (n = 8). All the groups were collected at the same time and from the same herd. Serum samples from calves in each of the groups were pooled, submitted to viral RNA/DNA enrichment, and sequenced by HTS. Viral genomes of Pestivirus A, Ungulate erythroparvovirus 1, bosavirus (BosV), and hypothetical circular Rep-encoding single-stranded DNA (CRESS-DNA) viruses were identified. Specific real-time PCR assays were developed to determine the frequency of occurrence of such viruses in each of the groups. The absolute number of distinct viral genomes detected in both PI calf groups was higher than in the control group, as revealed by higher number of reads, contigs, and genomes, representing a wider range of taxons. Genomes representing members of the family Parvoviridae, such as U. erythroparvovirus 1 and BosV, were most frequently detected in all the three groups of calves. Only in MD-affected PI calves, we found two previously unreported Hypothetical single-stranded DNA genomes clustered along with CRESS-DNA viruses. These findings reveal that parvoviruses were the most frequently detected viral genomes in cattle serum; its frequency of detection bears no statistical correlation with the status of calves in relation to Pestivirus A infection, since clinically normal or MD-affected/non-affected PI calves were infected with similar U. erythroparvovirus 1 genome loads. Moreover, MD-affected PI calves were shown to support viremia of CRESS-DNA viral genomes; however, the meaning of such correlation remains to be established. [ABSTRACT FROM AUTHOR]

Background: We investigated the sensitivity of neutrophil to lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR), as well as a combination of NLR and PLR to predict endoscopic disease severity based on mucosal assessment in ulcerative colitis (UC). Methods: The study group consisted 104 patients with active UC, 104 patients in remission, and 105 healthy individuals. Disease activity was described with Rachmilewitz endoscopic activity index (EAI). Curve analysis was used to determine the optimal cutoff values of NLR and PLR for obtaining remission. The patients with both PLR and NLR values higher than the cutoff values were coded as »high risk,« those with one parameter higher were coded as »moderate risk«, those with both parameters lower than the cutoff values were coded as »low-risk« patients. Results: The mean NLR and PLR values in the endoscopi-cally active disease group were higher than the others, with higher values in the endoscopic remission group compared with the control group (p<0.001). Rachmilewitz EAI in high-risk patients was significantly higher than that in others (p<0.001). In Cox regression analyses, moderate and high risk, high erythrocyte sedimentation rate and high EAI were found as independent predictors of endoscopic active disease. Conclusions: This is the first study that investigated the use of NLR and PLR combination to assess endoscopic disease severity in UC. Either high NLR or PLR levels can predict active endoscopic disease. However, the use of these parameters in combination is more accurate in evaluating mucosal disease and inflammation in UC. [ABSTRACT FROM AUTHOR]

Introduction: Rectal resection after neoadjuvant chemoradiotherapy is the standard of care for rectal cancer. Non-operative management of rectal cancer is the new frontier. Selection of these patients is based on the absence of mucosal disease after neoadjuvant therapy. The question that is quintessential is whether absence of mucosal disease means absence of nodal disease. Aim: To see the correlation between absence of mucosal disease and mesorectal disease in rectal resections after neoadjuvant therapy for rectal cancer. Materials and Methods: A retrospective study was done on 479 patients of locally advanced carcinoma rectum from 2008 to 2015. All patients received neoadjuvant therapy which was mainly long course radiation therapy with 5040cGy over duration of 28 days with concurrent chemotherapy. Some patients underwent neoadjuvant chemotherapy. After an interval of approximately 6 weeks they underwent curative surgery. The patients who had complete pathological response were analysed in this study. Results: Out of the 479 patients, 76 patients were found to have no disease in the rectal wall. Only 1 patient (1.3%) had node positive disease without having any rectal disease (T0N1). The rest had no tumour either in the rectum or the mesorectal nodes. Thus, 75 patients had a pathological complete response (15.6%). Conclusion: In patients with rectal cancer undergoing neoadjuvant chemoradiotherapy followed by radical resection, absence of tumour in the rectum correlates well with absence of disease in the mesorectum and absence of nodal disease. Thus, absence of mucosal disease can be taken as marker of complete response to neoadjuvant therapy.

To compare the outcome of type I tympanoplasty with cortical mastoidectomy in chronic otitis media active mucosal disease (wet ear) versus chronic otitis media inactive mucosal disease (dry ear). An observational analytic study was conducted and data collection was done from August 2014 to August 2016. All patients of chronic otitis media with mucosal disease were divided into two groups, one with active disease (group A) and another with inactive disease (group B). The outcome was studied in the form of graft take up rate. Total 103 patients were studied, group A (wet ear) had 67 and group B (dry ear) had 36 patients. Graft take up rate was 94% in wet ear and 100% in dry ear and p value was 0.2. There was no statistically significant difference found between the two groups. [ABSTRACT FROM AUTHOR]

Bovine viral diarrhea virus (BVDV) belongs to the Pestivirus genus, which is further divided into subgenotypes (1a–1u and 2a–c). When persistent infection occurs, the calf will be immunotolerant to BVDV and possibly develop mucosal disease. This study describes an outbreak of BVDV-1d–induced mucosal disease lacking intestinal lesions. Eleven calves presented with anorexia, sialorrhea, lameness, recumbency, and death. Three calves were necropsied, showing ulceration of the interdigital skin and the oral and nasal mucosa; linear ulcers in the tongue, esophagus, and rumen; and rounded ulcers in the abomasum. Microscopically, mucosa and skin had superficial necrosis, with single-cell necrosis and vacuolation in epithelial cells, and severe parakeratosis. Immunohistochemistry (IHC) showed BVDV antigen in the cytoplasm of epithelial cells in skin and mucosa. All 11 dead calves were positive upon reverse transcription-polymerase chain reaction (RT-PCR) for the detection of Pestivirus along with another 11 live calves from the herd, which were positive again by RT-PCR and IHC after a 4-week interval. Sequencing of the 5′ untranslated region and N-terminal protease showed that viruses from these 22 calves were homologous and of subgenotype BVDV-1d. Cytopathic BVDV was isolated from 8 of 11 dead calves, but only noncytopathic BVDV was isolated from the 11 live animals. The findings indicate that this was an outbreak of mucosal disease caused by BVDV-1d, with high morbidity, and lesions restricted to the upper alimentary system and skin and absent from intestine. Thus, the epidemiological and pathological features in this form of mucosal disease may be similar to vesicular diseases, including foot and mouth disease. [ABSTRACT FROM AUTHOR]