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BACKGROUND Pre-examination stress is a common condition faced by the students prior to exams and is emerging as a major health problem, especially in medical students. The present study was undertaken to evaluate the effect of pre-examination stress on autonomic functions like pulse rate and blood pressure in the first M.B.B.S. students. MATERIALS AND METHODS The study group consisted of 100 medical students studying 1st M.B.B.S. in Andhra Medical College, Visakhapatnam. Among them, 45 students were males, 55 students were females. Their arterial blood pressure and pulse rate were measured one month prior to examination and again one week before examination. The data was analysed using student’s paired ‘t’ test. RESULTS In the present study, the results were consistent with early clinical studies reporting that there is increase in pulse rate, systolic blood pressure, diastolic blood pressure, one week before examination compared to values of one month before examination. CONCLUSION Majority of the students were under stress prior to examination. Stress produced a significant increase in the pulse rate, systolic blood pressure and diastolic blood pressure among the students. Relaxation techniques like meditation, yoga, breathing exercises, appropriate diet and physical exercises can be recommended to students.

BACKGROUND Hearing impairment is one of the commonest congenital disabilities in the world. The prevalence of congenital hearing loss has been estimated to be 1.2-5.7 per 1,000 live births and is more among high risk neonates. Screening is one of the most important methods for early diagnosis of hearing loss. Otoacoustic emission is an easy, cost effective and reliable method of testing of large number of infants for hearing loss. The present study emphasizes the use of otoacoustic emissions as a screening tool to detect hearing loss that would otherwise go unnoticed till 2-3 years. MATERIALS AND METHODS This descriptive study was conducted on 1000 neonates during the period August 2015 to August 2016. Neonates were selected from the department of Paediatrics, the department of Obstetrics and OPD of ENT of Konaseema Institute of Medical Sciences, Amalapuram, Andhra Pradesh. Neonates between 24-72 hours of age were screened with DPOAE. Those who failed the first DPOAE screen were subjected to a second DPOAE screening after 2 to 3 months. RESULTS Out of 1000 neonates, 0.9% had persistent failure with OAE test. The factors which had significant relationship with hearing loss include prenatal risk factors like foetal distress, eclampsia, maternal infection, low birth weight, ototoxic drugs. Data was statistically analysed by McNemar’s test and Chi-square test. CONCLUSION The two staged screening protocol with Distortion Product Otoacoustic Emission was found to be a useful tool in detecting hearing loss in newborn. It is important and logical from the point of health and economy that the screening tests should become necessary for all neonates.

BACKGROUND Thyroid carcinoma is overwhelmingly the most common type of endocrine malignancy. Clinically-recognised thyroid carcinomas constitute less than 1% of all malignant tumour. Improvements in diagnostics and understanding the pathophysiology have made the treatment more effective with good long-term results. The aim of the study is to study the clinical pattern, behaviour and management of carcinoma of thyroid. MATERIALS AND METHODS 50 patients of histopathologically-proven thyroid cancers treated during the period of 2 years from May 2006 to May 2008 were studied. Detailed history and physical findings were noted along with the investigations and treatment given. RESULTS Thyroid carcinoma formed 1.5% of all cancers treated during the period. It formed 17.45% of all thyroid swellings admitted for treatment during the same period. The ratio of female-to-male in this study was 2.9:1. Most of the cases of carcinoma (82%) were seen in the 21-50 years age group. All patients in this study had a goitre and 20% of patients presented with lymphadenopathy and hoarseness of voice. Fine-Needle Aspiration Cytology (FNAC) was the common diagnostic test done. Total thyroidectomy was the most common surgery done and papillary carcinoma was the most common histopathology seen. Transient hypocalcaemia was the most common postoperative complication seen in 20% of patients. CONCLUSION Thyroid cancers affect young adult females presenting as slow growing tumours. Majority of the tumours are papillary type in the early stage with good prognosis. FNAC is a simple test to detect cancer and total thyroidectomy is the procedure of choice for treatment.

BACKGROUND Myringoplasty is the surgical procedure performed for the closure of perforations of pars tensa of the tympanic membrane. Various graft materials are used such as temporalis fascia, periosteum, perichondrium, vein, dura and adipose tissue (fat). Fat myringoplasty is a simple, cost effective and outpatient procedure. This study is performed to evaluate the operative outcome of fat myringoplasty in patients with Chronic Suppurative Otitis Media (CSOM). The aim of the study is to assess graft uptake to assess hearing improvement and to assess the operative outcome in relation to the site of perforation after fat myringoplasty. MATERIALS AND METHODS This study was performed in Government ENT Hospital, Andhra Medical College, Visakhapatnam. A total of 20 patients between the age group of 18-50 years suffering from tubotympanic type of chronic suppurative otitis media were taken up for study. The study period was for 18 months from October 2015 to March 2017. RESULTS Results were analysed in terms of graft uptake and hearing improvement. Average audiometric gain after 6 months was 10.58 dB. Successful closure of perforation was achieved in 90% cases. Perforations involving posterior quadrant showed 100% graft uptake, compared to anterior quadrant perforations, which showed 75% graft uptake. No major postoperative complications were noted. CONCLUSION Fat myringoplasty can be safely performed in dry, small central perforations of tympanic membrane especially belonging to posterior quadrant. Ear lobule constitutes convenient source of fat graft. The procedure can be performed as a day care surgery. Proper selection of cases is necessary to obtain good results.

BACKGROUND Canal wall down and canal wall up mastoidectomy represent two surgical approaches to middle ear cleft pathology. Much literature has been devoted to the merits and demerits of these two procedures. In terms of eradication of disease and hearing improvement, a prospective analytical study is done on canal wall up and canal wall down techniques in atticoantral type of CSOM. MATERIALS AND METHODS The study was carried out at Government ENT Hospital, Visakhapatnam, from June 2016 to June 2017. A total number of 250 patients with atticoantral variety of CSOM were included in the study and subjected to surgical treatment by canal wall up or canal wall down mastoidectomy along with tympanoplasty. RESULTS Results were analysed in terms of condition of cavity, condition of graft and gain in hearing. In patients who underwent canal wall up tympanomastoidectomy, there were 91.3% of graft take up and also improvement in hearing. In patients who underwent canal wall down tympanomastoidectomy, the outcome was excellent with 93.49% graft take up and 92.68% restoration of hearing. CONCLUSION Although, the statistical evidence of success is almost similar in both the procedures, yet canal wall down procedure provides maximum benefit to patients with low socioeconomic status and poor follow up in terms of eradication of disease and hearing improvement.

BACKGROUND The term sinusitis refers to a group of disorders characterised by inflammation of the mucosa of the paranasal sinuses. Anatomical variations are found to block the ostiomeatal complex and cause sinusitis. CT scanning is the standard imaging in the evaluation of paranasal sinuses. MATERIALS AND METHODS The present study was carried out in the Government ENT Hospital, Visakhapatnam, Andhra Pradesh and comprises of 107 cases of rhinosinusitis. The patients presenting with symptoms of sinusitis were randomly selected for the study. RESULTS The incidence of anatomical variations in CT scan study were- Concha bullosa ( 42.99%), Agger nasi cells (41.12%), Deviated nasal septum (34.60%), Paradoxical middle turbinate (10.28%), Haller cells (10.28%), Onodi cells (5.61%), Pneumatised uncinate (2.80%). CONCLUSION The high incidence of variations emphasises the need for proper preoperative assessment for safe and effective endoscopic sinus surgery.

The present study is undertaken to evaluate any association between BMI, WC and Blood pressure and any tendency to develop prehypertension. The study comprises of 100 medical students of NRI medical college, Sangivalasa near Visakhapatnam. It was carried out ongirl students with age of 17 ye ars. Their BMI, WC and Blood pressure were determined. The examination included measurement of weight, height of the student to determine BMI, measurement of waist circumference, and measurement of blood pressure by sphygmomanometer. In the present study t he results are consistent with early clinical studies reporting that there is elevated systolic and diastolic blood pressure with increasing BMI and waist circumference and there is tendency to develop prehypertension in students with higher BMI. Modificat ion of life style factors should be emphasized.