Cavity Discharge Research Articles

Сочетанное использование свето- и фаготерапии у пациентов с гипертрофией глоточной миндалины

The adenoid hypertrophy is a fairly common pathology in children, which is steadily increasing. Objective. The assessment of clinical results of combined use of light and phage therapy in patients with pharyngeal tonsil hypertrophy. Patients and methods. The study is based on a clinical cases on 95 patients aged 3 to 7 years with pharyngeal tonsil hypertrophy of the 1st–2nd degree. The first group (49 people) received the treatment including irrigation of the nasal cavity and nasopharynx with isotonic NaCl solutions and local antibacterial therapy. The second group (46 people) received treatment according to the original method of combined use of light and phage therapy. Results. The combined use of light and phage therapy in patients with pharyngeal tonsil hypertrophy of the 1st-2nd degree statistically reliably helps to stop the typical symptoms of the disease, as well as other symptoms such as swelling of the mucous membrane and pathological discharge in the nasal cavity and nasopharynx. Conclusion. It has been clinically proven that light and phage therapy in patients with pharyngeal tonsil hypertrophy reduces the severity of symptoms and could be used in medical institutions with appropriate low-energy laser equipment, under the outpatient supervision of an otorhinolaryngologist and/or pediatrician at the local areas. Key words: hypertrophy of the pharyngeal tonsil, laser therapy, phage therapy

A Denoising Method of Partial Discharge Signal Based on Improved SVD-VMD

A denoising method combined with singular value decomposition (SVD) and Variational mode decomposition (VMD) is proposed to eliminate noise in on-site partial discharge (PD) signals from high-voltage electrical equipment. In the Fourier transform power spectrum, periodic narrowband interference was eliminated after SVD was offered to determine the number of singular values of periodic narrowband interference. Then, the PD signal was decomposed into K intrinsic mode function components by VMD. The empirical mode decomposition method was used to determine the K value of white noise’s intrinsic mode function components. An improved 3σ criterion threshold method was proposed to eliminate the residual noise in the PD signal. The denoising method was compared with the other two methods to analyze the denoising effect on the simulation and experimental PD signal. This paper’s denoising method can eliminate periodic narrowband interference and white noise in different PD signals of cavity discharge, corona discharge, and those from the motors’ coil. The denoised PD pulse waveform has a higher signal-to-noise ratio and normalized correlation coefficient and a lower mean square error, indicating that the waveform’s original characteristic remains.

UNILATERAL RHINITIS AND HEMOBARTONELLA FELIS INFECTION IN DOMESTIC CATS WITH A HISTORY OF CHRONIC KIDNEY DISEASE

Rhinitis is an inflammation of the mucous membranes of the nasal cavity, which can arise from a number of intranasal or systemic disorders. Hemobartonella felis is a gram-negative intracellular bacterium that attacks cat's erythrocytes. This treatment aims to discuss diagnostic and treatment techniques for rhinitis and Hemobartonellosis infection in cat with kidney failure. The animal is a local cat with a history of kidney failure, female, 6 years old and weighing 2.7 kg. The owner came with complaints of a serous discharge in the right nasal cavity and occasional sneezing. The cat has decreased appetite since 6 months and looks weak. Clinical examination showed swelling of the right mandibular lymph nodes and inspection of the oral cavity found gingivitis, tartar, and halitosis. Routine hematological examination results showed that the cat had macrocytic hypochromic anemia accompanied by thrombocytopenia. Examination of the blood smear preparations found coccoid formations with short chains or rod formations in the cat's erythrocytes which indicated a positive result for Hemobartonella felis. Case animal was diagnosed with unilateral rhinitis and Hemobartonella felis infection. The therapy given consisted of Doxycycline antibiotics at a dose of 10 mg/kg once a day for 14 days, anti-inflammatory Dexamethasone at a dose of 0.5 mg once a day for 5 days and Sangobion as a supportive therapy 1 capsule once a day for 10 days. The therapy given helps to improve the condition of the case animal. General check up of health conditions is required during the maintenance period.

O-054 Live Births following Laparoscopic Caesarean Scar Niche Repair in patients with Secondary Infertility: A Self-Controlled Case Series and Literature Review.

Abstract Study question Does laparoscopic repair of caesarean scar niches as a treatment for secondary infertility improve live birth rates? Summary answer In our self-controlled case series, the laparoscopic repair of caesarean section niches in patients with secondary infertility has improved pregnancy and live birth rates. What is known already A niche is an iatrogenic myometrial defect due to abnormal tissue healing at a previous caesarean section scar site. Patients with a niche present with symptoms of vaginal discharge, abnormal uterine bleeding, chronic pelvic pain, dyspareunia and secondary infertility. As a niche is secondary to caesarean sections, rising caesarean section rates will lead to an increase in the rate of niche presentation and diagnosis. Study design, size, duration A retrospective review was performed of all women undergoing a hysteroscopy assisted laparoscopic niche repair between 2016 and 2023 at Guy’s and St Thomas’ Hospital in London. The primary outcome measure was live births. A literature review was performed to interrogate the currently available evidence on live birth rate following niche repair. Ultrasound images of the niche prior to and post repair, as well as intra-operative laparoscopic and hysteroscopic images and videos, are also presented. Participants/materials, setting, methods The cases were identified from the Assisted Conception Unit database. Only women who presented with secondary infertility with a diagnosis and repair of a niche were reported. Niche diagnosis was made in patients presenting with abnormal discharge, bleeding and fluid in the uterine cavity. Any incidental myometrial defect found on transvaginal ultrasound was also a diagnostic characteristic. Main results and the role of chance There are some reports in the literature on pregnancy outcome following niche repair. A scarcity of studies reporting specifically on live birth rates following repair, suggests this case series as unique. Eleven patients underwent caesarean section niche repair by two surgeons at our unit. The mean age at repair of the patients was 36. All patients had two or more years of subfertility on presentation, with a proportion having several failed in-vitro fertilisation (IVF) cycles prior to repair. The pregnancy rate, clinical pregnancy rate and live birth rate were 73% (8/11), 64% (7/11) and 45% (5/11) respectively. One patient had an early miscarriage at age 48 following repair and has not conceived again since. One patient underwent a second repair and is awaiting further investigations. Two patients have not yet conceived following repair, one of which had sickle cell disease, age factor and endometriosis. Our findings suggest a positive correlation between surgical repair of the niche and live births. However, this could be due to a strict selection criteria in a small sample size. In the two patients that did not have live births following repair, other factors of subfertility such as age, male factor and comorbidities could also play a role. Limitations, reasons for caution The small sample size can lead to selection bias and impairs the external validity of our findings. The likelihood of random error is high. Lack of a control group prevents any comparisons. Furthermore, all repairs were performed by the two surgeons which introduces operator bias. Outcome assessors were not blinded. Wider implications of the findings Subfertility secondary to niches is likely to be a growing challenge as caesarean section rates continue to increase. Our study suggests that surgical repair may improve live birth rates. We present our findings to augment the current international data on live birth rates following niche repair. Trial registration number not applicable

Sphenochoanal polyp in a child presented with recurrent middle ear effusion: a case report

BackgroundSphenochoanal is a rare benign sinu-nasal lesion. It arises from the sphenoid sinus and passes to the choana then to the nasopharynx. It usually presents with nasal obstruction, discharge, snoring, and headache. It has been reported—only once in the English literature—to cause Eustachian tube dysfunction and middle ear effusion (MEE) in an adult male. In this report, we described an 8-year-old child with a sphenochoanal polyp presented with MEE.Case presentationAn 8-year-old boy was referred to us by his family physician with recurrent earache. Otoscopic examination showed MEE on the left side. Anterior rhinoscopy showed a thick grayish discharge in the left nasal cavity. Nasal endoscopic examination showed a polyp in the posterior part of the left nasal cavity obstructing the choana. Computed tomography revealed soft tissue density on the left sphenoid sinus extended to the choana and nasopharynx. Diagnosis of sphenochoanal polyp was established. Endoscopic sinus surgery with removal of the lesion and ventilation tube insertion in the left ear was performed. Histopathologic examination confirmed that the polyp was inflammatory. Follow-up for 1 year showed no recurrence.ConclusionsSphenochoanal which is a rare lesion in children could be a cause of Eustachian tube dysfunction and MEE. Nasal endoscopy and computed tomography are important for diagnosis. We recommend to list sphenochoanal polyp as a cause of Eustachian tube dysfunction and recurrent MEE in children.

Maxillary Aneurysmal Bone Cyst: About a Case

Introduction: Aneurysmal bone cyst (ABC) is a primary or secondary benign tumor, consisting of an intraosseous cavity, uni or multilocular, with hematic content. It can develop on all bones of the skeleton with, however, a predilection for the long bones and the spine. KOA mainly affects children and young adults, with a slight female predominance. Objective: The aim of this work is to reveal the diagnostic features at the imaging level. Case Report: This is an 11-year-old female patient with no previous pathological history who has presented for 1 year with diffuse maxillofacial pain, with intermittent fluid discharge in the oral cavity. Facial CT scan without and with contrast injection objective a lytic image centered on the lateral wall of the left maxillary sinus bulging into the sinus lumen with a spontaneously hypodense multicompartmental appearance without contrast gain after PDC injection. Conclusion: KAO is a very polymorphic lesion, which presents a diagnostic problem (Aspecific radiological appearance). In spite of the different therapeutic modalities proposed, it is the surgical treatment which exposes less risk of recurrence.

Оценка эффективности назначения репарантов у больных острыми риносинуситами

Introduction. In patients with acute rhinosinusitis (ARS), under the influence of external and internal factors, the final proliferative stage of inflammation is often disrupted, which necessitates the administration of drugs that regulate reparative regeneration at the site of alteration. Objective. To evaluate the effectiveness of local administration of reparative drugs for inflammation of the mucous membrane (MM) in patients with ARS. Materials and methods. The study was conducted with the participation of 138 patients with ARS (age 19–50 years), who were divided into 4 groups. Group No. 1 (n = 34) received standard anti-inflammatory treatment; in the comparison groups, additional local reparative drugs were prescribed: in group No. 2 (n = 36), sodium deoxyribonucleate solution; in group No. 3 (n = 34), dexpanthenol; in group No. 4 (n = 34), sodium hyaluronate. To assess the severity of disturbances in the regeneration of the ciliated epithelium of the nose, the regeneration index was assessed based on an analysis of the state of the inflammatory reaction of the mucus, mucociliary transport time (MCT), and disturbances in the crystallization of the solid phase of the nasal secretion (NS) obtained by the method of wedge-shaped dehydration. Patients were monitored upon presentation, on days 5, 10, 21, 30, 42, and 60. Results. In group No. 2, already on the 5th day, there was a statistically significant (p ≤ 0.05) decrease in purulent discharge in the nasal cavity in comparison with other groups; on the 10th day, patients with a mild degree of severity of the inflammatory reaction of the mucous membrane predominated in this group. Pronounced positive dynamics in the structure of the solid phase of the NS and a statistically significant improvement in MCT in the groups taking reparative drugs were noted already from the 21st day of observation. Even by the 60th day in group No. 1, 25 (73.5%) patients had a mild degree of regeneration impairment, which was significantly higher than in the comparison groups. Conclusions. When using reparative drugs in patients with ARS, there was a significantly faster improvement in MCT, normalization of the solid phase of the NS, and a decrease in the proportion of people with identified disorders of reparative regeneration.

Clinical case of rhino-orbital mucormycosis in a convalescent COVID-19 patient: diagnostic and treatment tactics

According to current data, SARS-CoV-2 virus has the ability to cause multi-organ pathology, leading to acute damage of various organs and systems and long-term consequences characterized by polymorphic symptoms. Recently, a high incidence of invasive mycoses, particularly mucormycosis COVID-M, has been noted among the COVID-19 complications. The predisposing factor for the development of this pathology is diabetes mellitus, immunodeficiency states, and prolonged use of high doses of glucocorticosteroids. Mucormycosis is characterized by severe clinical manifestations and high lethality, and timely diagnostics of this pathology often represents a difficult problem. The aim of this study was to analyze a clinical case of rhino-orbital mucormycosis in convalescent COVID-19 patient. In the study, there was used mucopurulent nasal discharge from the patient previously hospitalized with a severe novel coronavirus infection. Here, we describe the methodology allowing to isolate and identify a pure mold fungus culture from the biomaterial using methods of routine bacteriology and MALDI-ToF mass spectrometry. Direct microscopy examination of nasal cavity discharge revealed branched non-septic hyphae with a characteristic branching angle, allowing to preliminarily diagnose invasive mucormycosis. Growth of mycelial fungus colony was observed by using Sabourauds medium with potassium tellurite. Microscopy of the pure culture revealed branching mycelium without septa, broad, with irregular thickness, unsegregated hyphae, and sporangia with a typical column specific to mucormycetes. Analysis of the obtained mass spectra allowed to establish the microbial species identity as Lichtheimia corymbifera. The latter along with other members of the order Mucorales, are known to cause mucormycosis. As a result of antifungal treatment (Amphotericin B) and timely surgical intervention, the patient was discharged from the hospital with prominent clinical improvement and no complaints during further outpatient follow-up period. The analysis of this clinical case showed the lack of alertness in some clinical diagnostic laboratories to detect pathogens of invasive mycoses. To avoid errors, while making a diagnosis, attention should be paid not only to detection of fungal spores in clinical material, but also take into account the structure of mycelium underlying major difference between yeast-like fungi, higher and lower molds. The isolation and identification of a pure pathogen culture allows to confidently verify the diagnosis, timely correct the treatment tactics and monitor circulation of mycotic agents to prevent occurrence of mycoses in most vulnerable patients cohorts.

Clinical Staging for Accurate Preoperative Clinical Assessment of Patients with Nasopharyngeal Angiofibroma

Background: The location of the tumor and its accompanying symptoms, which include substantial epistaxis and nasal obstruction, cause the Nasopharyngeal Angiofibroma, a histologically and physiologically benign tumor with aggressive activity. Methods: The Otolaryngology & Head Neck Surgery division at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka carried out this retrospective cross-sectional study. The research was done in 2012, from February to November. 30 people made up the study's entire sample size. Result: The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. People living in rural area (53.33%) are more sufferers from nasopharyngeal angiofibroma. The majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. Maximum (90%) has varying degree anaemia at presentation. All patient has soft tissue mass in Nasopharynx, half of the patient has pterygopalatine fossa extension at presentation. Maximum (56.66 %) patient admitted with stage II nasopharyngeal angiofibroma. Conclusion: It is necessary to acquire preoperative clinical staging and imaging parameters from data of one of the largest NA case series.

Socio-demographic Characteristics of Patients with Nasopharyngeal Angiofibroma: A Cross-sectional Observational Study in BSMMU, Bangladesh

Background: A rare head and neck tumor that makes up about 0.5% of all head and neck neoplasms is the nasopharyngeal angiofibroma. They are benign, non-encapsulated, highly vascular tumors with a high incidence of persistence and recurrence from a histological standpoint, but they are also locally invasive tumors. Methods: This retrospective cross-sectional study was conducted by the Otolaryngology & Head Neck Surgery division at Bangabandhu Shiekh Mujib Medical University, Dhaka Medical College Hospital, and Shaheed Suhrawardy Medical College Hospital in Dhaka. The study was conducted from February through November of 2012. The total sample size for the study was 30. Result: The majority of individuals (54%) who have nasopharyngeal angiofibroma are between the ages of 16 and 20. The middle class people (40%) are more sufferers from nasopharyngeal angiofibroma. People living in rural area (53.33%) are more sufferers from nasopharyngeal angiofibroma. The majority of patients have similar symptoms such epistaxis, nasal blockage, nasal discharge, anemia, and masses in the nasal cavity. Conclusion: It is hypothesized that the affected patients' socioeconomic status and geographic location may have an impact on the biologic behavior of nasopharyngeal angiofibroma.

Performance Against Cavity Index and Discharge Coefficient between Broad and Sharp Crested Weirs

The purpose of this research is examining the performance of rectangular broad and sharp crested weirs in terms of cavity index and discharge coefficient. For this purpose, a computational fluid dynamics CFD code FLUENT is applied. Firstly, the code verified by applies on the experiments work of Hagre et al 1994 the results show excellent agreements between CFD and Hager et al 1994. Secondly the code applied on both broad and sharp crested weirs. The results demonstrate that broad crested weirs have a lower discharge coefficient than sharp crested weirs, implying that broad crested weirs have a lower ability to discharge flow than sharp crested weirs. While the cavity index of a broad crested weir is lower than that of a sharp crested weir, the risk of cavitation is lower for a broad crested weir. Finally, designers should use caution when deciding which type of crest to use in their designs.

Gastroduodenal Perforation in a Child With Sickle Cell Anemia: A Case Report

Objectives: Gastroduodenal perforation (GDP) is a rare cause of acute abdominal pain in children. Case Presentation: A 12-year-old boy presented with abdominal pain around the periumbilical and epigastric region on 7previous days. His familial history was significant for sickle cell anemia in the mother and minor thalassemia in the father. He had been diagnosed with sickle cell anemia at the age of 4 years and had received blood transfusion and hydroxyurea every month. At physical examination, a distended abdomen and decreased intestinal sounds were seen. Also, he had a history of cholecystectomy (for cholelithiasis). Fecal occult blood was detected, while no Helicobacter pylori antigen was present. Abdominal ultrasound examination revealed splenomegaly and evidence of free fluid. Surgical results showed bile discharge in the abdominal cavity, and perforation of duodenum and pylorus. Conclusions: Since the symptoms of GDP in children are non-specific, especially in children with sickle cell anemia, it should be considered in these patients with abdominal pain.

Study of electrophysical processes and aging of the material of highvoltage insulators to determine their working life

The article is aimed to discuss the results of research on the characteristics of partial discharges on defects of different types in high-voltage insulators - on dielectric rod and contact «terminal rod». The atypical characteristics of partial discharges in high-voltage insulators were analysed using an original method of determining their condition using a set of diagnostic parameters.METHODS. Experimental results are obtained by electromagnetic and acoustic methods of non-contact measurements of partial discharge characteristics.THE RESULTS of conducted studies are obtained circuits of electrophysical processes in dielectric cavities of defects at dielectric rod and contact «terminal rod» during one period of high voltage application. The circuit of electrophysical processes takes into account changes of the field induced by partial discharges in the defect cavity and on its dielectric surfaces.CONCLUSHIONS. The main conclusion is the fact that the developed scheme of generation of conventional and powerful partial discharges found confirmation in the model of the process of generation and subsequent distribution of primary discharge in the defect cavity. Under real conditions of partial discharge radiation in polymer and porcelain high-voltage insulators is more complex, so the first attempt to explain the generation of powerful partial discharges in real high-voltage power systems was made. The increase in the number of partial discharges and their intensity during the phase interval of 20° and the presence of powerful partial discharges are the main signs of defective high-voltage insulators.

Pathophysiology and clinical presentation of odontogenic maxillary sinusitis

This study aims to consolidate the emerging data regarding the pathophysiology and clinical features of odontogenic maxillary sinusitis (ODMS). A search of existing English literature was performed on Pubmed, and Scopus databases using the following keywords: “odontogenic sinusitis” and “maxillary sinusitis of dental origin”. A total of 56 articles were included in this study. Endodontic and periodontal infections are one of the most frequently mentioned causes of ODMS in the literature. However, newer studies suggest iatrogenic causes as the leading cause. Microbiological studies reveal that the most common anaerobic isolates are Peptostreptococcus spp, Fusobacterium spp, pigmented Prevotella, and Porphyromonas spp. Histological findings of the maxillary sinus mucosa demonstrate numerous papillary-like folds in the surface of the epithelium with an increased expression of TJ protein claudin-4, round cell infiltration, fibrosis, cystic degeneration, and mucosal hyperplasia. The most common symptoms are: unilateral purulent rhinorrhoea and foul smell/ taste. Patients may also have post nasal drip, nasal congestion, cheek pain, purulent discharge in the oral cavity and dental pain. Our study comprehensively reviews the pathophysiology and clinical features of ODMS to provide a more holistic understanding of this condition, facilitating the early diagnosis and management of ODMS patients.

Treatment of recurrent pilonidal sinus by flap technique(Limberg flap)

Background: pilonidal sinus (PNS) is a chronic disease that mostly affects young adults. describes a hair-filled cavity in the subcutaneous fat of the post sacral intergluteal region, known as the natal cleft , its name arises from the Latin terms “pilus” and “nidus” meaning a nest of hair PNS can be asymptomatic, or may be present as a recurrent abscess or as chronic inflamed cavity and local discharge from sinus or sinuses and local pain and discomfort . Materials and Methods: retrospective study was done from (November 2017 to November 2018) at surgical department in Kirkuk General Hospital in 50 patients with recurrent PNS all will be treated with Limberg flap then follow up for one year this surgery done by excision of PNS till we reach fascia overlying sacrum inferiorly and laterally till we reach gluteal fascia and dissection was performed with electro cautery and reconstruction done by flap (Limberg flap) from gluteal area. Results: in 50 patient with recurrent PNS we have 45 (90%) were male and 5 (10%) were female ,30 patient (60%) patients had a familial history of PNS and 42 patients(84%) with etiology-related risk factors to develop PNS then we divided them according first time surgery done either, by excision and primary closure 30 patient(60%) or excision and healing by granulation tissue and secondary intension 20patient (40%) Discussion: pilonidal sinus not classified as dangerous condition but any patients with PNS live in non-comfortable state and may have complications such as abscess formation or discharging sinus even severe pain therefore Limberg flap is commonly used method to treat recurrent PNS and this good result with healing in short period also satisfactory results in long duration but this method with Sacrococcygeal area disfigure mentation as one long duration complications but less recurrence rates and short stay in hospital and better patient tolerability in this way if we compare it to all other methods even with surgical challenge to create a flap but it less wound infection, hematoma ,edema , wound separation if we compare it to other surgical techniques but fluid accumulation in close space under flap is one of important complications in this method and we decrease it by using a drain and putted in site until fluid drainage in area decreased to be less than 50 ml/day . In this method recurrence rate in our study is 2% but reported recurrence rate for Limberg flap are from 0.8 to 2.7% if we compare to 12% recurrent rate in primary closure therefore we have very good recurrence rate Conclusions: the approach for recurrent PNS should be differ from primary PNS flap reconstruction methods in treatment for recurrent PNS is very good and efficient method even with surgical challenge procedure to create flap, personal hygiene are the keystones for preventing recurrence

Phenotypic and genetic characteristics of antimicrobial resistance of Klebsiella pneumoniae clinical isolates in hospitals of Nizhny Novgorod

Objective. To study in vitro antimicrobial resistance and prevalence of the most clinically important carbapenemases genes in Klebsiella pneumoniae clinical isolates in Nizhny Novgorod. Materials and Methods. A total of 238 K. pneumoniae clinical isolates from upper and lower respiratory tracts, abdominal cavity, urogenital tract, and wound discharge were tested in this study. Species identification was done using WalkAway 96 analyzer (Siemens, Germany) with POS Combo Type 20 tablets (Beckman Coulter, USA) and Multiscan FC spectrophotometer (Thermo Scientific, Finland) with Microlatest tablets (PLIVA-Lachema, Czech Republic). Antimicrobial resistance was determined by discdiffusion method and using microbiological analyzer WalkAway 96 (Siemens, Germany). Minimal inhibitory concentrations for colistin were determined using the “MIC Colistin” kit (Erba Mannheim, Czech Republic). Detection of carbapenemases genes (KPC, OXA-48 group, IMP, VIM and NDM) was performed by RT-PCR using CFX-96 machine (Bio-Rad, USA) and commercial kits «MDR KPC/OXA-48-FL» and «MDR MBL-FL» (AmpliSens, Russia). Results. More than 90% of K. pneumoniae isolates in Nizhny Novgorod were resistant to III–V generation cephalosporins, 53.8% – to gentamicin, 71.2% – to ciprofloxacin, 81.2% – to co-trimoxazole, 88.1% – to ertapenem, 37.1% – to doripenem, 21.6% – to imipenem, 34.3% – to meropenem, 3.2% – to colistin. Genes of КРС-like carbapenemases were detected in 13.1% of isolates, OХA-48 – in 21.6%. Metallobeta-lactamases were not identified among tested isolates. Conclusions. Currently, there are no antimicrobials that active against all K. pneumoniae isolates in Nizhny Novgorod. Carbapenems and polymyxins remain active against more than 50% of isolates.

A Case of Life-Threatening Airway Obstruction Caused by Acute Diphtheria Infection in the United Kingdom

Diphtheria is a highly contagious and potentially life-threatening infection. Cases in the United Kingdom are rare due to widespread vaccination. However, in recent years, there has been a notable increase in cases in the United Kingdom. We present the case of a 76-year-old British Caucasian female who presented to the Emergency Department with shortness of breath and “chest tightness.” She reported a five-day history of worsening sore throat, odynophagia, and aphonia. On inspection, she had noisy, laboured breathing with the use of her accessory muscles. Flexible laryngoscopy revealed purulent, thick yellow discharge in the nasal cavity, oropharynx, and supraglottis, with oedema of the subglottic mucosa. She became increasingly breathless and was peri-arrest when emergency orotracheal intubation was performed. She was transferred to the Intensive Care Unit for ventilatory support and intravenous antibiotics. Four days after presentation, her microbiology results confirmed toxigenic Corynebacterium ulcerans. Public Health England was informed immediately. The patient was isolated and contact tracing was commenced. Thirty staff members were required to self-isolate and take prophylactic antibiotics due to close patient contact. It was particularly noteworthy that our patient was a UK national with no recent history of foreign travel. This case demonstrates the importance of remaining vigilant to atypical causes of airway obstruction secondary to infection. Early suspicion and prompt patient isolation may prevent community and occupational transmission and minimise the impact of contact tracing on hospital staffing. Migration from endemic countries and declining childhood vaccination rates may lead to a further rise in UK cases of diphtheria in the future.

Protracted otitis media with effusion in an adult patient with adenoid vegetation. Clinical case presentation

Background Otitis media with effusion (OME) is characterized by the accumulation of non-purulent discharge in the middle ear cavity, with no signs or symptoms of acute ear infection. If the effusion persists for 3 months or more, this is considered a case of chronic otitis media with effusion (COME). The main pathogenetic mechanism for the occurrence of serous otitis is the dilatory dysfunction of the Eustachian tube. This dysfunction can be due to a number of reasons, the main one being an external obstruction resulting from the constriction of the opening of the Eustachian tube by adenoid vegetation or tumors. We present a case of protracted otitis media with effusion and adenoid vegetation in a 24-year-old man– with bilateral combined hearing loss, upper airway obstruction, and chronic sinuitis– successfully treated by bilateral tympanostomy and adenoidectomy. Materials and methods In our clinical case we have described chronologically the investigations and chosen tactics of treatment, applied to our patient, some immediate results, but also the long-term consequences of the management of this disease. Results In our opinion, the outcomes in this patient’s case were prompted not only by the specifics of this disease, but also by the interpretation of the instrumental examination and the decision-making regarding the initial treatment.

Management of nasal myiasis and type 2 diabetes mellitus: A rare case and review article.

BackgroundNasal myiasis is a nasal infestation caused by house fly larvae (maggot). It's a rare condition with only a few reported cases and no treatment consensus.Case presentationA 54-year-old woman was admitted to the emergency unit with a complaint of larvae found in the left nasal cavity and bloody nasal discharge for 2 days. Anterior rhinoscopy found some living larvae in a narrowed left nasal cavity. Patient's management included larvae removal manually with forceps, nasal saline irrigation, a systemic broad-spectrum antibiotic, and insulin to controlled blood sugar.DiscussionRemoval of larvae in the nasal cavity using irrigation saline and systemic broad-spectrum antibiotics is effective in the absence of bone destruction.Conclusionmanual extraction combined with nasal saline irrigation and systemic broad-spectrum antibiotic was effective to manage nasal myiasis.

Our Experience Olopatadine Treatment of Allergic Conjunctivitis in Children

The authors analyzed the treatment results of 53 patients (106 eyes) with allergic conjunctivitis. All patients received Olopatadine 0.2 % (Visallergol) in drops once a day during 1 month. All patients underwent the same tests: scraping from the conjunctiva for the presence of eosinophils, evaluation of the inflammation symptoms using 4-ball scale, biomicroscopy of cornea and conjunctiva with staining by lissamine green and tear film stability (Norn’s method). All of the above-mentioned tests were performed before the treatment, on 14-th day and after the course of therapy. The inflammatory reaction of conjunctiva, the amount of discharge in the conjunctival cavity and the staining of the conjunctiva with lissamine green decreased in all patients starting from the 14-th day of treatment. The maximal effectiveness of the drop was registered in patients with the chronic type of allergic conjunctivitis. The manifestation of the disease reduced significantly after 1 month of treatment, but it does not disappear completely. So it is necessary to continue therapy after 1 month. The laboratory methods of diagnosis confirm the effectiveness of Visallergol by disappearance of eosinophils in the conjunctiva scrapings. The secondary dry eye syndrome developed in all types of the allergic conjunctivitis and needs a long-term treatment. The maximal intensity of dry eye syndrome was registered in patients with chronic type of the allergic conjunctivitis. The drop can be used starting from 2 years old.