ENT Symptoms Research Articles

A study on otorhinolaryngological manifestations in pregnant women

<p><strong>Background: </strong>Pregnancy is characterized by various endocrinological and physiological changes affecting different organs including ear, nose and throat. Otorhinolaryngological manifestations in pregnant women are mainly due to changes in levels of sex hormones such as estrogen and progesterone. While majority of these conditions are benign and reverse after parturition, some do not. The study was conducted with an objective to find the incidence of various otorhinolaryngological manifestations among pregnant women and to create awareness among the medical professionals to diagnose these conditions.<strong></strong></p><p><strong>Methods</strong>: This is a hospital based cross sectional study of 240 pregnant women who presented to the department of otorhinolaryngology with ENT symptoms. Detailed history, general physical examination and complete ENT examination was done on all subjects.</p><p><strong>Results</strong>: 47.9% of the study cases had otological manifestations among which otitis media was the main finding.</p><p>16.7 % of the cases had nasal symptoms among which rhinits was the main condition predominantly observed in the 3<sup>rd</sup> trimester. 19.6% of the cases had oral cavity lesions with stomatitis being the most commonly found cause. 15.8% of the cases had throat complaints, among which gastroesophageal reflux disease (GERD) was the most common cause found during 2<sup>nd</sup> and 3<sup>rd</sup> trimester.</p><p><strong>Conclusions: </strong>Recognition and understanding of pregnancy related ear, nose throat complaints will allow otolaryngologist to reassure and manage these patients, improving their experience of the gestational period.</p>

How COVID-19 brought smell disorders in the spotlight

Abstract The rapid spread of the COVID-19 infection required prompt recognition and immediate isolation of patients. In the evolution of the disease various symptoms were indicated as suggestive of a SARS-CoV-2 infection, among them being also described anosmia and ageusia. In order to review how olfactory disorders are related to COVID-19 disease, we carried out an analysis by searching PubMed, Science Direct, Springer, and LILACS. The research was made using MeSH descriptors and the Boolean operator, “AND”, for the terms “olfactory disorders” or “olfactory dysfunction” or “anosmia” or “neurologic manifestations” or “ENT symptoms” AND “COVID-19” or “SARS-CoV-2” or “coronavirus infections”, with a filter on the publication date set for 01.01.2020 – 18.06.2021. A total of 956 articles were found in the databases, out of which 14 were included in the study. The statistics suggest that alterations of the chemosensory function are strongly correlated with COVID-19, although the exact pathophysiologic mechanism is not well established. Symptomatology suggestive of chemosensory dys-function (smell primarily and then taste alterations) elevate the degree of suspicion of a SARS-CoV-2 infection and they commend prompt isolation and surveillance measurements.

ENT Symptomology in Active COVID-19 Patients in our Tertiary Care Centre.

The aim of this study is to obtain a clear picture of ENT related symptoms in active COVID-19 patients. This study also intends to determine the association of ENT symptoms with Olfactory and Gustatory dysfunction in these patients. Material and Methods: This is a prospective study on 70 active COVID-19 patients who were admitted in the Tertiary Care Hospital. History of all symptoms including Olfactory and Gustatory function were enquired after obtaining Informed Consent. Results: Throat related symptoms was 77.78%, Nasal symptoms accounted for 63.49% and Ear related symptoms constituted 14.28%. It was seen that Rhinorrhoea and Sneezing was significantly more associated in the presence of Olfactory dysfunction. The most common ENT symptoms were Sore throat (49.21%), Rhinorrhoea (34.92%), Sneezing (33.33%), changes in Smell perception (36.51%), changes in Taste perception (47.62%) and Headache (30.16%). 17.14% of the patients in this study had both Olfactory and Gustatory dysfunction. Ear related symptoms were also observed where 11.11% had Aural fullness, 3.17% with Tinnitus and 6.35% of the patients complained of Hearing loss which was either noticed for the first time or had worsened on contracting the COVID-19 disease. Discussion: Knowledge of ENT symptomatology in COVID 19 patients will aid in early quarantine and hence limitation of viral transmission. The manifestation of Anosmia or Hyposmia, Ageusia and Aural Fullness in SARS-CoV-2 infected patients can also act as an important tool and help in early isolation and quicker initiation of COVID-19 therapy.

Etiological Work-Up for Adults with Bronchiectasis: A Predictive Diagnostic Score for Primary Ciliary Dyskinesia and Cystic Fibrosis.

Background: etiological investigations are not done for all adult patients with bronchiectasis because of the availability and interpretation of tests. The aim of the study was to elaborate a score to identify patients at high risk of having cystic fibrosis or primary ciliary dyskinesia (CF/PCD), which require appropriate management. Methods: diagnostic work-ups were carried out on a French monocenter cohort, and results were subjected to logistic-regression analyses to identify the independent factors associated with CF/PCD diagnosis and, thereby, elaborate a score to validate in a second cohort. Results: among 188 patients, 158 had no obvious diagnosis and were enrolled in the algorithm-construction group. In multivariate analyses, age at symptom onset (8.69 (2.10–35.99); p = 0.003), chronic ENT symptoms or diagnosed sinusitis (10.53 (1.26–87.57); p = 0.03), digestive symptoms or situs inversus (5.10 (1.23–21.14); p = 0.025), and Pseudomonas. aeruginosa and/or Staphylococcus aureus isolated from sputum (11.13 (1.34–92.21); p = 0.02) are associated with CF or PCD. Receiver operating characteristics curve analysis, using a validation group of 167 patients with bronchiectasis, confirmed the score’s performance with AUC 0.92 (95% CI: 0.84–0.98). Conclusions: a clinical score may help identify adult patients with bronchiectasis at higher risk of having CF or PCD.

Ear, Nose, and Throat Manifestations of COVID-19 in Children.

The article reviews and analyzes the different ear, nose, and throat (ENT)-related manifestations reported in coronavirus disease 2019 (COVID-19)-positive pediatric patients (age <18 years) in peer-reviewed and published literature. We searched the PubMed database using medical subject headings and associated key words, focusing on ENT symptoms in children with COVID-19. We included relevant published and peer-reviewed articles in English and excluded case reports and articles in press. There were 1,140 children positive for COVID-19 (56% boys) in the 23 studies included in this review. Although 11% of patients were asymptomatic, the most common symptoms reported were fever (48%) and cough (37%). Nasal symptoms (stuffy nose, nasal congestion, rhinorrhea) and sore throat occurred in about 22% of all patients. Otitis, dizziness, anosmia, and ageusia are hardly reported in children with COVID-19. Although fever and cough are the most common symptoms, ENT manifestations are frequently observed in pediatric patients with COVID-19. [Pediatr Ann. 2021;50(7):e277-e281.].

Otorhinolaryngological manifestation in COVID-19

&lt;p class="abstract"&gt;&lt;strong&gt;Background: &lt;/strong&gt;Coronaviruses (CoV) disease caused by the seventh member of enveloped RNA coronavirusdisease. The COVID-19 is presented mainly by lower respiratory tract related symptoms such as fever, cough, dyspnea and chest tightness that could progress rapidly to acute respiratory distress syndrome (ARDS) whereas the different upper respiratory tract related symptoms include nasal congestion, sore throat and smell dysfunction. The aim of this study is to contribute to current knowledge about COVID-19 and to study about the otorhinolaryngological manifestations and its effects in COVID-19 patients.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This prospective observational study was done on 644 patients who got admitted to COVID suspect ward of a tertiary care centre in middle India. The patients were assessed for the signs and symptoms and the findings were analysed.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results: &lt;/strong&gt;Within the included 664 cases, 423 (64%) were males and 241(36%) were females. The maximum number of patients in 50 to 60 years of age ,128(19%). Among which 97% (646) from urban area and 3% (18) from rural area. 564 (85%) were symptomatic with 459 patients had symptoms for 1-4 days,112 patients for 5-10 days,4 patients between 11-15 days. The most common symptoms with which these patients presented were cough (68%), fever (62%), signs of breathlessness (61%). The most common ENT manifestations were sore throat 333 (59%), nasal discharge 120 (12%), anosmia 65 (12%), ear discharge 46 (8%).&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Even though the most common manifestations of COVID-19 were cough, fever, breathlessness significant proportions of patients do manifest with ENT symptoms like sorethroat, nasal discharge, anosmia, ear discharge which may go unnoticed. Recognizing the cases and addressing them properly is important for curbing the rapid spread of COVID-19 pandemic.&lt;/p&gt;

Middle ear effusion prevalence at time of tympanostomy before and during COVID-19 pandemic

BackgroundManagement of pediatric otitis media with effusion (OME) and recurrent otitis media typically includes observation up to 3 months. Bilateral myringotomy and tube (BMT) placement is performed due to persistent effusion with associated symptoms such as decreased hearing. With the COVID-19 pandemic and mandatory stay at home orders (MSHO), children were quarantined at home and many remained home after MSHO. We reviewed the prevalence of middle ear effusion (MEE) at the time of BMT during similar time periods in the year before, during and after MSHO in this pandemic year. Study designRetrospective summary of BMT cases at a single tertiary children's hospital. MethodsAll children <18 years who underwent BMT between March 1, 2020 and July 1, 2020 and between March 1, 2019 and July 1, 2019 were included. Statistical analysis included chi-squared and Mann-Whitney U tests. ResultsA total of 778 cases were reviewed; 551 (71%) were performed pre-pandemic and 227 (29%) during onset of pandemic (N = 778). There were no significant differences in gender, age, and BMI between groups, but significantly fewer Caucasians (58% vs. 45%, p < 0.05) and more Hispanics (20% vs. 33%, p < 0.05) during-COVID. The prevalence of intraoperative effusion during-COVID was significantly lower compared to pre-COVID (65% vs. 83%, p < 0.001). ConclusionPandemic and COVID-19 MSHO were associated with significantly lower intraoperative OME prevalence. Further research may elucidate the impact of face covering, social distancing, and virtual schooling on the incidence of pediatric ROM, OME, and ENT symptoms.

POS0121 RESPONSE OF EOSINOPHILIC GRANULOMATOSIS WITH POLYANGIITIS TO MEPOLIZUMAB ACCORDING TO DISEASE MANIFESTATIONS. A SINGLE CENTRE EXPERIENCE

Background:Eosinophilic granulomatosis with polyangiitis (EGPA) is a relapsing disease with frequent glucocorticoid (GC) dependence. Mepolizumab (MEPO) has been demonstrated to reduce flares and spare GC. However, EGPA is a heterogeneous disease and the effects of MEPO on specific disease manifestations has not been completely delimitated.Objectives:To analyze the impact of MEPO on manifestations derived from small-vessel vasculitis, ENT symptoms, asthma, eosinophilic tissue infiltration and ANCA status in a single-centre cohort of EGPA patients.Methods:Medical chart of EGPA patients treated with MEPO were reviewed to describe demographics, clinical characteristics, steroid dose at the initiation of MEPO and during follow-up, flares, disease activity, damage accrual and laboratory results.Results:Among 52 EGPA patients regularly controlled in our department, 11 patients were treated with MEPO. MEPO was prescribed when a) patients required prednisone (PDN) at ≥ 7.5 mg/d to maintain stability, or b) when maintained with &lt; 7.5mg/d, presented at least 4 exacerbations/year requiring an increase in PDN dose. 6 were males and 5 females, with a mean age of 54 years at MEPO initiation. Baseline characteristics of the patients and course under treatment are presented in Table 1. ENT involvement, followed by asthma and eosinophil-related tissue-infiltration (ETI) were the most common symptoms when prescribing MEPO. Regarding treatment, patients received MEPO at 100-300mg SC monthly. The definition of flare was the same used in the MIRRA trial1. The mean time of treatment with MEPO was 34 months. All patients achieved a BVAS score of 0 points at 12 months or earlier. In general, patients reduced the number of flares, which tended to be milder, and all related to asthma or ENT manifestations. All improved their asthma control, but 3 of them persisted with recurrent ENT symptoms in spite of treatment with MEPO. None of them had vasculitic manifestations (cutaneous, neurological, gastrointestinal, renal) manifestations during treatment. All patients were able to tapper their PDN dose to ≤5 mg/day or less, except 3 patients. Of the 3 patients who required ≥5mg/d, 1 had severe asthma, but diminished the previous PDN dose (22.5 mg/d pre-MEPO, 10 mg/d currently) and the yearly rate of flares (8.2 pre-MEPO, 0.64 under-MEPO). The other one notably improved his asthma, but had ENT symptoms that responded unsatisfactorily to MEPO and required a maintenance PDN dose of 7.5 mg/d. The last one, improved her asthma control and was able to begin PDN tapering, but persisted with ENT symptoms. Regarding damage accrual, 6 patients remained stable during treatment, and 5 worsened. Two of three ANCA positive patients remained positive in spite of treatment.Table 1.Baseline characteristics at diagnosisAt mepolizumab initiationAfter mepolizumab (last follow-up)Age, median (range) years49 (23-67)54 (35-69)-Male/Female, n (%)6/5 (54.5%/45.5%)--BVAS, median (range)11 (2-20)2 (0-6)0FFS, value (n, %)1 (1, 9.1%)--VDI, mean (range)-1.7 (0-5)2.3 (0-5)Asthma, n (%)11 (100%)3 (27.3%)0 (0%)ENT, n (%)10 (90%)4 (36.4%)3 (27.3%)SVV, n (%)4 (36.4%)0 (0%)0 (0%)ETI signs/symptoms, n (%)7 (63.6%)2 (18.2%)0 (0%)Constitutional symptoms, n (%)4 (36.4%)0 (0%)0 (0%)Eosinophils, mean (range) cells x1095500 (600-8850)240 (0-600)55 (0-200)ANCA positivity (IIF)7 (77.8%)32Anti-MPO titers, mean (range)286 (93-740)88 (3-739)7 (3-37)Yearly rate of flares-1,750.51Immunosuppressants, n-31Prednisone dose, mg/d (range)8 (7.5-25)11.4 (5-22.5)5.125 (0-10)Conclusion:MEPO was effective for the treatment of patients with EGPA, with a reduction in the number and severity of flares and a decrease in PDN doses. A worse response of ENT involvement was observed. No vasculitic flares were observed in spite of GC reduction. Mepolizumab did not prevent damage accrual during the treatment period.

Gastroesophageal reflux disease - from the point of view of a gastroenterologist, otolaryngologist and surgeon.

Gastrooesophageal reflux disease is the regurgitation of stomach contents into the esophagus, which causes troublesome symptoms or complications for the patient. Before starting the treatment, it is always necessary to objectively confirm gastroesophageal reflux disease, especially in correlation with ENT symptoms, as extra esophageal complications. In diagnostics, the &quot;gold standard&quot; is a 24-hour impedance-pH supplemented with endoscopy. Treatment without objective confirmation of the disease is not recommended, the more so that non-acid gas proximal reflux, detectable only in the MIIpH test, causes the greatest number of laryngological complications. It is important to confirm the coexistence of clinical symptoms of GERD with ESS. Considering the time of treating the disease and its consequences, it is worthwhile to be cautious and careful with the diagnosis of the disease, and the treatment should be carried out for a long time in relation to the recommendation, preferably in cooperation with an ENT specialist and gastroenterologist. The greatest therapeutic effectiveness is achieved by combining PPI with itopride while maintaining the appropriate doses of drugs and observing a sufficiently long duration of treatment, while maintaining the correct dose reduction and drug discontinuation regimen. In case of failure of pharmacological treatment, antireflux surgery should be take into consideration.

A Study on Otorhinolaryngological Presentations in Covid 19 Patients in a Tertiary Health Care Center.

Corona virus also known as 2019 novel corona virus, a single stranded positive sense RNA virus is the causative agent of COVID 19 disease. It mainly spreads via the respiratory route by means of aerosols. The objectives of our study were. To know the prevalence of ENT presentations in COVID 19 patients and to know the relationship between the symptoms and category of the disease as well as to know the relation between the blood group and recovery from the disease. The first 500 patients who were tested positive for COVID 19 and getting treated in our hospital were included in the study after taking written informed consent from the patients who were willing to participate in the study. A detailed history was taken from all the patients and more stress was given on the ENT symptoms with respect to its onset, duration and time taken for the relief of symptoms. The ENT symptoms were compared with the category of the disease as well as the blood group of the patients. Statistical analysis was done using Chi square test and Statistical Package for Social Sciences [SPSS] for Windows Version 22.0 Released 2013. Armonk, NY: IBM Corp., was used to perform statistical analyses. In our study 310 (62.0%) were males and 190 (38.0%) patients were females (38%), of age group ranging from 2 years to 87 years. In our study 367 (73.3%) patients were symptomatic and the rest 133 (26.6%) were asymptomatic. There were 335 (67.0%) patients in category A, 140 (28.0%) in category B and 25 (5.0%) in category C. The most common ENT presentation was headache and its prevelance was more in category C and it was of statistical significance. On comparing the blood group and the ENT symptoms occurrence of sore throat was of statistical significance and its prevelance was more among the O blood group patients. In terms of recovery from the disease the patients with blood group O had good recovery rate. Covid 19 pandemic is still an on going problem and newer strains of the virus are arising as well hence. In our study we found out that isolated ENT symptoms such as aguesia and anosmia were the only presentation of the disease. Thus they can be considered as early marker of the disease and it will be helpful in early detection and isolation of the patient as well as prevention of further spread of the disease.

Exploratory classification of clinical phenotypes in Japanese patients with antineutrophil cytoplasmic antibody-associated vasculitis using cluster analysis

A novel patient cluster in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) may be identified in Japan. We performed multiple correspondence and cluster analysis regarding 427 clinically diagnosed AAV patients excluding eosinophilic granulomatosis with polyangiitis. Model 1 included the ANCA phenotype, items of the Birmingham Vasculitis Activity Score, and interstitial lung disease; model 2 included serum creatinine (s-Cr) and C-reactive protein (CRP) levels with model 1 components. In seven clusters determined in model 1, the ANCA-negative (n = 8) and proteinase 3-ANCA-positive (n = 41) groups emerged as two distinct clusters. The other five myeloperoxidase-ANCA-positive clusters were characterized by ear, nose, and throat (ENT) (n = 47); cutaneous (n = 36); renal (n = 256), non-renal (n = 33); and both ENT and cutaneous symptoms (n = 6). Four clusters in model 2 were characterized by myeloperoxidase-ANCA negativity (n = 42), without s-Cr elevation (< 1.3 mg/dL) (n = 157), s-Cr elevation (≥ 1.3 mg/dL) with high CRP (> 10 mg/dL) (n = 71), or s-Cr elevation (≥ 1.3 mg/dL) without high CRP (≤ 10 mg/dL) (n = 157). Overall, renal, and relapse-free survival rates were significantly different across the four clusters in model 2. ENT, cutaneous, and renal symptoms may be useful in characterization of Japanese AAV patients with myeloperoxidase-ANCA. The combination of s-Cr and CRP levels may be predictive of prognosis.

Prevalence of Otorhinolaryngological Symptoms in Covid 19 Patients.

To determine prevelance of ENT symptoms in COVID 19 positive patients. A cross sectional study was performed at SRTR GMC AMBAJOGAI, a tertiary care hospital amongst the patients admitted in COVID 19 isolation ward with a positive RT-PCR report. Amongst the included 180 patients, 112 patients had one or more ENT related symptoms that included throat pain (47.2%), loss of smell (55.5%), loss of taste (58.8%) and hearing loss (54.44%) along with generalized COVID 19 symptoms. ENT symptoms can be considered as biomarkers for early diagnosis of Covid-19 patients ensuring faster treatment and isolation allowing better containment of the disease.

The Gastroesophageal Disease and Its Association to Ear, Nose, Throat Complaints

Objectives: In many articles, gastroesophageal reflux has been identified as a strong underlying factor in laryngeal and extra-laryngeal disorders. But the exact mechanism of these complications is still controversial. The present study was designed to investigate the association of gastroesophageal acid reflux to ear, nose and throat diseases in children. Materials and Methods: The present study is a descriptive cross-sectional study and its statistical population includes children with gastroesophageal reflux disease over a period of 18 months visited Salmaniya Medical Complex, Kingdom of Bahrain. The diagnosis of GERD (Gastroesophageal reflux disease) was recorded based on symptoms, radiological and endoscopic findings and ESPGHAN guidelines. The ear, nose and throat were examined and problems recorded followed by initiation of medical treatment. After one and six months of follow up post treatment all clinical findings were recorded. Results: 26.4% of the children were under one year old. In 78% of children, a family history of GERD was reported to be negative. Cough was the most common clinical complaint. After one month of treatment, 15% of gastrointestinal symptoms and 40% of ENT symptoms completely improved. After six months of treatment 72% percentage of gastrointestinal symptoms and ENT symptoms completely improved. Conclusion: This study showed that gastroesophageal reflux disease should be considered, diagnosed and treated in all children with refractory ear, nose and throat symptoms.

How a COVID-19 positive patient can present to an otolaryngologist, a variable presentation: what not to miss?

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; COVID-19 has led to the global pandemic which started in Wuhan, in China. It is highly contagious and the presenting symptoms may not alarm the patient or the doctor and can be confused with allergies and other simple viral respiratory tract infections in mild cases. Aim of this study was to evaluate the various presentations of COVID-19 patients in department of otorhinolaryngology.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; This study was done during pandemic, from March 2020 to May 2020 for a period of 3 months in government medical college Srinagar. If the patient had any significant travel or contact with the known or suspected COVID-19 positive patient and the various ENT symptoms with which COVID positive patients presented, to the department were evaluated. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Majority of patients were males between the age group of 21 to 40 years. The most common symptoms encountered was cough and fever followed by sore throat and rhinitis. One patient also presented with subacute thyroiditis and two others as neck abscess. Two patients presented with sudden sensorineural hearing loss.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Patients in the department can present with mild respiratory tract infection or also with some peculiar symptoms of subacute thyroiditis or abcess. So, careful history is the key to recognize these patients. And it is highly recommended that doctors during addressing the patients should be in proper protective kits to avoid contracting the disease.&lt;/p&gt;

Otorhinolaryngological manifestations in 61 patients with mucopolysaccharidosis

ObjectivesThe mucopolysaccharidoses (MPS) are inherited lysosomal storage disorders with multisystemic and highly variable clinical manifestation. ENT symptoms are common and early signs of MPS. The most common ENT diagnoses are chronic/recurrent rhinosinusitis, acute otitis media, otitis media with effusion, hearing loss and airway obstruction. MethodsA single-centre retrospective chart review of 61 patients (36 M/25F) with different MPS subtypes (MPS I (n = 15), MPS II (n = 10), MPS III (n = 17), MPS IV (n = 15) and MPS VI (n = 4)) was conducted. The age of ENT presentation and frequency of ENT symptoms, surgeries and their distribution among MPS subtypes was studied. The relationship between ENT presentation, first ENT surgery and the age of diagnosis was also evaluated. ResultsMedian age at the first ENT manifestation was 2.8 years, median age at MPS diagnosis 4.1 years. The great majority of patients (90%) manifested at least one ENT diagnosis; often before the diagnosis of MPS (75%). Chronic/recurrent rhinosinusitis was the most prevalent ENT diagnosis (77%), followed by upper airway obstruction (65%) and hearing loss (53%). Chronic/recurrent rhinosinusitis was the first ENT symptom to appear (median age 2.2 years), followed by otitis media with effusion (3.7 years) and hearing loss (4.5 years). At least one ENT surgery was performed in 57% of patients; in 69% before MPS diagnosis was established. Median age of the first ENT surgery was 4.1 years. ENT symptoms and surgical procedures were earliest present in MPS II. ConclusionsOur study documents high and early occurrence of various otolaryngologic symptoms in MPS and thus highlights the role of ENT specialist in prompt diagnosis of these rare diseases and their long-term management.

Presentation of psychiatric patient in ENT Clinic With unexplained symptoms.

Objectives: It’s very common that patients with psychiatric illness visit other specialties and in a survey it was found to hold a percentile of 15% to 30% of all primary care consultations. This study is designed to assess psychiatric patients who present in Clinic with ENT symptoms but result in no disease. Study Design: Cross-sectional study. Setting: ENT OPD of People Medical College, Nawabshah. Period: 1ST Jan 2019 to 31ST Jan 2019. Material &amp; Methods: We selected a total sample of 320 patients who presented with ENT diseases where we excluded patients with organic diseases and studied those who didn’t show any clinical sign of organic diseases. The registered patients were evaluated by psychiatrist. Results: It was observed that out of 320 patients 180 patients were having psychiatric problem and those patients were advised to visit psychiatrist and take follow up on month end. Out 0f 180 patients 140 patients visited ENT OPD twice and 110 patients got relief in one visit. Conclusions: We found that conducting a cross-sectional survey using GHQ-12 helped us in detecting psychiatric patients presenting with unexplained diseases in ENT Clinics however to reach more accuracy in results, further tools can be utilized .We also believe doctors at all specialty clinics need to give more attention to their diagnosis and assist patients to open up to them and not to feel embarrassed.

Nutritional aspects of the palliative care of head and neck cancer patients

Nutrition remains a relevant issue until the end of life, both for patients and their relatives. This is particularly true for palliative patients with advanced head and neck cancer. In addition to local problems caused by the disease and its treatment, patients suffer from social aspects such as isolation, decreasing strength, and reduced mobility. Effective nutritional counselling and therapy are necessary to retain quality of life and self-care for as long as possible. Dialogue between the palliative care team and ENT oncologists should serve as the basis for developing an individual plan for each patient in this difficult situation. Aspecial section of this manuscript focuses on the value of traditional herbal medicine for different ENT symptoms in the context of nutrition. The aim of this review is to promote qualified discussion between patient, relatives, and professionals.

A study on otorhinolaryngologic manifestations in human immunodeficiency virus infected patients

&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Background: &lt;/span&gt;&lt;/strong&gt;The main aim of this study was to find out the ear, nose, and throat (ENT) manifestations in a selected regional population of 100 HIV infected patients, to identify the commoner ENT manifestations among them and to make these manifestations, a guide for regional ENT surgeons, to diagnose HIV/AIDS patients early and to treat them accordingly.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Methods: &lt;/span&gt;&lt;/strong&gt;The study was a prospective study which was conducted for a period of five years which included 100 HIV seropositive patients, among the patients attending the Outpatient Department of the Otorhinolaryngology and anti-retroviral therapy centre across Government Hospitals in Tamil Nadu according to our inclusion or exclusion criteria. Detailed ENT clinical examination as well as laboratory investigations were carried out to evaluate the nature of ENT presentations of HIV infection. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Results: &lt;/span&gt;&lt;/strong&gt;Out of the 100 HIV positive patients, who had some form of ENT symptoms, the most common ENT manifestation in HIV/AIDS was oral candidiasis (40%) followed by cervical lymphadenopathy (30%). Other common manifestations are oral herpes simplex and sensorineural hearing loss. Less common manifestations are chronic sinusitis, tuberculous laryngitis, chronic otitis media, oral hairy leukoplakia, nasal polyps and Kaposi’s sarcoma. Oral candidiasis, chronic/recurrent mucocutaneous herpes simplex, oral hairy leukoplakia and Kaposi’s sarcoma are the AIDS defining illnesses. Oral hairy leukoplakia, is pathognomonic of HIV infection.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;&lt;span lang="EN-US"&gt;Conclusions: &lt;/span&gt;&lt;/strong&gt;These manifestations help ENT surgeons, to recognize HIV/AIDS patients from the specific ENT lesions occurring in them, for early diagnosis and subsequent treatment.&lt;/p&gt;

Immunoglobulin E (IgE) Assay for the Diagnosis and Prevention of Pollinosis in the District of Abidjan

Allergology in Africa is booming. In addition to clinical studies, many studies in biology focus on molecular aspects. This work aims to list the species of the Ivorian flora incriminated in pollinosis and to indicate the pollens that may have molecular similarities with those from Europe. Biological tests using food and mixed allergens were used to search for IgE in 20 patients (14 men and 6 women). The people selected were those who had lived for more than a year close to the target plants and had given their consent for the study. A grid representing cross-allergies ''Food-Pollens'' was used to search for any possible reactions. The plant species of Cote d'Ivoire suspected to be the causes of allergies were Cocos nucifera (Arecaceae), Elaeis guineensis (Arecaceae) and Petersianthus macrocarpus (Lecythidaceae). The same patient may have one or more symptoms. Most of the patients showed ENT (80%), skin (40%), lung (35%), and eye (30%) symptoms. Allergic rhinitis was representative of ENT signs, but allergic asthma has reached 10% of people suffering from lung diseases. During the flowering of Petersianthus macrocarpus, 87% of the respondents present ENT and respiratory symptoms. Biological analyses revealed 70% of patients were sensitized to trophallergens and 60% to pneumallergens. The two patients with no clinical signs were the only negative patients in the biological tests. The most common cross-reactions were between the pollens of Secale cereal ''Rye'' and the fruits of Corylus avellana ''Hazelnut''. The study shows that, the European Panels are useful to start allergological investigations but insufficient to develop a precise diagnosis in Cote d'Ivoire. Therefore, a specific panel composed of Ivorian pollens is being established.

Clinical correlation between tonsillar hypertrophy and tonsillitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Tonsillar hypertrophy is a common clinical condition seen by an otorhinolaryngologist. Tonsils undergo hypertrophy due to recurrent infection or as a part of generalized lymphoid hypertrophy. The aim of this study is to clinically correlate the association between tonsillar hypertrophy and acute/chronic tonsillitis.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; 100 patients attending the Oto-Rhino-Laryngology Department at Vijayanagar Institute of Medical Sciences, Ballari, Karnataka with complaints of tonsillitis acute, chronic, acute on chronic, other ENT symptoms and asymptomatic patients were assessed for tonsillar enlargement using Brodsky Tonsillar Grading scale for tonsillar hypertrophy. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; Out of the 100 patients with tonsillar enlargement and the symptoms at presentation we observed a statistically significant (p=0.0001) irrespective of the severity of the infection to the tonsillar hypertrophy graded according to Brodsky tonsillar grade.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; It is a common prudence that most of the general public and majority of general physicians are of the opinion that tonsillar grades are related to clinical pathology. Our study reveals tonsillar hypertrophy and severity of clinical disease are not directly proportional hence our study indicates management of acute or chronic tonsillitis cannot be influenced by the grade of tonsillar enlargement. We can consider tonsillar enlargement as a guide for prognostic evaluation. We were unable to find any literature regarding our objective of study. Hence this study can be considered as a stepping stone for further in depth clinical studies.&lt;/p&gt;