Evaluation Of Symptoms Research Articles

Temperature-Controlled Radiofrequency Treatment of the Nasal Valve in Patients With Nasal Obstruction: Long-Term Outcomes.

To evaluate the efficacy, safety, and durability of temperature-controlled radiofrequency (TCRF) treatment of the nasal valve in patients with severe or extreme nasal airway obstruction (NAO). A long-term, prospective, multicenter, single-blind, randomized controlled trial. Sixteen otolaryngologic clinics and academic centers. Patients received TCRF treatment on the lateral nasal valve. All patients were followed through 3 years. Outcome measures included the Nasal Obstruction Symptom Evaluation (NOSE) Scale, Epworth Sleepiness Scale (ESS), and adverse events (AEs). Treatment responders were defined as a ≥1 reduction in severity class or ≥20% reduction in NOSE score. Out of 108 patients who received TCRF treatment, 54 reached the 3-year follow-up timepoint. The baseline mean NOSE score was 76.3 (95% confidence interval [CI], 73.6 to 79.1). The 3-year NOSE score treatment effect was -49.4 ([95% CI, -56.5 to -42.4]; P < .001) a 64.7% improvement from baseline; 88.7% of patients were responders. Most patients reported significant improvements in sleep post-treatment with a mean ESS score of 4.5 (95% CI, 3.4 to 5.7) at 3 years compared to 10.3 (95% CI, 9.2 to 11.4) at baseline. Treatment with the TCRF device for nasal valve obstruction resulted in sustained improvements in nasal obstruction symptoms and sleep quality over a 3-year period without any serious AEs. These findings support the long-term benefits and sustained improvements in symptoms in patients with NAO.

Effects of Pickleball Intervention on the Self-Esteem and Symptoms of Patients with Schizophrenia

Background: Schizophrenia is classified by the World Health Organization (WHO) as one of the top ten diseases contributing to the global medical economic burden. Some studies have pointed out that exercise is effective for physical and mental health, as well as cognition. We hypothesized that participation in pickleball intervention would lead to improved self-esteem and reduced psychiatric symptoms in schizophrenia patients. Method: We recruited participants with schizophrenia from a long-term care facility and a regional hospital, dividing them into two groups based on the institutions. The experimental group underwent a nine-week pickleball exercise intervention, with sessions three times a week, each lasting 90 min, and a Dink ball test was conducted weekly. Questionnaires on self-esteem and the short-form health survey were collected both before and after the intervention. Result: This trial included 30 patients, divided equally into the experimental group (n = 15) and the control group (n = 15). After the nine-week pickleball intervention, there were no significant differences between the experimental and control groups in the Rosenberg Self-Esteem Scale (RSES) (p = 0.153) or the Brief Symptom Rating Scale (BSRS-5) (p = 0.289). However, the Dink test scores in the experimental group showed significant improvements in physical activity capabilities and attention over time, with average hit counts increasing from 5.3 ± 1.5 to 10.7 ± 2.3 (p &lt; 0.01). Conclusions: Although the pickleball intervention did not yield significant differences in self-esteem and symptom measures between groups, the improvements observed in physical performance and attention in the experimental group suggest that exercise remains a feasible complementary approach for managing schizophrenia symptoms. Further research with larger sample sizes is recommended.

Posterior nasal nerve neurolysis in addition to radiofrequency ablation of the inferior turbinates for patients with chronic rhinitis.

This study aimed to evaluate the outcome of radiofrequency ablation of the inferior turbinates (RFIT) combined with posterior nasal nerve neurolysis (RPN3) in comparison with RFIT alone in the treatment of patients with chronic rhinitis unresponsive to pharmacological therapy. A retrospective cohort study was conducted on adult and adolescent patients with chronic rhinitis who demonstrated a poor response to medication. Patients with a total 24-hour reflective total nasal symptom score (rTNSS) of ≧5, rhinorrhea score of ≧2, and congestion score of ≧2 were included. The treatment outcomes of patients who underwent RPN3 and RFIT alone were assessed. The primary endpoint was the change from baseline in 12-h reflective total nasal symptom score (rTNSS), nasal obstruction symptom evaluation scores (NOSE), and the response rate defined as rTNSS improved ≧by 30% during follow-ups. A total of 64 patients were included (45 males, 70.3%). Overall, 49 patients underwent RPN3, and 15 patients underwent RFIT alone. The rTNSS had improved by 78.4% and 65.8% in RPN3 and RFIT groups, respectively (both p < 0.001). The NOSE score had improved by 92.89% and 86.81% in the RPN3 and RFIT groups (both p < 0.001), respectively. Patients in the RPN3 group demonstrated statistically significantly better results after three months than patients in the RFIT alone group (p < 0.05). The response rate was 98% in the RPN3 group after 3 months. The proposed RPN3 alleviated rhinitis symptoms, which demonstrated a high response rate with a superior symptom control rate than RFIT alone in chronic rhinitis with severe rhinorrhea and nasal congestion cases.

The Association Between Posting WeChat Moments and the Risk of Depressive Symptoms Among Middle-Aged and Older Chinese Adults: Prospective National Cohort Study.

The association between social media usage and the risk of depressive symptoms has attracted increasing attention. WeChat is a popular social media software in China. The impact of using WeChat and posting WeChat moments on the risk of developing depressive symptoms among community-based middle-aged and older adults in China is unknown. The objective was to assess the association between using WeChat and posting WeChat moments and the risk of depressive symptoms among middle-aged and older adults in China. A prospective national cohort study was designed based on the data obtained from the fourth and fifth waves of the China Health and Retirement Longitudinal Study (CHARLS). The strength of association between using WeChat and posting WeChat moments and the risk of depressive symptoms was estimated by modified Poisson regressions. Depressive symptoms were determined using the 10-item Center for Epidemiologic Studies Depression Scale. Meanwhile, the heterogeneity of the associations was explored through multiple subgroup analyses. Moreover, multiple sensitivity analyses were performed to verify the robustness of the associations between the exposures and depressive symptoms. A total of 9670 eligible participants were included in the cohort study, and the incidence rate of depressive symptoms was 19.08% (1845/9670, 95% CI 19.07%-19.09%) from the fourth to fifth waves of the CHARLS. Using WeChat (adjusted relative risk [aRR] 0.691, 95% CI 0.582-0.520) and posting WeChat moments (aRR 0.673, 95% CI 0.552-0.821) reduced the risk of depressive symptoms among middle-aged and older Chinese adults. The association between the exposures and depressive symptoms was robust, proved through multiple sensitivity analyses (all P<.05). However, the associations were heterogeneous in certain subgroup catagories, such as solitude, duration of sleep at night, nap after lunch, physical activity, and having multiple chronic conditions. Using WeChat and especially posting WeChat moments can mitigate the risk of depressive symptoms among community-based middle-aged and older Chinese adults. However, there is likely a need for a longer follow-up period to explore the impact of the exposures on the risk of long-term depressive outcomes.

Functional and aesthetic outcomes of alar base reduction

BackgroundThe surgical step of alar base reduction (ABR) is often done as the last stage of rhinoplasty surgery. However, it may also be done independently if the main concern is alar flare. This work was designed to assess the functional as well as aesthetic results among cases who undergo ABR which is so important to find out a better way to increase the functional, aesthetic consequences of patients.MethodsThis prospective study included 20 consecutive cases arranged for reduction rhinoplasty. All cases were categorized into three groups: group A (n = 6): patients with thick alar base had ABR, group B (n = 5): patients with wide nostrils had nostril size reduction, and group C (n = 9): patients with thick alar base with wide nostrils had combined alar base and nostril size reduction.ResultsRegarding nasal score post 1 month, levels of trouble sleeping, unable to get enough air through my nose during exercise, and total nasal obstruction symptom evaluation (NOSE) score was significantly different among all groups. Regarding nasal score post 3 month, trouble sleeping, unable to get enough air through my nose during exercise, and total NOSE score showed a significant variance among all groups (p < 0.05). Regarding standardized cosmesis and health nasal outcomes survey (SCHNOS) score post 1 month, breathing through my nose during sleep and how well my nose suits my face were significantly different among all groups (p < 0.05).ConclusionsEffectiveness of ABR in improving nasal function and alleviating symptoms associated with congestion, blockage, and trouble breathing. The procedure resulted in significant improvements in various dimensions, including nasal breathing during sleep, mood, self-esteem related to the nose, and overall symmetry of the nose, as assessed by the SCHNOS score.

Levatorplasty’s role in rectal prolapse management for patients with wide pelvic hiatus: a cohort study

Background and aimsRectal prolapse (RP) is a debilitating condition and can cause symptoms of fecal incontinence, obstructed defecation, incomplete evacuation of the rectum, and pain. In recent years, there has been increasing evidence that prolapse development is strongly associated with pelvic hiatus (GH) size (normal 4.5 +/- 0.7). Multiple surgical studies have suggested that an enlarged pelvic hiatus may be associated with prolapse recurrence. The main aim of this study is to assess the role of combining levatorplasty -with different rectal prolapse surgeries- on recurrence rate and improvement of symptoms in patients that were treated for rectal prolapse with wide pelvic hiatus.Patients and methodsOur study is a combined retrospective and prospective cohort study which included sixty patients with rectal prolapse with wide pelvic hiatus, they were divided into two groups (each group thirty patients). One group underwent rectal prolapse repair, the other group underwent rectal prolapse repair with levatorplasty.ResultsLevatorplasty group showed improvement in Wexner score, recurrence rate in comparison to the other group. Both groups showed similar results in postoperative pain and dyspareunia.ConclusionRectal prolapse repair combined with levatorplasty in patients complaining of rectal prolapse with wide pelvic hiatus have better outcome mainly in decreasing recurrence rate.

Intelligent Symptom Analysis and Report Interpretation for Thyroid Disorder Prediction Using Machine Learning

The thyroid gland, situated at the front of the neck, is essential for producing hormones that regulate many of the body’s critical functions. This paper presents a machine learning-based system aimed at enhancing early detection and providing personalized care for thyroid disorders. Leveraging the Random Forest algorithm chosen for its robust classification abilities the system incorporates two key models: an initial assessment tool that examines self-reported symptoms to determine if further diagnostic testing is recommended, and a diagnostic model that interprets test results to identify specific thyroid disorders. Additionally, the system provides customized diet and exercise suggestions. With an accuracy of 85%, the system effectively supports early symptom analysis and accurate diagnosis. By combining symptom evaluation with tailored health guidance, this approach enables timely detection, accurate diagnostics, and effective management of thyroid conditions, offering personalized insights for patients and support for healthcare providers. Key Words: Machine Learning, Random Forest, Thyroid Disease , Data Preprocessing, Healthcare informatics

The potential role of machine learning and deep learning in differential diagnosis of Alzheimer's disease and FTD using imaging biomarkers: A review.

The prevalence of neurodegenerative diseases has significantly increased, necessitating a deeper understanding of their symptoms, diagnostic processes, and prevention strategies. Frontotemporal dementia (FTD) and Alzheimer's disease (AD) are two prominent neurodegenerative conditions that present diagnostic challenges due to overlapping symptoms. To address these challenges, experts utilize a range of imaging techniques, including magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), functional MRI (fMRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT). These techniques facilitate a detailed examination of the manifestations of these diseases. Recent research has demonstrated the potential of artificial intelligence (AI) in automating the diagnostic process, generating significant interest in this field. This narrative review aims to compile and analyze articles related to the AI-assisted diagnosis of FTD and AD. We reviewed 31 articles published between 2012 and 2024, with 23 focusing on machine learning techniques and 8 on deep learning techniques. The studies utilized features extracted from both single imaging modalities and multi-modal approaches, and evaluated the performance of various classification models. Among the machine learning studies, Support Vector Machines (SVM) exhibited the most favorable performance in classifying FTD and AD. In deep learning studies, the ResNet convolutional neural network outperformed other networks. This review highlights the utility of different imaging modalities as diagnostic aids in distinguishing between FTD and AD. However, it emphasizes the importance of incorporating clinical examinations and patient symptom evaluations to ensure comprehensive and accurate diagnoses.

Post-concussion symptom burden and dynamics: Insights from a digital health intervention and machine learning.

Individuals who sustain a concussion can experience a range of symptoms which can significantly impact their quality of life and functional outcome. This study aims to understand the nature and recovery trajectories of post-concussion symptomatology by applying an unsupervised machine learning approach to data captured from a digital health intervention (HeadOn). As part of the 35-day program, patients complete a daily symptom diary which rates 8 post-concussion symptoms. Symptom data were analysed using K-means clustering to categorize patients based on their symptom profiles. During the study period, a total of 758 symptom diaries were completed by 84 patients, equating to 6064 individual symptom ratings. Fatigue, sleep disturbance and difficulty concentrating were the most prevalent symptoms reported. A decline in symptom burden was observed over the 35-day period, with physical and emotional symptoms showing early rates of recovery. In a correlation matrix, there were strong positive correlations between low mood and irritability (r = 0.84), and poor memory and difficulty concentrating (r = 0.83). K-means cluster analysis identified three distinct patient clusters based on symptom severity. Cluster 0 (n = 24) had a low symptom burden profile across all the post-concussion symptoms. Cluster 1 (n = 35) had moderate symptom burden but with pronounced fatigue. Cluster 2 (n = 25) had a high symptom burden profile across all the post-concussion symptoms. Reflecting the severity of the clusters, there was a significant relationship between the symptom clusters for both the Rivermead (p = 0.05) and PHQ-9 (p = 0.003) questionnaires at 6-weeks follow-up. By leveraging digital ecological momentary assessments, a rich dataset of daily symptom ratings was captured allowing for the identification of symptom severity clusters. These findings underscore the potential of digital technology and machine learning to enhance our understanding of post-concussion symptomatology and offer a scalable solution to support patients with their recovery.

The effects of war-related experiences on mental health symptoms of individuals living in conflict zones: a longitudinal study

On October 7, 2023, a large-scale attack in southern Israel and the subsequent war resulted in extensive loss of life and injuries, with many individuals experiencing traumatic losses, such as family members or close friends being killed or kidnapped. This study aims to longitudinally examine its effects on mental health, specifically, clinical symptoms of anxiety, depression, and posttraumatic stress disorder (PTSD). We anticipated greater symptom severity among individuals who experienced traumatic loss, were forcibly displaced, or suffered income loss, as well as among women and members of ethnic minorities. This three-wave online survey study assessed mental health symptoms in a sample of 1052 individuals, aged 18–40, residing in conflict zones in Israel from February 2024 (day 1), through March 2024 (day 30), to May 2024 (day 90). Symptoms of anxiety, depression, and PTSD were measured using the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-9 (PHQ-9), and Primary Care PTSD Screen (PC-PTSD). Individuals experiencing traumatic losses, forced displacement, or economic hardships, as well as females, consistently demonstrated higher rates of anxiety, depression, and PTSD symptoms compared to those without such experiences or to males, across all time points (F values ranged from 17.7 to 215.3, p < .001). For ethnic minorities (Arab and other), as compared to Jewish, anxiety and depression symptoms were higher at every time point (F = 8.3–97.1, p = .004 to < .001). This study highlights the urgent need for targeted mental health interventions in conflict zones, particularly for affected individuals. Further research should expand these findings to broader populations.

Faecal microbiota transplantation for patients with diabetes type 1 and severe gastrointestinal neuropathy (FADIGAS): a randomised, double-blinded, placebo-controlled trial

Diabetic gastroenteropathy is associated with nausea, vomiting, bloating, pain, constipation, and diarrhoea. Current therapies are scarce. We tested faecal microbiota transplantation (FMT) for patients with type 1 diabetes and gastroenteropathy. In a randomised, double-blinded, placebo-controlled pilot trial, adults with type 1 diabetes and moderate-to-severe gastrointestinal symptoms were randomised (1:1) to encapsulated FMT or placebo. Each patient received around 25 capsules containing 50g of faeces, administered in a single dose. The placebo capsules contained glycerol, saline and food colouring. All patients received FMT as a second intervention. The primary endpoint was number of adverse events of severity grade 2 or more assessed by the Common Terminology Criteria for Adverse Events during the week following the first intervention. Secondary endpoints included gastrointestinal symptoms and quality of life assessed four weeks after treatment. Public trial registration, ClinicalTrials.govNCT04749030. We randomised 20 patients to FMT or placebo. Following this intervention, 26 adverse events of grade 2 or more occurred. Four patients in the FMT group reported seven adverse events, and five patients in the placebo group reported 19, with no differences between the groups. The most frequent adverse events were diarrhoea, bloating, and abdominal pain. No serious adverse events were related to the treatment. Patients who received FMT reduced their median Gastrointestinal Symptom Rating Scale-Irritable Bowel Syndrome score from 58 (IQR 54-65) to 35 (32-48), whereas patients receiving placebo reduced their score from 64 (55-70) to 56 (50-77) (p=0.01). The Irritable Bowel Syndrome Impact Scale score improved from 108 (101-123) to 140 (124-161) with FMT and 77 (53-129) to 92 (54-142) with placebo (p=0.02). The Patient Assessment of Gastrointestinal Symptom Severity Index declined from a median of 42 (28-47) to 25 (14-31) after FMT and 47 (31-69) to 41 (36-64) after placebo (p=0.03). FMT was safe and improved clinical outcomes for patients with type 1 diabetes suffering from bowel symptoms. Steno Collaborative Grant.

DYADIC AMBIVALENCE IN ALZHEIMER’S DISEASE: LINKING BEHAVIORAL AND PSYCHOLOGICAL SYMPTOMS TO LIFE SATISFACTION

Abstract Caring for a spouse with Alzheimer’s disease (AD) can elicit considerable distress but there are also positive moments. A growing body of work has examined caregivers’ ambivalence in the care relationship and linked it to negative caregiver outcomes such as depression, but dyadic assessments of both parties’ perspectives are missing. We examined ambivalence in both people with AD and their spousal caregivers, seeking to identify the predictors and well-being outcomes of such ambivalence in this unique context. Participants included 73 couples managing early-stage AD. People with AD and spousal caregivers independently self-reported positive and negative relationship qualities (used to indirectly calculate their ambivalence) and life satisfaction. Caregivers reported both partners’ demographic characteristics and their spouses’ behavioral and psychological symptoms of dementia (BPSD), focusing on memory-related behaviors and psychological symptoms. Path analyses revealed that the number and frequency of psychological symptoms in people with AD were positively associated with their own and caregivers’ ambivalence. Caregivers’ distress ratings of memory-related behaviors and psychological symptoms were positively associated with their ambivalence. Greater ambivalence was associated with lower life satisfaction in both spouses. BPSD directly affected both spouses’ life satisfaction but there was also a marginally significant indirect effect via ambivalence. This study utilizes a dyadic approach to assess ambivalence in dementia care. Findings reveal the conflicting emotions that couples experience as they cope with early-stage AD, identify sources of such ambivalence, and shed light on the development of dyadic interventions that can promote positive outcomes in both partners.

Evaluation of Suicidal Symptoms in Adult Depressive In-Patients at Birat Medical College and Teaching Hospital

INTRODUCTION Suicide is a critical public health concern and a leading cause of death globally, particularly among individuals with major depressive disorder (MDD). Understanding the prevalence and correlates of suicidal symptoms in hospitalized depressive patients is crucial for effective intervention and prevention strategies. This study aimed to evaluate the prevalence, severity, and associated factors of suicidal symptoms in adult depressive in-patients at Birat Medical College and Teaching Hospital, focusing on gender differences and clinical predictors. MATERIAL AND METHODS A descriptive, cross-sectional study was conducted over a 1-year period (July 2022 - June 2023). A total of 120 adult in-patients diagnosed with MDD according to DSM-5 criteria were selected using purposive sampling. Data were collected using a structured proforma and the Hamilton Depression Rating Scale (HDRS). Statistical analyses included descriptive statistics, independent t-tests, Spearman’s correlation, and regression analysis. RESULTS Of the 120 patients, 54% reported suicidal ideation, with a higher prevalence among females (68%) compared to males (44%). Significant positive correlations were found between HDRS scores and suicidal symptoms (r = 0.74, p &lt; 0.001). Regression analysis indicated that HDRS scores and duration of illness were significant predictors of suicidal symptoms (R² = 0.68, p &lt;0.01). CONCLUSION Suicidal symptoms are highly prevalent among depressive in-patients, especially in females. The severity of depression and longer duration of illness are associated with an increased risk of suicidal behavior. These findings highlight the importance of routine screening and targeted interventions in hospitalized patients with MDD.

Missed Opportunity for Initial Diagnosis in Children With Complex Appendicitis.

Delayed diagnosis of acute appendicitis in children may result in complex appendicitis with appendiceal perforation. Delayed diagnosis can result from missed opportunity for initial diagnosis (MOID) despite medical attention. Studies report MOID of less than 5% in pediatric emergency departments (EDs), but we hypothesized that many MOID occurs outside tertiary care facilities. Our goals were to determine the MOID rate in all presenting facilities in children with complex appendicitis and to identify associated risk factors. Children (age ≤18) undergoing appendectomy for complex appendicitis between 2018 and 2022 at a single free-standing academic children's hospital were reviewed. Missed opportunity for initial diagnosis was defined as evaluation for related symptoms without a diagnosis of appendicitis within 7 days prior to appendectomy. Logistic regression and UpSet plots were used to identify associated risk factors. Of 856 children, 140 (16.4%) had MOID. Most MOID originated from nontertiary facilities [urgent care (38.6%), local EDs (26.4%), primary care (25.0%)] compared to our pediatric ED (11.4%). Compared to single-encounter diagnosis, MOID was associated with younger age (adjusted odds ratio per year [aOR] 0.93, 95% confidence interval [CI]: 0.88-0.97) and non-English/Spanish primary language (aOR 2.61, 95% CI: 1.18-5.76). Uninsured patients had lower MOID (aOR 0.22, 95% CI: 0.05-0.96). Missed opportunity for initial diagnosis was associated with more complications (33.6% vs 19.1%, P < 0.0001), prolonged length of stay (6 vs 4 days, P < 0.0001), and increased readmission (11.4% vs 6.6%, P = 0.044). Missed opportunity for initial diagnosis of complex appendicitis occurs in nontertiary care facilities, is more common in younger children and non-English/Spanish speakers, and is associated with worse outcomes, highlighting the need for interpreters and algorithmic evaluation in nontertiary care facilities.

Evaluation of long-term symptoms and recurrence of bowel nodules after resection of deep bowel endometriosis: A retrospective cohort study

Background — Bowel endometriosis nodules (BEN) result from an abnormal growth of endometrial fragments located on intestine causing visceral pain, scars, and organ adhesions. Deep endometriosis operation (DEO) is performed in case of deep infiltrating endometriosis (DIE) as a routine procedure for BEN excision. In this retrospective cohort study, the authors aimed to investigate the long-term symptoms and the recurrence rate of BEN in DIE women. Methods — The cases were pooled into two groups based on presence of surgery of bowel endometriosis (SBE, n=32) and absence of surgery of bowel endometriosis (no-SBE, n=44). Using inclusion and exclusion criteria, we selected 76 DIE women from Arash Women’s Hospital (Tehran, Iran). General patient information and surgery-related data were extracted from medical histories of DIE patients (2018-2021). Two years of postoperative follow-up were part of our study, and endometriosis symptoms, pelvic pain, and BEN recurrence rate were assessed. Data were analyzed using SPSS (v.19), and statistical significance was assumed at p&lt;0.05. Results — No statistically significant (p=0.54) differences were detected between two groups (SBE and no-SBE) regarding pain recurrence. In SBE group, 28.1% of DIE women exhibited BEN recurrence, while this proportion was 9.4% in no-SBE women that had larger size of BEN. Changes in BEN sizes were not significant (p=0.6) as compared with pelvic pain. Conclusion — No significant differences were found between long-term symptoms and recurrence of BEN in women with DIE after SBE and without SBE. Excision of BEN during surgical procedures is not recommended clinically.

RELATIONSHIP OF EARPHONE USAGE WITH THE EMERGENCE OF HEARING LOSS AND HEALTH PROBLEMS IN MEDICAL STUDENTS OF SOUTH PUNJAB

Noise induced hearing loss (NIHL) is a rising concern, particularly in the young adult population who frequently use personal listening devices (PLDs) such as earphones. Medical students are at risk of having hearing related problems due to the high usage of PLDs for both academic and recreational purposes. This study aimed to assess the prevalence of hearing loss, symptoms associated with earphone use, and the relationship between earphone usage patterns and hearing thresholds among medical students in South Punjab, Pakistan. Objective: To evaluate the prevalence of hearing loss and associated symptoms (headache, tinnitus, otalgia, fatigue) about earphone usage habits, including daily duration, volume, and frequency of use, among undergraduate medical students. Methods: This cross sectional study was conducted at Nishtar Medical University and CMH Institute of Medical Sciences (CIMS), Multan from October 2023 to August 2024. A total of 267 medical students aged 18 26 years participated in this study. Participants were categorized into two groups: mild users (≤1 hour/day) and Intense users (&gt;1 hour/day) of PLDs. Data were collected using a self administered questionnaire on demographics, earphone usage patterns, and associated symptoms. Audiometric testing was performed using Pure Tone Audiometry (PTA) to assess hearing thresholds at 250 Hz to 8000 Hz. Descriptive statistics, t tests, chi square tests, and Pearson correlation were used to analyze the data. Results: The majority of participants (55.4%) were aged 21 23 years, with a balanced gender distribution (52.4% male, 47.6% female). Intense users (53.2%) had significantly higher hearing thresholds at all frequencies compared to mild users, particularly at higher frequencies (4000 Hz and 8000 Hz). In the right ear, the prevalence of hearing loss is 3.2% for mild users and 13.3% for intense users whereas in the left ear, it is 4.8% and 12.7% for mild and intense users respectively. The most common form of hearing loss was mild sensorineural hearing loss at 4000Hz. Intense users reported higher rates of symptoms, including headache (35.9% vs. 16%), fatigue (47.2% vs. 17.6%), otalgia (46.5% vs. 22.4%), and tinnitus (34.5% vs. 17.6%), with statistically significant associations between symptom prevalence and usage duration and volume. Conclusion: Prolonged earphone usage is significantly associated with the emergence of hearing loss and increased prevalence of auditory symptoms among medical students. Despite being aware of the risks, many students do not follow safe listening practices, underscoring the need for educational initiatives. Promoting the "Rule of 60" and encouraging regular breaks during usage are essential steps to mitigate the risk of NIHL.

Endoscopic Electric Drilling in the Correction of Nasal Septal Spur of the Vomer

Abstract: Background: Nasal septal spurs (NSS) are a frequent cause of nasal obstruction, headache, and other symptoms. Endoscopic septoplasty (ES), particularly with endoscopic electric drilling (EED), has emerged as a promising alternative to traditional septoplasty, offering superior precision and reducing the incidence of complications. This study aimed to evaluate the effectiveness of EED in the treatment of NSS. Methods: This prospective study was conducted on a cohort of 60 patients with NSS was treated using EED between March 2022 and February 2024. Preoperative assessments included nasal endoscopy, computed tomography (CT), and medical history. Intraoperative bleeding and operative time were recorded, and postoperative complications were monitored. Symptom improvement was assessed using the NOSE (Nasal Obstruction Symptom Evaluation) score. Results: The mean age of the participants was 25.17 ± 7.04 years, with male predominance (53.3%). The average operative time was 9.49 ± 1.14 minutes, and the intraoperative bleeding was 110.33 ± 10.57 ml. Postoperatively, NOSE scores decreased significantly from 70.5 to 15.2 (p &lt; 0.001), indicating substantial symptom relief. Only 1.7% of patients developed septal perforation and 1.7% developed synechia, both of which were managed successfully. Conclusion: EED is a safe, efficient, and minimally invasive technique for correcting nasal septal spurs, providing significant symptom relief with minimal bleeding and a low complication rate. This technique is a promising alternative to traditional septoplasty, particularly for isolated septal spurs. Further studies with larger sample sizes and long-term follow-up are needed to confirm the long-term efficacy of the study.

Validity and reliability of the Empty Nose Syndrome Index (ENSI).

To validate the French version of the Empty Nose Syndrome Index (Fr-ENSI). Patients with ENS, chronic rhinitis/rhinosinusitis, and asymptomatic individuals were recruited from April to August 2024. The internal consistency was evaluated with Cronbach-alpha. The test-retest reliability was assessed with the intraclass correlation coefficient (ICC). The external validity was assessed with a correlation study between the Fr-ENSI and the Sinonasal Outcome Tool-22 (Fr-SNOT-22), and Nasal Obstruction Symptom Evaluation (Fr-NOSE). The Fr-ENSI threshold for suspecting the ENS diagnosis was determined with the receiver operating characteristic (ROC) curve. Ninety-three subjects completed the evaluations. There were 36 ENS patients, 23 patients with chronic rhinosinusitis/rhinitis, and 34 healthy individuals. The mean age was 44.8±14.7 years. Patients with ENS reported significantly higher Fr-ENSI scores compared to others, indicating high internal validity. The Cronbach-alpha of Fr-ENSI was 0.891, which indicates an adequate internal consistency. The test-retest reliability was high. Depression and anxiety scores were associated with sleep disturbances. The Fr-ENSI was significantly correlated with Fr-SNOT-22, which supports a high external validity. The threshold of Fr-ENSI associated with the highest sensitivity and specificity was &gt;23/60. The Fr-ENSI is a valid and reliable questionnaire for documenting 12 prevalent symptoms of ENS. The consideration of sleep disorders in ENSI is important regarding its association with depression and anxiety.

Repositioning the Posterior Septal Angle in Rhinoplasty: Methods and Outcomes.

Repositioning and fixation of the posterior septal angle (PSA) relative to the anterior nasal spine (ANS) is a well-known maneuver performed during rhinoplasty. Suture techniques through the periosteum along with transosseous drilling through the spine are the two most common fixation methods. We report on how nasal airway patency varies as a function of technique and patient demographic factors. A retrospective analysis was performed on patients who underwent PSA repositioning and stabilization during rhinoplasty due to caudal septal deformities. Nasal Obstruction Symptom Evaluation (NOSE) scales were measured pre- and post-operation to evaluate functional outcomes. 207 patients with either mobile or immobile PSA underwent ANS fixation secured with either a suture passed through the periosteum of the ANS or with the creation of a drill hole through the ANS. In all patients regardless of clinical or demographic groupings, postoperative NOSE scores were significantly decreased when compared to preoperative scores (p < 0.05). Preoperative NOSE score, fixation method, sex, functional versus cosmetic, age, follow-up period, and graft site did not independently affect the postoperative NOSE score. Though the differences between primary and revision outcomes were statistically significant, patients in both groups reported significant improvements in postoperative NOSE scores that deescalated their symptoms from "severe" to "mild." Repositioning and fixation of the PSA improve patient outcomes. However, there is no significant difference between fixation methods on final NOSE scores. Septal fixation with consideration for patient anatomy allows for effective treatment. 4 Laryngoscope, 2024.

Effectiveness of Antiviral Treatment with Intravenous Peramivir and Oral Oseltamivir for Seasonal Influenza in Children

Background/Objectives: Influenza poses significant risks in children, causing complications like febrile seizures and hospitalizations. Antiviral treatments include oseltamivir and peramivir, both FDA-approved neuraminidase inhibitors. This study aims to compare the effectiveness of intravenous peramivir and oral oseltamivir in pediatric patients presenting to an emergency department, with a primary focus on the revisit rate within 72 h post-treatment. Methods: A retrospective study analyzed 1327 children aged 1–15 years diagnosed with influenza A or B between 1 January 2019 and 29 February 2020, at a single urban hospital. Patients were divided into oseltamivir (n = 1243) and peramivir (n = 84) groups. Data included demographics, clinical symptoms, emergency department stays, and revisit rates. Fisher’s exact test was used for analysis, with p-values &lt; 0.05 considered significant. Results: A total of 1327 pediatric patients were included, with 1243 receiving oseltamivir and 84 receiving peramivir. Patients in the peramivir group were older (median age 5.88 years vs. 4.54 years, p = 0.002) and had higher rates of gastrointestinal symptoms. The emergency department length of stay was significantly longer in the peramivir group (167 min vs. 63 min, p &lt; 0.001). The revisit rate within 3 days was 5.63% for oseltamivir and 9.52% for peramivir, with no statistically significant difference (p = 0.22). Conclusions: Peramivir presents as an effective alternative treatment for influenza in children, particularly in situations where oral administration is not feasible due to gastrointestinal intolerance, highlighting the importance of an alternative route of antiviral administration.