Throat Discomfort Research Articles

Mediastinal and thoracic hematoma following transradial cerebral angiography: a case report

BackgroundCerebral angiography through the transradial approach (TRA) is associated with a low risk of complications, but in rare cases, these complications can be life-threatening.Case presentationA 56-year-old female patient was admitted for transradial cerebral angiography due to the complaint of right limb weakness and the diagnosis of cerebral infarction and cerebral artery stenosis. During the procedure, the patient coughed with expectoration and complained of throat discomfort, palpitations, and pains in the right shoulder and back. Emergency CT scan indicated hematoma in the middle mediastinum and the right thoracic cavity, and perforation of a branch of the subclavian artery was highly suspected. Subclavian artery angiography was conducted immediately, which revealed a patchy contrast medium overflow in a branch of the right costocervical trunk. Selective endovascular occlusion therapy was performed successfully with gelfoam particles and placement of 2 microcoils. At 12 days after cerebral angiography, the patient recovered well and was discharged from the hospital.ConclusionMediastinal and thoracic hematoma may occur due to vessel perforation during TRA cerebral angiography, in which guidewire advancement must be cautious. Early detection and appropriate countermeasures can reduce the severity of vascular perforation and subsequent hematoma.

Is intranasal dexamethasone effective in reducing sore throat following surgery?

ABSTRACT Objectives: Postextubation, individuals may experience the discomfort of a sore throat. Our main aim of the study was to investigate if intranasal dexamethasone is successful in reducing postoperative sore throat occurrence. Materials and Methods: The study involved 96 adult individuals who were scheduled for elective eye surgery at Faiz Medical Center, which is affiliated with Isfahan University, between July 2020 and March 2021. The individuals were assigned by chance to two cohorts of 48 people each, with one cohort getting dexamethasone (IND) through the nose and the other cohort getting normal saline (INS) through the nose right after the endotracheal tube insertion. The presence of symptoms such as aching throat, cough, and hoarseness after surgery was recorded and examined with version 23 of the SPSS software. Results: Upon analysis, it was observed that there were no statistically significant alterations in demographic attributes, tracheal intubation variables, duration of surgery, and postoperative outcomes (P < 0.05). Within the IND cohort, a notable 80.2% decrease in the occurrence of sore throat was noted immediately following the surgical procedure, along with a 34% reduction within the initial 6 hours of hospital stay (P < 0.001). Moreover, dexamethasone also decreased the occurrence of cough and hoarseness by 31.7% and 38.2% during recovery, as well as 19% and 25.4% within the initial 2 h upon admission to the ward (P < 0.001). Conclusion: The current study showcased the preventive impact of dexamethasone intranasally in decreasing the occurrence of sore throat in the early stages of postoperative period. Nevertheless, its efficacy diminished after 6 h. Furthermore, the intranasal application of dexamethasone exhibited the ability to alleviate hoarseness and cough within the first 2 h following surgical intervention.

A patient report scale research to access the symptom burden in patients with IgA nephropathy

Patients diagnosed with IgA nephropathy (IgAN) commonly experience a substantial burden of symptoms encompassing both physical and psychological aspects. Presently, there's a dearth of standardized assessment tools to effectively gauge the extent of symptom burden in IgAN patients. Therefore, this study aims to devise an IgAN Symptom Assessment Tool that enables a comprehensive evaluation of patient symptom burden and their self-perceived severity. Employing a prospective observational design, this study conducted a survey among patients diagnosed with IgAN at a hospital in China. The research team formulated an IgAN Symptom Burden Assessment Scale and administered a questionnaire to gauge patient symptom burden. Severity assessment was conducted on a 5-point Likert scale, with higher scores indicating a more pronounced burden of symptoms. The finalized scale comprised 14 distinct symptom items, and the questionnaire survey garnered responses from 200 patients, achieving a 100% response rate. Statistical analysis unveiled that nearly all patients regarded these symptoms as prevalent and significantly impactful on their daily lives, resulting in a considerable burden. Notably, mild oliguria, moderate nasal congestion, bitter taste , throat discomfort, alongside severe manifestations such as muscle weakness, fatigue, and foamy urine, were frequently reported by patients. The findings underscore that a substantial proportion of IgAN patients grapple with a significant burden of symptoms, emphasizing the imperative for healthcare providers to prioritize symptom management and implement proactive measures to alleviate these challenges. This study presents an innovative tool tailored for evaluating symptom burden specifically in IgAN patients. Subsequent research should center on validating this tool within larger patient cohorts to optimize the efficacy of symptom management in this demographic.

Likelihood of Laryngeal Involvement in Autoimmune Thyroid Disorder Patients: A Meta-Analysis.

The involvement of the larynx in many situations can have a substantial impact on a person's voice, breathing, and general health. Individuals with autoimmune thyroid disorders can experience a variety of conditions affecting the larynx. Autoimmune thyroid disorders, such as Hashimoto's thyroiditis [HT] and Graves' disease [GD], are prevalent conditions affecting the thyroid gland. Beyond their established impact on thyroid function, these disorders have been associated with laryngeal involvement. The current study aims to explore the likelihood of laryngeal involvement in patients with Autoimmune Thyroid Disorders [AITD]. This study involved a retrospective analysis of medical records from patients diagnosed with autoimmune thyroid disorders. Inclusion criteria were a confirmed diagnosis through laboratory investigations and clinical assessment. Patients with pre-existing laryngeal pathologies or other conditions affecting the larynx were not considered. We collected data from 4 research articles and 3 clinical trials from Embase, PubMed, and NCBI-Trials portals, focusing on reported laryngeal symptoms. The severity of laryngeal involvement was assessed and categorized based on its extent and impact on vocal function. Preliminary analysis of the collected data indicated a significant proportion of patients with autoimmune thyroid disorders reporting laryngeal symptoms. Among these patients, various manifestations of laryngeal involvement were observed, including vocal changes, hoarseness, and throat discomfort. The findings show that laryngeal symptoms may be an underappreciated feature of these diseases, potentially impacting vocal function and quality of life in affected people. Further research is also needed for more precise projections in this direction.

Sick Building Syndrome Overview- UK’S Indoor Sick Building Syndrome Formation Analysis

Building-related illnesses pose a critical risk to public health and have consistently been a source of concern. The illnesses are collectively referred to as Sick Building Syndrome (SBS) and are used to elaborate on a situation in which the occupants of a house experience headaches discomfort-related effects or symptoms of air borne diseases that seems to be connected to the time spent in houses. Symptoms are many, but in general, occupants may experience throat, eye, and nose discomfort, as well as fatigue and, on occasion, dizziness. The increased prevalence of this syndrome has prompted substantial research. Although there is no known specific cause of SBS, some experts have concluded that indoor pollutants have a significant role in exacerbating the illness. The sources of indoor pollutants include biological contaminants, chemical contaminants, and particulate matter. These contaminants include bacteria, volatile organic compounds (VOCs), and dust, respectively. This study will examine the role of indoor pollutants in Sick Building Syndrome symptoms, investigate the causes and effects, and recent progress in understanding and controlling SBS caused by these contaminants.And also outlines an overview of the UK’s SBS issues.

Clinical Observation of Zero-P System Interbody Fusion Combined with Traditional Chinese Medicine-Directed Drug Delivery Technology for Treating Cervical Spondylotic Myelopathy

Objective: To investigate the clinical efficacy of the Zero-profile fusion cage (Zero-P) combined with Traditional Chinese Medicine-directed drug delivery technique in the treatment of cervical spondylotic myelopathy, and to assess its impact on potential postoperative complications. Methods: 13 patients with cervical spondylotic myelopathy were selected from January 2022 to October 2023. The intraoperative bleeding volume, operation duration, and hospitalization days were recorded, the incidence and improvement of postoperative complications were observed, and the pain index and cervical function index were analyzed, including Visual Analogue Scale (VAS) score, Japanese Orthopedic Association (JOA) score, Neck Disability Index (NDI) index, etc. Results: The operation duration of patients was 65–110 (81.92 ± 13.47) min; mean intraoperative blood loss was 12.30 ± 7.80 ml, and mean postoperative hospital days were 9.62 ± 3.52 days. All patients in this group were followed up over 3 months after surgery, and the study found that the VAS, JOA, and NDI scores improved significantly compared with the preoperative difference (P < 0.01); and the VAS, JOA, and NDI scores 1 month postoperative improved significantly compared with 1 week postoperative (P < 0.01). In addition, the incidence of postoperative complications of the Zero-P system was low, with no incision infection, implant rejection, fracture, displacement, cerebrospinal fluid leakage, recurrent laryngeal nerve injury, and laryngeal edema; one patient had mild dysphagia (7.69%) and nine patients had throat dryness and discomfort (69.23%), which completely disappeared after 1 week of TCM-directed drug treatment and symptomatic treatment. Conclusion: Zero-P system interbody fusion has a significant effect on cervical spondylotic myelopathy, with a low incidence of postoperative complications and fast improvement speed, which can effectively enhance the impact of surgery on cervical spondylotic myelopathy patients, thus it is worthy of application and promotion.

Rare manifestations of cutaneous diphtheria: a case report

BackgroundThis case report presents an exceptionally rare and atypical presentation of diphtheria in a 17-year-old female of Hausa ethnicity residing in an area with an elevated incidence within Kano State, Nigeria. By the end of 39th epidemiological week of 2023, only two cases of cutaneous diphtheria have been reported among 5,811 cases managed at MMSH diphtheria treatment center (DTC), representing approximately 0.035% of all diphtheria cases during that time period.Case presentationA 17-year-old Hausa female presented with a 3-day history of throat discomfort, malaise, and muffled speech. Physical examination revealed a pseudomembrane covering the tonsillar pillars, grade 3 tonsillar enlargement, and an unusual genital manifestation characterized by extensive vulval edema, severe pain, and a large, greyish patch extending into the vaginal introitus. Her medical history was significant for recent exposure to diphtheria and the emotional impact of her sibling's death from the same disease. Diagnostic tests, including throat swab culture and histocytology, confirmed diphtheria in the throat and vulvovaginal regions. The patient was promptly initiated on diphtheria antitoxin, Azithromycin, and innovative sitz baths with hydrogen peroxide. After 4 days of Sitz bath therapy, complete pseudomembrane clearance was observed, and the patient's symptoms resolved.ConclusionThis case underscores the complexity of diphtheria presentations, particularly with rare pseudomembranes in both throat and vaginal regions. The successful management, combining traditional and innovative therapies, highlights the importance of recognizing and addressing unusual manifestations promptly. The potential role of auto-inoculation and the efficacy of interventions like hydrogen peroxide sitz baths warrant further investigation. Overall, this case contributes to the understanding of diverse diphtheria presentations, guiding future clinical strategies for management of diphtheria cases and emphasizing the imperative of comprehensive vaccination efforts.

A comparison of COVID-19 and post-COVID-19 syndrome among symptomatic and asymptomatic patients in Bangladesh: A retrospective cohort study

BackgroundThe differentiation between COVID-19 and post-COVID-19 syndromes is not properly defined as some patients remain asymptomatic for post-COVID-19. It can be characterized by several signs and symptoms. Risk factors related to post-COVID-19 remain unsolved. Here we aimed to differentiate post-COVID-19 patients among symptomatic and asymptomatic groups to check the percentage among them and the risk factors for post-COVID-19 and the association of different symptoms. MethodsThis study was conducted in Chittagong division, Bangladesh at different hospitals. Data were collected from the participants either by in person interview or online (email) or mobile phone calls. Follow up was done after 3 months to check the development of post-COVID-19 syndromes. Relevant data were taken, and symptomatic and asymptomatic patients were divided based on the presence and severity of specific symptoms. ResultsOur results showed that 41.88 % patients develop post-COVID-19 symptoms. Fever and Cough were classified as one of the factors of post-COVID-19, followed by dyspnea, fatigue, cough, rhinitis, sore throat, and muscular discomfort. On the other hand, age, respiratory distress, lethargy, duration of illness and severity were classified as risk factors for post-COVID-19. There was a significant difference between symptomatic and asymptomatic patients as only 16.3 % patients showed post-COVID-19 symptoms. Based on the severity grade, 80.7 % of patients had mild COVID-19. We also found that people with ‘B’ positive blood group had a higher chance of developing post-COVID-19 syndrome. ConclusionIt was concluded that age, duration of illness, presence of respiratory distress, blood group, and disease severity are major risk factors for the development of post-COVID-19 syndrome.

Vocal cord immobility after lateral pharyngotomy extraction of the impacted dentures in the upper esophagus: A Case Report

Impaction of foreign bodies in the esophagus is a frequent emergency in otorhinolaryngology. However, diagnosing and managing denture impaction in the esophagus presents greater challenges compared to other foreign bodies, often leading to various complications. This study reported a rare case of vocal cord immobility after the evacuation of denture impaction in the esophagus using lateral pharyngotomy. The patient, a 73-year-old man, experienced throat discomfort after swallowing a denture an hour before admission. According to the CT scan carried out, a 3.7 cm long denture was found around the T3-T5 spine level and was located 3 mm lateral right to the descendant aorta and 4 mm posterior of the trachea. During esophagoscopy extraction, the denture was stuck in the upper esophagus and was successfully evacuated by lateral pharyngotomy. Subsequently, the patient developed vocal cord immobility, and this case underscores the importance of considering vocal cord complications following the extraction of a denture impaction in the esophagus.

Evaluation of the clinical efficacy of ultra-fast track anesthesia for endoscopic thoracic sympathectomy of palmar hyperhidrosis.

In this study, we investigated the safety and practicability of ultra-fast track anesthesia (UFTA) for endoscopic thoracic sympathectomy (ETS). A total of 72 patients with palmar hyperhidrosis undergoing ETS were randomly divided into three groups: the UFTA group (group I), the group undergoing single-lumen tracheal intubation with local infiltration anesthesia technique (group II), and the group undergoing single-lumen tracheal intubation with routine anesthesia (group III). Mean arterial pressure (MAP) and heart rate (HR) were recorded for all three groups at the following six time points: Before anesthetics administration (T0), the time of intubating or inserting laryngeal mask airway (T1), the time of incising skin (T2), the time of disconnecting of the right sympathetic nerve (T3), the time of disconnecting of the left sympathetic nerve (T4), the time of withdrawing the tracheal tube or laryngeal mask airway (T5), and the time of transferring the patient to a post-anesthesia care unit (PACU) (T6). The three groups were compared from the following perspectives: surgery duration; anesthesia recovery duration, that is, the duration from discontinuation of anesthesia to extubating the tracheal tube; the dose of propofol and remifentanil per kilogram body mass per unit time interval (the time at the end of the procedure, which lasted from anesthesia induction to incision suturing); and the visual analog scale (VAS) in the resting state in the PACU. Based on pairwise comparisons, the average HR and average MAP values of the three groups differed significantly from T2 to T6 (p < 0.05). As demonstrated by the correlation analysis between remifentanil and propofol with HR and MAP, the doses of the total amount of remifentanil and propofol were lower, and group I used less remifentanil and propofol than group II. No patient in group I experienced throat discomfort following surgery. Patients in groups II and III experienced a range of postoperative discomfort. The VAS scores of groups I and II were significantly lower than those of group III, with group I lower than group II. When utilized in ETS, UFTA can provide effective anesthesia for minor traumas. It is safe, effective, and consistent with the enhanced recovery philosophy of fast-track surgery departments.

A Case Report of Vallecula Angioleiomyoma

Angioleiomyoma is benign smooth muscle tumor originating from the vascular wall. While they can occur in various anatomical locations, they are rarely reported in the vallecula region of the oropharynx. We present a case of a 58-year-old female patient with a five-year history of progressive dysphagia and throat discomfort. Laryngoscopy revealed a large, soft, mobile mass located on the right side of the vallecula. Radiological imaging further characterized the lesion as a well-circumscribed, heterogeneous mass. Surgical intervention in the form of Transoral Videolaryngoscopic Surgery (TOVS) was performed, leading to the successful removal of the mass. Histopathological analysis confirmed the diagnosis of angioleiomyoma.

Randomized Controlled Trial of Awake Transnasal Laser-Assisted Surgery for Benign Laryngeal Lesions.

To compare functional and cost-effectiveness of awake transnasal laser assisted-surgery versus microlaryngeal surgery for benign laryngeal lesions. This was a prospective non-inferiority randomized controlled trial conducted from May 2021 to December 2022 at two tertiary referral hospitals in Hong Kong. Patients were block-randomized to receive either awake transnasal laser-assisted surgery or microlaryngeal surgery, with post-operative follow-up in a multidisciplinary voice clinic for 1-year. Primary outcome was Voice Handicap Index (VHI-30). Secondary outcomes included operation time, complications, length of stay, peri-operative discomfort, recurrence, and medical costs. Sixty-one patients were randomized to either awake transnasal laser-assisted surgery (n = 30) and microlaryngeal surgery (n = 31). Both groups had comparable demographics and laryngeal pathologies. Both groups showed significant improvement of VHI-30 score over time and had comparable post-operative VHI-30. Awake transnasal laser-assisted surgery group had a significantly shorter length of stay (0.5 vs. 1 day) and less throat discomfort (2 vs. 4) compared to microlaryngeal surgery group. Intraoperative complications were more common in microlaryngeal surgery group (14.3% vs. 0%). Otherwise, both groups had similar operative time and recurrence rate. Cost-analysis showed a significantly lower hospital cost for awake transnasal laser-assisted surgery (USD 3090) compared to microlaryngeal surgery group (USD 5120). Awake transnasal laser-assisted surgery was safe, functionally non-inferior, as measured by VHI-30, to microlaryngeal surgery in managing benign laryngeal lesions, while superior to microlaryngeal surgery in peri-operative discomfort and medical costs. 2 Laryngoscope, 134:3732-3740, 2024.

Death from caustic ingestion: A case report

Rationale: Acute caustic ingestion from suicidal intent is not usual in emergency departments in developed countries. One of the substances commonly ingested by suicidal patients, phosphoric acid, tends to cause multi-system derangements. Patient’s Concern: A 41-year-old male patient presented with complaints of throat discomfort, severe generalized abdominal pain, and multiple episodes of hematemesis after ingesting a restroom cleaning solution. Diagnosis: Poisoning by acute caustic ingestion (containing &lt;30% phosphoric acid and &lt;4% ethylene glycol). Interventions: The patient was administered 50 mL of 8.4% sodium bicarbonate solution followed by an isotonic sodium bicarbonate solution running at 500 mL/h, a hyperkalemia kit, ceftriaxone, metronidazole, omeprazole, and atropine. The patient then underwent urgent hemodialysis. Outcomes: The patient suffered gastrointestinal bleeding as a result of local caustic injury. In addition, his course of illness was complicated by severe acidemia from high anion gap metabolic acidosis and deranged electrolytes (hyperphosphatemia, hyperkalemia, and hypocalcemia). He developed multi-organ failure and eventually demised. Lessons: The clinician needs to be mindful of the multi-system complications arising from such a caustic ingestion. These patients need to be monitored closely for deterioration, and have prompt management of the various arising complications, to reduce the high morbidity and mortality associated with this condition.

Clinical manifestations of gastro esophageal reflux among patients with chronic laryngitis in Benghazi, 2018

Gastroesophageal reflux disease is a chronic, complex condition that may present with atypical symptoms, including laryngitis. The aim of study to demonstrates the relationship of sings of reflux laryngitis in patients with typical manifestations of Gastroesophageal reflux disease (GERD). The present study included a total of 60 patients suffering chronic laryngitis with a range of age of 23 to 88 years in descriptive study in Benghazi Medical Center in the year 2018. History was collected and indirect laryngoscopy done for cases and data were analyzed using SPSS 23.0. Results The most common symptoms were hoarseness of voice, throat clearing, dysphagia, throat discomfort and globus sensation. No significant association of symptoms with gender of the patients. Most common laryngeal findings were hyperemia, vocal cord changes and posterior commisure hypertrophy. Significant association included only posterior commissure hypertrophy and infra-glottal edema. Conclusions and recommendations, Many didn't seek medical advice and most had no diagnostic procedure. Stronger study designs using proper diagnostic technique and patient education with staff training are recommended.

Case report: a rare combination of diffuse idiopathic skeletal hyperostosis and cervical septic spondylodiscitis

Ossification of the anterior longitudinal ligament of the spine is a rare pathology with still unclear etiopathogenesis, although some authors associate it with metabolic diseases such as diabetes. Another rare disorder whose etiopathogenesis is also closely related to immunological disorders in diabetes is spinal epidural empyema. We present a case of a 62-year-old man with comorbidities of arterial hypertension and type II diabetes mellitus, with complaints of dysphagia and throat discomfort one and a half years prior to hospitalization. About a month before hospitalization, the patient reports pain with limited cervical mobility, followed by episodes of fever up to 38°C, with developing upper extremity muscle weakness and self-care incapacity. After imaging and laboratory studies, the patient was diagnosed with Forestier disease according to Resnick and Niwayama criteria, with ossification of the anterior longitudinal ligament and spondylodiscitis with epidural empyema in the cervical compartment. The patient was started on empiric antibiotic therapy and emergency surgery was undertaken for osteophytectomy, median corpectomy with medullar decompression and vertebrodesis. Postoperatively, the patient had improvement in dysphagia and upper extremity muscle strength - MRC 5/5 at the 6-month follow-up. Timely diagnosis and operative treatment with adequate decompression, anterior vertebrodesis and subsequent targeted antibiotic therapy are essential for a good outcome in the management of patients with this combined pathology.

Differences Between Patients With Chronic Epipharyngitis With and Without Previous COVID-19 Infection.

Objective Epipharyngeal abrasive therapy (EAT) is effective in patients with chronic epipharyngitis who previously had coronavirus disease 2019 (COVID-19). The study aimed to evaluate differences between patients with chronic epipharyngitis with (long COVID) or without a history of COVID-19 (non-long COVID). Methods This is a retrospective study based on the analysis of medical records of patients who visited the Mogitate ENT Clinic in Kawasaki, Japan,for six months from March 2022. Results Patients with long COVIDwere significantly younger (p=0.018). Fatigueand brain fogwere prevalent in patients with long COVID, whereas throat discomfort,postnasal drip,and sputumwere more common in those with non-long COVID. Epipharyngeal endoscopic findings in patients with long COVID showed significantly higher scores (p<0.001) compared with patients with non-long COVID. Conclusions The primary differences between patients with long COVID and non-long COVID were age, symptoms, and severity scores of endoscopic findings. The EAT should be aggressively implemented in patients with chronic epipharyngitis with or without COVID-19 infection, as there is no reason not to treat a patient with a condition caused by COVID-19 infection.

Clinical Aspects of Chronic Idiopathic Postnasal Drip: An Entity Not to Be Overlooked.

Postnasal drip may be related to several diseases, but not all patients are clearly diagnosed. Patients with chronic, idiopathic postnasal drip symptoms are easily overlooked, and their clinical features are yet to be identified. This study aimed to analyze the clinical features and response to first generation antihistamine-decongestant therapy in patients with chronic idiopathic postnasal drip, suggesting it as a distinct entity. A retrospective cohort study involving 157 chronic idiopathic postnasal drip patients was conducted, analyzing demographics, symptoms, and treatment response to first-generation antihistamines and nasal decongestants. Mean age of patients was 55.4±17.0 years old. Median duration of symptom was 36 months (range=12-66 months) and severity in the visual analogue scale was 7 (range=5-8). Throat discomfort was the most frequently associated symptom (73.7%). Cough was recorded in 30.3% of patients. Viscosity of postnasal drip was associated with rhinorrhea and throat discomfort. Of the patients, 71.6% responded positively to 1st generation antihistamine-decongestant medication. However, 25.9% of patients presented symptom re-occurrence. Patients with nasal stiffness or persistent symptoms presented a higher re-occurrence rate compared to others. This study outlines the clinical features of patients with chronic idiopathic postnasal drip and suggests it as a distinctive entity., This proposal aims to enhance diagnostic precision and promote further research in the field.

Clinical management of Kandamaalai (Cervical Lymphadenopathy) through higher-order Siddha medicines: A case report

Abstract Cervical lymphadenopathy, characterized by the swelling of lymph nodes in the neck region, presents a complex clinical scenario with varied aetiologies. The integration of traditional medicinal systems, like Siddha, offers potential alternative therapeutic approaches. This case study deals with the management of bilateral cervical lymphadenopathy using Siddha remedies tailored for Kandamaalai. A 47-year-old female patient presented with a two-month history of cervical swelling, throat discomfort, otalgia, rhinitis, and anorexia. Diagnosis revealed bilateral cervical lymphadenopathy, akin to the Siddha concept of Kandamaalai. Treatment involved Siddha medications targeting Kandamaalai, administered without adverse effects. Subsequent improvement was clinically observed, with the resolution of symptoms and reduction in lymph node size corroborated by ultrasound (USG) findings. This case underscores the potential efficacy of Siddha therapy in treating cervical lymphadenopathy, particularly Kandamaalai. Further research, including robust clinical trials, is essential to validate these outcomes and elucidate the role of Siddha medicine in contemporary healthcare settings.

Impact of COVID-19 Pandemic on Emergency Medical Services

Emergency medical services (EMSs) are crucial to national health-care systems, facilitating the transfer of disaster, accident, and illness victims to hospitals or providing treatment in ambulances. During the COVID-19 pandemic, symptoms such as cough, fever, and throat discomfort significantly increased EMS calls in Israel, indicative of the virus’s impact. Concurrently, there was a notable rise in mental health-related calls and nonhospitalization incidents. As countries implemented social distancing and “stay-at-home” orders to reduce virus transmission and health-care system strain, several changes occurred in social behaviors and emergency response systems. This led to a reduction in emergency department (ED) visits, possibly due to fears of contracting COVID-19, suggesting that serious medical cases may have avoided seeking necessary care. Furthermore, in some regions, the high demand on EMS services resulted in prolonged response times. For instance, in Tijuana, Mexico, ambulance arrival times increased from 16.4 min in 2019 to 20.5 min during the pandemic’s peak. Similar delays were observed in New York City, including Manhattan and the Bronx. The global impact was also evident as ambulance response times, case volumes, and hospital wait times worsened even after lockdowns were lifted. In Italy, ambulance journeys that typically took 8 min extended to several hours. In addition, some trauma centers were unable to accept trauma patients due to a shortage of inpatient beds, further strained by the heightened demand for EMS amid the pandemic.

A Case of Tracheobronchopathia Osteochondroplastica Confirmed With a Subglottic Lesion

Tracheobronchopathia osteochondroplastica (TO) is rare idiopathic abnormality with incidence of 0.2%–0.7% from bronchoscopy. TO is characterized by focal or diffuse development of osseous and/or cartilaginous nodule in the submucosa of the trachea and bronchial walls. Most of the cases are asymptomatic, and if present, they can be nonspecific and diverse, such coughing and wheezing. Bronchoscopy and radiographic studies are useful diagnostic tool and conservative therapy is needed for each symptoms. Author reports a case of 49-year-old male who presented with throat discomfort without any significant past medical history. A subglottic nodular lesion with ulceration was identified, and laryngeal microsurgery for biopsy was done to rule out Tb or subglottic malignancy. However, the histopathological findings were indicative of TO, then we consult for bronchoscopy to confirm the diagnosis. Bronchoscopy also revealed consistent findings with TO. The patient is currently under conservative management and observation, without the need for further surgical intervention.