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Background: Chronic Otitis Media (COM) is a persistent inflammatory condition affecting the middle ear, characterized by symptoms such as ear discharge, tympanic membrane perforation, and hearing loss. Its prevalence, particularly high in developing countries like India, is influenced by socioeconomic factors and inadequate nutrition. This study aimed to evaluate graft uptake rates and hearing improvement in COM patients undergoing myringoplasty, regardless of ear moisture status. Additionally, the study sought to assess the impact of combining myringoplasty with cortical mastoidectomy on surgical outcomes. Methods: A prospective study was conducted at a tertiary Medical College in south India, from November 2021 to September 2023. Sixty patients with active and inactive mucosal type chronic otitis media were enrolled, with 30 patients in each group (dry and wet ears). Surgical procedures were performed based on individual patient characteristics, and outcomes were evaluated through graft uptake rates and hearing improvement. Results: Successful closure of tympanic membrane perforations was observed in both wet and dry ears, with comparable success rates of 89.65% and 96.67%, respectively. Graft uptake rates did not significantly differ between the two groups, suggesting similar outcomes irrespective of ear moisture status. While hearing gain was slightly lower in patients with wet ears compared to those with dry ears, the difference was not statistically significant. Conclusion: Myringoplasty remains an effective treatment for tubotympanic chronic suppurative otitis media, with comparable success rates in wet and dry ears. Factors such as age, sex, perforation size, and mastoid pneumatization did not significantly influence surgical outcomes. Cortical mastoidectomy, when warranted, may contribute to improved outcomes, particularly in cases of active disease. This study emphasizes the importance of thorough preoperative evaluation and patient selection in achieving favorable surgical results. [ABSTRACT FROM AUTHOR]

Background: The aesthetic aspect of Type I incomplete split ear lobe is underestimated. Most of the hole-retaining techniques described for large and split ear lobes are difficult to perform in Type I deformity. Aim: (1) To conduct a pilot study based on the postoperative review of the cases of Type I ear lobe deformities surgically managed with hole-retaining lobeplasty in a tertiary care centre in South India. (2) To assess the postoperative outcome of the hole retaining lobeplasty based on the Global aesthetic improvement scale and Patient satisfaction in Likert scale. Materials and Methods: A pilot study of hole-retaining lobeplasty technique was done based on the postoperative review of 6 patients with bilateral type1 incomplete split ear lobes who were operated in our institution with the same. The results were validated based on descriptive statistics and postoperative outcomes using GAIS score and Patient Satisfaction Score measured in a Likert scale. Results: None of the patients had any postoperative complications. At six months follow up, all patients had centrally placed, circular ear holes, well settled support flap and rounded lobe contour with an average GAIS score of 4.83 ± 0.38. All the patients were satisfied with their newly created ear hole and lobe contour, with an average Patient Satisfaction Score of 4.8 ± 0.4 Conclusion: Hole-retaining lobeplasty is a simple, cost effective, single staged, day-case procedure for repair of Type I large ear holes, that can be easily duplicated by young plastic surgeons with is aesthetically better, circular and centrally placed ear hole with a more rounded ear lobe with support to prevent recurrence. [ABSTRACT FROM AUTHOR]

India has been stated to have 10% of the world's total bat's diversity. The present survey was aimed to study the bat species diversity, distribution and activity patterns in north-western Himalayan region of India. Field surveys were conducted and echolocation calls were recorded using bat detector, Echometer touch 2 in Shiwalik ranges of Himalaya. The Greater False Vampire Bat (Megaderma lyra) has a broad distribution range that stretches from south to south east Asia. In India the distribution of the species was mostly recorded from southern subtropical coastal regions and north-eastern subtropical moist evergreen forests. In the present study The Greater False Vampire Bat (Megaderma lyra) has been recorded for the first time from Garhwal region of north-western Himalayas. Greater False Vampire Bat (Megaderma lyra) having long forearm (>6.63 ± 0.03cm) and lengthy ear (>3.66 ± 0.08cm), which is a distinguishable feature of the family Megadermatidae. The peak frequency (FMaxE) of echolocation was recorded as 50.295 ± 9.18 kHz. This frequency was initiated at 108.20 ± 2.51 kHz and terminated at 30.76 ± 1.37 kHz. The call structure recorded was very distinguishable and specific to this family. [ABSTRACT FROM AUTHOR]

Introduction: Ear biometry is a form of biometric identification that identifies individuals using unique physical characteristics of the ear. It is a non-invasive and reliable technique that can be used by forensic experts in related crime cases or for making a biological profile. The shape and size of the ear are determined by genetics and developmental processes and remain stable throughout a person's lifetime making this feature reliable and difficult to alter. However, these databases are scarce in India, and population variation can affect the accuracy of ear biometric identification. Aims and Objective: This study aims to develop population-specific discriminant formulas for sex estimation and a regression model for height estimation from the ear in the adult Haryanvi population. Materials and Methods: A total of 9 ear variables (left and right side) were measured on 113 males and 102 females with the help of vernier callipers. SPSS 16.0 was used for statistical analysis. Student's T-test showed a significant difference between males and females. Results: Discriminant function analysis revealed a sex classification accuracy of 78.1% accuracy using 8 variables. However, the regression analysis showed a weak correlation of ear variables with height (R2=.053 to 0.174). Conclusion: The findings of this research demonstrate that ear variables could be used to estimate sex but prediction with stature was found to be not highly significant and population variation must be considered for accurate results. The results of the present study can be used in different forensic scenarios for sex and stature estimation as well as in clinical and anthropological settings. [ABSTRACT FROM AUTHOR]

Introduction: Telemedicine is the practice of using telecommunication technology to provide healthcare services to patients in remote areas. Teleconsultation is used in various specialties of medicine, especially during the COVID-19 pandemic situation. But in developing countries like India, it is less practicable in surgical specialties like Otorhinolaryngology. Aim: To determine the eligibility and effectiveness of telemedicine practice in otorhinolaryngology during the COVID-19 pandemic in a tertiary care centre of Chengalpattu district, Tamil Nadu, India. Materials and Methods: A prospective cohort study was conducted at Chettinad Hospital and Research Institute, Tamil Nadu, India from September 2021 to February 2022 which involved 90 patients who requested a consultation for various ear, nose, and throat complaints. Based on history, a provisional diagnosis was made and treated. Feedback forms contained 11 questions were sent during the revisit and analyses were made. Statistical analysis were done using mean, proportion and Chi-square test. Results: This study included 49 (54.4%) male and 41 (45.6%) female patients with a mean age of 40.68 years. Only 23 (25.6%) patients had no problem seeing the doctor clearly and 19 (21.1%) had no trouble hearing the doctor. Only 4 (4.4%) patients accepted teleconsultation and will use teleconsultation services again. Conclusion: This study concluded that teleconsultation practice was not satisfactory for the majority of patients in the field of otorhinolaryngology. The inability to arrive at the definitive diagnosis and subsequent therapeutic procedures by using telemedicine was the limitation. [ABSTRACT FROM AUTHOR]

In recent times, nonrespiratory manifestations of COVID-19 have been well established. The skin manifestations in COVID-19 appear to be diverse and can result from viral infections, systemic consequences, or prescribed drugs. To date, five common lesions have been identified in patients with COVID-19. Here we report a diabetic patient with COVID-19 who developed papular lesions following COVID-19 infection. The lesions were not due to the drugs and were seen on the face, forehead, ears, neck, and upper limbs. As the studies related to cutaneous manifestations in COVID-19 are scarce, this report adds value to the existing literature. In some instances, skin lesions might be the only symptom of COVID-19. Hence, it becomes necessary for dermatologists to get acquainted with the various skin lesions for proper diagnosis and management of COVID-19. [ABSTRACT FROM AUTHOR]

Between August and October 2020, following the monsoon, signs of lumpy skin disease (LSD) were recorded and described in 154 oxen, 34 cows, 13 calves (Bos indicus) and two Asian water buffalo (Bubalus bubalis) cows belonging to smallholder farmers in 32 villages located around the Kanha and Bandhavgarh tiger reserves in the state of Madhya Pradesh, central India. Affected animals were subjected to a full clinical examination and detailed findings were recorded in a clinical register. A semi-structured questionnaire was attached to the existing clinical register format to gather information on the clinical disease history and animal husbandry practices relevant to the spread of LSD virus. The affected animals were between 4 months and 14 years of age (mean 6.4 (SD 2.5) years). Persistent high temperature, depression, anorexia, and characteristic round nodules (lumps) on the skin were reported. The nodules were 2–5 cm in diameter and spread over the face, ears, neck, back, perineum, scrotum, legs, tail, udder, and nasal and oral mucosa. Secondary complications of myiasis (n = 39), mastitis (n = 16) and ulcerative lesions on legs were noticed. Death was reported for one animal (0.5%). The affected animals' recovery times were variable (mean 18.4 (SD 2.7) days). There was a significant positive correlation between delay in initiating treatment and the duration of sickness. Reduction in milk yield of 30–55% was reported in Bos indicus cows. Clinical findings and treatment responses consistent with lumpy skin disease and its sequelae. The presumptive LSD outbreak caused serious economic loss to the animal keepers. LSD is a new disease for India and in the absence of active immunisation, efficient vector control, animal movement control and stall-feeding practice, it will inevitably become endemic in the country. The severe impacts resulting from the introduction of a new disease to a previously unaffected country highlight the need for iterative improvements in global transboundary disease surveillance. The value of clinical examination and recording of findings is demonstrated in the context of smallholder farming systems with limited access to laboratory diagnosis, which are common around the world. The description of an LSD outbreak in naïve populations of cattle and buffalo illustrates the need for increased awareness of the associated clinical signs and maintenance of high levels of biosecurity in hitherto disease-free countries. [ABSTRACT FROM AUTHOR]

Present study observed growth index and morphological characters of male and female Indian gerbil, Tatera indica (N = 64) live trapped from crop fields in Punjab, India as an attempt to record intra-specific variations. Growth index determined on the basis of increase in body weight and length of body parts recorded at weekly intervals upto nine weeks revealed a positive correlation between the two. No significant difference was found between growth index of male and female gerbils (body weight <150g and >150g). Tail length was slightly shorter (in <150g) or more (in >150g) than head+body length in females while, it was shorter than head+body length in males. Length of hind limbs was more in males, ears were oblong with fine hair on inner margin and the soles of hind paws were granulated. The study clearly depicted some differences in morphological and morphometric characteristics of T. indica suggesting further comprehensive studies to establish intra-specific variations. [ABSTRACT FROM AUTHOR]

Expression of anatomical landmarks of the ear results in the success of ear reconstruction in microtia. Ear reconstruction in India is routinely done with a two-dimensional (2D) template by tracing the contralateral ear with an X-ray sheet. There is a need of a proper template to understand the finer details of the ear reconstruction. In this report, a three-dimensional (3D) template in association with a 2D template is utilised to augment the reconstruction ability of the plastic surgeon. After computed tomography scan, an accurate 3D scan of the normal ear is obtained. Using the 3D ear model file, a negative mould of the ear 3D model is developed and fed into a 3D printer. The model is sterilised and used for reconstruction. Hyperbaric oxygen therapy is used as an adjunct for the procedure. Simultaneous utilisation of 3D and 2D templates for ear reconstruction appears to increase the ability of plastic surgeons to recreate the ear. [ABSTRACT FROM AUTHOR]

Introduction Amidst another wave of COVID-19, the alarming number of cases per day in India has affected the healthcare system and professionals tremendously. As the disease burden continues to increase, ear, nose, and throat (ENT) specialists remain at high risk of exposure to this aerosol borne virus. This requires the creation and regulation of protocols for conducting routine clinical practice, especially by ENT specialists. Objectives To review the available literature and to propose strategies and recommendations for ENT practitioners to conduct their regular practice amidst this pandemic. Data synthesis A systematic review of the available literature on ENT practice during the COVID-19 pandemic was done. Out of the many protocols proposed in various studies, the most practical and feasible ones that could be adopted by practicing ENT doctors/ surgeons in the long run were selected. Adequate precautions and use of high level of personal protective equipment (PPE) is required to be adopted by all practicing ENT doctors. Use of teleconsultation has been promoted as it limits face-to-face exposure. Proper guidelines should be followed for both emergency and elective surgeries. Endoscopy can be used as a safe and useful tool for ENT examination. Conclusion As practicing otorhinolaryngologists, it is of utmost importance that we take all necessary precautions and adopt safety measures in our clinical practice while conducting out patient department (OPD) consultations, operative procedures, and emergency care to protect our patients, ourselves, and other healthcare staff during this time. [ABSTRACT FROM AUTHOR]

Determining the lateralizing value of lying-down nystagmus (LDN) in horizontal semicircular canal benign paroxysmal positional vertigo (HSC-BPPV). The authors prospectively investigated LDN in 35 consecutive patients of HSC-BPPV (28 geotropic and 7 apogeotropic variants) attending an Otoneurology Centre in South Rajasthan India over a period of 20 months. LDN was present in 45.7% (16/35) patients of HSC-BPPV; 50% in those with geo-HSC-BPPV (14/28), and 28.6% (2/7) with apo-HSC-BPPV. When present, LDN directs contralaterally in 93% of geo-HSC-BPPV (13/14) and ipsilaterally in 100% of apo-HSC-BPPV (2/2). Only in 1 out of the 35 patients (2.9%), LDN was solitarily decisive in lateralizing the affected canal as the supine roll test elicited nystagmus of symmetric strength on the lateral head roll to either side. LDN is an important secondary sign of lateralization (SSL) in patients with HSC-BPPV (both geotropic and apogeotropic variants). LDN direction is mainly corroborative, but rarely when the lateral head rolls to either side elicits horizontal positional nystagmus of symmetric strength to either side, it can be solitarily relied on for lateralization. [ABSTRACT FROM AUTHOR]

Background The right ear advantage (REA) observed for dichotic CV (DCV) testing in Indian languages is seen to be smaller compared with the observations in several studies in English and other languages. Purpose The present study aims to explore whether the differences in the temporal alignment of consonant--vowel (CV) stimuli used for the dichotic task is a contributing factor that can explain the smaller REAs observed in Indian languages. Research Design The study compared the laterality index (LI) values between DCV test results obtained using CV stimuli that were temporally aligned at the acoustic onset versus the burst onset, with 0 milliseconds lag between the right and left ears. Study Sample A total of 50 right-handed individuals (native speakers of Kannada language) in the age range of 17 to 30 years with normal hearing sensitivity participated in the study. Data Collection and Analysis The participants' responses to the two sets of DCV stimuli were recorded and compared. LI was calculated for the overall scores as well as for specific voiced and unvoiced segment combinations. To test the reliability of the findings, 10 of the participants were re-tested using the same stimuli and the data were checked for reliability. Results The overall LI was 15.1% for the stimuli temporally aligned at the burst onset, whereas it was 5.7% for the stimuli temporally aligned at the acoustic onset. The difference in LI was not significant between the alignment conditions for unvoiced--unvoiced and voiced--voiced CV combinations, but this difference was significant for the unvoiced--voiced and voiced--unvoiced CV combinations. Comparing test and retest scores showed good reliability. Conclusion The results support our hypothesis that smaller REA observed in DCV task in Indian languages was due to the temporal alignment of CV stimuli. In the acoustic-onset- aligned condition, presenting pairs contrasting in the voicing feature tends to cancel out a relative ear advantage. [ABSTRACT FROM AUTHOR]

Ear piercing is a simple office procedure commonly done in India for traditional purposes and after repair of the split ear lobule and ear lobule reconstruction. Multiple methods have been described, but the main goals of any procedure are that it should be simple, easily reproducible, inexpensive, and accurate and should allow the formation of a neat straight tract without complications, most commonly infection. We have devised a simple and reproducible method for ear piercing using an easily available, sterile intravenous cannula. The cannula creates a precise hole, and the earring can be easily threaded through the sheath after removing the needle. This method of piercing mitigates the risk of infection normally associated with the procedure especially when done through cartilage. The same technique can also be used in children with a slight modification as described in the article. [ABSTRACT FROM AUTHOR]

Coronary artery disease has been a number one killer worldwide and in India it has increased phenomenally as the most important cause of sudden natural death of cardiac aetiology in the last few decades. Changing lifestyles, stress, habits, presence of other predisposing pathologies etc have played direct as well as indirect roles in its causation. Conventionally the predictors for coronary artery disease have been predominantly risk factors. Notwithstanding this, of recently a number of extra cardio vascular physical parameters like ear lobe crease have shown a reasonably promising trend in predicting the presence of coronary artery disease thereby enabling prompt intervention which in turn can reduce cardiac mortality in the long run. The present study focuses on this aspect of detecting an association between diagonal ear lobe crease and sudden death due to coronary artery disease. A total of 188 cases brought for medicolegal autopsy was studied. It has been revealed that diagonal ear lobe crease detected at autopsy has a statistically significant association with both the presence of coronary artery disease as well as the severity of atheromatous occlusion in sudden deaths. Hence diagonal ear lobe crease can have a reasonable predictive value in detecting coronary artery disease that could be used for the early detection of individuals with coronary artery disease and thus pave the way for early interventional strategies. [ABSTRACT FROM AUTHOR]

Background: In otorhinolaryngology region, about half of the malformation affects the ear. Congenital anomalies of the ear can affect the external ear, middle ear, and inner ear. The ear malformations can be unilateral or bilateral. In this study, we enrolled patients with preauricular cyst, tag, accessory tragus, preauricular sinus, pinna sinus, microtia, anotia, EAC atresia, and congenital sensorineural hearing loss (SNHL). Hearing loss may lead to delayed language development and poor school performance. Universal newborn hearing screening allows for earlier detection and intervention in infants with hearing loss, which may result in improved language development in affected children. Estimated rates of congenital SNHL range from 1/1000 to 3/1000 live births. Aim and Objective: Proper and early diagnosis can change the future of a child by providing hearing rehabilitation and speech therapy. Materials and Methods: It is a prospective study of 122 patients of ear-related anomalies, conducted at the Government Medical College and Sir T. Hospital, Bhavnagar, Gujarat, India, from January 2016 to July 2018. Results: we have observed patients with otological malformations which includes external, middle and inner ear malformations. Conclusion: This study contains 122 patients, of which more than half of the patients are male (54.91%). We obsereved patients with Congenital SNHL, pinna anomalies, congenital facial weakness. We have also obtained cases with Waardenburg syndrome and Goldenhar syndrome. [ABSTRACT FROM AUTHOR]

Introduction: In India, significant number of individuals suffers from ischemic heart disease (IHD). Majority of chest pain victim initially report to his family physician. At times, sudden death is the first and last manifestation of IHD. Doctors are aware of various risk factors for IHD. The diagonal ear lobe crease (DELC) has been characterized in medical literature as a surrogate marker which can be easily identified as high‑risk case for impending IHD. We report here the incidence of IHD accompanied with DELC in rural population. Patients and Methods: Eight hindered and eighty eight patients attended to general physician Mahad during January 2012 to December 2015 with complaints of chest pain were investigated for presence of DELC. Presence of DELC was correlated to varies risk factors including hypertension, hyperlipidemia, diabetes mellitus (DM), body mass index (BMI), occipital baldness, and tobacco consumption. Results: Out of patients studied, 645 (72.6%) had hypertension, 508 (57.2%) had DELC, of these 486 (95%) suffered from IHD, 246 (48%) had DM, 246 (48%) had occipital baldness, and 325 (64%) had hyperlipidemia. Significant association between BMI > 25+ in male >50 years old with odd ratio 2.08 (95% CI: 1.27–3.39; P = 0.003). Interpretation: Presence of DELC with or without risk factors is a simple clinical observation easily noted during examination by family physician to investigate and to rule out IHD. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization (WHO) as per its recent estimates has predicted increasing prevalence of hearing loss globally. Data on magnitude of hearing loss in Delhi, India, are scarce, and the present study aims to highlight the extent of hearing loss problem in population using the standardized WHO protocol. Materials and Methods: A community-based cross-sectional study using the WHO protocol on "Survey for prevalence and causes of hearing loss" was conducted in selected rural and urban areas of Delhi from January to December 2017 among study participants aged 3 months and above. The sample size of 664 was taken from rural and urban areas of Delhi. Data collection instruments included the WHO structured questionnaire, hearing test, and ear examination using handheld otoacoustic emission (OAE) in children <5 years of age and pure-tone audiometry in persons >5 years. Ethical clearance was taken from the Institutional Ethical Committee. Written informed consent/assent was taken from study participants. Data were analyzed using SPSS (version 25). Qualitative data were expressed in percentage and quantitative data were shown as mean + standard deviation (SD). Results: The prevalence of hearing loss was 26.9%–15.6% in rural area (Barwala) and 84.4% in urban areas (0.62% in Balmiki Basti, 15.6% in Delhi Gate, 64.4% in Gokulpuri, and 3.8% in Vikram Nagar). Mean + SD age of study participants was 32.17 + 20.85 years. Mild hearing loss was seen in 66.7%, 54.5%, and 43.5% in 6–9, 10–19, and 20–39 years' age group of participants, respectively. Severe hearing loss was seen in 46.7% and 68.3% of study participants in 40–59 and >60 years' age group, respectively. Severe hearing loss was seen in 55.3% males and 42.8% females, respectively. In children <5 years, OAE was passed in 69.4% male and 30.6% female children. About 14.3% children with OAE referred were males and 85.7% were females. Conclusion: The prevalence of hearing loss using the WHO protocol was 26.9% in Delhi, and severity increased with increasing age and more among males than females. [ABSTRACT FROM AUTHOR]

Background: Candida auris has emerged globally as an MDR nosocomial pathogen in ICU patients.Objectives: We studied the antifungal susceptibility of C. auris isolates (n = 350) from 10 hospitals in India collected over a period of 8 years. To investigate azole resistance, ERG11 gene sequencing and expression profiling was conducted. In addition, echinocandin resistance linked to mutations in the C. auris FKS1 gene was analysed.Methods: CLSI antifungal susceptibility testing of six azoles, amphotericin B, three echinocandins, terbinafine, 5-flucytosine and nystatin was conducted. Screening for amino acid substitutions in ERG11 and FKS1 was performed.Results: Overall, 90% of C. auris were fluconazole resistant (MICs 32 to ≥64 mg/L) and 2% and 8% were resistant to echinocandins (≥8 mg/L) and amphotericin B (≥2 mg/L), respectively. ERG11 sequences of C. auris exhibited amino acid substitutions Y132 and K143 in 77% (n = 34/44) of strains that were fluconazole resistant whereas WT genotypes, i.e. without substitutions at these positions, were observed in isolates with low fluconazole MICs (1-2 mg/L) suggesting that these substitutions confer a phenotype of resistance to fluconazole similar to that described for Candida albicans. No significant expression of ERG11 was observed, although expression was inducible in vitro with fluconazole exposure. Echinocandin resistance was linked to a novel mutation S639F in FKS1 hot spot region I.Conclusions: Overall, 25% and 13% of isolates were MDR and multi-azole resistant, respectively. The most common resistance combination was azoles and 5-flucytosine in 14% followed by azoles and amphotericin B in 7% and azoles and echinocandins in 2% of isolates. [ABSTRACT FROM AUTHOR]

Aims and Objectives: To study the clinical spectrum & psychological well-being in Turner's syndrome. To evaluate bone health with assessment of BMD. Methodology: Diagnosis of Turner syndrome was done by karyotyping, involving a study of at least 50 metaphases and including G banding. All clinical features & laboratory investigation noted. Areal BMD using HOLOGIC DXA machine was performed inTurner syndrome&both height adjusted & unadjusted BMD Z scores were calculatedfor all the patients. After 20 years of age Z scores (Height unadjusted) were only taken into consideration. GAD 7 & PHQ9 questionnaire are used for psychological assessment if child age (311 years). GAD 7 score is used for anxiety assessment. PHQ9 questionnaire score were used for depression. Results: Most common karyotype is 45x (53.3%) followed by 45Xi (Xq) (13.3%). 46XY/45X (6.7%) underwent oophorectomy in view of malignant potential of gonads. The median age of diagnosis of Turner syndrome is 14 Year 3 months; Range (4Y-29Y). The main presenting complaints are short stature (98%) & delayed puberty (91%) including primary amenorrhea. Spontaneous puberty has occurred in 4.5%. Mean height SDS -3.45 and 98% has height below -2 SDS. Mean height SDS change with GH therapy is 1.19 (pvalue:<0.05). 68.2% has low BMD (Z score £-2) without height adjustment &median age of patients having low BMDwithout height adjustment 17 years 5 months (11-29 Years) while 9.1% patient has low BMD (Z score £ -2) with height adjustment. Mild, moderate & severeanxiety are present in 19.4%, 16.7% & 2.8% respectively. Mild, Moderate & severe depression are present in 13.9%, 22.2%, 5.6% respectively. Mild conductive, mild sensorineural & moderate sensorineural hearing loss in right ear is present in 11.1%,11.1% & 2.2% of the patients whilemild conductive & mild sensorineural hearing loss in left ear is present in 4.4% & 8.9% of the patients. Among other clinical stigmata in Turner syndrome includes webbed neck (60%), low hair line (64.4%), wide carrying angle (80%), high arch palate (73.3%), multiple nevi (33.3%), clinodactyly (20%), scoliosis (6.7%). Among cardiovascular complication bicuspid aortic valve (13.3%) & Coarctation of aorta (4.4%). Among ocular manifestation include lateral ptosis (6.2%)& squint (3.2%). Other clinical parameters include kidneyabnormalities (8.8%), hypothyroidism (8.9%), coeliac disease (1.6%) & type 1 DM (1.6%). Among laboratory parameters mean corrected calcium (9.54 mg/dl), mean phosphorous (4.1%) & ALP (199.9 u/l). Impaired glucose tolerance present in Turner syndrome based on FBSL (7.8%), PPBSL (10.4%) & HBA1C (19.3%). Conclusion: Height adjusted aBMDs are not low in Indian TS population while height unadjusted aBMD is low in Turner patients. Primary amenorrhea & short stature are most common manifestation which often leads to late diagnosis of the syndrome. Early detection and management is important for height outcomes, bone health and psychosocial support. Assessment of comorbidities is important to prevent further complication. [ABSTRACT FROM AUTHOR]

Cell phone explosions and resultant burn injuries are rarely reported in the scientific literature. We report a case of cell phone explosion that occurred when a young male was listening to music while the mobile was plugged in for charging. [ABSTRACT FROM AUTHOR]

Background:Cartilage-perichondrial grafts are often used for tympanic membrane and middle-ear reconstructions. Tragal and conchal cartilages are most frequently used for this purpose. Studies have shown that slicing the cartilage to less than 0.5 mm thickness improves acoustic benefit. However, the thickness of the cartilage in a given population may not be uniform.Objective:This descriptive cross-sectional study aimed to determine the average thickness of tragal cartilage (in terms of age and sex) in an Indian population.Method:A prospective study of 61 tragal cartilages harvested during serial tympanoplasty and modified radical mastoidectomy were analysed according to thickness.Results:The total average thickness of tragal cartilage was 1.228 ± 0.204 mm in males and 1.090 ± 0.162 mm in females. The overall thickness was 1.018 ± 0.139 mm in those aged less than 15 years, 1.139 ± 0.238 mm in those aged 15–30, and 1.189 ± 0.155 mm in those aged over 30 years.Conclusion:The findings help us to determine age-related cartilage thickness for slicing techniques in tympanoplasty. [ABSTRACT FROM PUBLISHER]

Objectives: The aim of our study is to find out whether early identification and intervention prevents severe linguistic and communication delays, minimizing the need for more elaborate rehabilitation during the school years. Design and Study Sample: A Cross-sectional study was carried out on one hundred and eleven children with documented deaf-mutism presenting at the Department of Oto-Rhino-Laryngology in two different geographical regions of India. Detailed history, clinical and audiological assessment along with assessment of the language and communication skills according to American Speech Language Hearing Association (ASHA) guidelines was done. Results: The children were predominantly male, of low socio-economic background, presented for rehabilitation, mostly after the age of six years. They commonly had more than 70dBHL (decibel hearing level) hearing threshold. The study found that the children who presented early for diagnosis and hearing aid usage had better response to rehabilitation. Conclusion: It is important that hearing loss be detected at an early age and amplification should be introduced as early as possible once there has been a diagnosis of a hearing loss. So that early intervention can have an impact on speech and language development. Without concurrent follow-up program, identification of hearing loss early in children is meaningless. [ABSTRACT FROM AUTHOR]

Aims and objectives The main aim of this survey was to assess the prevalence of common ear, nose and throat (ENT) disorders in the rural India. Setting After initial screening of the patients at the primary health center, a week long camp was organized in a district where entire population resides in the rural area and a complete ENT examination and investigation was done by the ENT specialists. Materials and methods A total of 950 patients were found to be suffering from the ENT ailments in the total population of thirty thousands of the district (4.31 %). Out of the total of 950 patients 36.6% of patients (n = 348) had ear problems, 23.57% (n = 225) had nasal problems, while 16.58% (n = 161 ) of patients were suffering from the throat disorders. Among the ear patients most common diagnosis was chronic suppurative otitis media (CSOM) 114 and presbyacusis 83. Deviated nasal septum and sinusitis was most common diagnosis in nasal symptoms while gastroesophageal reflux (GERD) was the commonest throat problems seen in this study. Eleven patients had various benign tumors of head and neck and only one patient was found to be having oropharyngeal malignancy. The congenital head and neck lesion was seen in only four patients. Conclusions In this survey 4.31 % of the rural population of the district were having ENT ailments. The highest numbers rural population (35.65%) were having ear diseases. This was primarily due to low socioeconomic status and lack of awareness of the population. The nasal problem was seen in 23.57%, while throat problem was seen in 16.58%. The percentage of head neck malignancy in this survey was 0.0028. [ABSTRACT FROM AUTHOR]

Pseudocyst of the pinna, a benign idiopathic cystic swelling is an uncommon condition. In the medline search there are over 113 cases reported in literature. Engel in 1966 reported the incidence in Chinese community. In this review article we describe the etiopathogenesis, demographic statistics and treatment modalities. This is a retrospective study of six cases treated by the senior author in the dept of Otorhinolaryngology, Head & Neck Surgery, Apollo Hospital Chennai, South India between 1993 through 2003. There is preponderance of incidence in adult male (5 cases) and a single case in a female . The author highlights the modalities of treatment and opines that the surgical technique described by Lim et al, with little modification is the gold standard, which retains the architecture of the pinna. Conservative methods adopted by others have failed. [ABSTRACT FROM AUTHOR]

Background Candida auris is a growing global threat; a pathogen associated with high mortality (up to 60%), multidrug resistance, the ability to spread from person-to-person and surface-to-person, presenting high risk for outbreaks in healthcare facilities. Ibrexafungerp is a novel IV/oral glucan synthase inhibitor (triterpenoid) antifungal with activity against Candida , Aspergillus, and Pneumocystis spp. in Phase 3 development. Methods In vitro studies tested ibrexafungerp against >100 clinical isolates of C. auris. Other in vitro studies evaluated the effects of ibrexafungerp against C. auris biofilms. In viv o activity against C. auris was evaluated using a disseminated murine model and a cutaneous infection guinea pig model. In humans, an ongoing open-label trial of ibrexafungerp for treatment of patients with infections caused by C. auris (the CARES study) has been initiated in the United States and India. Results In vitro and in vivo studies demonstrated that ibrexafungerp is active against C. auris , including MDR strains. The MIC mode for ibrexafungerp was 1 μg/mL and the MIC50 and MIC90 were 0.5 and 1 μg/mL, respectively. Many echinocandin-resistant C. auris isolates have shown susceptibility to ibrexafungerp. Furthermore, ibrexafungerp has been shown to reduce biofilm thickness. In animal models of C. auris infection, treatment with ibrexafungerp resulted in improved survival and reduced fungal burden in both the murine model of disseminated infection and the guinea pig model of cutaneous infection as compared with untreated controls. In humans, two patients with difficult to treat C. auris candidemias were enrolled in the CARES study and responded positively to oral ibrexafungerp with eradication of the infection. Conclusion These data demonstrate that ibrexafungerp possess potent in vitro and in vivo activity as well as promising clinical activity. Therefore, continued clinical evaluation of ibrexafungerp as an option to treat C. auris infections is warranted. Disclosures All authors: No reported disclosures. [ABSTRACT FROM AUTHOR]

Objective: To propose a new classification of inner-ear anomalies that is more clinically oriented and surgically relevant: the SMS (Sawai Man Singh) classification of cochleovestibular malformations., Methods: A retrospective multicentric study was conducted of 436 cochlear implantations carried out in 3 Indian tertiary care institutes. Patients with anomalous anatomy were included and classified, as per the new SMS classification, into cochleovestibular malformation types I, II, III and IV, based on cochlear morphology, modiolus and lamina cribrosa., Results: There were 19, 23, 8 and 4 patients with cochleovestibular malformation types I, II, III and IV, respectively. Two-year post-operative Meaningful Auditory Integration Scale scores were statistically analysed., Conclusion: This new classification for inner-ear anomalies is a simpler, more practical, outcome-oriented classification that can be used to better plan the surgery. These merits make it a more uniform classification for recording results.

Anemia in Indian women continues to be highly prevalent, and is thought to be due to low dietary iron content. The high risk of dietary iron deficiency is based on the Indian Council of Medical Research recommendation of 21 mg/d, but there is a need for a secure and transparent determination of the Estimated Average Requirement (EAR) of iron in this population. In nonpregnant, nonlactating women of reproductive age (WRA), the EAR of iron was determined to be 15 mg/d. Applying this value to daily iron intakes among WRA in nationally representative Indian state-based data showed that the median risk of dietary iron deficiency was lower than previously thought (65%; IQR: 48-78%), with considerable heterogeneity between states (range: 25-93%). However, in a validation, this risk matched the risk of iron deficiency as defined by blood biomarkers in a recently completed survey. When the risk of dietary iron deficiency was modelled for an increase in iron intake through food fortification of a single dietary staple, that provided 10 mg/d, the median risk reduced substantially (from 65% to 20%), and it virtually disappeared when supplementary iron intakes through the national iron supplementation program were considered. The risk of exceeding the tolerable upper level (TUL) of intake of iron remains low in the population when receiving fortification of 10 mg/d, but is much higher if they consume greater amounts of iron through supplements (range: 0-54%). This newly and transparently defined Indian EAR of iron should be used to evaluate, with precision, the benefits and risks of iron fortification and supplementation policies., (© 2019 American Society for Nutrition.)

Presents news briefs related to bioscience. How hair cells deep inside the ear operate when exposed to sound waves; How scientists from the United States Department of Agriculture are using pathogenic fungus to infect and subdue grasshopper populations in western U.S. rangelands; Length of time grasshoppers need to spend in the sun to warm their bodies enough to destroy the fungus; Effectiveness of face masks worn on the back in warding off tiger attacks in the Sunderban reserve of west Bengal; Number of volunteers who wore masks, depicting human faces, on the backs of their heads as they went about fishing and gathering.

The availability of techniques for the vitrification of cloned blastocysts can improve their effective use. The present study compared the developmental competence of buffalo cloned embryos derived from adult (BAF), newborn (BNF) and fetal fibroblast (BFF) before and after vitrification. Despite similar cleavage rates among the three groups, the blastocyst rate was lower for BAF- than BNF- and BFF-derived embryos (30.2±2.2% vs 41.7±1.7% and 39.1±2.1%, respectively; P<0.01). The total cell number of BNF-derived blastocysts was significantly higher (P<0.01) than that of BFF-derived blastocysts, which, in turn, was higher (P<0.01) than that of BAF-derived blastocysts. Following transfer of vitrified-warmed blastocysts to recipients, no pregnancy was obtained with fresh (n=8) or vitrified-warmed (n=18) BAF-derived blastocysts, whereas transfer of fresh BNF- (n=53) and BFF-derived (n=32) blastocysts resulted in four and three pregnancies, respectively, which aborted within 90 days of gestation. The transfer of vitrified-warmed BNF-derived blastocysts (n=39) resulted in the live birth of a calf weighing 41kg, which is now 23 months old and has no apparent abnormality, whereas the transfer of vitrified-warmed BFF-derived blastocysts (n=18) resulted in one live birth of a calf that died within 6h. These results demonstrate that cloned buffalo embryos cryopreserved by vitrification can be used to obtain live offspring.

Purpose: The aim of this study was to increase awareness of the different presentations of head and neck tuberculosis (TB) and to discuss its diagnostic difficulties., Materials and Method: A retrospective analysis of patients who presented to us, at a secondary referral hospital, primarily with TB of head and neck was done from January 1999 to July 2003., Results: A total of 117 patients presented with primary head and neck TB during the study period. Most of these (95%) had cervical lymphadenopathy, 2 patients had laryngeal TB, and there was 1 patient each of TB of cervical spine, oropharynx, ear, and retropharyngeal abscess. Forty-one were males, and 76 were females. Thirty percent of cases had associated lung or other organ TB. Nine percent gave history of previous or subsequent TB., Conclusions: 1) Diagnosing TB requires a high index of suspicion. 2) Tuberculosis of the cervical lymph nodes is the commonest presentation followed by laryngeal TB. 3) Fine needle aspiration cytology (FNAC) is a reliable and easy way to diagnose TB. However, newer diagnostic tests will increase the yield of positive cases and should be used whenever required. 4) In the larynx, the vocal cords were the commonest site affected and laryngeal TB need not be associated with lung TB or positive sputum always. 5) Patients who have TB of head and neck must be investigated to exclude pulmonary or systemic TB. 6) In cases of previous or subsequent TB infection, culture and drug sensitivity is indicated to reduce the problem of multiple drug resistance.