Government ENT Hospital

BackgroundDepression and anxiety are highly prevalent in the U.S. and can hinder engagement in preventive health services. Individuals affected by these conditions may have reduced motivation and lower health literacy, increasing their vulnerability to missed preventive-care opportunities such as vaccination. Awareness of human papillomavirus (HPV) and the HPV vaccine is crucial for cancer prevention but remains underexplored among adults with mental-health conditions.MethodsWe analyzed data from the Health Information National Trends Survey (HINTS) 5, Cycles 1-4 (2017-2020), to assess HPV and HPV-vaccine awareness among U.S. adults aged 18-44 with self-reported depression and/or anxiety. Weighted descriptive statistics, chi-square (χ²) tests, and multivariable logistic-regression models were used to assess awareness and associated sociodemographic and health-related factors. The primary aim was to estimate the prevalence of HPV and HPV-vaccine awareness, while the secondary aim was to identify associated sociodemographic and health-related predictors. Awareness was defined using binary (“yes”/“no”) responses to HINTS items, and mental-health exposure was defined as self-reported physician-diagnosed depression and/or anxiety.ResultsThe analytic sample included 1,105 adults, most of whom were female (n = 709; 64.1%), aged 18-34 years (n = 623; 56.4%), White (n = 753; 68.2%), and urban residents (n = 956; 86.5%). Approximately one-third (n = 372; 33.5%) held a college degree, and n = 384 (34.8%) reported annual income ≥ $75,000. Overall, 944 (85.4%) were aware of HPV, and 839 (75.9%) were aware of the HPV vaccine. Higher educational attainment (χ² = 46.7, p < 0.001) and female sex (χ² = 6.88, p = 0.009) were associated with greater awareness, whereas Hispanic ethnicity (χ² = 9.4, p = 0.024) and male sex were linked to lower awareness. Participants with two or more comorbidities showed higher HPV awareness (χ² = 6.11, p = 0.047) but not vaccine awareness (χ² = 2.34, p = 0.311).ConclusionsWhile overall awareness of HPV is high, disparities persist by sex, education, and ethnicity among adults with depression and/or anxiety. Integrating culturally tailored and literacy-appropriate HPV education into mental-health and primary-care settings may promote equitable vaccine awareness and uptake.

Background: Platelets, besides being major elements of hemostasis, play a significant role in inflammation and immunity, and hence, platelet lymphocyte ratio (PLR) has been tried as an indicator of the severity of inflammation. The objective of this study is to determine whether the PLR at admission can predict the severity and prognosis of snake envenomation and to identify a precise cutoff value for this measurement. Subjects and Methods: This was a prospective observational study done from July 2019 to June 2020 with a history of snake bite &lt;48 h. All patients were treated as per the National Snake Bite Treatment Protocol. PLR at admission was labeled as PLR1. The amount of Anti snake venom (ASV), duration of pediatric intensive care unit (PICU) stay, and major complications were correlated with PLR1 values. Results: PLR values were significantly higher ( P &lt; 0.001) in neurotoxic snake bites (179.31 ± 53.56) and hematotoxic snake bites (134.52 ± 48.35) compared to nontoxic ones. PLR1 values were also significantly higher ( P &lt; 0.001) in cases requiring &gt;20 ASV vials, &gt;2 days of PICU stay, and in patients with cellulitis. A PLR value 72.55 can predict envenomation with 91.5% sensitivity and 75% specificity. In addition, PLR values of 183.7 and 124.83 can predict the need for &gt;10 ASV vials with 51% sensitivity and 90% specificity and the occurrence of major complications with 78.6% sensitivity and 66% specificity, respectively. Conclusions: PLR at admission can predict the severity of snake envenomation and its complications in children with fair specificity and sensitivity.

Background: Alpha-1 blockers reduce smooth muscle tension and alleviate spasms, thereby decreasing obstructions and relieving irritative symptoms in the lower urinary tract. This study aimed to assess the effectiveness of Tamsulosin and its impact on health-related quality of life in patients with distal ureteral calculi. Methods: A total of 120 patients with distal ureteral calculi were enrolled in this study and randomly assigned into two groups. Group 1 (n=60) received conservative therapy, while Group 2 (n=60) received Tamsulosin (0.4 mg daily) in addition to conservative therapy. All patients were monitored for pain, intensity of ureteric colic, and spontaneous stone expulsion. Health-related quality of life (HRQoL) was assessed for each patient using the RAND SF-36 Health Survey 1.0. Results: Spontaneous stone passage occurred in 52 patients (85%) in Group 1 and in all 60 patients (100%) in Group 2, with a statistically significant difference between the groups (P&lt;0.001). Analysis by stone diameter further indicated significant differences favoring Tamsulosin treatment for stones ≤6 mm (P=0.04) and &gt;6 mm (P=0.003). Health-related quality of life scores were significantly higher in the Tamsulosin group compared to the conservative therapy group. Conclusion: Tamsulosin, an alpha-1 blocker, is recommended for treating distal ureteral calculi, as it facilitates faster stone expulsion, increases expulsion rates, and enhances quality of life by reducing the frequency and severity of ureteric colic.

Background: Sjögren's Syndrome (SjS) is a chronic autoimmune disorder predominantly affecting exocrine glands, leading to symptoms such as keratoconjunctivitis sicca and xerostomia. This review focuses on the ear, nose, and throat (ENT) manifestations of SjS, which significantly impact patient quality of life and pose diagnostic challenges. Aim: The review aims to consolidate current knowledge on the ENT manifestations of SjS, exploring pathophysiological underpinnings, clinical presentations, and treatment strategies, while addressing the diagnostic challenges associated with the disease. Review Summary: ENT manifestations in SjS include nasal dryness, recurrent sinusitis, otitis, and laryngeal dryness, which may precede other systemic manifestations, aiding in early diagnosis and management. This review highlights the importance of recognizing these symptoms for timely intervention, which can significantly improve disease prognosis. Future Implications: Understanding ENT manifestations can enhance multidisciplinary management approaches and foster development in diagnostic and therapeutic strategies, potentially improving patient outcomes and quality of life. Clinical Policy and Development: Enhanced awareness and training on the ENT aspects of SjS are recommended for healthcare professionals. Development of more sensitive diagnostic tools and personalized treatment plans could also address the variability in symptom presentation and response to treatment. Keywords: Sjögren's Syndrome, ENT Manifestations, Xerostomia, Keratoconjunctivitis Sicca, Multidisciplinary Management

Background: Laparoscopic cholecystectomy (LC), a minimally invasive gallbladder removal surgery, has revolutionized the field with benefits like quicker recovery. However, it is not without risks, and bile duct injury (BDI) is a severe but rare complication. BDI incidence during LC varies (0.4%-0.9%), with potentially life-threatening consequences. Surgeon experience, intraoperative cholangiography, and careful handling are crucial in preventing and managing BDIs. Aim of the study: This study aims to present and analyze a Multi centre experience regarding the management of these bile duct injuries in LC. Methods: This retrospective study, conducted at UAE medical institutions from 2014 to 2024, analyzed 2400 Laparoscopic Cholecystectomy surgeries over ten years. Out of 18 patients, thirteen patients were treated with ERCP, while five required additional surgery. Inclusion criteria involved patients aged 30 to 70+, of both genders, with BDIs. Exclusion criteria included minor BDIs and comorbidities. Two diagnostic techniques, including intraoperative cholangiography and postoperative assessments, identified BDIs. Treatment varied based on Strasberg classification, involving suturing, ERCP, stent placement, and Roux-en-Y hepaticojejunostomy. Data analysis employed SPSS, presenting results through tables and graphs with statistical parameters. Result: The study focused on Laparoscopic Cholecystectomy-related Bile Duct Injuries (BDI), with a cohort primarily aged 51-70 (66.67%). This age group showed higher susceptibility to BDI. The average participant age was 55.21±12.54 years, with a male majority (55.56%). Among 18 Endoscopic Retrograde Cholangiopancreatography (ERCP) cases, five had BDI, diagnosed intra/postoperatively. Two patients with clinical symptoms had postoperative diagnosis through Percutaneous Transhepatic Cholangiography (PTC). Strasberg classification revealed 60% Type A injuries; Types E1 and E2 each constituted 20%. Treatment modalities varied, with ERCP for Type A injuries (60%) and Roux-en-Y Hepaticojejunostomy (RYHJ) for Types E1 and E2. Conclusion: ERCP is a valuable method for diagnosing and managing Bile Duct Injuries (BDIs). The predominant type of BDIs, specifically Type A, is typically diagnosed after surgery. ERCP demonstrates its efficacy in addressing the majority of Strasberg Type A BDIs. In substantial and intricate BDIs, the Roux-en-Y Hepaticojejunostomy is a secure and efficient approach.

A Schwannoma is a benign tumour originating from Schwann cells within theperipheral, cranial, or autonomic nerves. Typically, these tumours manifest as a solitary, slow-growing mass with smooth surface, usually devoid of significant symptoms. Schwannomas most frequently appear in individuals aged 30-50years. Although they are relatively uncommon, approximately one-fourth of all Schwannomas are found in the head and neck area. Its occurrence within the oral cavity, with the tongue being the most common site, followed by the palate, floor of the mouth, buccal mucosa, lips, and jaws. Diagnosing these tumours before surgery can be challenging, and in most instances, a definitive diagnosis can only be established through surgical intervention and subsequent histological examination. Immunohistochemistry plays a crucial role in confirming the diagnosis, as it shows that Schwannoma cells exhibit a positive reaction to the S-100 protein. Here, we present a case of a Schwannoma in the floor of the mouth, observed in an 18-year-old male patient.

Postpartum depression affects many women and remains the fourth-leading cause of disability and premature death. This study reviewed Ghanaian mothers’ postpartum depression studies. This systematic study examined PubMed, Scopus, Up-to-date, Science Direct, Google Scholar, and Proquest to estimate postpartum depression prevalence. Between 2009 and 2022, published papers on the prevalence of postpartum depression in English were analyzed. Postpartum depression, risk variables, and prevalence were all included in the search approach. An examination of the literature revealed that a trend in the prevalence of PPD has been identified. According to the research, Community-based research in Northern Ghana found prevalence rates between 16.8 and 33.5 percent, whereas estimates from the rest of the nation were between 3.8 and 11.3 percent. The findings from this study might also be utilized to guide future investigations and the design of preventive measures.

REPORTside of the neck that was adjacent to the internal jugular vein and the carotid artery underneath.An infectious cyst was detected by FNAC.After obtaining the necessary consent, she was then IntroductIonHunczovsky was the first to describe cysts that were visible in the lateral part of the neck.These cysts have since been referred to by a number of names, including branchial cysts, tumors of the branchial cleft, lateral lymphoepithelial cysts, and benign cystic lymph nodes. 1 They result from the cervical sinus staying put while the branchial apparatus was differentiating.The sternocleidomastoid muscle's middle third of the anterior border is where they typically appear, but they can also appear anywhere between the middle constrictor muscle of the pharynx and the supraclavicular area. 2 The surgical case report guidelines are used to format this report. 3The cervical lymphoepithelial cyst is a unilateral, soft-tissue enlargement that often develops on the side of the neck, in front of the sternocleidomastoid muscle.In late adolescence or early adulthood, it becomes clinically evident.The skin or the aerodigestive tract is not physically connected to the cysts, per definition.Understanding the origin of adult lateral neck lesions and separating it from malignancy are the two main goals of this case report.The key to a successful treatment plan is a proper diagnosis and enough care. case descrIptIonA female patient in her fifties who had experienced right-sided neck swelling for 1 and 1/2 years presented to our Apollo ENT Hospital, Jodhpur, Rajasthan, India.The swelling grew progressively until it reached its current size, which was about 4 x 3 cm (Fig. 1).There was no prior history of pain, fever, swallowing issues, or breathing problems.The patient denied having an addiction.There was no history of trauma or difficulty moving the neck.The patient had no history of similar swelling on the other side.On examination, a 4 x 3 cm swelling was found at the junction of the upper onethird and lower two-thirds aspects of the anterior border of the right sternocleidomastoid muscle.It was nontransilluminate, nontender, and cystic in character.It was also only minimally movable.Swelling skin was pinchable.Both sinuses and fistula were absent.The oral examination went normal.The patient was taking drugs prescribed by her family doctor but she did not feel better.She was then instructed to undergo imaging using a CT scan (Fig. 2), which revealed a well-defined tumor on the right 1,

Gastroesophageal reflux disease (GERD) is among the most prevalent gastrointestinal (GI) disorders. It is known to often coexist with other chronic diseases such as asthma, chronic obstructive pulmonary disease (COPD), obesity, diabetes mellitus (DM), and hypertension. Upper endoscopy, esophageal manometry, and impedance-pH monitoring are a few invasive diagnostic options that are reserved for selected GERD patients. Symptom assessment by using questionnaires, such as the frequency scale for the symptoms of GERD (FSSG), is simple, convenient, noninvasive, and inexpensive. These questionnaires are widely used to facilitate diagnosis and appropriate treatment. Early diagnosis of GERD and timely management may improve clinical outcomes in patients. Proton pump inhibitors (PPIs) are the preferred therapy for GERD. However, evidence indicates that excessive and extended use of PPIs is linked to adverse events. An overview of the diagnosis and management of GERD, as well as an evidence-based overview of the relationship between GERD and asthma, COPD, obesity, DM, and hypertension, is presented in this review. Expert opinions and recommendations for diagnosing GERD using invasive tests and validated questionnaires have also been mentioned.

Choanal atresia is a rare congenital disorder characterised by anatomical closure of the posterior choana in the nasal cavity due to failed recanalization during foetal development. The main aim of our study is to focus on our experience with choanal atresia and its management. In this study, we are discussing the prospective study of 12 cases of choanal atresia that came to a tertiary hospital from July 2017 to July 2022. All 12 choanal atresia cases underwent thorough evaluation, including history, blood investigations, nasal endoscopy, and CT scanning. Intra-nasal endoscopic choanoplasty with stenting was performed on all patients, followed by a 2-year follow-up, except for one case that missed follow-up after 6months. All 12 cases were female, with their ages varying from newborn to 4months old. In our study, 75% were unilateral and 25% were bilateral cases from newborn to 4months old. The right was more prevalent in unilateral choanal atresia. The mixed type was the most commonly observed. The most common symptom was difficulty breathing and a running nose. All cases achieved an adequate patent airway. No intraoperative complications were noted in any case. All cases of choanal atresia can be diagnosed by a cold spatula test, failure to pass an intra-nasal catheter, and a CT scan is confirmatory. Surgical correction with endoscopic intranasal choanoplasty and stenting has less morbidity, a high success rate, and a lower recurrence rate.