In India, the pharmacovigilance program is still in its infancy. National Pharmacovigilance Program of India was started for facilitating the pharmacovigilance activities. The ADR reporting rate is still below satisfactory in India. This cross-sectional questionnaire based study was carried out in a tertiary care teaching hospital in Uttarakhand, which is a peripheral ADR monitoring centre to assess the level of knowledge, attitude, and the practices of pharmacovigilance among the doctors and to compare it with the group of doctors attending educational CME for improving awareness of pharmacovigilance. The most important revelation of this study was that although adequate knowledge and the right attitude about adverse drug reaction reporting were instigated in the doctors after the educational intervention, the practice was still neglectful in both groups, emphasizing the need to design the strategies to develop adverse drug reaction reporting culture.
Background. The objective of this prospective study was to evaluate the clinical profile, microbiological flora and radiological features in primary atrophic rhinitis patients and to identify their association with the etiology of primary atrophic rhinitis. Study design. Prospective case study. Materials and methods. Patients with primary atrophic rhinitis over a two years period were included in the study. Complete blood count, total protein and microbiological analysis from nasal swab were done to evaluate iron deficiency anemia, nutritional status and identification of the pathogenic bacteria respectively. Radiological evaluation was done to study the radiological features of primary atrophic rhinitis.
Observations. Ninety cases of primary atrophic rhinitis were studied. The most common symptom was nasal crusting. Nasal crust, odour and atrophy of mucosa were the most consistent finding. Nasal myiasis was found in 26.6% cases. The nasal mucociliary clearance time was markedly increased. On investigation there were low value of hemoglobin and total protein in 46.6% and 25.5% patients, respectively. Pseudomonas aeruginosa (37%) was the commonest organism isolated from culture. On radiological evaluation evidence of different grade of sinusitis was seen in 87.7% case.
Conclusion. The present study suggested that certain bacterial infections, anemia, poor nutrition and hereditary factor may contribute significantly to the etiology of primary atrophic rhinitis.
Otolaryngology, although considered a surgical specialty, also covers many diseases that are not cured by surgery. These are treated medically and thus the otolaryngologist should have a good knowledge of drug treatments. It also entails ability to recognize, when an ENT symptom may be caused by one of the patient’s medications, particularly as this is easily remedied by changing the drug. Although most of us know the common drugs that can cause otological side effects, there are many others that we may not be aware of. Here we have tried to consolidate a list of some commonly used drugs having otological side effects.
Ototoxicity; Ototoxic drugs; Hearing loss
Advanced cancer patients are managed by palliative care and its main aim is to provide best possible quality of life to the patients by symptom management. Pain is the most agonizing symptom experienced by advanced head and neck cancer patients. Control of pain hence requires more attention by the caregiver in order to improve their quality of life. Recently quality of life issues have emerged as a main focus of cancer treatment as compared to conventional increase in survival rate. This study mainly focuses on the effect of palliative drug therapy on quality of life.
Advanced head and neck cancer; Quality of life; Palliative drug therapy
Primary atrophic rhinitis is a progressive chronic nasal disease and histopathologically characterized by squamous metaplasia and two characteristic types of vascular involvement (type I and type II). Despite its chronicity and squamous transformation, nothing is known about the occurrence of malignancy in atrophic rhinitis. The present work was undertaken to study the histopathological characteristics in primary atrophic rhinitis and identify whether it has any association with malignant transformation. Nasal biopsies obtained from 90 patients diagnosed as primary atrophic rhinitis were studied. Squamous metaplasia was noted in 89% of patients, and type I and type II vascular involvement were seen in 67% and 33% of patients, respectively. This preliminary report suggests that there is no association between atrophic rhinitis and precancerous lesions of nasal cavity despite squamous metaplasia and confirms the presence of two types of vascular changes in the disease which is helpful to decide the treatment modality.
Gout is a metabolic disorder characterized by elevated uric acid levels in the body, associated with painful arthritis, tophi and nephropathy. The most frequently used pharmacologic urate lowering strategies involve reducing urate production with a xanthine oxidase inhibitor and enhancing urinary excretion of uric acid with a uricosuric agent. Urate lowering agents are limited in number, availability and effectiveness. The emergence of a new medication, febuxostat, to lower serum urate levels is welcome as no new drug have been approved since the introduction of allopurinol, in 1964, and the drugs that are available have limitations owing to inefficacy or toxicity. Febuxostat is a novel, nonpurine selective inhibitor of xanthine oxidase, is a potential alternative to allopurinol for patients with hyperuricemia and gout.
Gout; hyperuricemia; xanthine oxidase inhibitor
Background and Objective:
Though well recognized in the West, palliative care and quality of life are relatively newer concepts in a developing country like India. The aim of this study was to assess the effect of palliative care on pain and quality of life and to identify the association between the two.
Observational prospective study.
Materials and Methods:
Patients with advanced cancer, receiving palliative drug therapy, were recruited from a tertiary care hospital. City of Hope Medical Center Quality of Life Survey and visual analog scale (VAS) were used to assess the quality of life and cancer pain severity, respectively.
A total of 100 patients were included in the study. Palliative drug therapy produced a significant reduction in pain scores expressed as mean ± SD in VAS [7.13 ± 2.2 vs. 2.62 ± 2.1 (P<0.001) after 1 month in 93 patients; 7.06 ± 2.1 vs. 2.47 ± 2.1 (P<0.001) after 1 month and 2.02 ± 1.9 (P<0.001) after 2 months in 51 patients]. Also, significant improvement in the quality of life scores [919.78 ± 271.3 vs. 1280.65 ± 306.8 (P<0.01) after 1 month in 93 patients; 950.39 ± 238.2 vs. 1336.67 ± 291 (P<0.01) after 1 month and 1405.49 ± 368.3 (P<0.01) after 2 months in 51 patients] was obtained. There was a high correlation between the average change of pain intensity and quality of life scores (r= −0.53, P<0.02). Overall, a reduction in pain resulted in significant improvement in the quality of life (P<0.001).
This study emphasizes the role of palliative care and, more importantly, pain management in improving the quality of life of advanced cancer patients.
Advanced cancer; cancer pain; quality of life
A Zenker’s diverticulum is a blind pouch that branches off the cervical esophagus. Affected individuals may suffer from long-standing swallowing difficulties, regurgitation, bad breath, weight loss, and even aspiration.. Here we report a 80-years-old male presenting with dysphagia and regurgitation. Barium swallow reported the presence of a Zenker’s diveticulum. In view of the patient’s age, endoscopic diathermy was considered as a therapeutic option for the management.
Zenker’s Diverticulum; Inferior pharyngeal constrictor; Killian dehiscence
Angiogenesis is a fundamental biological process that is regulated by a fine balance between pro- and antiangiogenic molecules, and is deranged in various diseases. Historically, angiogenesis was only implicated in few diseases, such as, cancer, arthritis, and psoriasis. However, in recent years, it has been increasingly evident that excessive, insufficient or abnormal angiogenesis contributes to the pathogenesis of many more disorders. Research in angiogenesis offers a potential to cure a variety of diseases such as Alzheimer's and AIDS. Modulation of angiogenesis may have an impact on diseases in the twenty-first century similar to that which the discovery of antibiotics had in the twentieth century.
Angiogenesis; antiangiogenic drugs; vascular endothelial growth factor
Mucormycosis is a rare but serious fungal infection that rapidly attacks and kills its untreated victims, who are often immunocompromised. It is one of the most fulminant and often fatal mycotic infections known to human beings. Rhinocerebral mucormycosis is the commonest presentation and its extension to the orbit and brain is quite usual but the palatal involvement is a rare and late occurrence. Isolated location of mucormycosis on the palate in an immunocompetent host is an unusual clinical entity. Here we report a case of deep hard palate ulcer due to mucormycosis in a 56-year-old man without any predisposing factor. He was successfully treated with a combination of surgical debridement and systemic liposomal amphotericin B administration for six weeks. By presenting this case report we would like to emphasis that mucormycosis should be included in the differential diagnosis of the hard palate ulcers even in immunocompetent patient.
Palate; Ulcer; Mucormycosis
A 10-year-old female presenting with a discharging sinus in the midline of the neck of one month duration was diagnosed to have a thyroglossal sinus. She underwent sistrunk’s operation, intra-operatively a thyroglossal duct cyst was atypically sited in the intrahyoid region. The cyst may be located in the intralingual, suprahyoid, thyrohyoid or suprasternal region. A literature search revealed that this intrahyoid location of a thyroglossal duct cyst is extremely rare and so far only three cases have been reported. A case and review of literature regarding this unusual entity are presented.
Thyroglossal Duct Cyst; Thyroglossal Cyst; Hyoid Bone
Sinus histiocytosis with massive lymphadenopathy (also known as Rosai Dorfman syndrome) is a unique disease of unknown etiology with a childhood predilection. It is an uncommon benign condition, often confused with lymphoma. Patients usually present with massive, painless, bilateral cervical lymphadenopathy and clinical course is variable. This condition has been sporadically reported in Indian literature. Here we report a 26-year-old women presenting with a painless bilateral cervical lymphadenopathy. A FNAC from cervical lymph node was compatible with Rosai Dorfman syndrome and confirmed histopathologically.
Sinus histiocytosis; Massive lymphadenopathy; Rosai Dorfman syndrome
Choanal polyps almost always appear as solitary growth and most commonly arise from the maxillary sinus. Isolated polyp originating from the anterior wall of the sphenoid sinus or from its interior and extending as choanal polyp in to the nasopharynx are extremely rare clinical entities. Here we report a 34-year-old male presenting with a history of headache, intermittent nasal discharge and nasal obstruction. A diagnosis of sphenochoanal polyp (SCP) was made on nasal endoscopy and magnetic resonance imaging. The SCP was removed endoscopically via a transnasal sphenoidotomy and histopathologically it was confirmed as inflammatory polyp. In this paper we discuss the clinical presentation and surgical management of this rare clinical entity.
Choanal polyp; Sphenoid sinus; Endoscopy