Chronic Rhinosinusitis
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This document provides information on chronic rhinosinusitis (CRS). It defines CRS and describes its two main subtypes, CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). For each subtype, it outlines their pathophysiological characteristics including inflammatory markers. Diagnostic tests for CRS including endoscopy scores and smell identification tests are mentioned. Management strategies for CRS include various medications, sinus surgeries, and alternative approaches. Vitamin D is discussed as an emerging therapeutic option for augmenting immune responses in CRS.
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- TB is caused by the bacterium Mycobacterium tuberculosis, which most commonly affects the lungs.
- TB has been documented as far back as 5000 BC in ancient Egypt and China. Major advances in understanding and treating TB came in the late 19th/early 20th centuries.
- India has the highest global TB burden, with over 2 million new cases annually. Diagnosis involves sputum microscopy and culture, while treatment requires a multi-drug regimen over 6-24 months.
- Prevention involves the BCG vaccine and identifying latent
Ca Papillary(Thyroid Gland)
1. The patient presented with a swelling in his neck for 2 years that had been gradually increasing in size and causing pain for the past 2 months.
2. Examination and investigations including lymph node biopsy, ultrasound neck, and CT neck revealed metastatic papillary carcinoma of the thyroid.
3. The patient underwent a total thyroidectomy with modified radical neck dissection. Post-operative recovery was unremarkable.
Nasopharyngeal cancer
This document discusses cancer of the nasopharynx (NPC). Some key points:
- NPC is uncommon globally but more common in certain regions like Southern China.
- Risk factors include EBV infection, consumption of salted fish.
- Staging involves MRI and biopsy. Treatment depends on stage but often involves chemotherapy and radiation therapy.
- Advanced stages may receive neoadjuvant chemo followed by concurrent chemo-radiation. IMRT has improved treatment.
- Sequelae can include cranial neuropathy, xerostomia, endocrine issues. Lifelong follow up is needed due to risk of recurrence or second cancers. Outcomes have improved but salvage options after relapse present challenges
Rasmussen encephalitis in the eye of a Radiologist
Rasmussen encephalitis a rare entity of neurodegenerative disorder found in a 6 year old girl during my residency pleriod.
Prostate Imaging - PI-RADS v2.1
Imaging of the prostate with emphasis on evlauation for carcinoma, gains precedence as the curability and disease free survival rates are high. MRI with PIRADS protocol brings uniformity and enables the surgeons and radiologists to converse with great clarity and better stratification of the disease status.
LUNG CANCER- ALOK HRIDAY MISHRA GW4
THIS PRESENTATIONS COVERS THE TOPIC ON LUNG CANCER and its epidemiology among different age groups, its incidence and fatality rate, types of lung cancer andpathogenesis of lung cancer, diagnosis, treatment, complication and prognosis of lung caner
Tb
This document provides information about tuberculosis (TB), including:
1. TB is an infectious disease caused by Mycobacterium tuberculosis that typically affects the lungs but can also affect other parts of the body.
2. The DOTS (Directly Observed Treatment, Short-course) strategy is a cost-effective worldwide approach to TB control that doubles diagnosis accuracy, achieves treatment success up to 95%, prevents spread, and improves healthcare quality.
3. India has the highest TB burden globally with 20% of all cases. Case finding tools like sputum smear microscopy are important for diagnosis. Chemotherapy using multiple antibiotics over 6-9 months is needed to cure TB.
Systemic therapy in head and neck cancers 2014 1
Review of the treatment of head and neck cancers
Head and neck cancer workshop: National Cancer Institute
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This document discusses the management of early HER2+ breast cancer. It defines early breast cancer and describes the HER2+ subtype, which accounts for around 25% of cases. For early HER2+ breast cancer, neoadjuvant chemotherapy plus trastuzumab improves pathological complete response rates and long-term outcomes compared to chemotherapy alone. Multiple trials demonstrate the benefit of adding pertuzumab or T-DM1 to neoadjuvant regimens. Post-neoadjuvant surgery may require close evaluation of margins due to heterogeneous response.
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Harvesting cartilage for cartilage tympanoplasty
This presentation describes the various cartilage material that can be used for cartilage tympanoplasty and methods of harvesting the same.
Tracheostomy decanulation
Tracheostomy decannulation is always challenging and this presentation address the various issues, indications, contra-indications, problems and solutions.
Csom in children challenges in management
CSOM in Children poses several challenges. This presentation delivered during the SAARC ENT Congress 2014 held at Colombo, addresses these challenges.
Time management in middle ear & mastoid surgery
Time is precious and time is precious. Time is the only commodity which cannot be regained once last. Managing surgical time has many advantages. This presentation describes the advantages of time management during middle ear and mastoid surgeries and describes how to save time during these surgeries.
Path to Ever Green Revolution
In the last few decades, India has experienced rapid economic and Agricultural growth, supported by solid increases in crop yields, due to increased cropping intensity and greater area devoted to food crops. India is the top producer of milk, pulses and jute in the world. It ranks second in the production of rice, wheat, sugarcane, groundnut, vegetables, fruit and cotton. India also is a leading producer of spices, fish, poultry, livestock and plantation crops. However, India’s sustained economic development has no significant impact on world markets.
India’s policy effort to support farmers, promote rural development, and at the same time address food insecurity has been, and is now, very significant. A range of supply side programmes such as input subsidies for fertilisers, irrigation, electricity and farm credit, coupled with investments in irrigation, are designed to encourage higher yields and production. A range of market support prices are set to cover costs and improve farmer returns. High food subsidies are given to help poor consumers. In September 2013, India enacted a new National Food Security Act (NFSA), which is now implementing the most ambitious “right to food” programme yet to be applied in history, covering over 800 million people and providing 60 kg of food grain per person each year at prices that are about 10% of current retail prices for food grains.
However, despite its growth, the role of agriculture in India’s economy has been declining sharply as other sectors, particularly services, have grown more quickly. Primary agriculture accounted for about 14% of national gross domestic product (GDP) in 2012, down from close to 30% in 2000. But, while there has been a reduction in the share of agriculture in GDP, a commensurate reduction in its employment share has not taken place. Primary agriculture still employs around half of the Indian population, and it is the main driver of employment in rural areas, where 68% of the population live. Potential yield gaps remain, and concerns about the sustainability of growth in production are mounting. Rural labour costs are rising, water supplies are being depleted and smaller farm sizes due to fragmented land holdings potentially impede the capture of economies of scale. Natural calamities like drought and floods are adding to these woes, creating a severe agrarian crisis in the country with large number of farmers resorting to suicides.
Major concerns have centred on food insecurity in the presence of trade surpluses, and how to invigorate agriculture to promote growth and employment in populous rural communities, where unlike the experience of most countries, the size of average land holdings continues to decline. About one-quarter of the world’s food insecure people are within India, and improving its nutritional status remains a significant challenge.
However, despite the challenges, a big potential for positive Agriculture growth exists in the country with i
Evaluation and Challenges of Paediatric airway problems
Dr. Prahlada N.b is the contact author for information regarding Karnataka ENT Hospital & Research Center in Chitradurga, Karnataka, India. His contact information includes an address, email, and a link to the hospital website for further details.
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According to the document, over 63 million people in India suffer from significant hearing impairment, though there is a lack of training courses and resources to help these individuals. While India represents a major market opportunity for hearing aid companies, many citizens cannot afford such devices due to low awareness and the fact that just 8000 ear, nose, and throat surgeons must handle over 7875 cases each. The document calls for more collaboration and resources to help the millions of Indians affected by hearing loss.
Imaging requirements for cochlear implantation
1. Imaging such as HRCT and MRI are important for evaluating patients for cochlear implantation to identify any contraindications and guide surgery. HRCT is useful for evaluating bony anatomy while MRI can identify soft tissue anomalies.
2. Pre-operative imaging aims to evaluate factors like the size of the internal auditory meatus, status of the cochlear nerve, and presence of any neurovascular anomalies which could increase surgical risk. Anomalies of the bony and membranous labyrinth are also assessed.
3. Congenital anomalies identified on imaging can help determine the cause of hearing loss and surgical approach during cochlear implantation.
Preparing for Postgraduate Entrance Examination
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Imaging for Endoscopic Sinus Surgery
Preface
If not coincidence, at least it was in the same decade when endoscopic sinus surgery and computed tomography were introduced to Otolaryngologists, which have changed the approach to sinonasal problems dramatically. Probably, there are no such coincidences in the history of medicine where two new modalities of approaches appeared at the same time, to deal with the same problem and complement each other while doing so. The asset of improved visualization and magnification, available through endoscopes, has revolutionized the understanding of the pathophysiology of sinusitis, and resulted in better appreciation of the anatomy of the paranasal sinuses. However, non-invasive diagnostic endoscopy has its limits, and the deeper structures cannot be evaluated by endoscopy alone . Computed tomography, which has an ability to optimally display bone, soft tissue and air simultaneously, can not only complement endoscopic examination, it can provide a surgical road map delineating the anatomy, defining the obstructing lesions, and noting anatomic variations that may predispose to operative complications.
Computed tomography has scored over plain radiographs and polytomographs as an imaging modality in this area. Even though surpassing CT's capacity to image soft tissue, MRI is less suitable as an imaging modality for evaluation of this area because of the similar signal intensities for bone and air.
CT scanning has become imaging modality of choice and the cooperation required between the Radiologist and the Surgeon is mandatory for both evaluation and treatment of paranasal disorders. It is of paramount importance on the part of the Otolaryngologists to understand interpretation of CT films, Radiological anatomy of the paranasal sinuses, Anatomical variations and the pathology to complement the endoscopy findings for initial screening, surgical planning, reduce postoperative complications and to provide better results. This Presentations is prepared to help Otolaryngology colleagues to learn the Imaging/radiological aspects required for endoscopic sinus surgery.
Secrets of success in Tympanomastoid surgeries
This document provides secrets and tips for success in tympanomastoid surgeries based on the experiences of Dr. Prahlada N B. The key points discussed include:
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1. Describe the organisation of respiratory center
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These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
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3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
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Chronic Rhinosinusitis
- 1. CRS Dr. Prahlada N.B Tame YETI with NETI! Yeti Tamer ! Prahlada N.B
- 5. Classification • CRSsNP • Fibrosis • High interferon-Gamma • High tumor Growth factor -B • High T-reg activity • TH1 Polarization • CRSwNP • Tissue Edema • High tissue Eosinophilia • High IgE • High IL-5 & IL13 • Low T-reg activity • TH2 Polarization
- 9. University of Pennsylvania Smell Identification Test (UPSIT) Richard L Doty Et. al.
- 10. DNE - Lund-Kennedy Endoscopy Score 0 1 2 Polyp Asbent Only in MM Beyond MM Edema Absent Mild Severe Discharge Absent Clear thin discharge Purulent Scarring Absent Mild Severe Crusting Asbent Mild Severe Kennedy & Lund: Endoscopic grading - Quantification for staging sinusitis
- 16. Systemic Steroids: Poetker et al
- 19. CRS & Asthma • UNIFIED AIRWAY • Same pathophysiology • ASTHMA - CRS • CRSwNP - 60% • CRS Treatment - Severity of Asthma • Asthma: -ve Predictor for ESS in CRSwNP
- 23. FESS
- 24. Diet Immune modulation Anti-allergy MucolyticsIndigenous Off-label Nasal irrigaitons Vit, Mineral etc., Emerging Strategies Managing Microflora Herbal Immune enhancers Homeopathy Chinese!
- 26. Off-the label! - Budesonide - 0.5 mg - Dexa. Ophth. Drops 0.1% - Prednisolone Ophth. Drops 1% - Cipro/Dexa Otic Drops 0.3/0.1% + - 250 ml Normal Saline
- 28. Vit D • Augment innate & adaptive immune responses. • Reduces fibroblast proliferation in polyps • Increases sensitivity to Corticosteroids • Deficiency: • Severe CRSwNP & AFRS • Severe Bone Erosion • Vit D Supplements.
- 31. FACEMAX 2 23, 24, 25 JUNE 2017
- 32. Thank you