This document discusses ENT manifestations of AIDS. It begins by providing background on HIV, noting that it attacks CD4 cells. When CD4 counts fall below 200, opportunistic infections and malignancies can develop. ENT issues are then reviewed, including candidiasis, Kaposi's sarcoma, herpes zoster, Bell's palsy, sinusitis, oral thrush, hairy leukoplakia, and recurrent tonsillitis. Neck lymphadenopathy can indicate bacterial or mycobacterial infections, P. carinii, toxoplasmosis or fungal infections. Overall, the document outlines the varied ENT presentations associated with HIV/AIDS and emphasizes the need for a high index of suspicion to properly
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT)Dr Krishna Koirala
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT) is an important topic for MBBS and MS ENt students. Dr Krishna Koirala will be explaining this topic in a simplified way.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
Complications of rhinosinusitis(Dr ravindra daggupati)Ravindra Daggupati
orbital complications of rhino sinusitis,intra cranial complications of rhino sinusitis,classification of complications,diagnosis and treatment of complications
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT)Dr Krishna Koirala
Chronic Suppurative Otitis Media: Tubotympanic Type (CSOM TT) is an important topic for MBBS and MS ENt students. Dr Krishna Koirala will be explaining this topic in a simplified way.
Spaces of middle ear and their surgical importanceDr Soumya Singh
one of the imp topics in ENT that should be understood very thoroughly if u want to pursue as an otologist.I tried to simplify the topic with simple diagrams and models for better understanding .
Complications of rhinosinusitis(Dr ravindra daggupati)Ravindra Daggupati
orbital complications of rhino sinusitis,intra cranial complications of rhino sinusitis,classification of complications,diagnosis and treatment of complications
Role of CT Mastoids in the Diagnosis and Management of Chronic Inflammatory E...Dr.Juveria Majeed
This study emphasises the role of CT Temporal bone in the diagnosis and management of chronic inflammatory ear disease...published in the Indian Journal of Otolaryngology Head and Neck surgery.
Case report - discussion about presentation and managements of laryngoceles.
Published in Journal of Evolution of Medical and Dental Sciences 2015; Vol. 4, Issue 32, April 20; Page: 5586-5591
Abstract: Laryngoceles are rare, cystic dilatation of saccule of ventricle of larynx. Three types are recognized –internal, external and mixed types. Many of the laryngoceles are asymptomatic; few require surgical excision via internal/endoscopic or external approach. Contrast CT is the investigation of choice. A 40year old male presented to our OPD with a neck Scar, later diagnosed as laryngocele. Here is the case report about presentation, diagnosis and management of a large mixed layngocele.
KEYWORDS: Layngocele, Neck swelling, Saccule, Ventricle of larynx.
PAPILLARY CARCINOMA IN THYROGLOSSAL CYST-By Dr.Juveria Majeed MS ENT.Dr.Juveria Majeed
Carcinoma of thyroglossal duct cyst is a very rare entity. Here we present a case report of papillary carcinoma in thyroglossal cyst in a 21 year old female patient and discussion regarding dilemmas in the management, whether total thyroidectomy should be done or not.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
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. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Ent manifestations in aids
1. ENT Manifestations in AIDS
Dr. Juveria Majeed
MS ENT,
SR, Bhaskar Medical College/Hospital.
2. HIV
Retrovirus – Viral RNA
into DNA
Two types – Type 1 and
type 2
Type 1 - more common
and more pathogenic
Type 2 – less common
and less pathogenic
3. Once entering the host, this attacks the T-
lymphocytes and other CD4 surface markers.
With the fall of the CD4 lymphocytes(<500/cu.
mm) , the immunodeficiency is seen and many
other opportunistic and malignancy can appear.
When the CD4 cell counts appear less than 200,
death may appear in about 2-3 years.
4. CD4: disease progression indicator
When the CD4>500/mm3 essentially asymptomatic.
CD4 count 200 to 500 cells/mm the early
manifestations HIV infection.
CD4 <200 cells/mm vulnerable to processes
associated with AIDS.
CD4 < 50 cells/mm increasingly at risk unusual
opportunistic
5. EPIDEMIOLOGY
First case came into medical attention as early as
1980’s.
These cases were detected by retrospective
analysis to have occurred in 1978 in USA and in
late 1970’s in Equatorial Africa.
The first case was registered in 1986 in India
8. RISK GROUPS
Homosexuals.
Heterosexually promiscuous individuals.
Prostitutes and truck drivers.
I. V. drug users.
Recipients of blood and its products
(haemophilia, thalassemia, dialysis).
Children born to HIV mothers.
9. Hazard to health workers is
from blood and the body fluids
such as
• Amniotic
• Pleura
• Peritoneal
• Pericardial
Risk of acquiring infections
from specimen of Urine,
sputum, stool saliva, tears,
16. Seborrheic Dermatitis
83% of patients develop extensive
seborrheic dermatitis.
Face, scalp and the periauricular region
Recurrent superinfections of the
involved skin
Treatment: Dandruff shampoo and
topical steroid
17. Kaposi's Sarcoma OF External Ear
Either on the pinna or in the EAC
conductive hearing loss, may arise if the tumor extends onto the tympanic
membrane (TM) or into the middle ear.
TREATMENT
Carbon dioxide laser can excise canalicular KS.
With TM involvement-- argon laser spare normal tissue, TM perforation less
likely.
19. Infections of the External Ear
Pinna cellulitis - Staphylococcus aureus
Otitis externa - Pseudomonas aeruginosa.
Malignant Otitis Externa: No response to standard antibiotic regimens,
suspect skull base osteomyelitis- Pseudomonas, Aspergillus (rarely)
Extrapulmonary Infections with either Pneumocystis or Mycobacterium
tuberculosis separately can result in a tumor-like lesion in the EAC.
20. Otitis Externa
Malignant otitis externa caused
predominantly by Pseudomonas or by
Aspergillus fumigatus.
Treatment is by antibiotics for
pseudomonas or IV amphotericin B
followed by oral itraconazole for
aspergillus
23. Infections of the Middle ear
• Serous otitis media and recurrent acute otitis media.
• Pathogenesis: Eustachian tube dysfunction can result from
• Nasopharyngeal lymphoid hyperplasia
• Sinusitis
• Nasopharyngeal neoplasms
• Allergies and their associated mucosal changes.
• Acute inflammation of the mastoid air cells is seen
• Coalescing suppurative mastoiditis -- rare.
• Unusual organisms- M. tuberculosis and Aspergillus.
26. Sensorineural Hearing Loss
May be U/L or B/L
Sensorineural hearing loss worsens with increasing frequencies.
Speech discrimination normal.
Increased latencies on auditory brain stem testing central demyelination consistent
with a viral infection- primary infection by HIV
Rehabilitation with hearing aids should be considered
27. Vertigo
It is usually concurrent with multiple other neurologic symptoms.
Frequently a symptom of subacute encephalitis or HIV disease dementia.
HIV may directly affect the vestibular and auditory systems.
29. Facial Nerve/Central Nervous System Facial-Paralysis Syndromes
UMN PALSY
Unilateral or bilateral facial paralysis
CNS toxoplasmosis is the most common identifiable cause
HIV encephalitis and CNS lymphoma.
30. Idiopathic or Bell's Palsy
Bell's palsy, is the single most common diagnosis given for HIV-infected patients
with seventh nerve paralysis
The leading theory is infection of the facial nerve by herpes simplex virus (HSV).
In the immunocompromised patient, concurrent opportunistic infections
contraindicate the use of systemic steroids. Acyclovir used alone.
32. Herpes Zoster
Herpes zoster infection, or the Ramsey Hunt syndrome, occurs more commonly in
HIV-infected
Results from reactivation of a chronic herpetic infection of the geniculate ganglion
Results in painful herpetic vesicles in the distribution of the sensory component of
the facial nerve along with facial palsy, which occasionally is permanent.
Symptoms tend to be more severe in the HIV-infected.
36. Nasal Obstruction
A common symptom during HIV infection
Wide-ranging differential diagnosis
Adenoidal hypertrophy,
Allergic rhinitis,
Chronic sinusitis,
Neoplasms of the nose, paranasal sinuses, or nasopharynx.
37. RECURRENT/ PERSISTENT VESTIBULITIS
Inflammation of nasal vestibule
Immunosuppression
May have fulminant course Cellulitis
Danger area of face Cavernous sinus thrombosis
Local and systemic antibiotics
Early aggressive treatment
39. Allergic Rhinitis
• Polyclonal B-cell activation- Increased production of IgA, IgG and IgE.
• Excessive IgE production-Allergic symptoms
• Sneezing, perennial profuse thick rhinorrhea and nasal congestion.
• Rule out chronic bacterial sinusitis -- nasal endoscopy or CT imaging.
• Tx: 2nd gen Antihistaminics, topical steroids
40. Sinusitis
Immunosupression and Changes in the mucociliary clearance
BACTERIAL :
Streptococcus pneumoniae, Moraxella catarrhalis, and H. influenzae
Higher incidence of S. aureus and P. aeruginosa
FUNGAL:
Alternaria alternata, Aspergillus, Pseudallescheria boydii, Cryptococcus,Candida albicans
Increasing invasive Aspergillus sinusitis.
Incidence of rhinocerebral Mucormycosis not increased
49. Oral Hairy Leukoplakia
Almost exclusively in HIV-infected patients
White, vertically corrugated lesion
Anterior lateral border of the tongue
Shows rapid progression to the advanced stage of HIV disease
Epstein-Barr virus (EBV) is associated
No prognostic significance
Treatment is generally unnecessary
51. Recurrent Aphthous Ulcerations
Giant(several cms in diameter) aphthous ulcerations.
Cause tremendous morbidity
Severe odynophagia due to giant aphthous stomatitis produce anorexia and
dehydration.
May lead to AIDS wasting disease
Secondary infection further adds to the severe pain
Local anesthetics and supportive therapy
57. Candidiasis
Severe odynophagia
Some degree of aspiration--- interference with normal laryngeal function
Associated with advanced HIV disease and CD4
counts less than 200
Oesophagoscopy– Rule out oesophageal candidiasis
Tx: systemic antifungal agents
59. Herpes Simplex and Cytomegalovirus
The clinical findings are often nonspecific;
Biopsy with HPE and viral culture will usually confirm the diagnosis.
Systemic antiviral agents (ganciclovir or foscarnet)
Recurrent Aphthous Ulcerations
Giant aphthous ulcers (> 2 cm) in the oropharyngeal region
60. Recurrent tonsillitis
Part of HIV lymphadenopathy
Immunosuppression
Poor Orodental hygiene
Painful swollen tonsils, severe odynophagia
May progress to peritonsillar abscess
May involve deep neck spaces
64. Infectious Processes in the Neck
Bacterial lymphadenitis and deep neck infections
Present as enlarging tender mass in neck
Management should be surgical and aggressive
Cultures for mycotic, mycobacterial,and bacterial organisms from all involved tissue or any inflammatory
exudate.
Mycobacterial Infections
Extrapulmonary disease- Common
Mycobacterium avium complex (MAC) infection is the most common mycobacterial infection
2nd line drugs used.
68. TAKE HOME MESSAGE
India has the third-highest number of people living with HIV in the world
2.1 million Indians accounting for about four out of 10 people infected with the deadly virus in the Asia—
Pacific region, according to a UN report.
ENT surgeons encounter a varied presentation of sign and symptoms.
There is a paradigm shift from cure to quality of life.
High index of suspicion necessary for specific presentations.
UNIVERSAL PRECAUTIONS a must
for every surgeon..