REVIEW ON NASA ROGA (NASAL DISEASES) IN AYURVEDA MEDICINE WITH SPECIAL REFERENCE TO THE PINASA (CATARRH) IN SRI LANKAN TRADITIONAL MEDICINE

Pinasa (Catarrh) is an inflammatory disease of respiratory mucosa accompanied by sneezing, cough, headache, rhinorrhea, itching in throat and eyes. This cascade challenges the management of the disease and ultimately leads to negative impact to quality of life of the patient. At present, intervention strategies have been implemented in the management based on the herbal formulae with the light of Sri Lankan traditional medicine (SLTM). The study is focused to compile this scattered indigenous knowledge on Pinasa and compare them with the findings of Ayurveda medicine to explore the diagnosis and management gaps in both Ayurveda and SLTM. Data collection was done through documentary surveys, interviews and observations. The study revealed that the Pinasa has been considered as collective phenomena of Pratishyaya, Dushta Pratishyaya and Apinasa in Ayurveda medicine. Similarities has been found in etiology, clinical features and treatments stratergies in SLTM and Ayurveda medicine but types of the disease are varying. Pinasa was classified into 12 and 19 sub types in SLTM while 05 sub types of Pratishyaya have been described in Ayurveda medicine. Snehana (oleation), Swedana (fomentation) and Nasya (inhalation) were mentioned as external treatment modalities in Ayurveda medicine while same regimn are mentioned in SLTM but in different medical terminologies. Decoctions, pills, Kalka, Choorna and porridge were administered as internal remedies in both the medical system with different formulae while Nidana Parivarjana and Patyapatya Sewana considered as preventive measures. It can be concluded that the knowledge on Pinasa in SLTM is crucial important to conduct further research studies to find effective management along with novel preparation for Pinasa.

A STUDY ON THE ENDOSCOPIC SINUS SURGERY OVER THE PERIOD OF 9 YEARS

Objective: To share experience of 1000 patients who underwent functional endoscopic sinus surgery (FESS) in 4different hospitals for various diseases over span of 9 years. Study Design: Prospective observational study. Place and Duration of Study: Sheikh Khalifa Hospital Muzaffarabad, Combined Military Hospital Sialkot, PakEmirates Military Hospital Rawalpindi and CMH Quetta, from Jun 2009 to Jun 2018. Methodology: We included 1000 patients who underwent Functional endoscopic sinus surgery (FESS) in fourdifferent military hospitals, suffering with various diseases discussed later. Patients were operated after failureto get response to medical therapy. All the patients had preoperative endoscopic examination and CT-scan paranasal sinuses (PNS) done for disease assessment. Patients were examined post operatively at 1, 15 days and 2 months. All patients were documented for the level of satisfaction at end of 2 months post-operative period. Results: Most patients were suffering from rhino sinusitis 364 (36.4%). Bilateral ethmoidal polyps constitutedthe second largest group at 289 (28.9%) patients. About 837 (83.7%) of patients were completely free of symptom, 104 (10.4%) with partial improvement whereas, 59 (5.9%) patients did not report any improvement in symptoms. 899 (89.9%) of patients were discharged on their first post operation day meaning less hospital stay and quick recovery.Conclusion: Functional endoscopic sinus surgery (FESS) can be employed to treatment variety of common nasal diseases (chronic rhino-sinusitis, nasal polyps) & non-nasal diseases like cerebrospinal fluid (CSF) rhinorrhea & as approach to skull base. This method of treatment was quite effective in alleviating symptoms of patients.

Design and characterization of plasticized bacterial cellulose/waterborne polyurethane composite with antibacterial function for nasal stenting

A nasal stent capable of preventing adhesions and inflammation is of great value in treating nasal diseases. In order to solve the problems of tissue adhesion and inflammation response, we prepared plasticized bacterial cellulose (BCG) and waterborne polyurethane (WPU) composite with antibacterial function used as a novel nasal stent. The gelation behavior of BCG could contribute to protecting the paranasal sinus mucosa; meanwhile, the WPU with improved mechanical property was aimed at supporting the narrow nasal cavity. The thickness, size and the supporting force of the nasal stent could be adjusted according to the specific conditions of the nasal. Thermogravimetric analysis, contact angle and water absorption test were applied to investigate the thermal, hydrophilic and water absorption properties of the composite materials. The composite materials loaded with poly(hexamethylene biguanide) hydrochloride maintained well antibacterial activity over 12 days. Animal experiments further revealed that the mucosal epithelium mucosae damage of BCG−WPU composite was minor compared with that of WPU. This new type of drug-loaded nasal stent can effectively address the postoperative adhesions and infections while ensuring the health of nasal mucosal, and thus has an immense clinical application prospects in treating nasal diseases.

Prevalence of ENT diseases in Chitradurga district of Karnataka, India

<p class="abstract"><strong>Background:</strong> Study was conducted to observe the magnitude of ENT morbidity in the predominantly rural district of Chitradurga, Karnataka.</p><p class="abstract"><strong>Methods:</strong> It was a retrospective study based on medical records of the patients attending OPD of Otorhino-laryngology department in a tertiary care hospital. Retrieved data was tabulated in terms of frequency and percentage to assess the prevalence of ENT diseases in this region. </p><p class="abstract"><strong>Results:</strong> Study revealed high prevalence of ear diseases (40.4%) followed by throat problems (28.5%). Among ear group, majority of patients (19.7%) had otitis media. In throat region, there was high prevalence of pharyngitis (12.8%) and tonsillitis (8.0%). Nasal diseases reflected allergic rhinitis (7.0%) and symptomatic DNS (6.5%) as the major contributors to ENT pathologies.</p><p class="abstract"><strong>Conclusions:</strong> Results of the present study reveal that ear and throat diseases form the largest component of ENT problems. Most of these are infectious and preventable. Health education of general population will play a major role in curtailing the related morbidity.</p>

Level of Stress in Students with the Disturbance of Nasal Breathing and Comorbid Disorders

Background. The progressive increase of the number of schoolchildren with adaptation disorders and low level of health in recent years determines the need to assess the characteristics of the psychosomatic status in children and adolescents with various types of somatic pathology, including diseases of ENT organs, accompanied by nasal breathing disorders and hypoxia. It is also necessary to determine the severity of stress in children, for timely prevention and correction of these disorders.Aim:to assess the level of stress in schoolchildren with nasal breathing disorders against the background of nasal diseases and concomitant psychosomatic disorders.Materials and methods. 481 schoolchildren aged 12–17 (boys and girls) were examined. Nasal breathing disorders were assessed by a comprehensive ENT examination, including rhinoscopy, radiography of the sinuses, and olfactometry. The presence and severity of stress were determined by the questionnaire “Social factors and stress”.Results. We found that the high level of stress in children with nasal breathing disorders on the background of ENT pathology is more often associated with the high frequency and severity of psychosomatic symptoms: the presence of dorsalgia, asthenic syndrome, chronic headache and frequent episodes of abdominal pain. Moderately and significantly increased levels of stress associated with the presence of children with hypertension, asthenic syndrome, frequent abdominal pain, frequent pain in the cervical spine, panic disorders.Conclusions. Thus, the presence of certain psychosomatic complaints in children with nasal breathing disorders is directly related to the level of stress, which is important to take into account when planning preventive and corrective measures aimed at increasing the adaptive capacity and stress resistance of children. The studies illustrate the need to assess the psychosomatic status and the level of stress in schoolchildren with nasal breathing disorders taking into account their existing comorbid disorders of the psychosomatic spectrum.

A retrospective study of more than 400 feline nasal biopsy samples in the UK (2006–2013)

Objectives The main objective of this study was to utilise a large database from a UK-based, commercial veterinary diagnostic laboratory to ascertain the prevalence of different forms of nasal disease within the feline population. Further objectives included using this database to detect any breed, sex or age predilections, or associations between the degree of brachycephalism, and the different conditions diagnosed. Methods Records from the laboratory were searched for feline submissions received between 31 May 2006 and 31 October 2013. For all samples taken from the nasal cavity, the diagnosis was recorded together with the breed, age, sex and neuter status of the cat, whether the clinical presentation was uni- or bilateral and whether a nasal discharge was present. Pedigree breeds were further subclassified according to skull conformation into brachycephalic, mesocephalic and dolichocephalic. Logistic regression models were constructed to assess the adjusted magnitude of association of significant risk factors with each disease, and each disease was also used as a potential independent risk factor for each other disease. Results The most prevalent nasal disease was rhinitis, followed by neoplasia and polyps. The most commonly diagnosed neoplasm was lymphoma, followed by adenocarcinoma and undifferentiated carcinoma, with benign tumours being very uncommon. No significant association was found between skull conformation and nasal diseases. The only statistically significant association was polyps being more likely to arise in younger male cats, with a mesocephalic skull conformation and no nasal discharge. Conclusions and relevance No significant association was found between skull conformation and nasal diseases, contrary to what might be expected. The only significant association found between any of the potential risk factors and various forms of nasal disease was polyps being more likely to arise in younger cats; other identified associations are only likely to be weak.

Role of CT-PNS in non-neoplastic sino-nasal diseases: an observational study at tertiary care center in South Gujarat

<p class="abstract"><strong>Background:</strong> Role of CT scan in sinonasal disease is proved by many published articles. Most of them are having small sample size, poorly defined protocol of CT reporting and does not mention the window width and window level of the software. We did this study to include these points and tried to have sample size of at least 200.</p><p class="abstract"><strong>Methods:</strong> 231 patients included in the study. After clinical examination CT PNS was done. A strict protocol was maintained for the timing of CT, window settings (to get highest bony definition) and for the reporting of CT. </p><p class="abstract"><strong>Results:</strong> Few common anatomical variations were agger nasi (61.9%), DNS in 50.6%; concha bullosa (18.6%), paradoxical MT (20.3%), Onodi Cells (21.6%) and Haller cells (11.3%). Most common subtypes amongst some anatomical variations include middle meatal drainage of frontal recess (58.8%), type I frontal cell (7.1%), type I ethmoid roof (48.9%), type I attachment of UP (58.8%) and sellar type of sphenoid pneumatization (68%). CT has 100% sensitivity and specificity in detecting the diseased sinuses correctly. Except from 11.8% cases in which frontal recess drainage could not be assessed, all other anatomical variation were same intra-op as shown by CT. In fungal rhinosinusitis anatomical variations were difficult to detect by CT.</p><p class="abstract"><strong>Conclusions:</strong> This study proves that CT-PNS gives us the detailed and near exact picture of the disease with its extent as well as of existing anatomical variations in non-neoplastic sino-nasal diseases except in FRS cases where in anatomical variations are difficult to analyze.</p>

Sino-Nasal Outcome Test-22: Translation, Cross-cultural Adaptation, and Validation in Local Language

Introduction Quality of life questionnaires have been increasingly used in clinical studies to help estimate the magnitude of problem. Sino-Nasal Outcome Test -22 (SNOT-22) is considered to be a good tool to measure the severity of Sino-Nasal Diseases. As this test is in English, it may be difficult for the local population to express their symptoms correctly. Therefore we have translated and validated the SNOT- 22 test in local Indian language, Marathi. Materials and Methods An early Indian ( Marathi ) version of the SNOT 22 questionnaire was prepared. This was a prospective study,where forty patients with Sino-nasal Diseases confirmed on DNE & CT(PNS) filled the questionnaire. This was repeated after a period of 14 days to retest. For validation the questionnaire was also filled by healthy individuals. Results The mean SNOT-22 score ± SD was 50.17 ± 18.65 (range 10–93) in the initial test, and 49.61 ± 18.40 (range 21–91) in retest in the study group. Cronbach’s alpha was 0.835 and 0.837 at the initial and retest examination respectively, both values were suggesting a good internal consistency. The mean SNOT-22 score ± SD was 13 ± 11.68 in the control group and 49.61 ± 18.40 (range 21–91) in the sino-nasal disease group and proved by Mann- Whitney U test. Conclusion The Marathi SNOT-22 is a valid instrument to assess the symptomatology of patients of Sino-nasal Diseases in Maharashtra.