Will you use Corticosteroids in Acute Sore Throat for pain relief ?
Express your opinion on www.entindia.net
Answer will depend on the basis of knowing the whole story of the patient. If only this then NO.
Dr Arjun Dass
Combination of Anti-allergic along with corticosteroid helps in reducing pain & soreness earlier due to the synergistic antiallergic/ anti-inflammatory effect.A short course is really safe and effective
I would add oral steroids if the acute inflammation is accompanied by uvular oedema
Dr. Vishesh Malhotra, Gurgaon
steroids can be used if proper antibiotic coverage is assured
Dr Shrikant Pathak
I would give one off a dose of corticosteroids if I see swollen tonsils with exudate or uvular edema in sore throat along with antibiotics.
Dr Kiran Jumani
i've never used steroids in this scenario but have found them being prescribed by many physicians, albeit for few days. this study advocates a single dose administration, either oral or injectable. i feel this study will help us in judiciously using steroids in sore throat. many thanks to the uploader of this topic.
Dr Harpreet S Kochar
only if breathing difficulty.
kacker s k
Corticosteroids are beneficial for symptoms of upper respiratory tract infections
Sore throat is a common condition in primary care
Recent guidelines recommend that antibiotics should not be prescribed for sore throat
What this study adds
At 24 hours, patients with severe sore throat who are given corticosteroids in addition to antibiotics are three times more likely to report complete resolution of symptoms than those who do not receive corticosteroids
Corticosteroids also reduce the time to mean onset of pain relief in this patient group by about 6 hours
The effect of corticosteroids independent of antibiotics is unknown and should be the focus of future research
Published 6 August 2009, doi:10.1136/bmj.b2976
Cite this as: BMJ 2009;339:b2976
Click here to Read further
I think this study vindicates what I have felt for a long time, that a short course of steroids ( single shot, or max 3-5 days which does not need tapering)when used judiciously, significantly reduces mordbiditry and improves resolution.The side effects for such short term use are usually acceptable. I had mentioned this in treatment of Barotrauma, to enable cabin crew/flyers to get back to their jobs farster, but a lot of people were critical of this.
I just hope that this is not misused/overused, the way antibiotics have been.
Dr Ajit Mansingh (Max Hospital , Delhi)
We already know that post-op pain in tonsillectomy is much less if a single intraoperative dose of a steroid is used. So this concept of using steroid in tonsillitis does not sound too alien. however it also makes one wonder if our GP brethren who have been using steroids (mixing antibiotic powder crushed together with steroid)quoting their experiences knew better all along. Another factor to be considered is the reluctance of the population in general to using anything which has anything to do with steroids.
I think the steroids if given after the fever has gone and more over if steroids in mild dose are kept in oral cavity for some time before being swallowed are more useful
AS U ALL KNOW THAT MADHUMANI CHARITABLE SOCIETY FOR THE PAST 19YEARS SINCE 1991 CONDUCTING FREE ENT SURGICAL CAMP FOR THE POOR AND DESERVING ENT PATIENTS INVITING GUEST FACULTY AND THIS YEAR WE DID IT FROM 11TH AUGUST TO 16TH FOR ONE WEEK WITH 13 SURGEONS CMING FROM AP AND KARNATAKA TO PERFORM THE MAJOR ENT OPERATIONS LIKE TYPANOPLASTIES,FESS OPERTIONS FOR SINUSES,SOMETIC RHINIPLASTIES,HEAD AND NECK CASES ETC AND TOTALLY WE DID 82 SURGERIES THIS YEAR.
C.MADHU SUDANA RAO
MADHUMANI NURSING HOME
NANDYAL 518501.A.P. INDIA.
LAND LINE:+91-8514-243220, 246222
hello sir,i have to appreciate and praise your charitable efforts.not many people these days have such an attitude.i am also interested in charity work maybe i will get a chance
August 28, 2009 2:26 PM
Dr P.S.Jassal said...
Congratulations.There are many places in India which need charity work.All of us must devote some time for this purpose
Controversy surrounding tongue tie
The medical profession is divided about
the necessity for tongue tie release. Some
medical practitioners do not recognise the
reported problems as significant enough to
warrant surgical intervention. Evidence
exists in literature suggesting that some
tongue ties relax with time.
Before the decision to divide a tongue tie
is made, the severity of the symptoms on
the child should be assessed. The presence
of an unproblematic tongue tie is not an
indication for surgical division, and it is left
to the clinical judgement of the medical
practitioner to assess the significance.......
Click here to view full article from ENT NEWS
READERS COMMENTS ARE WELCOME BELOW
Intresting question.In fact I have been under quite pressure to do this procedure by my referring colleuges and parents of patient.I do about 5/10 patient including adult in a year but refuse to do in as many as 100 patients. They all come with a belief that this is some thing which will make the child start speaking immediately.
Dr K C Ahuja, Gwalior
None or one tongue tie surgery
Dr S K Kacker ,Delhi
tongue tie realease is less understood in this part of world.the tie should be released after the age of four years since the rease may occure by it self when child grows and use the tongue for speech. the evaluation should be done carefuly since it may not be the cause of the problem.
dr a k rai
Congenital high airway obstruction sequence (CHAOS) is a rare, life-threatening condition characterized by complete or near complete intrinsic obstruction of the fetal airway. CHAOS has been considered an almost invariably fatal condition which often goes incorrectly diagnosed until autopsy. However, advances in prenatal imaging, earlier diagnosis in utero, in utero surgical treatment, and delivery via ex utero intrapartum treatment (EXIT) to tracheostomy may contribute to improving the outcome of this condition.
CHAOS is diagnosed by prenatal ultrasound in a male fetus at 18-weeks-gestation. Findings included enlarged lungs, inverted diaphragms, dilated trachea distal to the obstruction, and ascites
CLICK HERE FOR FURTHER READING
One such case was presented by Department of ENT, AIIMS, in DELHI AOI clinical meeting held on 21/8/2009
Should we use fake operations to tap into the placebo effect and try to help consenting patients who might not see improvement through conventional treatment?
Or would sham surgery for therapeutic purposes be utterly wrong? Express your opinion
Yes ,I may (18%)
Yes ,I have done that (7%)
No comments (2%)
Votes so far: 76
- 1: Otol Neurotol. 2008 Feb;29(2):221-4.
The cost and analysis of nonuse of cochlear implants.
Yorkshire Cochlear Implant Service, Bradford Royal Infirmary, Bradford, UK. CHRaine@aol.com
OBJECTIVE: Analysis of the cost implications and reasons for nonuse of cochlear implants in an established cochlear implant unit. STUDY DESIGN: Clinical data were analyzed retrospectively to construct a table of cochlear implant use over time to identify nonuse and to suggest the reasons for this. SETTING: Yorkshire Cochlear Implant Service is a tertiary referral center. PATIENTS: Three hundred forty consecutively implanted patients from 1990 to 2005. MAIN OUTCOME MEASURES: Life table analysis showed that most children used their implant (p = 0.7 during 11 yr). However, 11 of 155 children and 2 of 185 adults became nonusers during the period of study. The 11 children stopped because of age at implant, educational placement, and family support. Two adults stopped because of psychological issues and inability to adapt to the signal. Surgical and implant costs have initial impact, with subsequent years' costs reflecting programming issues and maintenance. When considering nonuse, there are 2 effects: first, no more costs are incurred, and second, no more years of use are accumulated. Thus, nonuse reduces both costs and years. Costs of gaining a year of use as a function of time showed that there was little financial impact from the 11 children nonusers. As a ratio of "no nonuse" and observed "nonuse" in children, the ratio is 1.07 by 13 years of implantation (7%). The adult group was too few to analyze. CONCLUSION: The nonuse added 7% to the average cost. Retrospective audit identifies that patient selection by a multidisciplinary team is crucial to reducing nonuse.
From July 15th ,2009, online registration opens for the 14th Asian Research Symposium in Rhinology, Ho Chi Minh City, Vietnam , March 26-27, 2010 .
For full information about Congress and online registration, please visit our website at: www.arsr2010.vn
From August 1st, 2009, we begin to receive the online abstract submissions for the Scientific Program. Please be informed that the Scientific Program includes oral and poster submissions for both Clinical Research Program and Basic Science Program.
Please kindly forward this announcement to your colleagues and anyone who is interested in this congress.
We look forward to seeing you in Ho Chi Minh City , Vietnam.
Nguyen Thi Ngoc Dung, MD,PhD
President of 14th ARSR
Address: 155B Tran Quoc Thao Street, District 3, Ho Chi Minh City, Vietnam
Tel: (84.8) 39311607
Fax: (84.8) 39314650