ENT Quiz Round 5

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Answers to Round 3:-
Q.1
The petrosquamous suture line persists as
Korner’s septum

Q.2
The middle turbinate is
part of the ethmoid bone

Q.3
The parafollicular cells of the thyroid are derived from the
ultimobranchial body

Surgical management of Puberphonia:


When all the conservative methods fail then surgery will have to be resorted to. Isshiki type III relaxation thyroplasty has shown promise in managing these patients. This surgical procedure lowered the pitch of voice in these patients by shortening the length of the vocal folds. In the classic Isshiki type III thyroplasty 2 – 3 mm of vertical strips of cartilage were excised on each side of midline of thyroid cartilage. This procedure caused retrusion of the middle portion of the thyroid cartilage causing a reduction in the length of the vocal fold

Read Further... For Dr Balu Link

Can Tympanic membrane perforation may occur with valsalva maneuver ?

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Tympanic membrane perforation may occur when ear pressures are excessive, including valsalva maneuver associated with active labor and vaginal delivery. A pressure differential across the eardrum of about 5 psi can cause rupture; the increased intraabdominal pressure spikes repeatedly manifested by “pushing” during second-stage labor easily approach (and may exceed) this level

Reference

ENT Quiz 4

Click here to participate in ENT Quiz 4

ENT QUIZ ROUND 3 :Answers

First Two correct responses:(Total 106 responses till date )
DR.SUNEEL B.ALLAMPALLEWAR,NANDED

Dr VAISHALI SHAH,VADODARA

Question on Ear-
1]“Leaky integrator” helps to explain
A]Tullio phenomenon
B]Alexander’s Law
C]Coriolis phenomenon
D]Ewald’s Law

Question on Nose-
2]Regarding the nasal septum,the following statement is untrue-
A]the vomer is always in the midline
B]septoplasty is the most cost-effective method to control idiopathic epistaxis
C]the results of septoplasty are always consistent with the surgical correction
D]nasal packing helps to prevent haematoma formation and resorption of
the nasal septum

Question on Throat-
3]Pick out the correct statement-
A]the palatine tonsils have both afferent and efferent pathways
B]tonsillectomy is not prophylactic for rheumatic heart disease
C]secondary haemorrhage is the most common complication of tonsillectomy
D]laser and cold steel give similar results in tonsillectomy

1-B:

"Leaky integrator" refers to the VOR,which tends to always correct the gaze towards the centre in the event of a vestibular lesion,and thus explains Alexander's 3 laws.

2-C:

It has been proved beyond doubt that the final results of septoplasty are often unsatisfactory and not as expected from the surgical correction.

3-B:

Tonsillectomy does not offer any protection against rheumatic heart disease as the latter is an immune-complex reaction resulting from streptococcal sore throat,which is not common any more.Even in the preantibiotic era,removal of the tonsils was not advocated as a means to protect against RHD.
- Show quoted text -
--
Dr Jayita Poduval
Associate Professor
Department Of ENT
AIMST University
Kedah Darul Alam
Malaysia

Readers Forum:laryngeal papilloma

D/L of 45 years male who is non smoker.
Biopsy from the lesion suggest it to Squamous papilloma.
Comment on further management.

The diagnosis is laryngeal papilloma and the treatment is excision (MLS). One can use either LASER or cold instrument for excision. Also larger part of papilloma can be removed by a laryngeal microdebridder and the final touch can be done by LASER. Dr Ravi Meher
MS(ENT), DNB(ENT), MNAMS
Associate Professor(ENT)
Maulana Azad Medical College and associated Lok Nayak Hospital, New Delhi

ravimeher@gmail.com

*dr skmenon said...
laser excision is treatment of choice

*rajisampath nalamati
laser excision biopsy and follow up

*Admiral [Dr] V K Singh
mucosal changes ,do a total excision & Send for histopath study at a good centre.

* Dr Shashidhar

WE NEED TO GET CECT/ CONTRAST MRI OF LARYNX TO LOOK FOR PARAGLOTTIC, CARTILLAGE AND GLOTTIC INVOLVEMENT. LASER OR COLD KNIFE EXCISION IS A MATTER OF CHOICE AND FEASIBILITY EACH HAVING THEIR MERITS. THE IMPORTANT POINT IS SQ CELL CA USUALLY PRESENTS LIKE THIS AND BIOSPY FROM NONE REPRESENTATIVE PLACE MAY SHOW SQ PAPILLOMA. NEVERTHELESS HE NEEDS LONG TIME CLOSE FOLLOW UP FOR RISK OF MALIGNANCY

International Course on "BAHA", April 1-2, 2011 at UCMS & GTB Hospital

The Deptt of ENT, UCMS & GTB Hospital is pleased to announce a course on "Bone Anchored Hearing Aids".
Lectures detailing the indications, operative technique and outcomes will be delivered by the international faculty.
Also, issues relating to osseointegration will be discussed in detail. Live surgical implantation of BAHA will be demonstrated
in patients with different indications. The sessions will be interactive and delegates' participation will be encouraged.
Course Director: Prof P P Singh
International Guest Faculty: Dr Patrick Sheehan, UK
Contact: Prof Arun Goyal
arungoyal150@yahoo.co.in
09868399552
www.otologyindia.blogspot.com

“Surgical Techniques in ENT” Ephesus, Turkey, between April 22 and 24, 2011.

Dear Colleagues,

On behalf of SOCIETY of OTO-RHINO-LARYNGOLOGY and HEAD NECK SURGERY, I would like to invite you to the meeting “Surgical Techniques in ENT” which is going to be held in Ephesus, Turkey, between April 22 and 24, 2011.

This two-day meeting is designed to demonstrate video records of the surgical techniques of different surgeons representing various schools. The instructors are expected to demonstrate their methods by explaining the steps of their original surgical techniques on video while discussing with the audience.

The dates of the meeting is determined in such a way that, besides a high-standard scientific programme, the participants could also spend their regular spring or Easter holidays by visiting one of the most important historical places in the world, Ephesus.

We would like to see the colleagues from all over the world who want to get the opportunity of participating in a highly qualified meeting with a rich and enjoyable atmosphere of social programme.

We look forward to see you in Ephesus, Turkey, to show Turkish hospitality which is well-known all over the world.

With my warm regards,

Gursel DURSUN, M.D.
Professor of Otolaryngology,
President

Official meeting language: English
Topics and other details: www.ent2011.org
Scientific Correspondence:
Haldun OGUZ, M.D.
Associate Professor of Otolaryngology
Otolaryngologist - Head & Neck Surgeon
Congress Secretary

Surgical Techniques in ENT

ent2011.org

General Secretary
Society of Otolaryngology, Head & Neck Surgery (Ankara, Turkey)
kbbder.org
Tel: +90 533 300 00 00
E-mail: drhoguz@gmail.com
E-mail: haldun.oguz@kbbder.org

Status of Quiz Round -3

Two correct responses:(Total 73 responses )


DR.SUNEEL B.ALLAMPALLEWAR,NANDED

Dr VAISHALI SHAH,VADODARA

Dr Sonali Pandit:effect of stem cells on sensorineural hearing loss

I wish to share my achievement with our ENT colleagues.
I am Dr Sonali Pandit, an ENT surgeon currently working in Fortis Hiranandani Hospital Mumbai. I have worked extensively on effect of stem cells on sensorineural hearing loss. My study has been recently published in "Stem Cells". It has generated a lot of interest worldwide as this holds a lot of promise to the treatment of SN hearing loss in childhood as well as presbycusis. This research has been conducted at the prestigious Garvan Institute of Medical Research, Sydney, Australia
I am attaching the URL of the paper.

Read Article

Read News

Anonymous said...
Congratulations

February 13, 2011 3:42 PM
Anonymous said...
Can you please provide me with your consultancy address because i wish to to have an appointment with you.

Thank You,

-Abhishek

February 13, 2011 11:55 PM
hearing aid said...
Glad to see this information.its very useful for eneryone.thanks for sharing this post.

Hearing Aid


February 14, 2011 1:18 PM
Anonymous said...
if you need volunteer,kindly oblige me

ashishjoshiindia@gmail.com

February 16, 2011 1:49 AM

QUIZ ROUND 2-QUESTIONS


Click here for Answers


Dr Jayita Poduval
Associate Professor
Department Of ENT
AIMST University
Kedah Darul Alam
Malaysia
drjayitapoduval@gmail.com

Journal of Laryngology and Voice- Free Access

Free Access to current issue
Dear Colleague,

Greetings from the Journal of Laryngology and Voice.

We write to you to announce the publication of the first issue of our academic endeavor undertaken with you all as pillars of strength - the “Journal of Laryngology and Voice" has taken off!

The issue is now fully online and accessible across the world on the internet at http://www.laryngologyandvoice.org. Both full text and PDF versions of the articles are available for anyone to free download. We request you to bookmark it and offer your feedback / comments.

As the saying goes "Well begun is only half done", we fully understand the need to actively pursue this venture with all enthusiasm and professionalism and for this we seek your continued support. We ask you to proactively spread the online availability of this journal and encourage peers and juniors to submit high quality research to the publication. Also, we seek quality review articles and solicit your cooperation in them. We intend to steer this journal as a "sought-after: publication in the years to come and need your full support to achieve that.

For Subscription of the journal attached herewith Life Membership form of Laryngology & Voice Association. Life membership fee : Rs.1000/- for ENT surgeons and Rs.750/- for Speech Language Pathologist and Allied specialty to be sent by Cash / Multicity Cheque / Demand Draft in favour of “Laryngology & Voice Association”.payble at Pune.

Lt Col (Dr) Rakesh Datta
Editor-in-Chief
Journal of Laryngology and Voice
http://www.laryngologyandvoice.org

How long to preserve medical records?

How long to preserve medical records?
QUESTION—A patient was operated in 2003. A claim against the doctor has been made in 2011. How long should medical records be preserved?
ANSWER—
1—The consumer can file a complaint till 2 years after the service was provided. This is usually extended to mean—“Till 2 years after the defect in service comes to notice”. Courts can condone delay.

2—Records should be kept as follows:

A—Under MCI Regulations, 2002, applicable to doctors (not to hospitals)—
As per Regulation 1.3.1 of the Indian Medical Council (Professional conduct, Etiquette and Ethics) Regulations, 2002, “Every physician shall maintain the medical records pertaining to his / her indoor patients for a period of 3 years from the date of commencement of the treatment in a standard proforma laid down by the Medical Council of India and attached as Appendix 3”.

B—Under the DGHS guidelines, applicable to central government hospitals—

The guidelines for the government hospitals have been published by the DGHS vide letter No. 10-3/68-MH dated 31-8-68 as follows:

For inpatient medical records (case sheets)……………….10 years
For medico-legal registers…………………………………….10 years
For outpatient records………………………………………….5 years

The above requirement can be found in the “Hospital Manual” published in 2002 by the Directorate General of Health Services, MOHFW, GOI, in chapter 12 titled “Medical Record Services”.

C—Under other Acts applicable in the state concerned (such as the respective Clinical Establishments Act, Nursing Home Act etc.)—As per the provisions of the Act concerned.

---M C Gupta
MD (Medicine), LL.M.
Fellow: National Foundation of Clinical Forensic Medicine
Ex-Professor and Dean
Practicing advocate
mcgupta44@gmail.com
18 January 2011

What to do when relatives ask the doctor to stop treatment of a critically ill patient?

QUESTION—What should the hospital / doctors do when the attendants of an unconscious patient with tracheostomy tube, IV lines, Ryle’s tube and indwelling catheter demand that all these be removed at their own risk and responsibility?
ANSWER—

1—A doctor’s duty is to save, not to take life. Taking life is homicide. Removal of these gadgets will be tantamount to an attempt to take life which also is a criminal act.

2—A doctor is supposed to give or withhold or withdraw or change treatment as per principles of medicine and not as per the orders of a layman or even the patient himself. A doctor who acts otherwise will be guilty of misconduct / negligence.

3—If the act of removing the appliances is done by the doctors or the hospital staff, the risk and responsibility are to be faced by the person doing the act. The relatives cannot be made responsible for the acts of the hospital staff.

4—Even if the relatives make a written request to the hospital to withdraw treatment / appliances, such written request has no meaning in law. Consent for treatment or its stoppage has to come from the patient or his authorised representative.

5—If the authorised representative makes a written request to the doctors to stop treatment when the result of stopping treatment might result in death, the doctors should not act upon the request because euthanasia is not allowed by law. In such a situation, the hospital should contact its advocate for necessary guidance.


---M C Gupta
MBBS & MD (Medicine), AIIMS;
LL.B. (Delhi); LL.M. (Kurukshetra)
Fellow: National Foundation of Clinical Forensic Medicine
Ex-Additional Professor, AIIMS
Ex-Professor and Dean, NIHFW
Practicing advocate

Comments
Please add in para 5 ,inform police for such request made by relatives.Admiral[Dr] V K Singh

“Management of Vertigo Made Easy” February 11,AIIMS,Delhi

Department of Otolaryngology & ORL Society of AIIMS is organizing a CME on
“Management of Vertigo Made Easy”
Date- 11th February 2011 (Friday) - 2pm
Venue- Conference Hall (above JLN Auditorium)
AIIMS, New Delhi
Programme
2-3pm- Lunch
3-4 pm Lecture fallowed by Interactive session by
Prof. Michel Strupp, MD
Prof of Neurology and clinical Neurophysiology
Germany
4-5pm Panel Discussion- “Management of Vertigo Made
Easy”
Tea
All are invited. No registration fee
Panel discussion on vertigo on 11.2.11

1. Magnitude of problem
2. What are common causes of vertigo in your experience?
3. Acute vertigo-
a. Line of management
b. Diagnostic- what stage
i. Audiometry/ positional test
c. Therapeutic- medication and route
i. Cinnarazine/ B histine and other drugs
d. Role of imaging in acute vertigo
4. Battery of investigations
a. Role of ENG Vs VNG
b. VEMP
c. ABR
d. Other- Imaging /ECHO/ Doppler
5. Rehabilitation
6. Specific cases base discussion

6th National FESS Workshop,8-10 October,2011,Apollo Hospital Delhi



NATIONAL FESS WORKSHOP
at APOLLO HOSPITAL, New DELHI
on 8th, 9th & 10th October,2011

Course Director- Dr. ARVIND SONI
Faculty- Dr. Ashok Gupta(PGI, Chandigarh)
Dr. Nishit J. Shah, Bombay Hospital, Mumbai
Hands-on Cadaveric Dissection on 8th & 10th Oct,2011
Live Surgery & Discussions on 9th Oct,2011

Contact- Dr. Arvind Soni, 9811098523, drarvindsoni@yahoo.co.in

ENT Quiz Round 1

1.1]SECTION ON EAR-Marquet’s technique may be employed in
A]cochlear implant surgery
B]tympanoplasty
C]stapedectomy
D]removal of acoustic neuroma

2 Prominent differences between cystic fibrosis(CF) and primary ciliary dyskinesia(PCD)are all except
A]nasal polyposis is more common in CF than in PCD
B]interleukin IL-8 is higher in CF than in PCD
C]prognosis is worse in CF than in PCD
D]diagnostic tools are more basic in CF than in PCD

3. Apathetic thyrotoxicosis may be encountered in
A]elderly patients
B]children
C]patients suffering from depression
D]pregnant women

Click here for Answers
Dr Jayita Poduval
Associate Professor
Department Of ENT
AIMST University
Kedah Darul Alam
Malaysia
drjayitapoduval@gmail.com

Understanding Laser , March 5-6,2011,Akola



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RAMACHANDRA TEMPORAL BONE COURSE – RTBC,2011

The Department of ENT, Head & Neck Surgery
Sri Ramachandra University
Organizes
RAMACHANDRA TEMPORAL BONE COURSE – RTBC
(Otology Skills Development Workshop)
on26th March 2011 , 23rd July 2011 & 22nd Oct 2011 at
The Skills Lab, 2nd Floor, OPD Block
Department of ENT, Head & Neck Surgery
Intended audience
This course is intended for Residents in training and practicing ENT Surgeons to make them aware of cutting-edge dissection techniques in order to master the fascinating anatomy of the temporal bone.

Course Overview
The objectives of the course are to improve the surgical skill of the participants through a series of dissection exercises and to review essential components of micro- ear surgery. Upon completion of the course, participants are expected to improve temporal bone dissection skills and perform micro- ear and mastoid surgery. This will reduce complications in their practice.
Procedures to be demonstrated
Stapedectomy
Cortical Mastoidectomy
Posterior Tympanotomy
Modified Radical Mastoidectomy
Facial Nerve Decompression
Cochleostomy

Limited Seats Available!
No Spot Registrations!
Kindly send your registrations / enquiries to:
Dr V V Ramachandran Phone +919444570157
Dept. of ENT, Head & Neck Surgery SRMC & RI,

Email: vedhachalamram@yahoo.co.in
& ramvedhachalam@cooltoad.com

Access to online fulltext articles in indexed journals.

Being an reviewer in several interantionaljournals I am able to gain access to online fulltext articles in indexed journals.
Hence started this section for ENT Pg's and surgeons who do not have access to fulltext online journals.
They can send in their request for the article in this forum and we will try and provide them with full text articles across ENT forum.
I would be grateful if this message can be passed on to doctors visitng your forum, who could take advantage of this service.
Look forward to hearing from you.

Sincerely,

Vishal

Mail:drvishalrao@yahoo.com

Dr U.S. Vishal Rao,
Consultant Oncologist- Head& Neck Surgeon,
Fortis-Wockhardt Hospital
Visitng Consultant,
Bangalore Institute of oncology / Apollo Hospital

How to make Branches Association of Otolaryngologits of India

Following is relevent text from constituition of AOI to form City/State Branches:-

32. Branches :
(a) There will be two types of Branches - City Branch and State Branch. For forming a branch the branch will have to take permission of the parent body.
(b) The Branch can admit Postgraduate students and local allopathic medical practitioners as full members to achieve the objects of the Association and to augment its resources. There should be a minimum membership of ten (10) to form any Branch.
(c) Rules of Branches :
Local branches shall be independent of each other and autonomous as far as their internal
management is concerned, but their rules shall not be in conflict with the rules of the Association. A copy of the branch rules must be submitted to the Governing Body for approval and all subsequent changes in the rules shall be notified to the Central Office.
(d) Liabilities of Branches :
The Association of Otolaryngologists of India shall not be liable for any of the branches nor shall any of the branches be liable for any of the debts and liabilities of the Association.
(e) Names of Branches :
As far as possible the Branches should be named "The Association of Otolaryngologists of India ……………. Branch e.g. Bombay, West Bengal, Andhra Pradesh, or Tamil Nadu. They should open
accounts in their local banks after a resolution is passed at a local annual or special meeting for the purpose.
(f) It is desirable to open state branches in every State and members should be encouraged to form State Branches.

SEND queries to update@entindia.net

MMR Vaccine -Autism Link Fraud

The MMR vaccine controversy refers to claims that autism spectrum disorders can be caused by the MMR vaccine, an immunization against measles, mumps and rubella.

Claims of a connection between the vaccine and autism were raised in a 1998 paper in The Lancet, a respected British medical journal. Investigation by Sunday Times journalist Brian Deer discovered that the lead author of the article, Andrew Wakefield, had multiple undeclared conflicts of interest, had manipulated evidence,and had broken other ethical codes. The Lancet paper was retracted, and Wakefield was found guilty by the General Medical Council of serious professional misconduct in May 2010 and was struck off the Medical Register, meaning he could no longer practice as a doctor in the UK. The research was declared fraudulent in 2011 by the BMJ.
Link

International Micro Ear Surgery Workshop & Launch of Cochlear Implant Programme, February 14-15,Delhi

International Micro Ear Surgery Workshop & Launch of Cochlear Implant Programme
Under the auspices of Max India Foundation and Max Healthcare
&
Claros Foundation
Barcelona, Spain
Venue:
14th February 2011, Monday
Max Super Speciality Hospital
Press Enclave, Saket, New Delhi

15th February 2011, Tuesday
Max Super Speciality Hospital
108, A, I.P.Extension,
Patparganj, Delhi 110 092

Chairman Organising Committee: Co-Chairman:
Dr. Sanjay Sachdeva Dr. Sharad Maheshwari

Registration Fees: Complimentary
For registration contact:
Dr. Sanjay Sachdeva, +91 9810129864
Dr. Sharad Kumar Maheshwari, +91 9810487335
Mr. Rajesh Sood,
+91 9910317286, +91 9717117594
rajesh.sood@maxhealthcare.com
i.soodrajesh@gmail.com
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