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   Table of Contents - Current issue
Coverpage
January-March 2023
Volume 7 | Issue 1
Page Nos. 1-22

Online since Monday, January 9, 2023

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REVIEW ARTICLE  

Current treatment of Meniere's disease p. 1
Santosh Kumar Swain
DOI:10.4103/mtsm.mtsm_8_22  
Meniere's disease (MD) is a morbid inner ear disease that manifests disabling symptoms such as episodic vertigo, tinnitus, and fullness in the ear, for which patients seek immediate medical attention. The treatment of disabling vertigo of patients with MD remains controversial. Endolymphatic hydrops of the inner ear is presently considered the pathophysiology for explaining the underlying mechanisms of MD. There are many therapeutic options for MD, but no one is considered a highly effective modality for the cure of the MD. The primary purpose of the medical treatment of MD is to treat his or her symptoms rather than disease. Betahistine and diuretics are usually effective medical treatments for controlling vertigo in MD. However, there is no proven medical therapy for hearing loss or evolution of the disease in MD. There are several reports in favor of intratympanic use of aminoglycosides for the control of vertigo. Endolymphatic sac decompression is a surgical treatment option in the case of medically intractable MD. Vestibular neurectomy and labyrinthectomy are two important surgical techniques for the treatment of disabling vertigo of MD, but these surgical procedures are associated with relatively higher surgical morbidity. Recently, treatment with chemical labyrinthectomy/transtympanic gentamycin injection and endolymphatic sac decompression have gained favor for MD because they have less invasive techniques and are associated with fewer risks and side effects. The objective of this review article is to discuss current treatment options for MD to relieve disabling symptoms of MD and so improving the quality of life.
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ORIGINAL ARTICLES Top

Evaluation of morphological changes in hepatic parenchyma, bile ducts, and hepatic vasculature in patients with oriental cholangiohepatitis using ultrasonography p. 7
Mir Junaid Ahmad Kazime, Obaid Ashraf, Mohd Ilyas
DOI:10.4103/mtsm.mtsm_53_20  
Objective: The objective of this study is to study the morphological changes in hepatic parenchyma, to characterize the intra and extrahepatic ductal changes and to study the morphological changes in vasculature of the liver in patients with oriental cholangiohepatitits (OCH). Materials and Methods: All documented or newly diagnosed cases of OCH, referred to the department of radiodiagnosis and imaging from Departments of Surgical Gastroenterology and Medical Gastroenterology were evaluated by ultrasonography (USG) and color Doppler study. The dilatation of the intrahepatic as well as extra-hepatic ducts was noted. The morphological changes in the liver parenchyma as well as hepatic vasculature were studied. Results: USG showed calculi in 53 (98.1%) cases, ductal dilatation in 52 (96.3%), and worms within biliary ducts in 10 cases (18.5%). Among parenchymal changes, atrophy was seen in 9 cases (16.6%), space-occupying lesion was seen in seven cases (12.9%), and peri-portal echogenicity in 10 cases (18.5%). Significant association was found between atrophic segments and reduced/absent blood flow in the affected segmental portal venous branches. Conclusion: USG is the preferred primary examination. Further imaging depends on the USG findings, the patient's symptomatology, the clinical problems, and the intended mode of treatment. Advances in Knowledge: USG plays a pivotal role in the evaluation of oriental cholangiohepatitis in the low resource settings where higher modalities like MRI are not available, especially in the remote areas of developing countries, as it has high degree of accuracy in the diagnosis of OCH.
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Sphenoid sinus mucocele: Our experiences at a tertiary care teaching hospital of Eastern India p. 12
Santosh Kumar Swain, Prasenjit Baliarsingh
DOI:10.4103/mtsm.mtsm_4_22  
Background: Sphenoid sinus mucocele is a benign expansile mucus-filled cystic lesion as a result of chronic obstruction of the sinus ostium. Because of its expansile, growth may affect nearby vital structures and result in the involvement of optic nerve and intracranial structures. Objective: This study aims to evaluate the details of patients with sphenoid sinus mucocele. Materials and Methods: In 5 years, we reported eight patients with mucocele in the sphenoid sinus. The detailed clinical presentations of these patients were documented. All the patients with sphenoid sinus mucocele were investigated with diagnostic nasal endoscopy and imaging such as computed tomography scan and magnetic resonance imaging (MRI) of the nose, paranasal sinuses, and brain. All underwent transnasal endoscopic transsphenoidal marsupialization of the mucocele in the sphenoid sinus. Results: There were eight patients diagnosed with sphenoid sinus mucocele. Out of eight patients, five (62.5%) were male and three (37.5%) were female with a male-to-female ratio of 1.66:1. The mean age of enrolled patients was 48.37 years. Out of eight patients with sphenoid sinus mucocele, three (37.5%) patients had allergic rhinitis, two (25%) patients had chronic sinusitis, and one (12.5%) patient had a history of radiation therapy for nasopharyngeal carcinoma. Conclusion: Sphenoid sinus mucocele is a rare clinical condition. In this study, headache was the most common symptom. Allergic rhinitis, sinusitis, and radiation to the head-and-neck region are important predisposing factors for causing sphenoid sinus mucocele. Orbital symptoms are indicators for prompt surgical intervention. Endoscopic sinus surgery is an effective and safe treatment option for sphenoid sinus mucocele.
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Role of topical intranasal corticosteroid for treatment of post-COVID olfactory dysfunction – Our experiences p. 16
Santosh Kumar Swain, Swaha Panda, Ansuman Sahu, Somya Ranjan Pani
DOI:10.4103/mtsm.mtsm_5_22  
Background: The coronavirus disease 2019 (COVID-19) is a highly contagious acute respiratory disease caused by a novel virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 infection presents with respiratory illness and even respiratory failure and death. Olfactory dysfunction is an important clinical manifestation that has an impact on quality of life. Objective: This study is designed to analyze the role of the topical nasal corticosteroid in post-COVID olfactory dysfunction. Materials and Methods: This is a prospective and descriptive study on 72 COVID-19 patients who were administered topical intranasal corticosteroids and olfactory training. All of them were diagnosed with COVID-19 infection by reverse transcription–polymerase chain reaction of the nasopharyngeal swab. The detailed clinical examination and treatment with intranasal corticosteroid and its outcome were analyzed. Results: In this study, 46 (63.88%) patients were male and 26 (36.11%) were female with a male-to-female ratio of 1.76:1. The age ranges from 18 to 58 years. There were 30 (41.66%) patients in the age range of 18–30 years and 42 (58.33%) patients in the age range of 31–58 years. Out of 72 patients, 11 (15.27%) patients recovered after 2 weeks, 34 (47.22%) patients recovered after 3 weeks, and 20 (27.77%) recovered after 4 weeks. Three patients lost to follow-up during the treatment period. Conclusion: COVID-19 infection is spreading quickly all the continents of the world. Olfactory dysfunction is an important symptom of the COVID-19 infection. Intranasal mometasone spray and olfactory training are useful treatment options for post-COVID olfactory dysfunction.
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CASE REPORT Top

Incidental finding of asymptomatic supracondylar process of the humerus: A case series p. 20
Ganesh Singh Dharmshaktu, Ishwar Singh Dharmshaktu, Naveen Agarwal
DOI:10.4103/mtsm.mtsm_9_22  
The supracondylar process is an uncommon anomaly that presents as a beak-like bony projection from the anteromedial aspect of the humerus. Many of these occurrences are reported as sporadic case reports or small series. While the true incidence cannot be assessed as very few of these have clinical problems like neurovascular compression (brachial artery or median nerve entrapment) due to ligament of Struther's attached to it. Incidentally, these lesions can be noted in clinical settings while treating some other conditions. We describe a series of four cases that were incidentally seen in our center when radiographs were done for various reasons.
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