Is surgical vestibular ablation necessary in disabling peripheral vertigo?

The use of intratympanic gentamicin is an easily performed office procedure for the conservative treatment of the Meniere’s disease patient who has failed medical therapy. The procedure provides excellent control for the symptom of vertigo and is one of the most successful methods in the treatment of vertigo due to inner ear disorders. Surgical ablation is no longer necessary for adequate control of vestibular symptoms and that chemical ablation/alteration may replace the need for surgical vestibular ablation in cases of disabling Meniere’s disease and other inner ear causes for peripheral vertigo.     

Incidence of uncomplained secretory otitis media in patients undergoing adenotonswlectomy

Secretory otitis media (SOM) is a pathologic condition of the middle ear in which an effusion is present behind an intact eardrum without signs of acute inflammation. This prospective study was conducted during the period of February 1998 to January 2000. One hundred children of age group 2–12 years were followed up at intervals of 1, 2, 4, 12 weeks, 6 months and 1 year postoperatively. We carried out the established techniques of myringotomies and grommet insertion (shepherd type) to detect and resolve SOM. We found that the URTI was a prime factor as the cause for SOM. Myringotomy and grommet insertion results in drying up of fluid and return of normal hearing status in SOM.     

Improved access to subspecialist diabetes care by telemedicine: cost savings and care measures in the first two years of the FITE diabetes project

We have used telemedicine clinics supplemented by online education to provide effective care for children with diabetes. Before the programme began, the mean interval between visits was 149 days; in year 1 of the programme it was 98 days, and in year 2 it was 89 days. Before the programme, there were on average 13 hospitalizations a year (47 days) and this decreased to 3.5 hospitalizations a year (5.5 days). Emergency department visits decreased from 8 to 2.5 per year. On 10 occasions after the programme started, ketosis was managed by telephone intervention alone, relying on family-initiated calls. Over 90% of patients and family members expressed satisfaction with the telemedicine service and wished to continue using it. In all, 95% felt little self-consciousness. Over 90% felt their privacy was respected. The programme saved US dollar 27,860 per year. The present study demonstrated improved access to specialized health care via telemedicine in combination with online education improved health status and reduced costs by reducing hospitalizations and emergency department visits.     

Can alzheimer's disease and dementias with Lewy bodies be distinguished clinically?

To determine if Alzheimer's disease (AD), its Lewy body (LB) variant (LBV), and diffuse LB disease (DLBD) are distinguishable at initial clinical evaluation, data from autopsy-confirmed AD, LBV, and DLBD were examined. No significant differences were found in age at onset, age at death, total duration of illness, duration of illness before initial visit, duration of illness from initial visit to death, or severity of illness at initial evaluation. Hallucinations and delusions were significantly more frequent for LBV and DLBD, respectively, than for AD, and falls were more frequent for DLBD than for AD. Extrapyramidal symptoms (EPS) were less frequent in neuroleptic-free AD subjects than in LB subjects; the percentage of AD patients with EPS after neuroleptic exposure was less than that among LB patients. Seizures were significantly more common for DLBD than for AD or LBV. LB dementias differed from AD at initial evaluation, with more frequent hallucinations and delusions, EPSs, and seizures, and longitudinally in neuroleptic sensitivity, but the data did not distinguish LBV from DLBD.     

Value of ultrasonography in laryngeal and laryngopharyngeal cancers

High-resolution sonography has improved in the past few years and has become a very valuable tool in the diagnosis of diseases of the head and neck. Ultrasonography (US) is commonly the first imaging modality after clinical examination. It is inexpensive, noninvasive and is easily tolerated by patients. It provides valuable diagnostic information with a high degree of diagnostic accuracy. This article provides the most up-to-date information about the indications, findings and limitations of high-resolution sonography in the evaluation of laryngeal and laryngopharyngeal cancers.     

Rapid and sensitive liquid chromatography-mass spectrometry method for determination of ropinirole in human plasma

A rapid and robust liquid chromatography–mass spectrometry (LC–MS/MS) method was developed for non-ergoline dopamine D₂-receptor agonist, ropinirole in human plasma using Es-citalopram oxalate as an internal standard. The method involves solid phase extraction from plasma, reversed-phase simple isocratic chromatographic conditions and mass spectrometric detection that enables a detection limit at picogram levels. The proposed method was validated with linear range of 20–1200 pg/ml. The extraction recoveries for ropinirole and internal standard were 90.45 and 65.42%, respectively. The R.S.D.% of intra-day and inter-day assay was lower than 15%. For its sensitivity and reliability, the proposed method is particularly suitable for pharmacokinetic studies.