Achal Gulati - Academia.edu (original) (raw)
Papers by Achal Gulati
Indian Journal of Otolaryngology and Head & Neck Surgery, 2015
Ectopic presence of teeth within the dentate region is common in clinical practice. However, the ... more Ectopic presence of teeth within the dentate region is common in clinical practice. However, the presence of teeth in non-dentate areas such as the nasal cavity or the maxillary sinus is rare. These may remain asymptomatic for years, may be misdiagnosed as foreign bodies, or may present with some serious complications involving the nose and paranasal sinuses. Complications such as nasal obstruction, epistaxis, headaches, rhinolith formation, epiphora, sinusitis and oro-antral fistula have been well described in literature, however, very few cases of antro-cutaneous fistulas have been reported. We discuss three cases of ectopic eruptions of teeth, all occurring in children. The clinical and radiographic findings of the cases, possible etiology, complication, diagnosis and treatment are discussed.
Singapore Medical Journal, 2013
We report the case of a 20-year-old man with a constellation of anomalies - a functional thyroglo... more We report the case of a 20-year-old man with a constellation of anomalies - a functional thyroglossal cyst and concurrent ectopic thyroid in the floor of the mouth, without an orthotopic thyroid gland. To our knowledge, this is the third such report in the otolaryngology literature. It is important to be aware of the possibility of concurrent ectopic thyroid and thyroglossal cyst in the absence of an orthotopic thyroid gland. The majority of reported cases of thyroid ectopy occur at the base of the tongue. The occurrence of an ectopic thyroid in the floor of the mouth is both unusual and not amenable to clinical examination. Even if there is good uptake on nuclear imaging, the ectopic thyroid may be hypofunctioning. We discuss the importance of thyroid imaging, as well as the need for preoperative imaging and an appropriate management strategy in the treatment of patients with this triad of anomalies.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2015
International Journal of Head and Neck Surgery, 2015
Journal of Allergy, 2016
The study was conducted to study the occurrence and clinical presentation of allergic fungal rhin... more The study was conducted to study the occurrence and clinical presentation of allergic fungal rhinosinusitis (AFRS), characterize the same, and correlate with the microbiological profile. Clinically suspected cases of fungal rhinosinusitis (FRS) depending upon their clinical presentation, nasal endoscopy, and radiological evidences were included. Relevant clinical samples were collected and subjected to direct microscopy and culture and histopathological examination. 35 patients were diagnosed to have AFRS. The average age was 28.4 years with a range of 18-48 years. Allergic mucin was seen in all the AFRS patients but fungal hyphae were detected in only 20%. 80% of cases were positive for IgE. All the patients had nasal obstruction followed by nasal discharge (62.8%). Polyps were seen in 95% (unilateral (48.57%) and bilateral (45.71%)), deviated nasal septum was seen in 28.57%, and greenish yellow secretion was seen in 17.14%. Direct microscopy and septate hyphae were positive in 71.42% of cases. 91.4% of cases were positive by culture. 5.7% yielded mixed growth of A. flavus and A. niger. Prompt clinical suspicion with specific signs and symptoms along with timely sampling of the adequate patient specimens and the optimal and timely processing by microscopy and culture and histopathological examination is a must for early diagnosis and management.
Diagnostic Cytopathology, 2001
Rhinology, Sep 1, 2011
Based on the `European Position Paper on Rhinosinusitis and Nasal polyps (EP3OS 2007)`, this stud... more Based on the `European Position Paper on Rhinosinusitis and Nasal polyps (EP3OS 2007)`, this study aimed to investigate general practitioners (GPs) and other specialists` understanding when managing patients with acute rhinosinusitis (ARS) in Asia. Among a total of 2662 questionnaires completed, 2524 (94.8%) were valid for analysis. There were 1308 GPs (51.8%), 989 otolaryngologists (39.2%) and 227 paediatricians (9%) from Mainland China, Hong Kong, Indonesia, India, Malaysia, Pakistan, Philippines, Singapore, Thailand and Taiwan. ARS is affecting an estimated 6 - 10% of patients seen in a daily out-patient practice. The EP3OS criteria are well supported by Asian physicians (94.1%). Most physicians (62.7%) agreed that radiological investigation is not needed to diagnose ARS. However, even for mild ARS (common cold), medical treatments were still recommended by 87% of GPs, 83.9% of otolaryngologists, and 70% of paediatricians. The top three first-line treatments prescribed were antihistamines (39.2%), nasal decongestants (33.6%), and antibiotics (29.5%). Antibiotics usage increased as the first line treatment of moderate (45.9%) and severe (60.3%) ARS. ARS is commonly managed by GPs, otolaryngologists, and paediatricians in Asia. However, understanding of the management of ARS needs further improvement to minimize unnecessary use of radiological investigations, overuse of antibiotics, and under use of nasal corticosteroids.
The Journal of Laryngology & Otology
A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in ... more A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in a female diabetic, is reported. The significance of the associated diabetes is discussed.
Indian Journal of Otolaryngology and Head & Neck Surgery
Indian Journal of Otology
Extracanalicular osteomas of the temporal bone are rare, slow-growing, benign neoplasms. Although... more Extracanalicular osteomas of the temporal bone are rare, slow-growing, benign neoplasms. Although they may occur anywhere in the temporal bone, they are most common in the mastoid area. Often, symptoms are negligible and treatment is unnecessary. However, surgical removal is indicated when growth of the osteoma causes distressing symptoms or cosmetic issues. The patient described in this report had no symptoms but underwent surgical excision of a mastoid osteoma for cosmetic reasons. At 4-month follow-up, she remains asymptomatic and recurrence-free.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2015
Ectopic presence of teeth within the dentate region is common in clinical practice. However, the ... more Ectopic presence of teeth within the dentate region is common in clinical practice. However, the presence of teeth in non-dentate areas such as the nasal cavity or the maxillary sinus is rare. These may remain asymptomatic for years, may be misdiagnosed as foreign bodies, or may present with some serious complications involving the nose and paranasal sinuses. Complications such as nasal obstruction, epistaxis, headaches, rhinolith formation, epiphora, sinusitis and oro-antral fistula have been well described in literature, however, very few cases of antro-cutaneous fistulas have been reported. We discuss three cases of ectopic eruptions of teeth, all occurring in children. The clinical and radiographic findings of the cases, possible etiology, complication, diagnosis and treatment are discussed.
Singapore Medical Journal, 2013
We report the case of a 20-year-old man with a constellation of anomalies - a functional thyroglo... more We report the case of a 20-year-old man with a constellation of anomalies - a functional thyroglossal cyst and concurrent ectopic thyroid in the floor of the mouth, without an orthotopic thyroid gland. To our knowledge, this is the third such report in the otolaryngology literature. It is important to be aware of the possibility of concurrent ectopic thyroid and thyroglossal cyst in the absence of an orthotopic thyroid gland. The majority of reported cases of thyroid ectopy occur at the base of the tongue. The occurrence of an ectopic thyroid in the floor of the mouth is both unusual and not amenable to clinical examination. Even if there is good uptake on nuclear imaging, the ectopic thyroid may be hypofunctioning. We discuss the importance of thyroid imaging, as well as the need for preoperative imaging and an appropriate management strategy in the treatment of patients with this triad of anomalies.
Indian Journal of Otolaryngology and Head & Neck Surgery, 2015
International Journal of Head and Neck Surgery, 2015
Journal of Allergy, 2016
The study was conducted to study the occurrence and clinical presentation of allergic fungal rhin... more The study was conducted to study the occurrence and clinical presentation of allergic fungal rhinosinusitis (AFRS), characterize the same, and correlate with the microbiological profile. Clinically suspected cases of fungal rhinosinusitis (FRS) depending upon their clinical presentation, nasal endoscopy, and radiological evidences were included. Relevant clinical samples were collected and subjected to direct microscopy and culture and histopathological examination. 35 patients were diagnosed to have AFRS. The average age was 28.4 years with a range of 18-48 years. Allergic mucin was seen in all the AFRS patients but fungal hyphae were detected in only 20%. 80% of cases were positive for IgE. All the patients had nasal obstruction followed by nasal discharge (62.8%). Polyps were seen in 95% (unilateral (48.57%) and bilateral (45.71%)), deviated nasal septum was seen in 28.57%, and greenish yellow secretion was seen in 17.14%. Direct microscopy and septate hyphae were positive in 71.42% of cases. 91.4% of cases were positive by culture. 5.7% yielded mixed growth of A. flavus and A. niger. Prompt clinical suspicion with specific signs and symptoms along with timely sampling of the adequate patient specimens and the optimal and timely processing by microscopy and culture and histopathological examination is a must for early diagnosis and management.
Diagnostic Cytopathology, 2001
Rhinology, Sep 1, 2011
Based on the `European Position Paper on Rhinosinusitis and Nasal polyps (EP3OS 2007)`, this stud... more Based on the `European Position Paper on Rhinosinusitis and Nasal polyps (EP3OS 2007)`, this study aimed to investigate general practitioners (GPs) and other specialists` understanding when managing patients with acute rhinosinusitis (ARS) in Asia. Among a total of 2662 questionnaires completed, 2524 (94.8%) were valid for analysis. There were 1308 GPs (51.8%), 989 otolaryngologists (39.2%) and 227 paediatricians (9%) from Mainland China, Hong Kong, Indonesia, India, Malaysia, Pakistan, Philippines, Singapore, Thailand and Taiwan. ARS is affecting an estimated 6 - 10% of patients seen in a daily out-patient practice. The EP3OS criteria are well supported by Asian physicians (94.1%). Most physicians (62.7%) agreed that radiological investigation is not needed to diagnose ARS. However, even for mild ARS (common cold), medical treatments were still recommended by 87% of GPs, 83.9% of otolaryngologists, and 70% of paediatricians. The top three first-line treatments prescribed were antihistamines (39.2%), nasal decongestants (33.6%), and antibiotics (29.5%). Antibiotics usage increased as the first line treatment of moderate (45.9%) and severe (60.3%) ARS. ARS is commonly managed by GPs, otolaryngologists, and paediatricians in Asia. However, understanding of the management of ARS needs further improvement to minimize unnecessary use of radiological investigations, overuse of antibiotics, and under use of nasal corticosteroids.
The Journal of Laryngology & Otology
A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in ... more A case of Rhinoscleroma of the left maxilla and ethmoid with involvement of the orbital apex, in a female diabetic, is reported. The significance of the associated diabetes is discussed.
Indian Journal of Otolaryngology and Head & Neck Surgery
Indian Journal of Otology
Extracanalicular osteomas of the temporal bone are rare, slow-growing, benign neoplasms. Although... more Extracanalicular osteomas of the temporal bone are rare, slow-growing, benign neoplasms. Although they may occur anywhere in the temporal bone, they are most common in the mastoid area. Often, symptoms are negligible and treatment is unnecessary. However, surgical removal is indicated when growth of the osteoma causes distressing symptoms or cosmetic issues. The patient described in this report had no symptoms but underwent surgical excision of a mastoid osteoma for cosmetic reasons. At 4-month follow-up, she remains asymptomatic and recurrence-free.