N. Shunyu - Academia.edu (original) (raw)

Papers by N. Shunyu

Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway m... more Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway management other than Macintosh laryngoscopy will help the emergency medical team in decision making and thus avoid any fatal situation. The present retrospective observational study was aimed to evaluate fractures and airway management patterns in cranio-maxillofacial injury patients with fracture of the mandible. It was also aimed to assess the clinical findings which predict airway management by other than Macintosh laryngoscopy. Anaesthesia management record, critical care assessment record and surgical team notes were evaluated in all craniomaxillofacial injury patients with mandible fracture who required anaesthesia, critical care, and ENT specialty services. The duration of the study was between 2009-10 to 2013-14 and the collected data were evaluated by using INSTAT software. Fifty-nine (64.13%) out of 92 cranio-maxillofacial injury patients (with at least one head and neck or fac...

Iranian Journal of Otorhinolaryngology, 2016

Introduction: Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India... more Introduction: Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India. Though the role of environmental contributors of NPC in the North-Eastern part of India is firmly established, EBV as an etiological agent in the region remains unexplored. Material and Methods: Fifty-one patients, who presented at the department of ENT, NEIGRIHMS and were confirmed as NPC upon histopathological examination, were included in the study. Chromogenic in-situ hybridization (CISH) was used for the evaluation of EBER (Epstein Barr Virus Encoded RNA). Presence of nuclear signals was taken as positive for EBER expression. EBER status was correlated with various clinicopathological parameters like age, sex, dietary habits, histological types of NPC, and ethnicity of the patients. Results: The age range of the study group was 25 to 70 years with a mean age of 44.64 years and a male:female ratio of 3:2. Non-keratinizing undifferentiated type of NPC was the most common histologica...

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021

Background: Defect following radical resection for advance head and neck cancers are complex and ... more Background: Defect following radical resection for advance head and neck cancers are complex and without doubt microvascular free flap offer the best reconstructive option. The purpose of this study is to investigate the flap survival rate and review each vascular compromised flaps.Methods: This is a reviewed of 218 microvascular free flaps done for reconstruction of 204 head and neck patients. There were 112 (51.3%) radial forearm flaps (RFF), 82 (37.6%) fibula flaps (FF) and 24 (11%) anterior lateral thigh (ALT) flaps. Results: There were 16 complete flap loss and 3 partial flap loss, giving an overall flap survival rate 91.8% (19/218) and flap survival in turn of complete loss 92.7% (16/218). In RFF, there were 7 complete and 1 partial flap loss, giving an overall flap survival rate 92.9% (8/112) and flap survival in turn of complete loss 93.8% (7/112). In FF, there were 6 complete flap loss, giving a flap survival rate 92.7% (6/82). In ALT flap, there were 3 complete and 2 part...

Iranian Journal of Otorhinolaryngology, 2016

Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site f... more Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site for schwannomas, tongue being the most common location. Here we are presenting a case of a young adult who presented with a huge swelling in the tongue which was removed by mandibulotomy approach and pre-operative tracheostomy. A 22-year-old male patient presented to the outpatient department with a history of swelling in the tongue for the last 4 years with progressive difficulty in swallowing food and change of voice over the last few months. Upon examination a large swelling was observed on the posterior part of the tongue compromising the oropharyngeal inlet. The approximate size of the swelling was 5cmx4cm. After proper clinical evaluation the patient was advised to obtain a magnetic resonance imaging (MRI) study of the oral cavity, which showed it to be a nerve sheath tumor (Schwannoma) originating from the hypoglossal nerve branch. The patient was admitted for surgery. As difficult...

Otolaryngology–Head and Neck Surgery, 2011

Objective. To study the histological and proliferation characteristics of the pars tensa retracti... more Objective. To study the histological and proliferation characteristics of the pars tensa retraction pocket. To investigate the hypothesis that such retraction pockets may demonstrate breaks in the epithelial basement membrane. Study Design. Prospective evaluation. Fifty stage II-IV surgically resected retraction pockets. Setting. Tertiary care academic hospital. Methods. Paraffin sections stained with hematoxylin and eosin. Basement membrane evaluation by Periodic acid-Schiff (PAS) and silver-methenamine (SM). Evaluation of cellular proliferation by immunohistochemistry (MIB-1 score). Results. Following are findings noted as frequent but not invariable in pars tensa retraction pockets: (1) subepithelial chronic inflammation (86%), (2) proliferation and hyperkeratinization of the outer epithelial layer, (3) epithelial cones with proliferating cells (increased MIB-1 score) in the basal epithelial layer (39%), (4) loss of the middle double collagen layer (71%), and (5) loss of the inne...

Acta Cytologica, 2016

Objective: We aimed to evaluate the role of brush cytology in the screening of oral lesions with ... more Objective: We aimed to evaluate the role of brush cytology in the screening of oral lesions with malignant suspicion and compare it with histopathology in north-eastern India. Study Design: Brush cytology samples taken from 48 patients were processed for conventional cytology (CC) and liquid-based cytology (LBC), and biopsy samples were also obtained. LBC samples were also stained to assess the argyrophilic nucleolar organizer region (AgNOR). The cytology was compared with histopathology, both individually and in combination with AgNOR. The smear quality was compared with histopathology for evaluating their diagnostic accuracy. Results: The sensitivity of diagnosing oral cavity squamous cell carcinoma by LBC and CC alone was 75 and 85%, respectively, which improved on combining with the AgNOR count, with a cutoff of 6.5. The presence of round cells on cytology was significantly associated with high-grade lesions. LBC provided clearer cytomorphology but compromised the background inf...

Journal of clinical and diagnostic research : JCDR, 2015

The incidence of head and neck squamous cell carcinoma (HNSCC) is quite high in North Eastern Ind... more The incidence of head and neck squamous cell carcinoma (HNSCC) is quite high in North Eastern India. Apart from the traditional risk factors like tobacco and alcohol consumption, human papilloma virus (HPV) is now considered an established causative agent. These HPV related tumour have a clinico-pathological profile that is quite divergent from conventional non-HPV related tumours. Association of HPV in oral cancers has not been explored in north-east India. Thirty-one patients with oral cavity squamous cell carcinoma (OSCC) on treatment from October 2010 to January 2013 were included in the study. Patients who received neo-adjuvant chemotherapy were excluded. HPV 16/18 DNA was evaluated using Chromogenic in-situ Hybridization (CISH). Presence of nuclear signals was taken as positive HPV expression. p16 was evaluated using immunohistochemistry and was considered positive if ≥ 80% of the tumour cells showed strong and diffuse nuclear/cytoplasmic immunostaining. The results were analy...

Multiple cranial nerve palsies is a clinical problem encountered not infrequently in practice. Mu... more Multiple cranial nerve palsies is a clinical problem encountered not infrequently in practice. Multiple factors can account for the occurance of the entity. However, in a few number of cases despite thorough investigations accurate diagnosis may not be possible to establish. They represent the idiopathic variety of multiple cranial nerve involvement. To label Idiopathic variety of cranial nerve palsy we have to exclude an extensive list of causes of multiple cranial nerve involvement. The disease shows good response to corticosteroids .We report such a case of idiopathic multiple cranial nerve palsy who presented to us with progressive involvement of multiple cranial nerves within a period of a few months. Keywords- cranial nerve, palsy, idiopathic, corticosteroids

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Post traumatic pseudoaneurysm is a well documented complication of vascular injuries which needs ... more Post traumatic pseudoaneurysm is a well documented complication of vascular injuries which needs early diagnosis and early management otherwise there may be significant morbidity and mortality. We present a patient who had been operated elsewhere for a foreign body lodged in neck during splinter injury sustained while bursting a cracker. He presented to ENT department of our hospital with bleeding from the wound site. We are reporting this case because pseudoaneurysm of the lingual artery as such is very rare. We could not find any other reported case in available English literature. Moreover the treating ENT surgeons need to be sensitized to the presence of such an entity and hence avoid late complications.

Journal of Maxillofacial and Oral Surgery, 2015

The aim of this clinical study was to find similarities; dissimilarities of neck space infections... more The aim of this clinical study was to find similarities; dissimilarities of neck space infections along with challenges faced by treating physician for their diversified clinical presentations and complications. Patients with neck space infections were compared for the purpose. The classic manifestations of these infections, such as high fever, systemic toxicity, and local signs were not present in all cases leading to dilemma in physician's decision making. They progress towards fatality very fast. Prompt recognition, diagnosis and management of such cases and complications are of paramount importance to reduce morbidity and mortality. In addition to broad spectrum antibiotic therapy along airway protection, surgical drainage is necessary in nearly all cases. Neck space infections still continue to be a well prevalent health problem in poor socioeconomic group in developing countries having significant morbidity as well as mortality.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2014

Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer.... more Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer. Though osteocutaneous micro-vascular free flap is generally accepted to be the mainstay of mandibular reconstruction, other reconstructive options are also done for mandibular reconstruction with good results. Seventeen patients of oral cavity cancer involving the alveolus who had underwent hemi-mandibulectomy were reconstructed using 5th rib osteo-pectoralis major myocutaneous flap. Procedure related pleural tear occurred in 3 patients during harvesting of the rib which were repaired intra-operatively with no post-operative complications. There were 2 failures in our series, in the rest 15 patients the flap had taken up; have good oral continence taking semi-solid diet and have satisfactory cosmetic appearance. This study shows that 5th rib osteo-pectoralis major myocutaneous flap is a quick, easy to learn, one stage reconstructive procedure with a good predictable cosmetic and functional outcomes.

International Journal of Surgical Pathology, 2008

Only 2 cases of nasopharyngeal small cell carcinoma have been reported. Another case of this rare... more Only 2 cases of nasopharyngeal small cell carcinoma have been reported. Another case of this rare type of nasopharyngeal tumor confirmed by immunopositivity for CD56, synaptophysin, and chromogranin A is described in this study. The tumor was also negative for cytokeratin (CK) 20 and thyroid transcription factor-1. Clinical investigation did not find any primary tumor in other anatomic sites. Therefore, this case was established as a primary nasopharyngeal small cell carcinoma. Epstein-Barr virus was shown to be absent by Epstein-Barr virus encoded RNA in situ hybridization study in this case, which further distinguished it from conventional nasopharyngeal carcinoma. Clinical features of this case and 2 previously reported cases are compared. They do not differ from conventional nasopharyngeal carcinoma in clinical presentation, but the prognosis seems to be worse. More cases are needed to confirm the observation and for understanding the clinical behavior of this rare type of nasop...

Indian Journal of Medical Microbiology, 2011

Sr. No. Title Page No. 1. Abbreviations vii-viii 2. Distribution list (Controlled copies) ix 3. A... more Sr. No. Title Page No. 1. Abbreviations vii-viii 2. Distribution list (Controlled copies) ix 3. Amendment sheet x 4. Chapter 1: General guidelines 1-13 5. Chapter 2: Specimen collection, transport & processing Blood CSF Body fluids Ocular specimens Respiratory specimens Pus Urine Fecal specimen Tissue 15-47 6. Chapter 3: Identification of isolates Enterobacteriaceae Salmonella Stenotrophomonas maltophilia, Burkholderia cepacia complex Pseudomonas Acinetobacter Staphylococci Enterococci Fecal isolates Streptococcus sp (beta and alpha hemolytic) Streptococcus pneumoniae 49-77 7. Chapter 4: Antimicrobial Susceptibility Testing Definitions Disc diffusion testing ATCC control strains Preparing antibiotic discs in-house Minimum Inhibitory Concentration (MIC) testing Zone diameters and MIC breakpoints 79-103 8. Chapter 5: Special Tests (Phenotypic) Carba-NP test (For Enterobacteriaceae and Pseudomonas spp.) Modified carbapenem inactivation method (mCIM and eCIM); (For Enterobacteriaceae and Pseudomonas spp.) D-test for inducible clindamycin resistance Vancomycin screen agar for S. aureus and Enterococcus spp. MIC for vancomycin by broth micro dilution method Detection of heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) population analysis profile/area under curve (PAP/AUC) analysis Combination antimicrobial testing to evaluate the best combination of drugs for MRSA Detection of over-expression of efflux pumps MIC 105-113 9. Chapter 6: Quality control (QC) Reference strains for QC Storing and testing QC strains Frequency of testing Quality control of media

American Journal of Clinical Oncology, 1998

ABSTRACT

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolesce... more Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. Extension to intracranial cavity is not uncommon and presents difficulties in management. Here we report a patient who had Radkowsky stage IIIB lesion, with blood supply from internal carotid artery. In view of anticipated problems with surgery, the patient was treated with 30 Gy in 15# external beam radiotherapy. On follow up, tumour was noted to disappear gradually overtime and at 3 years complete disappearance was noted with normal return of vision. Hence we are re-affirming the earlier studies than angiofibroma mass regresses gradually after completion of radiotherapy. Radiotherapy is a useful way of treating angiofibroma with significant intracranial extension.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolesce... more Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. Extension to intracranial cavity is not uncommon and presents difficulties in management. Here we report a patient who had Radkowsky stage IIIB lesion, with blood supply from internal carotid artery. In view of anticipated problems with surgery, the patient was treated with 30 Gy in 15# external beam radiotherapy. On follow up, tumour was noted to disappear gradually overtime and at 3 years complete disappearance was noted with normal return of vision. Hence we are re-affirming the earlier studies than angiofibroma mass regresses gradually after completion of radiotherapy. Radiotherapy is a useful way of treating angiofibroma with significant intracranial extension.

Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway m... more Maxillofacial injuries affect airway in many ways. Knowing the factors which may lead to airway management other than Macintosh laryngoscopy will help the emergency medical team in decision making and thus avoid any fatal situation. The present retrospective observational study was aimed to evaluate fractures and airway management patterns in cranio-maxillofacial injury patients with fracture of the mandible. It was also aimed to assess the clinical findings which predict airway management by other than Macintosh laryngoscopy. Anaesthesia management record, critical care assessment record and surgical team notes were evaluated in all craniomaxillofacial injury patients with mandible fracture who required anaesthesia, critical care, and ENT specialty services. The duration of the study was between 2009-10 to 2013-14 and the collected data were evaluated by using INSTAT software. Fifty-nine (64.13%) out of 92 cranio-maxillofacial injury patients (with at least one head and neck or fac...

Iranian Journal of Otorhinolaryngology, 2016

Introduction: Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India... more Introduction: Nasopharyngeal carcinoma (NPC) is a common cancer in the North-East region of India. Though the role of environmental contributors of NPC in the North-Eastern part of India is firmly established, EBV as an etiological agent in the region remains unexplored. Material and Methods: Fifty-one patients, who presented at the department of ENT, NEIGRIHMS and were confirmed as NPC upon histopathological examination, were included in the study. Chromogenic in-situ hybridization (CISH) was used for the evaluation of EBER (Epstein Barr Virus Encoded RNA). Presence of nuclear signals was taken as positive for EBER expression. EBER status was correlated with various clinicopathological parameters like age, sex, dietary habits, histological types of NPC, and ethnicity of the patients. Results: The age range of the study group was 25 to 70 years with a mean age of 44.64 years and a male:female ratio of 3:2. Non-keratinizing undifferentiated type of NPC was the most common histologica...

International Journal of Otorhinolaryngology and Head and Neck Surgery, 2021

Background: Defect following radical resection for advance head and neck cancers are complex and ... more Background: Defect following radical resection for advance head and neck cancers are complex and without doubt microvascular free flap offer the best reconstructive option. The purpose of this study is to investigate the flap survival rate and review each vascular compromised flaps.Methods: This is a reviewed of 218 microvascular free flaps done for reconstruction of 204 head and neck patients. There were 112 (51.3%) radial forearm flaps (RFF), 82 (37.6%) fibula flaps (FF) and 24 (11%) anterior lateral thigh (ALT) flaps. Results: There were 16 complete flap loss and 3 partial flap loss, giving an overall flap survival rate 91.8% (19/218) and flap survival in turn of complete loss 92.7% (16/218). In RFF, there were 7 complete and 1 partial flap loss, giving an overall flap survival rate 92.9% (8/112) and flap survival in turn of complete loss 93.8% (7/112). In FF, there were 6 complete flap loss, giving a flap survival rate 92.7% (6/82). In ALT flap, there were 3 complete and 2 part...

Iranian Journal of Otorhinolaryngology, 2016

Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site f... more Schwannoma is a benign nerve sheath tumor composed of schwann cells. Oral cavity is a rare site for schwannomas, tongue being the most common location. Here we are presenting a case of a young adult who presented with a huge swelling in the tongue which was removed by mandibulotomy approach and pre-operative tracheostomy. A 22-year-old male patient presented to the outpatient department with a history of swelling in the tongue for the last 4 years with progressive difficulty in swallowing food and change of voice over the last few months. Upon examination a large swelling was observed on the posterior part of the tongue compromising the oropharyngeal inlet. The approximate size of the swelling was 5cmx4cm. After proper clinical evaluation the patient was advised to obtain a magnetic resonance imaging (MRI) study of the oral cavity, which showed it to be a nerve sheath tumor (Schwannoma) originating from the hypoglossal nerve branch. The patient was admitted for surgery. As difficult...

Otolaryngology–Head and Neck Surgery, 2011

Objective. To study the histological and proliferation characteristics of the pars tensa retracti... more Objective. To study the histological and proliferation characteristics of the pars tensa retraction pocket. To investigate the hypothesis that such retraction pockets may demonstrate breaks in the epithelial basement membrane. Study Design. Prospective evaluation. Fifty stage II-IV surgically resected retraction pockets. Setting. Tertiary care academic hospital. Methods. Paraffin sections stained with hematoxylin and eosin. Basement membrane evaluation by Periodic acid-Schiff (PAS) and silver-methenamine (SM). Evaluation of cellular proliferation by immunohistochemistry (MIB-1 score). Results. Following are findings noted as frequent but not invariable in pars tensa retraction pockets: (1) subepithelial chronic inflammation (86%), (2) proliferation and hyperkeratinization of the outer epithelial layer, (3) epithelial cones with proliferating cells (increased MIB-1 score) in the basal epithelial layer (39%), (4) loss of the middle double collagen layer (71%), and (5) loss of the inne...

Acta Cytologica, 2016

Objective: We aimed to evaluate the role of brush cytology in the screening of oral lesions with ... more Objective: We aimed to evaluate the role of brush cytology in the screening of oral lesions with malignant suspicion and compare it with histopathology in north-eastern India. Study Design: Brush cytology samples taken from 48 patients were processed for conventional cytology (CC) and liquid-based cytology (LBC), and biopsy samples were also obtained. LBC samples were also stained to assess the argyrophilic nucleolar organizer region (AgNOR). The cytology was compared with histopathology, both individually and in combination with AgNOR. The smear quality was compared with histopathology for evaluating their diagnostic accuracy. Results: The sensitivity of diagnosing oral cavity squamous cell carcinoma by LBC and CC alone was 75 and 85%, respectively, which improved on combining with the AgNOR count, with a cutoff of 6.5. The presence of round cells on cytology was significantly associated with high-grade lesions. LBC provided clearer cytomorphology but compromised the background inf...

Journal of clinical and diagnostic research : JCDR, 2015

The incidence of head and neck squamous cell carcinoma (HNSCC) is quite high in North Eastern Ind... more The incidence of head and neck squamous cell carcinoma (HNSCC) is quite high in North Eastern India. Apart from the traditional risk factors like tobacco and alcohol consumption, human papilloma virus (HPV) is now considered an established causative agent. These HPV related tumour have a clinico-pathological profile that is quite divergent from conventional non-HPV related tumours. Association of HPV in oral cancers has not been explored in north-east India. Thirty-one patients with oral cavity squamous cell carcinoma (OSCC) on treatment from October 2010 to January 2013 were included in the study. Patients who received neo-adjuvant chemotherapy were excluded. HPV 16/18 DNA was evaluated using Chromogenic in-situ Hybridization (CISH). Presence of nuclear signals was taken as positive HPV expression. p16 was evaluated using immunohistochemistry and was considered positive if ≥ 80% of the tumour cells showed strong and diffuse nuclear/cytoplasmic immunostaining. The results were analy...

Multiple cranial nerve palsies is a clinical problem encountered not infrequently in practice. Mu... more Multiple cranial nerve palsies is a clinical problem encountered not infrequently in practice. Multiple factors can account for the occurance of the entity. However, in a few number of cases despite thorough investigations accurate diagnosis may not be possible to establish. They represent the idiopathic variety of multiple cranial nerve involvement. To label Idiopathic variety of cranial nerve palsy we have to exclude an extensive list of causes of multiple cranial nerve involvement. The disease shows good response to corticosteroids .We report such a case of idiopathic multiple cranial nerve palsy who presented to us with progressive involvement of multiple cranial nerves within a period of a few months. Keywords- cranial nerve, palsy, idiopathic, corticosteroids

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Post traumatic pseudoaneurysm is a well documented complication of vascular injuries which needs ... more Post traumatic pseudoaneurysm is a well documented complication of vascular injuries which needs early diagnosis and early management otherwise there may be significant morbidity and mortality. We present a patient who had been operated elsewhere for a foreign body lodged in neck during splinter injury sustained while bursting a cracker. He presented to ENT department of our hospital with bleeding from the wound site. We are reporting this case because pseudoaneurysm of the lingual artery as such is very rare. We could not find any other reported case in available English literature. Moreover the treating ENT surgeons need to be sensitized to the presence of such an entity and hence avoid late complications.

Journal of Maxillofacial and Oral Surgery, 2015

The aim of this clinical study was to find similarities; dissimilarities of neck space infections... more The aim of this clinical study was to find similarities; dissimilarities of neck space infections along with challenges faced by treating physician for their diversified clinical presentations and complications. Patients with neck space infections were compared for the purpose. The classic manifestations of these infections, such as high fever, systemic toxicity, and local signs were not present in all cases leading to dilemma in physician's decision making. They progress towards fatality very fast. Prompt recognition, diagnosis and management of such cases and complications are of paramount importance to reduce morbidity and mortality. In addition to broad spectrum antibiotic therapy along airway protection, surgical drainage is necessary in nearly all cases. Neck space infections still continue to be a well prevalent health problem in poor socioeconomic group in developing countries having significant morbidity as well as mortality.

Indian Journal of Otolaryngology and Head & Neck Surgery, 2014

Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer.... more Reconstruction of mandible is of paramount importance following ablative surgery for oral cancer. Though osteocutaneous micro-vascular free flap is generally accepted to be the mainstay of mandibular reconstruction, other reconstructive options are also done for mandibular reconstruction with good results. Seventeen patients of oral cavity cancer involving the alveolus who had underwent hemi-mandibulectomy were reconstructed using 5th rib osteo-pectoralis major myocutaneous flap. Procedure related pleural tear occurred in 3 patients during harvesting of the rib which were repaired intra-operatively with no post-operative complications. There were 2 failures in our series, in the rest 15 patients the flap had taken up; have good oral continence taking semi-solid diet and have satisfactory cosmetic appearance. This study shows that 5th rib osteo-pectoralis major myocutaneous flap is a quick, easy to learn, one stage reconstructive procedure with a good predictable cosmetic and functional outcomes.

International Journal of Surgical Pathology, 2008

Only 2 cases of nasopharyngeal small cell carcinoma have been reported. Another case of this rare... more Only 2 cases of nasopharyngeal small cell carcinoma have been reported. Another case of this rare type of nasopharyngeal tumor confirmed by immunopositivity for CD56, synaptophysin, and chromogranin A is described in this study. The tumor was also negative for cytokeratin (CK) 20 and thyroid transcription factor-1. Clinical investigation did not find any primary tumor in other anatomic sites. Therefore, this case was established as a primary nasopharyngeal small cell carcinoma. Epstein-Barr virus was shown to be absent by Epstein-Barr virus encoded RNA in situ hybridization study in this case, which further distinguished it from conventional nasopharyngeal carcinoma. Clinical features of this case and 2 previously reported cases are compared. They do not differ from conventional nasopharyngeal carcinoma in clinical presentation, but the prognosis seems to be worse. More cases are needed to confirm the observation and for understanding the clinical behavior of this rare type of nasop...

Indian Journal of Medical Microbiology, 2011

Sr. No. Title Page No. 1. Abbreviations vii-viii 2. Distribution list (Controlled copies) ix 3. A... more Sr. No. Title Page No. 1. Abbreviations vii-viii 2. Distribution list (Controlled copies) ix 3. Amendment sheet x 4. Chapter 1: General guidelines 1-13 5. Chapter 2: Specimen collection, transport & processing Blood CSF Body fluids Ocular specimens Respiratory specimens Pus Urine Fecal specimen Tissue 15-47 6. Chapter 3: Identification of isolates Enterobacteriaceae Salmonella Stenotrophomonas maltophilia, Burkholderia cepacia complex Pseudomonas Acinetobacter Staphylococci Enterococci Fecal isolates Streptococcus sp (beta and alpha hemolytic) Streptococcus pneumoniae 49-77 7. Chapter 4: Antimicrobial Susceptibility Testing Definitions Disc diffusion testing ATCC control strains Preparing antibiotic discs in-house Minimum Inhibitory Concentration (MIC) testing Zone diameters and MIC breakpoints 79-103 8. Chapter 5: Special Tests (Phenotypic) Carba-NP test (For Enterobacteriaceae and Pseudomonas spp.) Modified carbapenem inactivation method (mCIM and eCIM); (For Enterobacteriaceae and Pseudomonas spp.) D-test for inducible clindamycin resistance Vancomycin screen agar for S. aureus and Enterococcus spp. MIC for vancomycin by broth micro dilution method Detection of heteroresistant vancomycin intermediate Staphylococcus aureus (hVISA) population analysis profile/area under curve (PAP/AUC) analysis Combination antimicrobial testing to evaluate the best combination of drugs for MRSA Detection of over-expression of efflux pumps MIC 105-113 9. Chapter 6: Quality control (QC) Reference strains for QC Storing and testing QC strains Frequency of testing Quality control of media

American Journal of Clinical Oncology, 1998

ABSTRACT

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolesce... more Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. Extension to intracranial cavity is not uncommon and presents difficulties in management. Here we report a patient who had Radkowsky stage IIIB lesion, with blood supply from internal carotid artery. In view of anticipated problems with surgery, the patient was treated with 30 Gy in 15# external beam radiotherapy. On follow up, tumour was noted to disappear gradually overtime and at 3 years complete disappearance was noted with normal return of vision. Hence we are re-affirming the earlier studies than angiofibroma mass regresses gradually after completion of radiotherapy. Radiotherapy is a useful way of treating angiofibroma with significant intracranial extension.

Indian journal of otolaryngology and head and neck surgery : official publication of the Association of Otolaryngologists of India, 2008

Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolesce... more Juvenile nasopharyngeal angiofibroma is a benign, locally aggressive, vascular tumour of adolescent males. Extension to intracranial cavity is not uncommon and presents difficulties in management. Here we report a patient who had Radkowsky stage IIIB lesion, with blood supply from internal carotid artery. In view of anticipated problems with surgery, the patient was treated with 30 Gy in 15# external beam radiotherapy. On follow up, tumour was noted to disappear gradually overtime and at 3 years complete disappearance was noted with normal return of vision. Hence we are re-affirming the earlier studies than angiofibroma mass regresses gradually after completion of radiotherapy. Radiotherapy is a useful way of treating angiofibroma with significant intracranial extension.