Purpose of review The overall prevalence of deafness in India is 0.2%, but the prevalence in the southern state of Tamil Nadu is much higher (around 0.6%) because of consanguinity. Especially in India, establishing cochlear implantation as a treatment modality for hearing loss has been a daunting task, but in the last decade, the cochlear implantation program has emerged as an unqualified success in many states, with over 20 000 cochlear implantations done till date. Several states are sponsoring free implants to children under the age of 6 years and below poverty line. Recent findings Nearly 3000 cochlear implantations have been performed in Tamil Nadu under the Chief Minister's Comprehensive Health Insurance Scheme, with the goal to have a 'deafness free Tamil Nadu' by 2025. This scheme covers nearly 40 million people in rural areas. Valuable lessons have been learnt from this social experiment. One of the cornerstones of this scheme is the method to deliver habilitation via satellite centers in rural areas at the doorstep of the patient. The outcomes in peripheral centers were found to be statistically similar to those in the main center and correlated well with duration of habilitation. Summary Opening up satellite centers for habilitation across the state of Tamil Nadu has greatly helped to improve the attendance and outcomes. The Indian model has been hugely successful and has helped start similar cochlear implantation programs in neighboring countries such as Nepal, Sri Lanka and Bangladesh. Correspondence to Prof. Mohan Kameswaran, Department of Neurotology and Auditory Implants, Madras ENT Research Foundation, No. 1, First Cross Street, Off. Second Main Road, Raja Annamalai Puram, Chennai 600028, Tamil Nadu, India. Tel: +91 44 24311411x412x413x414x415; fax: +91 4424311416; e-mail: merfmk30@yahoo.com Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.
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Τετάρτη 25 Απριλίου 2018
Chronic Nerve Compression Accelerates the Progression of Diabetic Peripheral Neuropathy in a Rat Model: A Study of Gene Expression Profiling
J reconstr Microsurg
DOI: 10.1055/s-0038-1642023
Objective This article investigates the role of chronic nerve compression in the progression of diabetic peripheral neuropathy (DPN) by gene expression profiling. Methods Chronic nerve compression was created in streptozotocin (STZ)-induced diabetic rats by wrapping a silicone tube around the sciatic nerve (SCN). Neurological deficits were evaluated using pain threshold test, motor nerve conduction velocity (MNCV), and histopathologic examination. Differentially expressed genes (DGEs) and metabolic processes associated with chronic nerve compression were analyzed. Results Significant changes in withdrawal threshold and MNCV were observed in diabetic rats 6 weeks after diabetes induction, and in DPN rats 4 weeks after diabetes induction. Histopathologic examination of the SCN in DPN rats presented typical changes of myelin degeneration in DPN. Function analyses of DEGs demonstrated that biological processes related to inflammatory response, extracellular matrix component, and synaptic transmission were upregulated after diabetes induction, and chronic nerve compression further enhanced those changes. While processes related to lipid and glucose metabolism, response to insulin, and apoptosis regulation were inhibited after diabetes induction, chronic nerve compression further enhanced these inhibitions. Conclusion Our study suggests that additional silicone tube wrapping on the SCN of rat with diabetes closely mimics the course and pathologic findings of human DPN. Further studies are needed to verify the effectiveness of this rat model of DPN and elucidate the roles of the individual genes in the progression of DPN.
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The effect of two locally administered anti-resorptive agents on bone regeneration in a rat fibula model: Alendronate and 15-deoxy-Δ12,14-prostaglandin J₂
Bisphosphonates are well-known drugs as inhibitors of bone resorption acting on inducing programmed cell death of osteoclasts. However, many in vitro studies report that optimal concentration of the bisphosphonate affects not only osteoclasts but also osteoblasts, that is, it induces the anabolic effects of osteoblasts. Recently reported 15-deoxy-Δ12,14-prostaglandin J₂ (15d-PGJ2) is an endogenous ligand of peroxisome proliferator-activated receptor−gamma, with an inhibitory activity on bone loss.
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Assessment of posterior choanal obstruction caused by adenoidal hypertrophy: Intra-operative mirror versus rigid nasendoscopic examination
The aim of the study is to compare the degree of posterior choanal obstruction caused by adenoidal hypertrophy intra-operatively, when assessed by mirror versus rigid nasendoscopic examination, in children undergoing adenoidectomy.
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Rigid endoscope-assisted orotracheal intubation for vallecular cyst surgery in neonates and young infants
To investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method.
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Head and neck presentation of Gardner Syndrome: A pediatric case series
Gardner Syndrome (GS), now known to be a variant of familial adenomatous polyposis (FAP), is a rare but serious genetic syndrome characterized by colonic polyposis, osteomas and other soft tissue tumors [1]. The WHO criteria for diagnosis of Gardner Syndrome are any of the following: 1) 100 or more colorectal polyps, 2) APC gene germline mutation, or 3) family history of FAP and at least one osteoma, epidermoid cyst, or desmoid tumor [2]. GS also has more prominent extra-colonic manifestations than other variants of FAP [3].
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Preventive nasal bacteriotherapy for the treatment of upper respiratory tract infections and sleep disordered breathing in children
The purpose of this prospective study was to assess the effectiveness and safety of Streptococcus salivarius 24SMBc administered as a nasal spray in children affected by recurring infections of the upper airways, adenotonsillar hypertrophy, and sleep disordered breathing (SDB).
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