MyMedR

Management of laryngeal foreign bodies in children

Sharma HS, Sharma S

J Accid Emerg Med, 1999 Mar;16(2):150-3.

PMID: 10191459

Foreign body aspiration is one of the leading causes of accidental death in children. Food items are the most common items aspirated in infants and toddlers, whereas older children are more likely to aspirate non-food items. Laryngeal impaction of a foreign body is very rare as most aspirated foreign bodies pass through the laryngeal inlet and get lodged lower down in the airway. Two rare cases of foreign body aspiration with subglottic impaction in very young children (under 2 years of age) are described. In both the cases subglottic impaction occurred consequent to attempted removal of foreign body by blind finger sweeping. The clinical presentation, investigations, and management of these rare cases are discussed.

Antrochoanal polyp--a rare paediatric emergency

Sharma HS, Daud AR

Int J Pediatr Otorhinolaryngol, 1997 Jul 18;41(1):65-70.

PMID: 9279638

An antrochoanal polyp, a common clinical entity, with a rare presentation is being reported. A 12 year old boy was brought to Accident and Emergency department with an unusual sudden presentation of polypoidal mass filling the oral cavity up to his incisors as a result of which he could not swallow and speak. Prior to this episode he had no complaints of the disease. An emergency removal was planned and only during the operation could it be diagnosed as a antrochoanal polyp because of its pedicle in the lateral wall of the nose, which was confirmed by histopathological examination.

Ear lobe crease: incidence in a healthy Malay population

Dharap AS, Sharma HS, Than M

Anthropol Anz, 2000 Sep;58(3):309-15.

PMID: 11082788

The incidence of ear lobe crease (ELC) was studied in 1576 healthy Malay subjects (566 males and 1010 females), randomly selected from the residents of Kota Bharu, Malaysia. ELC was present in 31.1% of males and in 3.6% of females; this difference in incidence between the two sexes is statistically significant (p > 0.05). In males the incidence of Type I crease was highest (10.1%) while that of Type III crease was lowest (2.3%). In females Type II crease showed the highest incidence (1.9%) and Type III the lowest. The incidence of bilateral presence of all three types of ELC showed an age-related increase in males. The ELC often starts unilaterally and later develops bilaterally and earlier in males than in females.

Retropharyngeal abscess: recent trends

Sharma HS, Kurl DN, Hamzah M

Auris Nasus Larynx, 1998 Dec;25(4):403-6.

PMID: 9853664

Retropharyngeal abscess (RPA) is relatively rare today. A study of 17 cases of RPA treated at our hospital in the past 10 years showed a shift in the disease from children below 6 years of age (41%) to older children and adults (58%). Upper respiratory tract infection (URTI) was found to be the commonest (52%) aetiological predisposing factor in all age groups. Other aetiological factors were septicaemia (11%) in children below the age of 6 years and trauma due to foreign body (35%) in the older children and adult age groups. Klebsiella, Staphylococcus and Streptococcus were the commonest species of microorganisms grown from pus. The changing clinical trends, microbiology, choice of antibiotics, usefulness of radiology, and complications of this potentially fatal illness are discussed.

Tuberculoid granulomatous lesion of the pharynx--review of the literature

Sharma HS, Kurl DN, Kamal MZ

Auris Nasus Larynx, 1998 May;25(2):187-91.

PMID: 9673733

Pharyngeal involvement in tuberculosis is rare and is usually secondary to pulmonary tuberculosis. We report a very rare case of chronic granulomatous pharyngitis, which later turned out to be due to primary tuberculosis of the pharynx. The clinical presentation, diagnosis, treatment and complications of this rare clinical entity are presented.

Malignant paraganglioma of frontoethmoidal region

Sharma HS, Madhavan M, Othman NH, Muhamad M, Abdullah JM

Auris Nasus Larynx, 1999 Oct;26(4):487-93.

PMID: 10530746

Nonchromaffin paragangliomas are unusual tumours arising from widely distributed paraganglionic tissues probably of neural crest origin. In the head and neck region they are usually seen as carotid body or jugulotympanic tumours. Other rarely reported sites in the head and neck region are the orbit, nose and larynx. This report deals with a case of sinonasal paraganglioma which was initially treated with surgery and radiotherapy. Twenty two years later the tumour recurred and showed a rapid growth due to malignant transformation which we believe is late effect of radiotherapy. The clinical features, histopathology and role of radiotherapy in sinonasal paragangliomas together with a review of the medical literature have been discussed.

Orbital abscess due to acute ethmoiditis in a neonate

Reddy SC, Sharma HS, Mazidah AS, Darnal HK, Mahayidin M

Int J Pediatr Otorhinolaryngol, 1999 Jun 15;49(1):81-6.

PMID: 10428409

Orbital complications due to ethmoiditis are not uncommon in children. However, they are very rare in infants. A case of orbital abscess due to acute ethmoiditis in a 10 days old boy is reported. Causative microorganisms isolated from the operated specimen were Staphylococcus aureus and aspergillosis. Successful outcome was achieved following antimicrobial therapy, external ethmoidectomy, and surgical drainage of the abscess. The aetiopathogenesis and management of this clinical entity is discussed, with a brief review of the literature.

Eccrine cylindroma of the ear canal--report of a case

Sharma HS, Meorkamal MZ, Zainol H, Dharap AS

J Laryngol Otol, 1994 Aug;108(8):706-9.

PMID: 7930929

Eccrine cylindroma is a benign tumour arising from sweat glands in the skin. It favours the face, forehead and scalp involving the turban area and hence is called a turban tumour. Amongst a variety of tumours originating from adnexal skin structures, which may appear in the ear canal, eccrine cylindroma forms a very rare entity. We present such a case and discuss its pathological and clinical features.

Metastatic osteosarcoma of the ethmoid: an unusual cause of recurrent epistaxis and proptosis

Sharma HS, Reddy SC, Mohamad A, Kamal MZ, Halder D

J Laryngol Otol, 1996 Jul;110(7):676-8.

PMID: 8759546

Osteosarcoma is the most common primary malignant tumour of bone and it usually metastasises to the lung. In the nasal cavity metastatic disease is extremely rare. We describe a case of osteosarcoma presenting with recurrent epistaxis, and proptosis due to secondaries in the nasal cavity. To our knowledge such a case has not been reported previously in the available English literature.

Teratocarcinosarcoma of the nasal cavity and ethmoid

Sharma HS, Abdullah JM, Othman NH, Muhamad M

J Laryngol Otol, 1998 Jul;112(7):682-6.

PMID: 9775307

Sinonasal teratocarcinosarcoma is very unusual malignant neoplasm histologically consisting of an epithelial element and one or more mesenchymal components. This is a report of teratocarcinosarcoma, in a 74-year-old male, involving the right nasal cavity and ethmoids with intracranial extension. The tumour was totally resected via the craniofacial approach and the patient was given post-operative chemotherapy. Extensive tumour necrosis, rapid growth and local destruction are the prominent features of this tumour. The clinical presentation, pathological features and clinical course of this rare malignancy are discussed with a review of the literature.

Fulltext The impact of omalizumab on paid and unpaid work productivity among severe Japanese cedar pollinosis (JCP) patients

Müller M, Igarashi A, Hashiguchi K, Kappel M, Paolini F, Yoshisue H, et al.

J Med Econ, 2022 1 25;25(1):220-229.

PMID: 35072591 DOI: 10.1080/13696998.2022.2033051

AIMS: Japanese cedar pollinosis (JCP) is a form of seasonal allergic rhinitis that affects 38.8% of the Japanese population. Particularly severe and most severe symptoms among JCP patients can lead to impairments of paid work productivity and unpaid work activities. Indeed, the current standard of care (SoC) is not always able to relieve these symptoms. Omalizumab, a novel JCP treatment recently approved in Japan, provides an effective add-on therapy to the SoC. This study estimates the effect of omalizumab on paid and unpaid work activities (i.e. its social impact) in patients with severe and most severe JCP symptoms in Japan.

METHODS: The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties.

RESULTS: Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD.

CONCLUSIONS: Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.

Kimura's disease: a report of three cases with a brief review of literature

Madhavan M, Othman NH, Singh MS, Indudharan R, Sharma HS, Shamsuddin AR

Acta Otorhinolaryngol Ital, 2000 Aug;20(4):284-9.

PMID: 11234448

Kimura's disease (KD) is an uncommon chronic inflammatory condition of unknown aetiology involving subcutaneous tissue, presenting as a tumor like lesion with a predilection for the head and neck region. Clinically it is often confused with parotid tumor with lymph node metastasis. It is difficult to diagnose before tissue biopsy. Fine needle aspiration cytology has only limited value. Unless the pathologists are aware of this entity, it might be misdiagnosed. Surgery, radiotherapy and steroid therapy have been tried but none is proved best and recurrence is common. Three cases of KD seen in our hospital and the problems encountered in them are presented.

Fourth branchial pouch cyst: an unusual cause of neonatal stridor

Sharma HS, Razif A, Hamzah M, Dharap AS, Mahbar Z, Kamal MZ, et al.

Int J Pediatr Otorhinolaryngol, 1996 Dec 20;38(2):155-61.

PMID: 9119603

Fourth branchial pouch anomalies are extremely rare and only a few such cases showing sinuses and cystic masses have been reported in the literature. We describe a patient who presented on the third day of life with cystic neck swelling of fourth branchial pouch origin giving rise to respiratory obstruction and stridor. Despite repeated aspiration of the cystic mass to relieve respiratory obstruction, rapid recurrence of the mass continued to cause stridor and ultimately required surgical excision. The clinical, radiological, and histopathological findings of this unusual condition are discussed with a review of the literature.

Differentially Expressed Genes and Their Clinical Significance in Ischaemic Stroke: An In-Silico Study

Appunni S, Rubens M, Ramamoorthy V, Sharma H, Singh AK, Swarup V, et al.

Malays J Med Sci, 2020 Dec;27(6):53-67.

PMID: 33447134 DOI: 10.21315/mjms2020.27.6.6

Background: Ischaemic stroke (IS), a multifactorial neurological disorder, is mediated by interplay between genes and the environment and, thus, blood-based IS biomarkers are of significant clinical value. Therefore, this study aimed to find global differentially expressed genes (DEGs) in-silico, to identify key enriched genes via gene set enrichment analysis (GSEA) and to determine the clinical significance of these genes in IS.

Methods: Microarray expression dataset GSE22255 was retrieved from the Gene Expression Omnibus (GEO) database. It includes messenger ribonucleic acid (mRNA) expression data for the peripheral blood mononuclear cells of 20 controls and 20 IS patients. The bioconductor-package 'affy' was used to calculate expression and a pairwise t-test was applied to screen DEGs (P < 0.01). Further, GSEA was used to determine the enrichment of DEGs specific to gene ontology (GO) annotations.

Results: GSEA analysis revealed 21 genes to be significantly plausible gene markers, enriched in multiple pathways among all the DEGs (n = 881). Ten gene sets were found to be core enriched in specific GO annotations. JunD, NCX3 and fibroblast growth factor receptor 4 (FGFR4) were under-represented and glycoprotein M6-B (GPM6B) was persistently over-represented.

Conclusion: The identified genes are either associated with the pathophysiology of IS or they affect post-IS neuronal regeneration, thereby influencing clinical outcome. These genes should, therefore, be evaluated for their utility as suitable markers for predicting IS in clinical scenarios.

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