There are contradictory findings on the role of vitamin D-binding protein in COVID-19 development, disease severity, and outcomes. Therefore, we aimed to explore the association between the serum vitamin D level, DBP, and the COVID-19 severity and outcomes. In this cross-sectional study, we observed the suspected and confirmed admitted patients with COVID-19 for the possible outcomes after measurements of vitamin D, vitamin D binding protein (DBP). The study included patients with a mean age of 70.89 years (range: 28-99), mostly aged ≥60 years (84.81%) and male (54.43%). Most were admitted to medical wards (60.76%) or ICU (39.24%). The majority had confirmed COVID-19 (81.01%), while 12.66% were not diagnosed. Hospitalization duration varied: 1-3 days (21.52%), 4-7 (17.72%), 8-14 (37.97%), and >14 days (22.78%). Outcomes: 53.16% died, 34.18% discharged, 12.66% recovered. Disease severity was critical (41.77%), severe (30.38%), moderate (24.05%), and mild (3.80%). All received oxygen: 56.96% via reservoir mask, 36.71% continuous positive airway pressure (CPAP), and 6.33% nasal mask. Common comorbidities: hypertension (67.09%), diabetes (37.97%), ischemic heart disease (IHD) (25.32%), and smoking (21.52%). Symptoms: shortness of breath (77.22%), cough (75.95%), chest pain (60.76%). Fever types: persistent (44.59%) and high (27.03%). Only 25.32% were vaccinated (Pfizer 45%, AstraZeneca 30%, Sinopharm 25%), mostly with two doses (85%). Vitamin D was low (16.88). DBP protein (mean: 5.51, range: 0.15-25.20) showed no significant differences across outcomes or severity (p > 0.05). Our study's results, particularly the exceptionally low mean DBP value in a cohort with high COVID-19 severity and mortality, highlight a crucial area of investigation.

Synechiae formation is a common and undesired complication after functional endoscopic sinus surgery. Mitomycin-c, known for its anti-proliferative and anti-fibroblastic properties holds potential for reducing synechiae and scar tissue formation following endoscopic sinus surgery. This study aims to evaluate the efficacy of topically applied mitomycin-c postoperatively in minimising adhesions and nasal obstruction symptoms using the Lund- Kennedy Endoscopic Scoring and Nasal Obstruction Symptom Evaluation (NOSE) scores.

This double-blind randomised study assessed topical mitomycin-c's efficacy in reducing adhesions post-FESS in 50 chronic rhino-sinusitis patients. Participants who were selected based on Lund-Mackay CT scores underwent functional endoscopic sinus surgery (FESS). The mitomycin-c and saline-soaked nasal packs were placed in middle meatuses either of one in each nasal cavity. Postoperative care included antibiotics, analgesics and saline douching. Outcomes were evaluated at 1, 4 and 12 weeks using the NOSE (nasal obstruction symptom evaluation) questionnaire and Lund-Kennedy scoring to determine mitomycin-c's impact on nasal obstruction and synechiae formation.

The results indicated statistically significant variation between mitomycin-c and control sides in terms of symptoms and endoscopic findings in the first week postoperatively. By the fourth week, the clinical pictures of both sides were nearly identical.

Data suggested that low-dose mitomycin-c significantly reduces adhesions and improves nasal symptoms in the early postoperative period for chronic rhinosinusitis patients. These results align with previous research, supporting mitomycin-c as a valuable adjunctive therapy in sinus surgery. Future studies are recommended to explore varying dosages and application methods for potential differences in outcomes.

Chronic obstructive pulmonary disease (COPD) is the third most prevalent cause of death in India. In 2012, over 3 million people succumbed to COPD, accounting for 6% of global deaths. COPD is the second most common respiratory disease after pulmonary tuberculosis. Early identification of cardiac manifestations may guide clinicians in implementing timely interventions to manage both the respiratory and cardiac aspects of COPD. This study aims to analyse the ECG changes in COPD patients and their correlation with airflow restriction.

This cross-sectional observational prospective study was conducted on 50 patients with COPD at Kurnool Medical College for a period of two years from December 2019 to June 2021. The ECG was recorded using a spectrophotometer.

The most frequent ECG abnormalities were RS in V6 (60%), Incomplete Right Bundle Branch Block (40%), and Right Axis Deviation of QRS (34%). The correlation analysis demonstrated significant associations between specific electrocardiographic changes and FEV1/FVC ratio. The P wave axis, QRS, P wave height, R V6 height, and RBBB showed statistically significant correlations with FEV1.

Our findings highlight the prevalence of electrocardiography changes in chronic obstructive pulmonary disease patients, with specific ECG anomalies demonstrating a correlation with the severity of both COPD and pulmonary functional impairment. Further research is warranted to validate these associations and explore their implications for clinical management.

The study assessed and compared the efficacy of Budesonide steroid nasal douching versus Fluticasone nasal spray in preventing recurrence of symptoms and nasal polyps post-FESS.

A prospective cohort study conducted in the Department of ENT, Saveetha Medical College and Hospital, Thandalam from June 2022 to June 2023 involving 60 patients diagnosed as Chronic sinusitis with polyposis were scheduled for FESS. Inclusion criteria included adults aged 18 and above with a confirmed diagnosis based on clinical symptoms, endoscopic findings, and radiological imaging. The severity of CRS was evaluated with SNOT22 score and Lund-Kennedy Endoscopic grading system. Patients were randomly assigned to two groups: Group A which was started on Budesonide nasal irrigation twice a day, and Group B, which received Fluticasone nasal spray.

The average age of participants were 33.23 years, with an even distribution between females and males. Preoperative SNOT-22 and Lund-Kennedy scores were similar between both groups. One month postoperatively, both the groups had similar SNOT22 scores, but the Budesonide group had significantly lower Lund-Kennedy scores. At three months, no significant differences were observed. However, at six months, the Budesonide group had significantly lower SNOT22 and Lund-Kennedy scores when compared to the patients receiving Fluticasone.

While Budesonide and Fluticasone are both effective post-FESS treatments, Budesonide nasal irrigation may offer better long-term symptom control and endoscopic outcomes. The broader nasal coverage achieved through nasal douching could contribute to its enhanced therapeutic effect.

Variants in the cystic fibrosis transmembrane conductance regulator (CFTR) gene, which causes cystic fibrosis, have become increasingly well-characterized in recent decades. However, clinicians remain challenged by CFTR variants that result in variable expressivity and reduced penetrance, including the variant R117H (c.350G>A) and the intron 9 poly-thymidine (poly-T) and poly-thymidine-guanosine (TG) tracts, highlighting a knowledge gap that impacts the delivery of accurate information to patients and families. To address this gap, we developed an educational resource that provides descriptive likelihoods of specific phenotypes that may result from genotypes including R117H and the poly-T and TG tracts. Development of the resource was grounded in an extensive literature review, clinical expertise, and publicly available CFTR variant databases, with feedback incorporated from CF clinicians, genetic counselors, and CF content experts. Genotypes were determined to have very low, low, moderate, high, or very high likelihood of resulting in CF, CFTR-related disorder (CFTR-RD), no symptoms, or the designation of CFTR-related metabolic syndrome/CF-screen positive, inconclusive diagnosis (CRMS/CFSPID) following CF newborn screening. The resource described in this report is intended to help clinicians navigate the uncertainty surrounding potential diagnostic scenarios to present accurate assessments to patients and families, a critical component of CF genetic testing and counseling.

Diagnosis and treatment of rhinogenic headache in children are among the most difficult and controversial problems of modern otorhinolaryngology and pediatrics. Headache is one of the leading causes of medical care in childhood. However, the differentiation between primary cephalalgia and secondary rhinogenic pain presents significant diagnostic difficulties. The detection of morphological changes using computed and magnetic resonance imaging of the paranasal sinuses and endoscopic signs of inflammation does not always correlate with the clinical picture of pain syndrome, which often leads to unjustified surgical tactics. This paper aims to critically analyze the main contradictions in the current approach to the diagnosis and treatment of rhinogenic headache in children. A comprehensive review of the literature was conducted to identify the key pathogenetic mechanisms of pain syndrome in various forms of rhinosinusitis and nasal cavity contact deformities. Special attention was paid to the differential diagnosis of rhinogenic and non-rhinogenic pain etiologies, the criteria for selecting patients for surgical intervention, and the optimization of postoperative management. The results of the study highlight the need to revise the existing approach to the diagnosis and treatment of rhinogenic headache in children, implement a unified algorithm for interdisciplinary differential diagnosis, and develop clear criteria for selecting patients for surgical intervention.

Treatment of patients with severe chronic and recurrent forms of sinusitis, complicated by pathological stretching of the paranasal sinuses, is not a trivial task. This is especially true for those clinical cases where a pathological increase in the size of the sinus leads to widespread destruction of its walls and may be accompanied by serious complications from adjacent structures. The paper presents an analytical review of publications on the topic of pathological stretching of the paranasal sinuses. In the first part of the article, the options for classifying this category of diseases were described in detail. In the second part of the article, potential factors influencing the development of this pathology, pathogenesis options, as well as modern approaches to the surgical treatment of this pathology, which can be carried out in one or two stages, depending on the presence of secondary aesthetic defects, are considered.

Vasomotor rhinitis (VR) is a chronic disease of the nasal mucosa that occurs due to impaired neurovegetative and endocrine regulation of vascular tone. The pathogenesis of vasomotor rhinitis is not fully understood; it is believed to be caused by dysregulation of the sympathetic and parasympathetic nervous systems, leading to inflammation of the nasal mucosa.

To examine the role of proinflammatory (TNF-α, IL-1, IL-8) and anti-inflammatory (IL-4 and IL-10) cytokines in chronic vasomotor rhinitis.

A total of 88 participants were examined: patients with chronic VR (VR group, n=42) and apparently healthy blood and nasal secretion donors (control group, n=46). Venous blood and nasal secretions were used for the study. The levels of TNF-α, IL-1, IL-4, IL-8, and IL-10 in the blood and nasal secretions were determined by enzyme-linked immunosorbent assay on a Multiskan FC immunoassay analyzer (Thermo Fisher Scientific Instruments Co., Ltd., USA). Statistical analysis of the study results was performed using the Statistica 10.0 software package. The sample was described using the median and interquartile range (25th and 75th percentiles). Normality of distribution was tested using the Kolmogorov-Smirnov method, with a significance level of p<0.05.

The median IL-1 level (1.65 pg/ml) in serum in VR patients was 5.7 times lower than the median in the control group, while the median IL-8 level (0.94 pg/ml) was 10.1 times lower. No statistically significant differences were found between the VR and control groups for TNF-α, IL-4, and IL-10 levels. The median IL-1 level (19.6 pg/ml) in VR patients was 22.8 times higher than in the control group. In nasal washes, the median IL-8 level was 24.5 times higher than the median in the control group, reaching 38.7 pg/ml. The median TNF-α, IL-4, and IL-10 levels in the VR group did not differ statistically significantly from the medians of these cytokines in the control group.

The study revealed low levels of IL-1 and IL-8 in the blood and high levels in nasal secretions in patients with vasomotor rhinitis. No statistically significant differences were found in the levels of the anti-inflammatory cytokines IL-4 and IL-10. The contrasting changes in the levels of proinflammatory cytokines IL-1 and IL-8 in vasomotor rhinitis may indicate a lack of a leading role for cytokines in the pathogenesis of this condition.

The voice is an important indicator of human health, since the state of voice function is related to the activity of the main body systems. Impaired vocal function significantly changes relationships with people for the worse, makes it difficult or completely impedes the performance of professional duties. The main causes of phonation-related diseases of the larynx, dysphonia, is a systematic overload of the voice.

Analysis of modern regulations for the examination of the connection of the disease with the profession and professional suitability in diseases of the larynx.

The analysis of existing and newly approved normative and methodological documents regulating expert work in determining the relationship of laryngeal disease with a profession and assessing professional suitability in workers of voice and speech professions has been carried out.

Diseases caused by an occupational factor are among the occupational diseases, the list of nosological forms of which is approved by the Ministry of Health of the Russian Federation. The procedure for the diagnosis of an occupational disease has been defined in two stages - preliminary and final diagnoses, and the necessary algorithms for the actions of specialists have been developed.

Strict consideration of all existing regulatory requirements for the examination of the relationship between the disease of the vocal apparatus and the profession and professional suitability of «voice professionals» is aimed at eliminating serious errors in detecting early symptoms of impaired vocal function, maintaining longevity, observing social justice and preserving the quality of life of employees and medical professionals.

To study the effect of therapeutic hypothermia on the sleep quality of patients in the early recovery period of ischemic stroke (IS).

The study included 32 patients in the early recovery period of IS. The test group included 22 patients (10 with IS in the vertebral-basilar system (VBS) and 12 with IS in the carotid system), and the control group included 10 patients (5 with IS in the VBS and 5 with IS in the carotid system). Control group patients received drug therapy, physiotherapy (magnetic therapy and electrotherapy), exercise therapy, and massage. Treatment in the test group also included craniocerebral hypothermia (CCH); 10 daily sessions of 90 min. Non-invasive radiothermometry was used to measure cerebral cortical temperature.

After CCH, the test group showed a statistically significant decrease in cerebral cortical temperature compared to the control group (p<0.015). Of note, the test group showed a statistically significant decrease in cerebral cortical temperature only in patients with IS in the VBS (p<0.001). It was shown that rehabilitation treatment with CCH significantly improved sleep efficiency, increasing the total sleep amount from 263 [101; 401] to 327 [181; 435] minutes, the sleep efficiency index from 51 [18; 72.6] to 62.3 [46; 85.3] %, the N2-stage of sleep from 25.6 [15.7; 36.9] to 29.0 [22; 42.9] %, and reducing the wake time during sleep from 40 [13; 57] to 34.5 [11; 44] % (p<0.05). Improved sleep quality in the test group was observed in patients with IS in the VBS. Sleep efficiency was unchanged in the control group.

Thus, the data obtained support the relationship between brain temperature and sleep processes. With a decrease in brain temperature, sleep quality improves.