OBJECTIVE:To analyse and compare the craniofacial characteristics of patients with nonsyndromic, surgically repaired, complete unilateral cleft lip and palate, aged 8-14 years, treated at 10 cleft care centres. METHODS:Lateral cephalograms of 396 patients (mean age 11.2 ± 1.6 years; male: female ratio 1:0.64) with unilateral cleft lip and palate from 10 comprehensive cleft care centres across India were evaluated using NemoStudio cephalometric software. Cephalograms were anonymised, coded and digitised for unbiased assessment. Two orthodontists independently traced all radiographs at different time intervals. Eleven hard-tissue and seven soft-tissue cephalometric variables were measured on each radiograph. Inter-rater reliability was assessed using the intraclass correlation coefficient (ICC). RESULTS:Cephalometric analysis demonstrated statistically significant intercentre differences for sagittal skeletal and soft-tissue parameters, including SNA, SNB, ANB, ANS-Me/N-Me, NAPog, nasolabial angle, N'A'Pog' and A'N'B'. In contrast, other parameters did not differ significantly among centres. Dental inclination variables Ui-PP and Li-MP also showed no significant differences. Inter-rater reliability was moderate to good, with ICC values of 0.51-0.85. CONCLUSIONS:Considerable intercentre variation was observed in sagittal hard- and soft-tissue craniofacial parameters among children with repaired unilateral cleft lip and palate. However, these variations cannot be attributed to any single component of the treatment protocol. Instead, it reflects the multifactorial nature of cleft care, including variations in surgical timing, technique, presurgical orthopaedics and patient-related factors.
Introduction: Fungal infections of the ear, nose and throat (ENT) region have emerged as an important cause of morbidity in both immunocompetent and immunocompromised individuals. The clinical spectrum of infections ranges from superficial, localized conditions like otomycosis, oral thrush and allergic fungal rhinosinusitis to aggressive, life-threatening invasive diseases like mucormycosis. Early and accurate diagnosis of ENT fungal infections requires a multidisciplinary approach involving clinical evaluation, proper microbiological identification, and histopathological confirmation. Materials and methods: A prospective observational study done at department of Pathology in collaboration with the department of Microbiology and Department of Otorhinolaryngology (ENT) in a tertiary care hospital from January 2025 to December 2025. Patients attending the outpatient departments with clinically suspected fungal infections involving ear, nose and throat were chosen as study population. Total 68 patients were selected with clinically suspected oropharyngeal candidiasis, fungal otitis externa and paranasal sinusitis. Oropharyngeal swabs from tongue, palate, oral rinses, mycelial matts/discharges from the external auditory canal, and sinonasal tissue and thick mucus secretions swabs from the nasal cavity were collected and sent for microbiological investigation and histopathological examination. Results: 68 patients were included in the study. 42 (61.8%) were males and 26 (38.2%) females, showing a male predominance. Nasal infections were commonest followed by ear and throat respectively. Site specific distribution showed that Aspergillus spp. was commonest in both ear and nose infections while Candida albicans was commonest in infections of oropharynx. The distribution of predisposing factors among ear, nose, and throat cases demonstrates varying patterns across the three groups. Conclusion: It may be concluded that Aspergillus niger and Aspergillus flavus were most common implicated in otomycosis and paranasal sinusitis. HIV positivity and faulty dentures were causative factors in establishing oropharyngeal candidiasis by Candida albicans.
Background: Pleural effusion is a common clinical finding in respiratory and systemic disorders. Differentiating between transudative and exudative effusions is critical for determining etiology and management. Conventional biochemical methods based on Light’s criteria require invasive sampling, whereas Thoracic Ultrasonography (TUS) offers a safe, bedside, radiation-free alternative capable of characterizing pleural fluid by internal echo patterns and dynamic signs. Objectives: To evaluate the diagnostic accuracy of TUS in distinguishing exudative from transudative pleural effusions, using biochemical Light’s criteria as the reference standard. Methods: This prospective study included 216 patients with radiologically confirmed pleural effusion attending the Department of Respiratory Medicine, Ashwini Hospital, Cuttack (May 2023-October 2024). Each underwent standardized thoracic ultrasound examination followed by diagnostic thoracentesis. Sonographic parameters-echogenicity, complexity, septations, and dynamic signs (“jellyfish,” “plankton,” “hematocrit”)-were compared with biochemical classification. Results: Of 216 patients (mean age 54.7 ± 13.7 years; 61.1 % male), 193 (89.4 %) effusions were exudative and 23 (10.6 %) transudative by Light’s criteria. Ultrasound classified 176 (81.5 %) as exudates and 40 (18.5 %) as transudates, yielding sensitivity 91.2 %, specificity 100 %, PPV 100 %, and NPV 57.5 %. Anechoic, non-septate patterns with “jellyfish” sign correlated with transudates, whereas complex, septate, “plankton,” and “hematocrit” signs indicated exudates (p < 0.05). Conclusion: TUS demonstrates excellent diagnostic accuracy for differentiating pleural effusions and can serve as a first-line, non-invasive diagnostic tool, particularly valuable in critical-care and resource-limited settings.
