Globus pharyngeus
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Globus pharyngeus is a feeling of something stuck or tightness in the throat. It was originally thought to be related to hysteria in women. Globus is a persistent but variable symptom that is difficult to diagnose and treat. It is considered functional if no organic cause can be found, though gastroesophageal reflux disease is a common potential cause. Globus affects men and women equally and is most common in middle age. While the exact cause is unclear, reflux of acid into the throat is a leading theory. Management focuses on reassurance and lifestyle changes to reduce anxiety and reflux, though the sensation often persists long-term for many patients.
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Git pathology lectureDr Ashish Jha This document discusses several congenital anomalies of the gastrointestinal tract, including Meckel's diverticulum, Hirschsprung's disease, and pyloric stenosis. Meckel's diverticulum is a true diverticulum of the small intestine resulting from persistence of the vitelline duct. It occurs in 2% of the population and can cause bleeding, obstruction, or inflammation. Hirschsprung's disease is caused by absence of ganglion cells in parts of the colon and is the most common cause of intestinal obstruction in neonates. Pyloric stenosis results from hypertrophy of the pyloric muscle and causes non-bilious vomiting in infants, usually starting after 3 weeks of age.
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INFANTILE PYLORIC STENOSIS.pptxLawrenceshamboko This document provides an overview of infantile hypertrophic pyloric stenosis (IHPS). IHPS is a condition that affects young infants where the pylorus becomes abnormally thickened, obstructing gastric emptying. Clinical features include projectile vomiting following feeds. Diagnosis is typically made using abdominal ultrasound showing pyloric thickening and dilatation. Treatment is surgical pyloromyotomy to divide the thickened muscle and relieve obstruction. Complications can include wound infection or incomplete division of the muscle.
Au med
Au medRosel Dimaandal The esophagus connects the hypopharynx to the stomach and functions to transport food and fluid. Gastroesophageal reflux occurs when stomach contents reflux into the esophagus. This can be caused by increased stomach pressure or decreased lower esophageal sphincter tone. Chronic reflux can lead to esophagitis and complications like strictures or Barrett's esophagus. Diagnostic tests include endoscopy, pH monitoring, and manometry. Treatment involves lifestyle modifications and medications to reduce acid production like PPIs.
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gastro-esophageal-reflux-disease-gerd-in-children (1)_OCR.pdfMohammad455814 This document discusses gastroesophageal reflux disease (GERD) in children. It defines GERD and covers topics like pathophysiology, prevalence, symptoms, diagnosis, and management. Regarding pathophysiology, it describes factors like lower esophageal sphincter (LES) tone and transient LES relaxations that can allow reflux. It notes that GERD symptoms are common in children and can impact quality of life. Diagnosis involves history, physical exam, tests like pH monitoring and endoscopy. Treatment goals are to relieve symptoms, heal esophagitis, prevent complications, and maintain remission.
Git Gerd 08.
Git Gerd 08.Shaikhani. Gastroesophageal reflux disease (GERD) is caused by the backflow of gastric contents into the esophagus, resulting in heartburn and regurgitation that affects 30% of the population. Common complications of long-term and severe GERD include esophagitis, Barrett's esophagus which increases cancer risk, and benign esophageal strictures. Lifestyle modifications and medications like PPIs are first-line treatments for GERD symptoms and healing esophagitis, while surgery may be considered for refractory cases or complications.
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Reflux and eosinophilic oesophagitis finalArul Lakshmanaperumal This document summarizes reflux and eosinophilic esophagitis. It defines gastroesophageal reflux (GOR) and gastroesophageal reflux disease (GORD) when symptoms are present. Laryngopharyngeal reflux (LPR) and extraesophageal reflux disease (EORD) are also discussed. The physiology and mechanisms of injury from acid exposure are explained. Common symptoms and investigations are outlined, including pH monitoring, impedance testing, and endoscopic findings. Associated conditions like laryngomalacia, subglottic stenosis, and apparent life-threatening events are covered. Management includes lifestyle changes and pharmacological or surgical interventions.
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Gastro Esophageal Reflux Disease (GERD) in children Azad Haleem GERD is the most common esophageal disorder in children. Symptoms vary depending on a child's age, and can include regurgitation, irritability, coughing, and poor appetite. Diagnosis involves ruling out other potential causes through history and examination. Tests like barium swallows, pH monitoring, and endoscopy may then be used to confirm and assess complications of GERD like esophagitis. Managing GERD is important as it can impact a child's eating, sleeping, school and social activities if not properly treated.
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approachtorecurrentpneumonia-170523181837.pdfSatyajitNaskar4 This document provides information on evaluating and diagnosing recurrent or chronic pneumonia in children. It discusses obtaining a thorough medical history including details of pneumonia episodes, risk factors, and associated symptoms. A complete physical exam focuses on the respiratory system, lymph nodes, growth, and other organ systems. Diagnostic tests include complete blood count, chest x-ray, pulmonary function tests, bronchoscopy, sweat test, and genetic testing to identify potential causes like cystic fibrosis, immunodeficiencies, structural lung abnormalities, or gastroesophageal reflux. The goal is to determine if episodes are due to infectious, anatomical, immune, or aspiration-related factors.
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Approach to recurrent pneumoniaSeema Rai This document provides information on evaluating and diagnosing children with recurrent pneumonia. It discusses obtaining a thorough medical history including details of pneumonia episodes, risk factors, and associated symptoms. A complete physical exam focuses on the respiratory system and signs of underlying conditions. Initial tests include a CBC, chest X-ray, and Mantoux test. Further tests like CT, PFTs, bronchoscopy may help identify structural abnormalities, aspiration, or immunodeficiencies causing recurrent pneumonia. Treatment involves managing the specific illness and providing nutritional/respiratory support.
More from Shekhar Krishna Debnath (20)
Pta(sbo 3)
Pta(sbo 3)Shekhar Krishna Debnath The Pure Tone Audiometry (PTA) test is used to determine a person's hearing threshold levels using pure tone pulses presented at standardized frequencies from 125-8000Hz. The threshold is the lowest sound level at which a person detects 50% of tones. Specific test conditions include the type and presentation of tones. Tones are presented one ear at a time through earphones to determine if hearing loss is present and what type based on the audiogram configuration. Sources of error in PTA tests include physiological, psychological, methodological, physical/acoustic factors, and ambient noise levels.
Vertigo
VertigoShekhar Krishna Debnath This document summarizes different types of vertigo and nystagmus. It describes 7 causes of vertigo: 1) Benign Paroxysmal Positional Vertigo, 2) Meniere's disease, 3) Vestibular Neuronitis, 4) Perilymph Fistula, 5) Vestibulotoxic drugs, 6) Labyrinthitis, and 7) Acoustic Neuroma. It also defines nystagmus as involuntary eye movements and classifies the degree of nystagmus into three levels based on the components of eye movement involved.
Stridor vol 1
Stridor vol 1Shekhar Krishna Debnath Stridor is an abnormal noise caused by partial airway obstruction. The document discusses different types of stridor and common causes of stridor in children, including croup (laryngotracheobronchitis), epiglottitis, and spasmodic croup. Croup most often affects children ages 3 months to 3 years and is caused by influenza viruses. Epiglottitis typically affects children ages 3 to 6 years and can cause drooling, muffled voice, and stridor. Management of airway obstruction may include oxygen, humidification, steroids, nebulizers, and intubation or tracheostomy in severe cases.
Obstuctive sleep apnoea in children
Obstuctive sleep apnoea in childrenShekhar Krishna Debnath Obstructive sleep apnea in children is defined as cessation of breathing for 6 seconds or more during sleep, which can lead to hypoxia and hypercapnia, disrupting normal sleep patterns. The severity of obstructive sleep apnea is classified based on the number of apneas per hour as mild, moderate, or severe. Obstructive sleep apnea can be caused by blockages at four levels - the adenoid pad, tonsils, tongue base, or supraglottic area. Treatment depends on the site of obstruction and may include adenoidectomy, tonsillectomy, use of nasal airways or mandibular advancement devices, or laser procedures. Adenotonsillectomy c
Nose
NoseShekhar Krishna Debnath The nose has important anatomical structures that allow it to carry out its key physiological functions. Externally, the nose is made up of bone and cartilage, including the nasal bones and lateral cartilages. Internally, the nasal cavity contains three turbinates that divide it into air passages. The osteomeatal complex includes structures like the agger nasi and ethmoid bulla that are involved in drainage and ventilation of the paranasal sinuses. Physiologically, the nose conditions inhaled air by warming, humidifying and filtering it. It also plays a role in respiration and protects the lower airways through mucociliary clearance.
Diseases of the tonsils 2
Diseases of the tonsils 2Shekhar Krishna Debnath This document discusses diseases of the tonsils, including recurrent acute tonsillitis and chronic tonsillitis. It outlines indications for tonsillectomy in cases of recurrent tonsillitis. The normal flora found on the tonsils is described, as are complications of tonsillitis like scarlet fever and rheumatic fever. Treatment approaches for acute and chronic tonsillitis are discussed. The role of the tonsils in immunity is covered. Finally, potential transmission of prion diseases like Creutzfeldt-Jakob disease via contaminated tonsillectomy instruments is mentioned.
Disease of tonsils
Disease of tonsilsShekhar Krishna Debnath The tonsils are lymphoid tissues located in the throat that help protect the respiratory and digestive tracts from infection. Common pathogens found in the tonsils include streptococcus and other bacteria. Acute tonsillitis is usually caused by streptococcus and presents with fever, sore throat, and painful swallowing. It is generally self-limiting but complications can include abscesses or spread of the infection. Chronic or recurrent tonsillitis may require treatment like antibiotics or tonsillectomy.
Corticosteroid in otolaryngology
Corticosteroid in otolaryngologyShekhar Krishna Debnath Corticosteroids readily diffuse into cells and bind with glucocorticoid receptors to form complexes that interact with proteins and act as transcription factors, reducing inflammation. Intranasal corticosteroids become effective within 3 hours and are most effective for symptoms like itching and sneezing, while systemic corticosteroids are more effective for blockage and anosmia. Methylprednisolone and dexamethasone are preferred for intravenous use due to their minimal mineralocorticoid effects. Prednisone is converted to prednisolone in the liver, while dexamethasone has minimal mineralocorticoid effects.
Viruses & antiviral agents
Viruses & antiviral agentsShekhar Krishna Debnath The document discusses several viruses that cause respiratory infections including influenza, respiratory syncytial virus, parainfluenza, adenovirus, rhinovirus, and coronaviruses. It notes that respiratory tract infections are very common worldwide and responsible for many lost work days. Diagnosis methods include enzyme immunoassays, immunofluorescent antibody tests, and PCR tests. Treatment depends on the virus but may include antivirals like acyclovir, oseltamivir, ribavirin, and interferon. Herpes simplex virus, Epstein-Barr virus, human papillomavirus, and others are described in relation to various diseases. Conditions with possible viral etiologies include Bell's p
Tumours of the head & neck in the childhood
Tumours of the head & neck in the childhoodShekhar Krishna Debnath The document discusses several types of tumors that can occur in the head and neck region of children. Lymphoma, rhabdomyosarcoma, medullary carcinoma of the thyroid, and neuroblastoma are some of the tumors mentioned. For lymphoma, the most common presentation is cervical lymphadenopathy, while rhabdomyosarcoma often presents with pain and swelling in locations like the orbit or paranasal sinuses. Diagnosis involves biopsy along with imaging and lab tests. Treatment depends on the specific tumor but may involve chemotherapy, radiation, and surgery. All childhood cancer cases should be referred to a specialist center.
The adenoid & adenoidectomy
The adenoid & adenoidectomyShekhar Krishna Debnath The document discusses the adenoid and adenoidectomy procedure. It covers the anatomy and function of the adenoid, including its role in immunity. It describes pathological effects like otitis media, upper airway obstruction, and rhinosinusitis. The assessment, management, and complications of adenoidectomy are outlined. While adenoidectomy is effective for upper airway obstruction and otitis media with effusion, its efficacy for other issues like recurrent ear infections, sleep apnea, and sinusitis requires more research. Mild adenoid hypertrophy does not always require surgery.
Otitis media with effusion
Otitis media with effusionShekhar Krishna Debnath This document provides information on otitis media with effusion (OME), including its definition, causes, characteristics, diagnosis, and epidemiology. Specifically:
- OME is the chronic accumulation of fluid in the middle ear for at least 12 weeks, usually presenting as hearing impairment. It is often preceded by acute otitis media or upper respiratory infection.
- The fluid results from inflammation of the Eustachian tube epithelium that prevents drainage of the middle ear. Histological examination shows replacement of normal epithelium with mucus-secreting cells.
- Diagnosis involves otoscopy, pneumatic otoscopy, and tympanometry which can classify effusions. Type B
Fungi( all fungal sinusitis & candidiasis)
Fungi( all fungal sinusitis & candidiasis)Shekhar Krishna Debnath 1) Mycotic diseases of the paranasal sinuses range from indolent infections in healthy individuals to lethal infections in immunocompromised people.
2) Fungal sinusitis is classified into invasive, noninvasive, and allergic types based on histopathology and clinical presentation. Invasive types can spread to nearby structures like the orbit and brain.
3) Diagnosis involves imaging like CT scans to assess bone destruction, biopsy and culture of tissue to confirm infection and identify the fungal species. Treatment depends on the type but may include antifungal drugs, surgery, and improving immune function.
Diseases of the tonsil
Diseases of the tonsilShekhar Krishna Debnath The tonsils are lymphoid tissue located in the throat that help the immune system. Acute tonsillitis is usually caused by viruses or bacteria like Streptococcus and is typically self-limiting. Treatment focuses on pain relief and hydration. Antibiotics may help if symptoms persist after 2-3 days. Complications are rare but include peritonsillar abscesses, which are treated with antibiotics and needle aspiration. The tonsils can also present lymphomas or cancers.
Chronic otitis media in childhood
Chronic otitis media in childhoodShekhar Krishna Debnath This document discusses chronic otitis media, including the histology and pathogenesis. It notes that chronic inflammation is characterized by both tissue destruction and attempts at healing. Repeated infections from the nasopharynx or external ear canal can prevent resolution of otitis media. Persistent bacterial biofilms and chronic perforations of the tympanic membrane also contribute. Chronic retraction of the pars tensa portion of the eardrum can lead to atrophy and complications like cholesteatoma formation over time if not addressed. Early intervention may be warranted for more advanced retractions to prevent future problems.
Branchial arch fistulae, thyroglossal duct anomalies& lymphangioma
Branchial arch fistulae, thyroglossal duct anomalies& lymphangiomaShekhar Krishna Debnath This document discusses the embryology and presentation of several congenital anomalies of the head and neck region, including branchial arch fistulae, thyroglossal duct anomalies, preauricular sinuses, and lymphangioma. It describes how these structures develop from the branchial arches and pouches during embryogenesis. Common locations and presentations of each anomaly are provided, along with diagnostic evaluation and treatment approaches. Surgical excision is often needed but can be challenging due to the relationship of these structures to nearby nerves and vessels.
Antimicrobial therapy
Antimicrobial therapyShekhar Krishna Debnath The document discusses the use of antimicrobial therapy and various classes of antibiotics. It provides details on the mechanisms of action, spectra of activity, indications for use, and side effects of different classes of antibiotics including beta-lactams (penicillins, cephalosporins, carbapenems), glycopeptides, quinolones, sulfonamides/trimethoprim, metronidazole, tetracyclines, chloramphenicol, macrolides, aminoglycosides, streptogramins, and oxazolidinones. It also discusses Clostridium difficile infection as a common gastrointestinal side effect caused by antibiotic use.
Acute otitis media in children
Acute otitis media in childrenShekhar Krishna Debnath Acute otitis media (AOM) is an inflammation of the middle ear caused by bacterial or viral infection. It is common in young children and causes symptoms like ear pain, fever, and hearing loss. While most cases clear up without treatment, antibiotics are usually prescribed to reduce symptoms and risk of complications. For recurrent cases, management involves identifying and addressing risk factors, medical or surgical prophylaxis including ventilation tubes, and vaccination when available. AOM poses a significant burden as it is one of the most frequent reasons children receive antibiotics.
Physiology of swallowing
Physiology of swallowingShekhar Krishna Debnath Swallowing involves three phases - oral, pharyngeal, and esophageal. In the oral phase, food is mixed with saliva and moved to the back of the throat by the tongue. The soft palate then elevates to protect the nasal airway. In the pharyngeal phase, the larynx and pharynx elevate to allow food to pass while protecting the airway, and a series of muscle contractions propel the food over the epiglottis and into the esophagus. In the esophageal phase, the upper esophageal sphincter relaxes to allow the food to pass into the esophagus for peristalsis down to the stomach.
B)mouth ulcer
B)mouth ulcerShekhar Krishna Debnath This document provides information on recurrent aphthous stomatitis (canker sores) and other conditions that can cause mouth ulcers. It describes the main types of canker sores, causes, diagnosis, and treatment options. Common causes include genetic factors and nutritional deficiencies. Diagnosis is based on clinical features and symptoms. Treatment focuses on managing pain, reducing healing time, and addressing underlying causes. The document also summarizes information on Behcet's syndrome, infections like herpes and tuberculosis, autoimmune diseases like pemphigus vulgaris, and other conditions that can manifest as oral ulcers.
Globus pharyngeus
- 1. Globus pharyngeus/pharyngis Globus pharyngeus is a feeling of something stuck or a sensation of a lump or tightness in the throat. Latin Globus means ball.Hippocrates first regarded it as a disease of women being inextricably involved in the uterine axis from which all hysteria was believed to be derived.Patient have no higher scores for hysteria than healthy subjects. So the term globus hystericus has been abandoned. Globus is a well defined ,clinical symptom that is persistent , difficult to treat, & has a tendency to recur. It is often a nebulous clinical diagnosis to make because the symptom are variable within & between subjects . Objective clinical findings are by definition absent. Globus is considered functional when no organic explanation is detected.The most popular organic explanation for globus can be GERD or caused by oesophageal dysmotility. Epidemiology Globus accounts for around 4% of otolaryngological referrals. The peak incidence of the symptom is middle age , very uncommon under the age of 20. Older people can complain of global sensation but it is often difficult to differentiate this from age –related mucosal inflammation. Since the time of ancient Greece, globus was considered a disease of women.The everyday experience of globus is more or less equally by the both sexes. Aetiology A wide variety of explanations ,physical & psychological ,have been proposed over the last four decades.some popular theories of the past include strap muscle spasm, hypertrophy of the lingual tonsils, sinusitis, anterior cervical osteophyte,overclosure of bite, granular pharyngitis,tonsillitis & thyroid nodules. The most popular organic aetiology theory of recent years is that globus is a atypical presentation of gastro-oesophageal reflex or oesophageal dysmotility. 1)Possible mechanisms for symptom production include contact of reflux acid & pepsin with oesophageal & tracheal mucosa that activates vagal refluxes leading to reflux or spasm. 2)In addition ,there may be direct inflammation of the upper oesophagus with or without frank pharyngo-oesophageal reflux. 3)There may also be reflux cough & throat clearing in response to distal or proximal oesophageal acid exposure. 4) No one really knows whether the issue is one of excess acid or excessive acid sensitivity ,direct or reflex or appear of acid in unusual location ( oesophageal-pharyngeal junction).
- 2. Presentation The patient complains of a lump in the throat not associated with eating. The sensation may be relieved by eating or drinking.The symptom aggravated by stress. Globus is essentially a sensory disturbance, like itching &tinnitus, D/D Cricopharyngeal web Symptomatic diffuse oesophageal spasm GERD Laryngo-pharyngeal reflex disease Skeletal muscle disorder(myasthenia gravis, polymyositis, myotonic dystrophy) Neurological disease; stroke, cranial nerve palsy, parkinsonism. Investigations Elderly male smokers are not the typical globus patients ,high index of suspicion pyriform fossa cancer. In a non-smoker female , iron deficiency anaemia to exclude post-cricoid carcinoma. CXR to see the cricopharyngeal indentations. Flexible laryngopharynoscopy orFlexible fibreoptic examinationof upper GIT. Reassure the patient & reserve futher investigations. Over investigations may reinforce anxiety. Therapeutic trail of antacids , flexible oesophagoscopy & PH metry. Management options Reassurance is important. Explain the uncertain pathophysiological mechanisms behind globus. Avoid dry swallows. A strong history of gastro-oesophageal reflux may respond to a powerful antacid. &PPI. PPI failed to demonstrate superiority over placebo. Suggesting that laryngopharyngeal reflux perhaps be a self-limiting disease. Tricyclic antidepressant can be quite effective. Neck & shoulder exercise to reduce the laryngeal muscle tension. Adequate rehydration & voice exercise together with avoidance of cigarette smoking & alcohol. Outcome: follow up & prognosis The sensation may persist at two years in 85% of women & 95% of men. Last as long as 7years in 45% of patients.