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Objective: Laryngopharyngeal reflux (LPR) is responsible for many otorhinolaryngology manifestations. There is little evidence regarding the LPR impact on olfaction. No other study has investigated the efficacy of proton pump inhibitors (PPIs) on olfaction. We aimed to evaluate the effect of antireflux medication on olfaction and nasal patency in patients with LPR.

Materials and methods: Thirty patients with LPR were recruited. Nasal symptoms were self-evaluated with NOSE and SNOT-22 surveys, while a taste visual analogue scale (VAS) was used for gustation. Olfaction was evaluated with Sniffin' Sticks test and nasal patency with anterior rhinomanometry. After 12 weeks of oral PPIs, the procedure was re-applied and clinical outcomes were compared.

Results: Variables with statistically significant difference included the olfactory threshold (means 1,87/ SD 3,3/ t -3,11/ p 0,004) and the combined threshold-discrimination-identification (TDI) scores of Sniffin' Sticks test (means -2,61/ SD 5.26/ t -2.75/ p 0.01) and the self-assessment NOSE (p 0.009) and SNOT-22 (0.031) tests. However, no variable concerning nasal patency revealed statistically significant difference before and after treatment in the study group (p 0.677).

Conclusions: Oral PPIs treatment was associated with better olfactory threshold and TDI scores. These results raise the need for further studies, regarding the effect of antireflux medication on patients suffering from LPR who express nasal symptoms and olfaction disfunction.

Background/aim: This study aims to explore the role of NF-kB p65/p50 expression in patients with inflammatory bowel disease (IBD), those with irritable bowel syndrome (IBS) and normal controls.

Patients and methods: Twenty patients with IBS, 19 subjects with IBD and 18 normal controls, who underwent colonoscopy, provided us with biopsies from the terminal ileum, cecum and rectum. Patients with IBS were categorized according to bowel habits. Two polyclonal antibodies, alpha-p65 rabbit Ab and alpha-p50 rabbit Ab, were applied for immunohistochemical examination.

Results: It was found that in patients with IBD, the expression of intensity and distribution of NF-kB p65/p50 were lower than in IBS patients and normal controls (p>0.05), but the NF-kB p65/p50 ratio was elevated (p>0.05). The NF-kB p65/p50 ratio was lower than in IBD patients and rather similar to normal controls. The distribution of NF-kB p65 as well as the distribution and intensity of NF-kB p50 expression were higher in IBS patients with predominant diarrhea, and the difference was statistically significant in the cecum epithelium. The NF-kB p65/p50 expression ratio was higher in IBS patients with predominant diarrhea, but statistical significance was documented only in cecum epithelium specimens.

Conclusion: The NF-kB p65/p50 ratio offers more significant information than each subunit. The increased expression of NF-kB p50 in IBS patients compared to IBD subjects or controls seems to be an early event in the process of inflammation. The similar pattern of NF-kB p65/p50 expression in IBS patients with predominant diarrhea and IBD patients may suggest possible common pathogenetic pathways.

Objectives: The diagnosis of infertility affects between 8-12% of couples of childbearing age worldwide. It is difficult to manage infertility, which often generates anxiety and depression.

Material and methods: We conducted a study that included women of childbearing age who were unsuccessful in getting pregnant. Our research was based on a questionnaire distributed online via social media and it was carried out over a period of two months. The questionnaire comprised 35 questions and intended to highlight the psychological impact of infertility diagnosis on the female participants in the present study.

Results: A total of 486 women with a diagnosis of infertility responded to the online questionnaire. Subjects had an average age between 31 and 40 years (58.4%) and most of them (80.2%) came from urban areas. It was found that 38.1% of patients experienced a very high level of stress generated by their infertility diagnosis and 54.7% stated that their greatest fear was that they would never get pregnant; 41.4% of these patients claimed that their quality of life was affected and 31.7% indicated a negative impact even on their couple life. Of all participants to the questionnaire, 96.6% stated that the costs of treatments or even assisted reproduction procedures were an additional stress and 73.7% believed that religion played an important moral role.

Conclusions: The women who were enrolled in the current study recognized the negative impact of their infertility diagnosis on both themselves and their couple's lives. At the same time, they believed in Divine help and looked optimistically to the future in terms of achieving pregnancy.

Background: Research evidence suggests the role of the vestibular system in cognitive functions like visuospatial memory, objective memory, spatial navigation, etc. Vestibular cortices send projection to the hippocampus and to the medial entorhinal cortex (MEC); the latter houses place cells, grid cells, and head direction cells, which play a major role in the formation of a cognitive map based on inputs from the vestibular apparatus. So, the present study aimed to assess cognitive functions in vestibular disorder patients.

Materials and methods: All patients with vestibular disorders were included after bedside tests like the Dix Hallpike test, head impulse test, Romberg test on foam with eyes closed/the clinical test of sensory interaction and balance (CTSIB) and timed up and go test. After that, a dizziness handicap inventory (DHI) was used to assess the severity of the vestibular dysfunction. Patients with diagnosed neurological disorders were excluded from the study. Cognitive function assessment was done using the trail making test (TMT) and the digit symbol substitution test (DSST). The assessment results were correlated with the severity of the vestibular dysfunction using Pearson correlation.

Results and discussions: Out of a total of 40 patients, 26 (62.5%) were males and 14 (37.5%) females. The results of TMT part A and part B were 86.14±11.00 and 247.07±39.0, respectively, in mild handicap score patients, and 102.7±10.69 and 290.0±10.35 in moderate handicap score patients, which was significantly (p<0.05) higher when compared to mild handicap patients. Even DSST scores in moderately handicapped subjects were significantly (p<0.05) lower than those with a mild handicap.

Conclusion: Patients with vestibular dysfunction have significant cognitive decline, and cognition is decreasing with the severity of the vestibular dysfunction.

Background: A cluster of metabolic indicators responsible to elevate the risk of high blood sugar, heart diseases along with stroke is called metabolic syndrome (MetS). Adipokines play critical roles in the formation and progression of these clusters of diseases. Adiponectin enhances fatty acid oxidation, prevents foam cell formation and improves lipid metabolism. In contrast, plasminogen activator inhibitor-1 (PAI-1) possesses pro-atherogenic properties. Carotid intima-media thickness (CIMT) is directly associated with an increased risk of myocardial infarction and stroke. Complete information about the association related to adipokines and CIMT in MetS of Indian population is lacking.

Objective: To evaluate the association of adipokine levels and PAI-1 with CIMT in MetS patients, including its components.

Materials and methods: We performed a cross-sectional study and IDF criteria were used for the screening of MetS. A total of 164 subjects with MetS (88 males and 76 females) and 100 controls (54 males and 46 females) were enrolled. Serum levels of adiponectin and PAI-1 were measured using ELISA. A CIMT measurement of carotid arteries was also done. The relationship between various parameters was assessed by the Pearson correlation coefficient test.

Results: The levels of adiponectin were lower (p < 0.001), while those of PAI-1 and CIMT were higher (p < 0.001) when we compared patients with controls. When the number of metabolic abnormalities increased, the levels of adiponectin decreased and those of PAI-1 increased. There was a strong negative association between PAI-1 levels and those of adiponectin (p <0.001).

Conclusion: Our findings indicate that elevated PAI-1 levels are associated with a higher probability of having MetS and negatively impact MetS-related components.

This paper presents a thorough examination of COVID-19 symptomatology among healthcare workers from All India Institute of Medical Sciences (AIIMS), Nagpur, India. Through meticulous analysis spanning from May 2020 to October 2020, we enrolled 73 healthcare workers engaged in COVID-19 screening, care and testing. Our study aimed to elucidate the spectrum of symptoms, adherence to protective measures and implications for early detection and intervention. Key findings revealed a diverse range of symptoms, including body ache, fatigue, headache, sore throat, fever, cough and loss of taste, among others. Notably, 21% of all positive cases were asymptomatic, underscoring the variability in clinical presentation. Adherence to personal protective measures varied across work areas, highlighting the importance of stringent compliance. Our discussion emphasizes the significance of early identification and tailored monitoring systems for mitigating transmission risks and ensuring healthcare worker safety. Additionally, addressing the mental health needs of healthcare workers is crucial for comprehensive pandemic management. Overall, this study contributes essential insights into COVID-19 symptomatology among healthcare workers, offering valuable guidance for infection control and prevention strategies in the pandemic.

Introduction: Lateral cervical cystic masses are a relatively common occurrence in the otolaryngology practice, which are often attributed to second branchial cleft cysts. However, there should always be a high suspicion for malignancy until proven otherwise.

Case presentation: We present a clinical report of a lateral cervical cyst surgical excision where histopathological examination has revealed features of a branchial cleft cyst harboring a papillary thyroid carcinoma. This led to the clinically latent thyroid primary which was treated through thyroidectomy with selective neck dissection and radioactive iodine therapy.

Discussion: Across current literature regarding thyroid carcinomas arising within branchial cysts, primary thyroid carcinoma was identified in almost half the cases where thyroidectomy was performed. There is no established consensus on the decision of whether to perform a thyroidectomy in such cases, due to the paucity of data for similar cases.

Conclusion: Although branchial cyst is a benign condition, it can harbor malignancy. When thyroid carcinoma occurs within such a cyst, without solid evidence of a thyroid primary, treating physicians are presented with a diagnostic and treatment dilemma. As more cases are discovered and reported, navigating this challenging dilemma will become clearer for the treating physicians.

Background: Non-small cell lung cancer (NSCLC) presents with a range of symptoms and is associated with a poor prognosis. Although both immunotherapy and chemotherapy improve survival, they are still associated with psychological disorders due to the reduced quality of life. This study aimed to investigate the levels of anxiety and depression in Greek patients with NSCLC receiving second-line chemotherapy compared to second-line immunotherapy.

Materials and methods: This is a comparative, prospective, non-randomized follow-up study in which measurement scales have been used to compare data from NSCLC patients in two hospitals in Athens, Greece. All patients completed a demographic data form in the first therapy cycle, while the hospital anxiety and depression scale (HADS) (value range 0-21) was completed from treatment cycle 1 to treatment cycle 6.

Results: Of the 111 selected patients, the majority (75.7%) were men, with a mean age of 66.5±9.2 years. Second-line chemotherapy was received by 61 patients and second-line immunotherapy by 50 patients. According to HADS, from treatment cycle 1 to treatment cycle 6, the mean anxiety score decreased from 4.83±5.1 to 3.2±3.8 (p=0.287), while the mean depression score decreased from 5.64±5.53 to 4.61±4.75 (p=0.113). Depressive symptoms were statistically significantly higher in patients who received chemotherapy from the fourth cycle onwards (p<0.05), but in any of the study groups, the value did not exceed the critical threshold of seven points. In the anxiety subscale, after cycle 3 there was a significant decrease (p=0.014) of a similar degree (p=0.608) in both groups.

Conclusions: The present study was the first attempt to investigate differences in psychological symptoms between treatment groups in Greek NSCLC patients. Anxiety and depression levels did not appear to be serious problems in the chemotherapy and immunotherapy group of patients.