The objectives of this review were to understand the epidemiology and outbreak of NiV infection and to discuss the preventive and control measures across different regions. We searched PubMed and Scopus for relevant articles from January 1999 to July 2018 and identified 927 articles which were screened for titles, abstracts and full texts by two review authors independently. The screening process resulted in 44 articles which were used to extract relevant information. Information on epidemiology of NiV, outbreaks in Malaysia, Singapore, Bangladesh, India and Philippines, including diagnosis, prevention, treatment, vaccines, control, surveillance and economic burden due to NiV were discussed. Interdisciplinary and multi sectoral approach is vital in preventing the emergence of NiV. It is necessary to undertake rigorous research for developing vaccines and medicines to prevent and treat NiV.
Bone remodelling is a normal physiological process which occurs in all bones. Hence bone changes should also be detected in undiseased or minimally diseased ethmoids as well as in chronic rhinosinusitis (CRS) patients. To test this hypothesis, we compared ethmoid bone histology between two groups of patients; a study group of CRS patients and a group of patients whose radiological, endoscopic and symptom scores were significantly less when compared to the CRS group. The study group had 75 patients who underwent functional endoscopic sinus surgery for CRS. The control group included 16 patients who had significantly different endoscopic and radiological scores from the study group. On histopathology, the bone harvested from the ethmoid sinuses were grouped as no remodelling activity (Score 1), mild activity (Score 2) and marked activity (Score 3). Thirty-six percent of patients in the study group and 37.5% of patients in the control group had Score 2 and 3 bone changes and the difference was not statistically significant (χ2 = 1.824, p = 0.402). Correlation of bone changes in CRS done with parameters like Lund-Mackay radiological, surgical and symptom scores and Lund-Kennedy endoscopic scores showed no statistical significance. Similar bone changes were detected in CRS patients and the control group. The bone changes seen in histopathology in CRS patients could partly be due to the normal physiological remodelling occurring in all bones.
Chronic rhinosinusitis has an incidence of 15% in India. Functional endoscopic sinus surgery (FESS), in case of failed medical management, is the current treatment protocol in Chronic rhinosinusitis. This study aims to assess the outcome of FESS as measured by subjective quality of life indices; Rhinosinusitis Disability Index (RSDI) and Sinonasal Outcome Test (SNOT-22. It also assesses the predictive factors which influence the outcome after FESS. The study was conducted among 100 patients with Chronic Rhinosinusitis who underwent FESS, after failure of medical management. Immunocompromised or pregnant patients and patients with history of previous sinus surgery or malignancy were excluded from the study. The evaluation was done using Lund Kennedy endoscopy scores, Lund Mackay CT scan scores and RSDI and SNOT-22 questionnaires (baseline and 3 months post-op). Statistical analysis was done using Wilcoxon signed-rank test, Kruskall Wallis test, Mann Whitney test and Chi-square test. p