Bentsenclapp0686

Novel corona virus, named as SARS-Cov-2 is the seventh coronavirus causing Corona Virus Disease (COVID-19) in human. It is one of the very few rare events in history of mankind to affect public health at such an enormous scale globally. Whole world is on standstill with this outbreak, which was declared pandemic by WHO in March 2020. All healthcare workers and especially the ones working in vicinity of nasal/oral regions are high risk group to be infected by this airborne virus. Recently, a 62 years old ENT specialist Liang Wudong died while treating patients with COVID in Wuhan city. Numerous reports of health care workers getting infected while serving their patients are coming from all parts of world. As health care providers are struggling to ensure safety and survival of people, their own wellbeing and preventing further spread of infection is also their responsibility. As head and neck surgical specialties are uniquely vulnerable to infection transmission, this communication highlights various instructions and suggestions given by International & National health agencies to safeguard the patient, surgical team, health workers and community. Though the decision regarding treatment is surgeon's discretion, we hope these guidelines will help in decision making.The surgical procedures in the temporal bone have the potential to generate aerosols which could affect the health care personnel. An innovative way to avoid aerosolization during ear surgery has been highlighted in this manuscript.COVID-19 outbreak is major pandemic affecting lakhs of people all across the globe. Along with other nonspecific clinical features, reports mention anosmia to be an important symptom in COVID-19 positive patients. To study the prevalence of anosmia in confirmed COVID-19 patients, in Indian population and to ascertain its significance as a symptom of COVID 19. Study was done at a tertiary care COVID treating hospital. While eliciting detailed history from Covid-19 positive patients, all patients were asked about symptom of anosmia. Same was asked from control group of subjects who were COVID-19 negative. The history of anosmia was also elicited on discharge after the patients tested negative for COVID-19. HA130 in vivo 74 patients formed part of the study. 11 of 74 (14.8%) patients had anosmia. On using the chi square test for significance the difference was significant (p  less then  .01), suggesting anosmia to be a significant clinical feature in COVID-19 patients. On comparing with world literature it was observed that the prevalence of anosmia is higher in European population as compared to Indian Also the symptom of anosmia improved when the patient recovered from the disease. Prevalence of new onset anosmia in Indian population with COVID-19 is 14.8%. Symptom of anosmia in present times should be considered as a important clinical feature and should raise a suspicion of COVID-19. The prevalence of anosmia in Indian population is much lesser than that reported in European population.Difficult airway is a commonly encountered problem in the anesthesia practice, might needing otolaryngologist expert in creation of surgical airway. Supraglottic airways, surgical or needle cricothyrotomy, high frequency jet ventilation, cardiopulmonary bypass (Tunstall in Can J Anaesth 36611-613, 1989) are initial rescue measures in such scenario. But in otolaryngology practice, patient presenting with stridor having difficult airway and difficult tracheostomy concurrently will definitely pose problems resulting in life-threatening consequences. We report cases in which difficult airway and difficult tracheostomy coexisted. (1) upper tracheal stenosis following strangulation and intubation (2) short neck with obesity (3) blunt trauma to neck with surgical emphysema (4) deep neck space infection (5) Paediatric tracheostomy in faucial diphtheria. Though difficult surgical tracheostomy in difficult airway is challenging, the anticipation of complications and planning can minimise the difficulty in the technique.Tracheostomy is the creation of a stoma at the surface of skin, which leads into trachea. In the critically ill patients, it is one of the most frequently done procedure especially in intensive care unit (ICU) for those requiring prolonged mechanical ventilation. About 24% of all patients in ICU need tracheostomy (Esteban et al. in Am J Respir Crit Care Med 1611450-1458, 2000). Historically it had a high complication rate and so many authors suggested that it should be done only in operating room (Dayal and Masri in Laryngoscope 965862, 1986). A standardized procedure to reduce complications was described by Jackson (Laryngoscope 19285-290, 1909). The aim of the study is to observe and analyze the outcome of bedside open tracheostomy, in relation to its safety, complications and simplicity. Study consists of 200 patients who underwent bedside tracheostomies in a tertiary care center from 2014 to 2017 in medical/surgical/paediatric ICU's. All the procedures followed a standard protocol. In all the surgeries, two E.N.T. surgeons were scrubbed and did the procedure, assisted by two ICU nurses. One anesthetist who administered sedation and monitored the patient. If coagulation disturbances were present in elective case then they were corrected prior to the procedure. We all want the latest, safest, simplest and cheapest available technique in medical practice. Bedside tracheostomy is one such procedure. It is better than tracheostomy in operating room for patients who need prolonged mechanical ventilation in ICU as it eliminates the need of patient transport to OR and its associated complications and also minimizing cost. Training programs need to be provided to the assisting staff for better procedural outcome.COVID-19 infection has spread widely over past 5 months to become a pandemic of global proportions affecting almost every country. While HCPs are expected to tackle this crisis by working in hospital and intensive care setting, there is real risk of them contracting infection and even dying. This article aims to report cases of healthcare personnel (HCPs) contracting COVID19 in various settings in a tertiary care hospital, a designated COVID centre, with view to disseminate information and review safety and psychological health issues of healthcare professionals. This study is a cross-sectional hospital-based survey from April 2020-June 2020. Data on demographics, workplace safety and psychological parameters from HCPs was collected by both interview and an online questionnaire form. A total of 40 healthcare workers were infected in the hospital in a period of 2 months since the first COVID case was admitted in the hospital. Almost 57.5% reported positive on several psychological parameters like anxiety, fear, anger, irritability and insomnia. About 42.5% had no psychological counselling after testing positive. These cases illustrate work-place risks for healthcare workers of acquiring COVID19 and highlight the problems faced in terms of risks of transmission to patients and colleagues, isolation of contacts in departments leading to near-breakdown of services and psychological stress to healthcare workers. Healthcare workers being at frontline of exposure to corona patients are at increased risk of developing COVID19 infections. Healthcare workers are working under tremendous stress in this pandemic and it is necessary to combat fear with facts and work towards safe work atmosphere so that they can discharge their duties to best of their ability.Septoplasty is a common procedure in ENT practice with fewer complication rates. Long term follow-up is usually not necessary. The aim of our study is to evaluate the feasibility of virtual telephonic consultation to follow-up the patients in the immediate postoperative period. After excluding the patients based on the criteria, twenty-four patients were telephonically followed up by a resident using structured NOSE questionnaires and the responses were noted. All the patients had improvement in symptoms with 14 patients completely asymptomatic (NOSE score of less then  5). Two patients had moderate symptoms (NOSE score 30-50) and 8 patients had mild symptoms (nose score 5-25). Majority of the patients interviewed were satisfied with the telephonic follow up and were willing to accept such patient-friendly services in the future. Virtual Telephonic follow-up of patient undergone uncomplicated septoplasty is a feasible, cost-effective model with a high rate of patient satisfaction.California has set ambitious climate policies, including economy-wide carbon neutrality by 2045. Yet levels of oil production and consumption remain high in the state. This gap between California's oil politics and its climate ambitions is deepened by decentralized decision-making processes. County officials are tasked with extractive planning decisions that have wide-ranging implications. In this Viewpoint article, we analyze proposals for enhanced extraction at the Cat Canyon oilfield in Santa Barbara County. After two of three proposals were withdrawn in recent months, we highlight how it has been oil industry volatility and public opposition - rather than state regulations - that have brought county development plans into closer alignment with state climate goals. As California pursues a goal of 'managing the decline' of domestic oil production, we identify strategies for bridging such gaps between local decision-making and state-level climate action, including a comprehensive state-wide ban on new enhanced oil extraction projects; a 2,500 ft buffer zone around extraction sites; and revenue generation schemes that support a just transition. As Covid-19 forces an oil surplus and lowered production, there are opportunities to enact such changes - particularly by redirecting oil industry labor toward the growing problem of well decommissioning.Canada's Extractive Sector Transparency Measures Act (ESTMA) is the culmination of a series of proposals and consultations with government, industry and civil society organizations to address conflict over Canadian extractive industry. Created in the context of a global call for extractive industry accountability, as well as increasing scrutiny of Canadian mining activities for alleged human rights and environmental abuses, the ESTMA aims to deter corruption via financial reporting requirements for Canadian extractive firms operating in Canada and abroad. By mandating that firms publicly disclose payments to various levels of government, however, the ESTMA is constructed atop global corruption discourse that identifies host states in the Global South as the source of social pathologies that facilitate corruption, largely excluding a critical analysis of extractive firms in the Global North. Drawing on interviews, document analysis of material related to the ESTMA and case studies of extractive firm financial reporting, this paper argues that under the ESTMA's financial reporting processes, corporate risk management trumps meaningful social regulation. While the Act does mandate disclosures useful to the advocacy community, limited oversight, a lack of standardized reporting and excluded activities under the Act mean that the ESTMA offers limited leverage to substantively address the human and ecological cost of Canada's extractive industry. As has resulted from transparency policies more broadly, however, the ESTMA provides firms a means to counter broader critique and, in complying with audit culture, promotes investment security.