Schwannoma of nasal inferior turbinate in young male: a rare occurrence

A 12-year old boy presented to the ENT Department of Abbasi Shaheed Hospital, Karachi, with a one year history of progressively increasing unilateral right sided nasal obstruction. He denied any other symptoms like that of rhinorrhea, epistaxis, facial pain, headache and any history of nasal trauma. After routine clinical examination, CT scan nose/PNS with contrast was advised and subsequently biopsy was done that revealed the mass to be as schwannoma. This was then removed via a lateral rhinotomy approach and the postoperative specimen again revealed the same. The boy was followed for 1-year and no recurrence is seen. He is still in the follow-up phase

[Investigation of temporal pattern of scorpion sting and snakebite incidence in patients referred to Masjedsoleiman's main hospital, during 24 months from 21 March 2008 to 20 March 2009]

Scorpion sting and snakebite are the important problems in some area such as Iran that must be addressed. This study was to investigate temporal pattern of scorpion sting and snakebite incidence in patients referred to Masjedsoleiman's main hospital, during 24 months from 21 March 2008 to 20 March 2009. It was an analytical study to scrutiny of monthly and seasonal procedure of scorpion sting and snakebite. Data were analyzed by SPSS and Minitab. To identify the goodness of fit model for monthly and seasonal incidence of scorpion sting and snakebite, autoregressive integrated moving average [ARIMA] models were used to explore time series analysis. Of all 9457 scorpion sting and snake-bite cases in patients referring to hospital, 45% [n = 4253] were men. Mean age of them was 28.26 +/- 0.36 years. Significant numbers [27%] of these patients had 21-30 years old, and were bitted in urban [93%], at their home [99.7%]. The auto regression suggested that monthly average incidents model have a moving average. The analyses through Anderson- Darling test provide evidence that the distribution of residuals was normal [P = 0.125]. Weather variables can be as the predictors of scorpion sting and snake-bite incidence for Masjedsoleiman.

Cut throat injury: one year study

To evaluate the cause and pattern of cut throat injury. Prospective study. This study was conducted in Abbasi Shaheed Hospital and Karachi Medical and Dental College from 01.09.2012 to 31.08.2013. Total number of patients with cut throat were 42 patients, in which 33 were selected in this study. During this period, those patients who came in emergency room in Abbasi Shaheed Hospital with cut throat injury were included in this study. In this study male were 24 patients [72.72%] and female were 9 [27.27%]. Male female ratio was 2.66:1. Maximum incidence of age was between 21-30-years 9 cases [27.27%]. Accidental cause was the main cause of cut throat with 19 patients 57.57%. In 9 [27.27%] cases of suicidal, 7 [77.77%] patients was history of psychiatric illness. Zone II was the commonest site which was 20 cases [60.60%] Skin and soft tissue is the commonest structure involved which was 20 cases [60.60%]. 26 patients [78.78%] were discharge from ward after treatment. Proper assessment the cause and accurate treatment may prevent complication

[Evaluation of correlation between lifestyle and morbidity of Ischemic heart disease]

Cardiovascular diseases are the leading cause of 17,000,000 worldwide deaths annually. If the current trends continue, the number of deaths will increase to 25,000,000 by the year 2020. Lifestyle contributes to many chronic diseases such as coronary heart disease. The aim of this study was to examine the correlation between lifestyle and ischemic heart disease. This case-control study was carried out in Damavand sevvom sha'ban hospital. The sample of the study consisted of 65 cases [patients suffering from coronary artery disease] and 65 healthy controls. Data were collected by three questionnaires: General Health Questionnaire [GHQ], FFQ [Food Frequency Questionnaire] and physical activity questionnaire . These questionnaires were completed by interviewing the participants. Data were analyzed by SPSS software. There was a significant correlation between Age, Marital status, Smoking, Physical activity, diet and Mental health and ischemic heart disease. Insufficient physical activity, high fat and low fiber diet, inappropriate mental status were risk factors and major causes of in heart ischemia incidence

Fibrous dysplasia of mandible

An elderly male presented to the ENT, Outpatient Department at Abbasi Shaheed Hospital [ASH] with a mass on the left side of the face and lower jaw for 8-9 years. It was of a tennis ball size. No treatment was sought by him during those years. A diagnosis of benign fibro-osseous lesion of the mandible was made. Later the histopathology proved the same. The first occurrence in a male gender and involvement of the mandible is uncommon

Comparison of three different ceruminolytic agents [soda-bicarbonate, almond oil and normal saline] with respect to their efficacy

To compare the efficacy of three ceruminolytic agents for cerumen impaction with respect to its ease of complete removal via suctioning or probe. A comparative prospective study. This study was conducted carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi from November 2010 to March 2011. A comparative prospective study of 75 adult patients with cerumen impaction in either or both of the ears carried out at the outpatient department of ENT, Abbasi Shaheed hospital, Karachi. The study was done after taking the consent of the patients. All the adult patients of age 18 years or greater, of either sex with the symptoms in the ear[s] because of cerumen which was hard/dry and difficult to remove were included in the study. Those of age less than 18 years and not having any symptomatology because of the cerumen or with soft wax which was easy to clear were not included in the study. The study was carried out from November 2010 till March 2011. the patients with problematic, difficult to remove cerumen or cerumen impaction with symptoms were divided in to three groups: Groups A, Group B and Group c; all having equal number of cases that is 25 each. In group A they were given soda-bicarbonate in glycerin based ear drops; in group B almond oil and group C the normal saline for instillation in ear. The doses and timings for drops were equal in all the group and it was 3 drops in the affected ear every 6-hourly for 1-week. They were councilled that the dose should not be missed and they have to lay down for 5 minutes so that drops are absorbed and does not come out of the ear. After one week they were called in the OPD, was compared with completeness of removal of impacted cerumen for the three groups. Ease and completeness of cerumen removal was 80% in group A, followed by 60% for group C and 20% for group B. We found soda-glycerin to be superior to almond oil and normal saline as ceruminolytic agent

unusual foreign body in trachea

We report a very unusual case of foreign body [FB] in the tracheo-bronchial tract of a male child, who presented to us in the emergency department at our tertiary care centre with the complaint of FB in throat, cough bouts and choking sensation with pain and difficulty in breathing for whom an emergency rigid endoscopy was carried out after appropriate investigations

[Survey the knowledge, attitude and practice [KAP] and educational needs assessment of road traffic injuries among traffic police officers]

Road traffic injuries are a leading cause of death and disability worldwide. Determining knowledge, attitude and practice among traffic police about road traffic injuries, can improve the desired outcomes. Determination of KAP and educational needs assessment regarding road traffic injuries among traffic police officers. A descriptive study was conducted among 185 traffic police who was randomly selected from all traffic police officers list in 2008. Data was collected by using structural questionnaire [questionnaire was validated by content validity and reliability was determined by test re test r=0.8], after a formal consent by trained experts. Educational need assessment was determined by one open question. Scores was categorized due to statistical quartiles of the subject. Mean +/- SD of age, was 33.4 +/- 6.8 years. There was a significant deference about good knowledge between bachelor officers and other levels of education [p<0.01]. There was lowest rate about knowledge [0.6%] attitude [0.6%] and Practice [0.7%] in Ms Level in comparison with other levels. The rate of good knowledge 63% and good practice 76% was significantly difference among middle level officers [p<0.001]. There was significantly difference about good attitude between operational occupations with other occupations [p<0.005]. High priority allocated to improvement of scientific information about educational need assessment at the level of world. The findings showed; the traffic polices need to planning for improvement traffic injuries education especially in senior officers, MS and upper degree of officers. Suitable educational planning and its continuity is a key issue to reduction of traffic injuries reduction

Brown tumor of maxilla - a rare occurrence

We report a case of a middle age male patient who presented in our outpatient department at Abbasi Shaheed Hosptial [ASH] with a swelling at [L] half of face and [L] half of hard palate that histologically proved to be a Brown tumor of Maxilla with normal parathyroid hormone [PTH] levels and an elevated serum Ca[++] levels. The site of brown tumor in our case is a rarity. Our aim for presenting this case report is to highlight the rare site of presentation and to emphasize t he multidisciplinary approach incorporating the maxillofacial surgeons, endocrinologists and radiologists for the optimum patient care and management

Outcome as a measure of quality of care in oncology: experience at Sultan Qaboos University Hospital, Oman

Measurement of outcomes is increasingly employed as an indicator of the quality of clinical care. The most commonly measured outcome in many clinical studies, especially in oncology, still remains the overall survival rate. Sultan Qaboos University Hospital [SQUH], Oman, is striving for excellence through quality management. In seeking continual improvement, quality measurement exercises have been initiated throughout the Hospital. We present the overall survival rate of four of the ten most common cancers diagnosed in Oman. The cancers included non-Hodgkin's lymphoma [NHL], Hodgkin's lymphoma [HL], breast cancer, and stomach cancer. The studies were all retrospective and had been conducted previously. For present purposes, only the overall survival was compared with studies both from the region, and with bench-mark studies. For NHL, with a median follow-up of 8 months, the 2-year overall survival rate was 64%; 90% for low risk, 55% for intermediate risk, and 15% for high risk groups. For HL, the 5-year overall survival rate was 64%; 76% for low risk and 42% for high risk. For breast cancer, the 5-year survival rate was 67%; percentages were 88%, 75% and 59% for Groups I, II, and III respectively. For gastric cancer, the 5-year survival rate was 16.5%; 24% for the non-metastatic group. The outcome of patients with early stages and fewer adverse prognostic factors is comparable to what has been reported in the international literature; however, the outcome is inferior for patients presenting withadvanced stage disease and several adverse prognostic factors

Description and pathology of research development in Tabriz medical University

Research in medical science, as in all other fields of science, is necessary in order to maintain and improve the public health. This is achievable only by researchers and faculty members. This study is attempt to identify intra-organizational factors that influence research planning and related interventions in Tabriz Medical University. In this descriptive cross-sectional study, the study group included all faculty members and masters of science [equivalent to faculties] in Tabriz Medical University, of which 121 persons were selected randomly. Lickert style questionnaires were developed to evaluate and compare the attitudes toward project approval process, knowledge about research facilities, departmental cooperations in research, and researchers' capabilities in project execution. Data analysis was performed using SPSS software. During a 3 year period, each faculty member had, on average, supervised 5.17 dissertations, conducted 1.15 approved research projects, and had 3.4 presentations in domestic and 0.36 presentations in international conferences. Lack of time was the main problem in conducting research. Comparing faculties with and without research experience, there was significant differences in regard of access to research facilities [p<0.01], assessment of the benefits of research [p<0.02], and the level of research knowledge [p<0.02]; while no significant difference was found regarding motivations, job satisfaction, departmental cooperation, and expecting benefits from conducting research. According to the faculties' views, intra-organizational problems are less important than personal factors in performing research projects; i.e. the main obstacles for research were lack of time, and lack of competence in research methodology and problem-finding. Intra-organizational factors such as delay in project approval and lack of knowledge about research priorities are classified in the next levels

[Amplification of invA gene of Salmonalla by polymerase chain reaction [PCR] as a specific method for detection of Salmonellae]

To detect invA gene in Salmonella serotypes by PCR. Sixty Salmonella strains were isolated from animals and human sources. In this research, 60 isolated Salmonella from animals and human were tested by biochemical tests [such as carbohydrate utilization and urease] and then were serogrouped by Salmonella O antisera. The DNA of isolated Salmonella were extracted by Holmes and Quigley method. Two primers [St[139] and St[141]] and PCR reagents were used for amplication of invA gene. PCR reaction was carried out in Master cycler. The PCR products were loaded into 1.2% agarose gel and electrophoresed for 60 minutes at 120 V. All isolates showed biochemical properties of Salmonellae. In PCR assay, target gene [invA gene] with 284bp size were observed in all of strains, which is corresponded with size of positive control and DNA marker. So in this survey all strains had invA gene. According to the results of this study PCR method based on invA gene is useful for rapid identification of Salmonella serotypes

[Effect of clinoptilolite on hepatic lesions and serum biochemical parameters of chickens in experimentally induced aflatoxicosis]

Study of gross and histopathological lesions, relative weight changes of liver and kidney and biochemical parameters of chickens in experimentally induced aflatoxicosis. Experimental study. Three hundred and twenty one-day-old Ross broiler chickens. Linear model analysis and Duncan's method for mean values using SAS system. Chickens were categorized into 6 groups and fed with diets; without aflatoxin [group 1]; containing 2ppm of aflatoxin [group 2]; containing 2% of DM clinoptilolite. plus 2 ppm of aflatoxin [group 4]. Aflatoxin was produced by infecting the autoclaved rice with Aspergillus parasiticus NRRL-2999. After 21 and 42 days. Three chickens from each group were randomly selected, livers and kidneys weighed, tissues fixed in 10% neutral buffered formalin, sectioned [5 microm thickness] and stained with haematoxylin and eosin [H and E]. Blood samples were randomly collected in non-heparinized tubes from 12 birds at the end of third and sixth week of age in each treatment group. Serum analyzed for total protein, albumin, cholesterol, LDH,ALP and AST values. Relative weights of the livers and kidneys [g/100g.b.w.] in group 3 showed significant increase compare to control [p<0.05]. histopathological examination revealed mild fatty changes, mild fibrosis and bile ductule hyperplasia in portal regions of chicken in group 3. Serum cholesterol, total protein and albumin showed decrease in affected chickens with aflatoxicosis [p<0.05]. The toxin fed group had higher LDH and AST activity and lower ALP activity. The results suggest that clinoptilolite [2% of DM] effectively diminished the detrimental effects of AF on the liver and biochemical parameters of serum. There were no pathological changes in liver of chickens that received clinoptilolite [2%] in diet [group 3]

[Retrospective study of radiography in diagnosis of diseases and disorders in equidae]

To determine the frequency of diagnosed disorders or anomalies in different organs and systems and also effects of breed, age and sex on their incidence rate.Retrospective study.32 horses, 7 donkeys and 5 mules referred to the radiology division.Data were collected from 107 equidae radiographs which had been taken in the Department of Radiology University of Tehran during 4- years [1998-2001]. Radiographs were evaluated for finding injuries and showing relation of disease with breed, sex, age and site of injuries. Information was gathered in the specific charts for determining of frequency of each condition. Diseases and disorders were fractures, exostosis, osteomylitis, osteoarthrosis, arthritis, navicular syndrome, pneumonia, pulmonary hypervascularization, soft tissue swelling, laminitis, guttural pouches disease, abscess and calcification. Fractures [18.18%] and exostosis [18.18%] had the highest frequency in horses. The most frequent disorders were diagnosed in phalangeal area of horse [31.25%]. Furthermore, the first and second most frequent bone disorders in horses were exostosis [25%] and comminuted fracture [18.75%]. Fractures and guttural pouches disease were seen with equal frequency [25%]. In mule, fractures [60%], exostosis [20%] and soft tissue swelling [20%] were diagnosed.This study showed that radiography is a valuable method for diagnosing of equidae disordered organs and systems [in relation with factors such as sex, breed, ageandsite] andalsotheirfrequency

[Potential of radiography in diagnosis of diseases and disorders in cattle]

Objective: the aim of this study was to determine the frequency of diagnosed disorders or anomalies in different organs and systems and also effects of breed, age and sex on disorders incidence rate

Design: retrospective study on cattle radiographs

Animals: a total of 74 cattle referred to the radiology division

Procedure: data were collected of 17 lcattle radiographs, which had been taken in the division of radiology during a 4-year period between 1998-2002. Radiographs were evaluated for site of injuries and relation of breed, sex and age with disorders incidence rate. The information was finally gathered in charts specified for frequency of disorders, sex, age and breed

Results: the disorders were fractures, osteomylitis, arthritis, actinomycosis, pneumonia, colon atresia,OCD and etc.The most frequent disorder was fractures [16.7%] and sites of the fractures were at lower jaw [7.1%], midshaft of radius and ulna, and digits [each 4.8%].All the colon atresia cases were detected in male calves. Frequency of disorders in immature cattle [89.4%] had a very obvious difference with matures [10.6%].Actinomycosis was more in female

Clinical implication: this study showed the potency of radiography in diagnosis of cattle diseases and disorders and also percentage of incidence probability of them in connection with factors such as sex, breed, age and site in different organs and systems of cattle

causes of deafness and hearing impairment in cohorts at the Ida Rieu school, Karachi

This is a case control cohort study of comparable age, gender, socioeconomic and other multidirectional variables. The study was carried out in 334 children during the period between March and August 97, at the Ida Rieu Ear Institute in Karachi. The methodology comprised of collecting data based on a questionnaire filled by the parents. Clinical examination involved routine physical and thorough ENT examination. All subjects were evaluated through pure tone audiometry. The findings are comparable to the results of a previous study conducted in this school during the year 1991-93. In this study majority of children [76.64%] had profound hearing loss. Consanguinity, communicable diseases and ototoxicity seem to be the dominating factors

Nasopharyngeal angiofibroma: experience at civil hospital Karachi

Juvenile nasopharyngeal angiofibroma [JNA] is a common clinical entity seen in adolescent males in our country. JNA is although benign histologically but the clinical course and behaviour is comparable to malignant lesions. Surgical ablation has remained the treatment of choice. Our current approach in its management include computerized tomographic scan, digital subtraction angiography, super selective embolization and excision through lateral rhinotomy and medial maxillectomy approach. Presented here is our recent experience with 25 patients of nasopharyngeal angiofibroma treated surgically at the ENT Department, Civil Hospital, Karachi