ABSTRACT
Background: To compare the post operative ostial patency at the rhinostomy site in the patients undergoing the primary endoscopic dacryocystorhinostomy, using Mitomycin-C application and Merocel packing. Methods: The patients visiting the Otorhinolaryngology out patients department at the tertiary referral hospital were included in this study. The study was prospective in nature and comprised of 50 patients suffering from primary dacryocystitis. Endonasal endoscopic dacryocystorhinostomy was done in the patients suffering from the chronic dacryocystitis with postsaccular obstruction of lacrimal system. The patients were divided in two equal groups containing 25 patients in each group. In first group (Group- A) Mitomycin-C (0.5 mg/ml for 15 min) was locally applied at the rhinostomy site and nasal cavity was packed with bactigras after the surgery, whereas in the second group, nasal cavity was packed with Merocel after reposition of the flap without application of any drug. Follow up was done every week in the first month, then monthly till the six months after the surgery. The post operative results were compared in terms of ostial patency at the rhinostomy site at one month, three months and six months of follow up. The surgical technique used remained same throughout the period of study. Results: The post operative ostial patency of rhinostomy stoma was better in the group of the patients undergoing application of Mytomycin-C at the rhinostomy site as compared to the packing of the nasal cavity with Merocel. The difference between both the groups was statistically significant. The rhinostomy created was free from synachiae and granulation tissue formation on follow up examination in the group of the patients having application of Mitomycin-C at the time of surgery. Ultimately the ostial patency was better in the patients having application of Mitomycin-C. Conclusion: Mitomycin-C has statistically significant beneficial effect in the maintenance of ostial patency after primary endonasal endoscopic dacryocystorhinostomy as compared to the merocel packing alone after the surgery.
ABSTRACT
A cross-sectional study was conducted to determine the prevalence, causes and outcome of head injury in children at Neurosurgery Department of Jinnah Postgraduate Medical Centre from 1st December, 2013 to 1st February, 2014. A total of 37 patients under the age of 12 years, presented with head injuries to the emergency department, were included in the study. A self-designed questionnaire was filled for these children after getting the oral consent from their parents. The questionnaire comprised a complete detail on the causes of head injury, clinical presentation on reaching the hospital, X-rays and Computed Tomography [CT] scans of the children and their reports. SPSS version 20 was utilized as an analytical tool. The mean age of patients was 6.93 years +/- 3.02. Out of these 37 patients, 54.1% were males and 45.9% were females. Road traffic accidents accounted for most of cases [48.6%] with marked peak observed in boys as compared to the girls. Majority had a good Glasgow Coma Scale [GCS] score [43.2%] whereas a depressed fracture was found to be the dominant feature [21.6%] on X-rays. Additionally, 29.7% of children had intracranial hemorrhage while 32.4% also acquired other injuries. In total 29.7% were offered surgical intervention with majority [83.8%] landing in neurosurgical ward. As head injury in childhood is an important issue, keeping in view the lack of research in this field we need to properly highlight the burden of such injuries in childhood so that all the concerned governing authorities should take every possible step in preventing as well as managing this devastating health concern
ABSTRACT
A case of transverse testicular ectopia of the left testis is hereby reported. A 5-year-old boy presented in surgical outpatient department with right inguinal hernia and impalpable testis in left scrotum and inguinal canal. Right herniotomy was performed. Left testis was found in right superficial inguinal pouch and brought to the left scrotum through transceptal window