ABSTRACT
Juvenile nasopharyngeal angiofibroma [JNA] is an uncommon tumor constituting less than 1% of all head and neck tumors. Tumor has an aggressive local behavior if left untreated. Surgery is the mainstay of treatment with no common consensus on a single approach. Tumour stage and surgical approaches are the major determinants of tumour recurrence. To evaluate the influence of stage of tumor in recurrence in nasopharyngeal angiofibroma. Descriptive study. Department of ENT and Head and Neck Surgery, PIMS, Islamabad and Ayub medical institution, Abbottabad. Jan 2010 to Jan 2014. Consisting of 34 diagnosed cases of nasopharyngeal angiofibroma. CT-scan was done in all patients and were treated surgically except one patient who was irradiated. All patients were followed up for one year. Among 34 patients, 24 patients were classified as stage III, 4 were in stage II and 5 were in stage IVa and one in stage IVb. 17.6% [6/34] of patients had disease recurrence. Stage IVb was treated by radiotherapy while the rest were treated surgically. Patients were followed up for one year both by clinical examination and imaging. Recurrence was found in 5 operated patients and residual disease in stage IV b. 1 [20%] patient of stage Iva disease and 4 [16%] patients of stage III disease had disease recurrence. Disease recurrence/ residual is directly related to the tumour stage in nasopharyngeal angiofibroma
ABSTRACT
Concern about the grim nature of postoperative acid aspiration syndrome grew among the anesthesiologist over the years warranting the need for preemptive intervention. The aim of the study is to compare the effects of preoperative oral ranitidlne versus pantoprazole given in regulating gastric pH in elective surgery. This prospective, parallel group, controlled, randomized, single-blind study was conducted at a tertiary care postgraduate teaching institute at Kolkata, involving 120 participants of either sex, aged 18-60 years of American Society of Anesthesiologists physical status I and II, who were scheduled for elective surgery under general anesthesia lasting for more than 2 h. The participants were divided into three groups. In group A [n = 40] participants received placebo tablet, in group B [n = 40] participants received ranitidine tablet while in group C [n = 40], participants received pantoprazole tablet and their gastric pH estimated serially. The participants in the three groups were comparable in terms of age, sex, body weight, duration of surgery and type of surgery distribution. In regard to changes in gastric pH trends, there was no statistically significant difference between serial pH values in group A [Friedman test; P>0.05] and group C participants. [P>0.05]. However, the mean preoperative gastric pH values [7.140 +/- .7652] were significantly lower than mean pH values [7.253 +/- .7514] after 2 h postoperatively in group B participants [P<0.05]. From the observations and analyses of the present study, it can be inferred that ranitidine is more effective than pantoprazole to raise the gastric pH for prevention of aspiration pneumonitis