ABSTRACT
Objective: this article discusses etiopathogenesis, diagnostic problems and various management modalities available to manage skull base osteitis [SBO] which is a rare but life threatening disorder and in addition national and international references will be reviewed
Material and Methods: cross sectional, retrospective study carried out at ENT unit-SIMS/SHL which included 17 patients with SBO which were sorted out for etiological diagnosis based on detailed history, physical examination and labs
Results: mean age was 52 years. Diabetes is the most significant risk factor and was seen in 82% of patients, pseudomonas was isolated in 8 patients. The main complication facial paralysis was present in 64% of patients
Conclusion: SBO remains a severe debilitating and life-threatening condition. It may develop in patients with benign otitis media and externa, and must be considered in all patients with temporal bone inflammation; especially those with risk factors and those who fail to improve with more conservative measures. Small-vessel vasculopathy and immune dysfunction associated with diabetes are primarily responsible for this predisposition. Cranial nerves most commonly the facial, can be affected by inflammation along the skull base or by a neurotoxin produced by Pseudomonas species. We, in this article, intend to share our experience in managing seventeen patients with SBO over a period of three years and review the relevant and recent global literature suggesting updates
ABSTRACT
Background: Post operative pain management is an important task, which requires proper training, knowledge of opioid, non opioid and local anesthetic pharmacology, as well as the understanding of pain pathways and mechanism
Objective: To compare the analgesic efficacy of ketorolac and diclofenac sodium during postoperative period
Patients and methods: This experimental study was carried out in Gynaecology Operation Theatre, Nishtar Hospital, Multan during the period from January 2009 to December 2009. A total of 60 patients were included in the study. The patients were divided into two equal groups [30 patients in each group] using non-probability convenience sampling technique
Results: Lower pain score was noted in recovery room after IN ketorolac Group-A than after 1/M diclofenac sodium Group-B. 27 out of30 patients experienced no pain. Some [3] had mild pain and none had severe pain after IN ketorolac, whereas after 1/M diclofenac, proportionately greater number had mild [7] to severe pain [3] and fewer [20] had no pain. Difference between the mean pain score was statistically significant, in group A mean pain score was 1.5 and 2.6 in group B. The time interval for first request for analgesia postoperatively after awakening from anaesthesia was greater in group-A [90 minutes] than group-B [60 minutes]. The number of doses required was also less [2] in this group than in those who received diclofenac sodium [5]
Conclusion: It is concluded that the patients who received ketorolac IN [Group-A] had longer pain free time interval and request for first analgesic supplement was made after 90 minutes compared to a shorter interval of 60 minutes in group-B, who received intramuscular diclofenac sodium and mean pain score was significantly lower in IV ketorolac group. [P<0.05]
ABSTRACT
Chronic malnutrition is one of the major causes of morbidity and mortality among preschool children and the future productivity of nations. To understand the prevalence of chronic malnutrition and to identify the factors affecting height-for-age z-score (HAZ) among preschool children, a cross-sectional study was conducted among 380 randomly-selected children aged less than five years in Dhaka city, Bangladesh. Results of analysis of this study data revealed that the prevalence of stunting among preschool children in Dhaka city was 39.5%, with 25% severely stunted and 14% moderately stunted (p<0.001). Results of bivariate analysis revealed that socioeconomic and demographic factors were most significantly associated with the stunting of children. Children were found to be well-nourished if their parents had a tertiary-level education or higher and if the mother held a job and had good knowledge of nutrition. Well-nourishment of the children were also associated with the height of mothers (above 148 cm), good family educational background, normal birthweight, greater frequency of food intake (more than six times/day), and fewer fever episodes in the last six months. Results of multivariate linear regression models showed that height of mothers, birthweight of children, education of fathers, knowledge of mothers on nutrition, and frequency of feeding were the most significant factors that had an independent and direct influence on the stunting of children. To achieve the Millennium Development Goal target of 34% malnutrition prevalence by 2015, it is important to have specific government intervention to focus on the causes that directly influence the stunting of children.