ABSTRACT
Objective: To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre
Study Design: Retrospective study
Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from June 2007 to June 2017
Methodology: All patients who underwent oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicled flaps were included
Results: Thirty-two reconstructions were done, of which 16 [50.0%] were supraclavicular flaps, 12 [37.5%] were pectoralis major myocutaneous flaps [PMMF] and 4 [12.5%] platysma myocutaneous flaps [PMF]. Among these, 24 [75%] were males and 8 [25%] females. The mean hospital stay was 18.75 +5.45 days. Complications were noted in 12 [37.5%], salivary fistula being the most frequent found in 6 [18.75%]. Wound dehiscence was noted in 4 [12.5%], partial flap necrosis and wound infection present in 1 [3.1%] each
Conclusion: Oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicle flaps is still very useful and safe to perform, associated with minimal flap and donor site complications
ABSTRACT
Objective: To determine the frequency of side branch [SB] occlusion during percutaneous coronary intervention [PCI] with stenting of bifurcation lesions and to assess the predictors of side branch occlusion in local population. Study Design: Cross-sectional study. Place and Duration of Study: Cardiac Catheterization Lab, Rawalpindi Institute of Cardiology, Rawalpindi, from July 2016 to January 2017
Methodology: A total of 200 patients fulfilling the inclusion criteria were included in the study with non-probability consecutive sampling technique. Variables like diameters and lesion lengths of main vessel and side branch were recorded using quantitative coronary analysis software [QCA]. The SB occlusion was defined as <3 TIMI score following main vessel PCI with stenting. The data was analysed using SPSS version 21.0
Results: Mean age [years] of the study population was 52.27 +/-13.33 including 180 [90.0%] male and 20 [10.0%] female patients. SB occlusion was observed in 15 [7.5%] of cases. Mean SB diameter was significantly larger in cases without SB occlusion than those with SB occlusion [2.06 +/-0.09 vs. 2.17 +/-0.26, p=0.003]. Similarly, SB lesions were significantly shorter in length in those without SB occlusion than those with SB occlusion [3.53 +/-0.51 and 4.66 +/-3.11, p<0.001]. However, mean MV diameter [mm] and mean MV lesions length [mm] in both the groups were statistically not significant
Conclusion: Mean SB diameter and lesion length are useful predictors of SB occlusion during stenting of bifurcation lesions in the local population
ABSTRACT
Objective: To determine the efficacy of 0.2% brimonidine eye drops on control of intraocular pressure following Neodymium: Yttrium-Aluminum-Garnet [Nd: YAG] laser posterior capsulotomy. Study Design: Quasi experimental study. Place and Duration of Study: Study was conducted in department of Ophthalmology, Combined Military Hospital Peshawar of six months duration from Oct 2013 to Mar 2014
Material and Methods: A total of 182 patients were included in this study. One drop of 0.2% brimonidine one hour prior to laser treatment was instilled in the eyes of patients. Cornea was anaesthetized with topical 0.5% proparacaine hydrochloride. "Ocular instruments ® Abraham Capsulotomy YAG contact lens" was used along with Q-switched Zeiss VISULAS YAG III [Nd: YAG] laser system to make a hole of 3-4mm in the posterior capsule using minimum amount of total laser energy. Data were analyzed using SPSS version 15.0. Mean and standard deviation was calculated for numeric variables like age and intraocular pressure at different occasions. Frequency and percentage was calculated for categoric variable i.e. gender. Efficacy was stratified among age and gender to see effect modifiers
Results: The mean age of participants was 63.3 +/- 7.7 years. Out of 182 patients, 109 [59.9%] were male while remaining 73 patients [40.1%] were female. Brimonidine 0.2% eye drops proved effective in 162 patients [89.0%]. Stratification of age and sex with regard to efficacy of 0.2% brimonidine eye drops was carried out
Conclusion: The use of 0.2% brimonidine has been proven effective to counteract the IOP increase following Nd: YAG laser capsulotomy in this study
ABSTRACT
N-[Substituted]-5-[1-[4-methoxyphenylsulfonyl]piperidin-4-yl]-4H-1,2,4-triazol-3-ylthio] acetamide were synthesized by following conventional as well as microwave assisted protocol through five consecutive steps under theimpact of various reaction conditions to control the reaction time and the yield of product. Starting from 4- methoxybenzenesulfonyl chloride and ethyl isonipecotate, product 3 was obtained which was converted into product 4by treating with hydrazine hydrate. In step 3, the product 4 was refluxed with methyl isothiocyanate and KOH to yield compound 5 which was finally treated with variety of N-substituted acetamides to yield an array of different new compounds [8a-k]. These synthesized compounds were evaluated for their inhibition potential against bovine carbonic anhydrase [bCA-II], acetylcholinesterase [AChE] and butyrylcholinesterase [BChE] enzymes. Compound 8g demonstrated good activity against bCA-II, AChE and BChE with IC50 values of 8.69 +/- 0.38 MuM, 11.87+/-0.19 MuM and 26.01+/-0.55 MuM respectively. SAR studies assisted with molecular docking were carried out to explore the mode of binding of the compounds against the studied enzymes
ABSTRACT
Objective: To determine the frequency of side branch [SB] occlusion during percutaneous coronary intervention [PCI] with stenting of bifurcation lesions and to assess the predictors of side branch occlusion in local population
Study Design: Cross-sectional study
Place and Duration of Study: Cardiac Catheterization Lab, Rawalpindi Institute of Cardiology, Rawalpindi, from July 2016 to January 2017
Methodology: A total of 200 patients fulfilling the inclusion criteria were included in the study with non-probability consecutive sampling technique. Variables like diameters and lesion lengths of main vessel and side branch were recorded using quantitative coronary analysis software [QCA]. The SB occlusion was defined as <3 TIMI score following main vessel PCI with stenting. The data was analysed using SPSS version 21.0
Results: Mean age [years] of the study population was 52.27 +/-13.33 including 180 [90.0%] male and 20 [10.0%] female patients. SB occlusion was observed in 15 [7.5%] of cases. Mean SB diameter was significantly larger in cases without SB occlusion than those with SB occlusion [2.06 +/-0.09 vs. 2.17 +/-0.26, p=0.003]. Similarly, SB lesions were significantly shorter in length in those without SB occlusion than those with SB occlusion [3.53 +/-0.51 and 4.66 +/-3.11, p<0.001]. However, mean MV diameter [mm] and mean MV lesions length [mm] in both the groups were statistically not significant
Conclusion: Mean SB diameter and lesion length are useful predictors of SB occlusion during stenting of bifurcation lesions in the local population
ABSTRACT
Objective: To compare the efficacy of ondansetron with a combination of ondansetron and dexamethasone after elective laparoscopic cholecystectomy in terms of postoperative nausea and vomiting
Study Design: Randomized controlled trial
Place and Duration of Study: Department of Surgery, Combined Military Hospital Rawalpindi Pakistan, from Apr 2014 to Mar 2015
Materials and Methods: Two hundred and twenty two patients fulfilling the inclusion criteria were selected for study and divided into two groups of 111 each. Group A was given ondansetron while group B was given combination of ondansetron and dexamethasone at induction of general anesthesia. Patients of both groups were observed at 24 hours postoperatively for nausea and vomiting
Results: Sixty six patients in group A had nausea as compared to 50 patients in group B [p-value 0.03], 46 patients in group A had vomiting as compared to 19 patients in group B [p-value <0.001], showing statistically significant difference between the two groups
Conclusion: Postoperative nausea and vomiting is significantly lower in ondansetron and dexamethasone combination group as compared to ondansetron alone group after elective laparoscopic cholecystectomy
ABSTRACT
Objective: To determine the success rate of intrauterine balloon tamponade versus B Lynch suture in the management of severe postpartum hemorrhage
Study Design: Randomized controlled trial
Place and Duration of Study: This study was conducted in department of Obstetrics and Gynaecology, Combined Military Hospital, Bahawalpur, from Jan 2017 to Jun 2017
Materials and Methods: A total of 104 patients with severe postpartum hemorrhage, 20 to 35 years of age of gestational age 36-42 weeks were included in the study. Patients with genital tract trauma, retained products of conception, ruptured uterus and any bleeding disorderwere excluded. Then selected patients were placed randomly into group A [intrauterine balloon tamponade] and group B [B Lynch suture] by using lottery method. Outcome variables like control of bleeding within 15 minutes after procedure [success rate] was noted
Results: The mean age of women in group A was 27.69 +/- 3.68 years and in group B was 27.60 +/- 3.65 years. The mean gestational age in group A was 39.98 +/- 1.57 weeks and in group B was 40.04 +/- 1.68 weeks. Success was 67.31 percent in group A [intrauterine balloon tamponade] and 88.46 percent in group B [B Lynch suture] with p-value of 0.009, showing statistically significant difference between the two groups
Conclusion: This study concluded that success rate [stoppage of bleeding within 15 minutes] of B Lynch suture is better as compared to intrauterine balloon tamponade in the management of severe postpartum hemorrhage and should be used as first line procedure in controlling severe PPH
ABSTRACT
Background: Exclusive breast feeding is essential for baby's health
Objective: To determine the factors associated with failure of exclusive breast feeding
Methodology: Study design: Cross - sectional study. Place and duration of study: The study was carried out in Pediatric department of Sheikh Zayed Hospital, Rahim Yar Khan, from 1 July 2015 to 30 June 2016. This study was conducted on five hundred women having infants up to 6 month of age and not on exclusive breastfeeding. A questionnaire was designed and data was collected through interviewing infant's mothers about various risk factors including maternal education, socioeconomic status, maternal employment status, family type, maternal separation, social myths, number of children, mode and place of delivery, maternal systemic illness, maternal breast condition, birth spacing, and counseling for breast feeding. The data was entered and analyzed by SPSS version 16
Results: Our study showed that among mothers having lack of exclusive breast feeding practice, following factors were found including lower socioeconomic status in 51.2%, joint family system 75.8%, male sex of infant in 62.8%, use of water up to 4 months is good in 64%, mother thinking that milk is not good in 29.2% and to familiarize baby to top feeding in 78.4%. Study showed that place of delivery was private clinics in 55.4%, caesarean section in 37.6% of and 73.4% of caesarean sections as mode of delivery took place at private clinics. Pathological maternal breast conditions [engorgement, sore or cracked nipples, abscess] were found in 36.6% and maternal systemic illness in 19.2%. It was found that proper counseling of mothers for exclusive breast feeding was done among 20.8%, at antenatal visits and 37.2% after delivery
Conclusion: Our study showed that among mothers not practicing exclusive breast feeding, most of these belonged to lower socioeconomic status, not employed, living in joint family system, and having social myths like use of water up to 4 months and to familiarize baby to bottle feeding. It was also found that pathological maternal breast conditions and lack of counseling, antenatally and postnatally were also important risk factors
ABSTRACT
Paraneoplastic syndromes are rare disorders that are triggered by an altered immune system response to neoplasm. Paraneoplastic syndromes may be the first or the most prominent manifestations of cancer. Wilm's tumor is the most frequent pediatric renal malignancy and usually presents with abdominal mass. Unusual presentations like acquired von Willebrand disease, sudden death due to pulmonary embolism and Cushing syndrome have been described in the literature. Cushing syndrome, as the presenting symptom of a malignant renal tumor in children, is a very rare entity. Few case reports are available in the literature exploring the option of preoperative chemotherapy as well as upfront nephrectomy. We report a rare case of paraneoplastic Cushing syndrome due to a Wilm's tumor. Based on gradual decrease of postoperative weight, blood pressure, serum adrenocorticotropic hormone, and plasma cortisol levels, along with histological confirmation of Wilm's tumor, paraneoplastic Cushing syndrome due to Wilm's tumor was confirmed
ABSTRACT
Objective: to assess the outcome of dorsal metacarpal artery perforator flap for coverage of finger defects extending up to distal interphalangeal joint [DIPJ]
Study Design: case series
Place and Duration of Study: Jinnah Burn and Reconstructive Surgery Centre, Lahore, from March 2015 to May 2017
Methodology: our study was carried out in two parts. 1st part of study was to measure average flap length in our population. Five hundred cases were enrolled to measure flap length, from pivot point of the flap to the distal border of extensor retinaculum. This length was traced to fingers to determine its coverage area. This was followed by clinical study in 35 cases. All patients with wounds over dorsal surface of fingers up to distal interphalangeal joint and volar surface of fingers up to mid of middle phalanx, single or multiple finger defects with exposed tendon joints or bones were included in the study. Patients with history of trauma to the dorsum of hand, metacarpal head or neck fracture and patients with history of diabetes or peripheral vascular disease were excluded
Results: flap length decreased from radial to ulnar side of hand. Average length of flap based on the second metacarpal artery was 7cm while of the third was 6.6 cm and the fourth was 6.1 cm. This flap length covered up to mid of middle phalanx in border digits while up to PIPJ in central digits. This data was confirmed in 35 patients in whom 36 flaps were raised to cover finger defects. Thirty-four flaps survived completely while tip necrosis was seen in 2 cases
Conclusion: the dorsal metacarpal artery perforator flap is a thin, pliable flap, which has minimal donor-site morbidity. It can reliably cover soft tissue defects of dorsum of fingers up to mid of middle phalanx in border digits and up to PIPJ in central digits
ABSTRACT
Objective: To determine the diagnostic accuracy of serum IgA anti-tissue transglutaminase antibody in the diagnosis of celiac disease taking histopathology as gold standard
Study Design: Cross-sectional survey
Place and Duration of Study: This study was conducted at the department of Pediatrics, Military Hospital Rawalpindi from April 2015 to July 2016
Patients and Methods: Ninety-five consecutive children presenting with suspicion of celiac disease were included in this study after taking written informed consent. A predesigned proforma was used to record patient's demographic details. Anti-tTG level of >/=25 U/ml was taken as diagnostic of celiac disease while results of histopathology on endoscopic biopsy were taken as gold standard
Results: The mean age of the patients was 6.48 +/- 3.20 years and majority [n=53, 55.8%] of the children were aged between 5 to 10 years. The serum anti-tTG level ranged from 8.0 U/ml to 759.0 U/ml with a mean of 298.75 +/- 225.51 U/ml. Taking a cut-off value of >/=25 U/ml for anti-tTG, 81 [85.3%] children were suspected of celiac disease. Histopathology of endoscopic biopsy confirmed celiac disease in 68 [71.6%] children with 62 true positive, 19 false positive, 6 false negative and 8 true negative cases. It yielded 91.18% sensitivity, 29.63% specificity and 73.68% accuracy for anti-tTG [>/=25 U/ml] in the diagnosis of celiac disease with positive and negative predictive values of 76.54% and 57.14% respectively
Conclusion: IgA anti-tissue transglutaminase antibody [>/=25 U/ml] was found to be highly sensitive test for the detection of celiac disease in children
ABSTRACT
Objective: This study was designed to determine the frequency of lateral open bite and its gender distribution among the patients visiting Orthodontics department of de.Montmorency College of Dentistry, Lahore
Methodology: This cross sectional study was carried out at department of Orthodontics, de.Montmorency College of dentistry, Lahore, where orthodontic records of 200 patients were included to find out frequency of lateral open bite [LOB]. The amount of LOB was confirmed by measuring vertical distance between cusp tips of posterior teeth affected by lateral open bite, with standardized digital vernier calipers on plaster models
Results: 200 patients were included [98 boys, mean age: 19.3 +/-1.3 years; 102 girls, mean age: 19.0 +/- 1.5 years] The frequency of lateral open bite was found to be 1%. Male to female ratio was 1:1
Conclusion: It was concluded that male and female were equally affected by lateral open bite and frequency was find out to be 1%
ABSTRACT
Background: hypothyroidism is one of the common complications among beta thalasemia
Objective: to determine the frequency of hypothyroidism in patients of beta thalassemia major in Thalassemia center, Rahim Yar Khan
Methodology: study design: Single center cross-sectional study. Place and duration of study: This study was carried out in "Thalassemia Center", Sheikh Zayed Hospital, Rahim Yar Khan over a period of one year from 1[st] January to 31[st] December 2015. This study was carried out on 144 patients of thalassemia major aged 5-16 years. The data was collected regarding demographic variables, serum ferritin, T4 and TSH and duration of transfusion. The data was entered and analyzed by using SPSS version 19
Results: hypothyroidism was found in 45 [31.2%] patients. Of these, 42 [93.3%] had sub clinical hypothyroidism [normal T4 level with elevated TSH] whereas only 3 [6.7%] patients has overt hypothyroidism [decreased T4 level with elevated TSH]. Frequency of hypothyroidism has significant association with patient's age and duration of transfusion
Conclusion: sub clinical hypothyroidism occurs in a significant proportion of thalassemia major patients. Frequency of hypothyroidism has significant association with age and duration of transfusion. Regular follow-up of thalassemic patients to detect and timely treat such complication could improve the quality of life of these patients
ABSTRACT
Objective: To determine the CT patterns of temporal bone cholesteatoma in patients presenting with chronic discharge from ear
Methodology: This was a cross-sectional study conducted at Department of Radiology, Rehman Medical Institute Peshawar from January 2013 to June 2014. 78 patients with chronic discharging ear, who were referred from E.N.T outpatient department, were included in the study. All scans were performed on 128 slice Multidetector Computed tomography [MDCT] scanner.O.Smm reconstructed images in bone window and 3mm images in soft tissue window were viewed on 5.1 vitrea workstation in axial, coronal and sagittal planes. The CT studies were correlated with clinical examination findings, surgical and histopathology. Basic radiologic patterns of cholesteatoma described on CT scan were assessed. The data was processed using Microsoft excel 2007
Results: Cholesteatoma was present in 48 [61%] cases. The disease was bilateral in 7 cases [14 %], 39 [81 %] were unilateral. 25 [52%] were left sided and 14 [29%] right-sided. 24 [30 %] patients were characterized as having otomas-toiditis whereas 7[8%] patients were radiologically difficult to characterize if they were cholesteatoma or not
Conclusion: Cholesteatomas can cause bone erosions and should be detected early. The important role of MDCT lies in the early detection of cholesteatoma, and more conservative surgical procedures can be used to eradicate the disease
ABSTRACT
Ingestion of multiple magnets can cause serious complications in children. A 6-year-old boy presented with clinical features of partial gastric outlet obstruction secondary to ingestion of multiple magnets. On exploration, six magnets were retrieved from stomach. The patient is doing fine thereafter
ABSTRACT
Objective: To find out serum zinc level in healthy pregnant women and pre-eclemptic pregnant women
Study Design: Ramdomized controlled trial study
Place and Duration of Study: This study was conducted at Department of Pathology, Lady Willingdon Hospital, Lahore and at Lahore College for Women University, Lahore from March 2015 to September 2015
Materials and Methods: Size of sample was determined statistically by using table and119 [102 experimental group[51 pre-eclamptic pregnant women and 51 normal pregnant women] and 17 control group] blood samples were collected randomly
Results: The average zinc concentration in healthy pregnant group was found 1.44 +/- 0.14 mg/l as compared to pre- eclamptic pregnant group 0.25 +/- 0.02 mg/l. In pregnant women average zinc concentration was found to be decreasing with trimester. The average systolic blood pressure in healthy pregnant women was 113.83 +/- 1.74 mm/Hg as compared to the pre-eclamptic pregnant women was 145.34 +/- 1.68 mm/Hg. Average diastolic blood pressure in healthy pregnant women, was found 75.23 +/- 1.46 mm/Hg as compared to pre-eclamptic pregnant women, which was 92.76 +/- 1.80 mm/Hg
Conclusion: Zinc level in the blood serum of pre-eclamptic pregnant women was found lower as compared to healthy pregnant women. Low blood serum zinc level is associated with the elevated systolic and diastolic blood pressure also
ABSTRACT
Objective: To compare the efficacy of early oral feeding and conventional oral feeding in elective intestinal stoma reversal in terms of mean number of days of NG tube out and hospital stay. Study Design: Randomized Controlled Trials. Settings: Surgical Units of Allied/DHQ hospitals Faisalabad. Duration of Study: 1 year duration from February 2014 to January 2015. Sampling Technique: Non-probability consecutive sampling
Methodology: 60 patients were selected from OPD. Patients were randomly allocated to two groups. All stomas were closed in single layer extramucosal seromuscular fashion, intraperitonealy. In post-operative period, patients in group I were allowed oral feed in early post-operative period [6-8 hours] after the surgery. Initially, oral liquids [30ml/hr] was given and patients were observed for nausea and vomiting. Oral feed was increased gradually with the response of the patient with semi-solid to solid diet on 1[st] or 2[nd] post-operative day. Patients in group II were started oral sips of liquids once they pass flatus or audible bowel sounds. At least two follow up visits were advised within two weeks of discharge of patients, 1[st] on the 7[th] day and 2[nd] on the 14[th] day, for removal of skin stitches
Results: Out of 60 patients 37 [61.7%] were males and 23 [38.3%] were females. Among the variables under the study, for both groups, the minimum total number of days of nasogastric decompression was 0 days and maximum total number of days of nasogastric decompression was 5 days with mean of 1.17 days and standard deviation of 1.33. In group 1, the mean of the total number of days of nasogastric decompression was 0.13 +/- 0.35 days and in group 2, the mean of the total number of days of nasogastric decompression was 2.20 +/- 1.13 days with p-value of 0.0001 for both the groups, the minimum total number of days of hospital stay was 3 days and the maximum was 9 days, with mean of 4.82 days and Std. Deviation of 1.70 days. In group 1, the mean of the total number of days of hospital stay was 3.37 +/- 0.61 days and in group 2 the mean of the total number of days of hospital stay was 6.27 +/- 1.08 days with p-value of 0.000
Conclusion: Early oral feeding in cases of elective intestinal stoma reversal is better than conventional oral feeding in terms of number of days of nasogastric decompression and hospital stay
ABSTRACT
Objectives: To determine damage of RLN with and without exposure during thyroidectomy. Study design: Randomized control study Sampling technique: Non-probability consecutive sampling. Sample size: 150 patients. Setting: Surgical units of Allied Hospital Faisalabad
Methodology: With informed consent, study was conducted on two groups[75 in each group].Patients were distributed on alternate basis into group A and group B for thyroidectomy with and without identification of RLN respectively
Results: In group A 30[40%] patients were between 31-40 Years and 18[24%] between 41-50 Years. In group B 32[42.7%] were between 31-40 Years,13[17.3%] between 41-50 Years and 15[20%] between 50-60 Years. Mean of age was 38.5 +/- 10.9[standard deviation].In group A,28[37.3%] were male and 47[62.7%] females while in group B 25[33.3%] were males and 50 [66.7%] females. In group A 38[50.7%] patients were of MNG, 10 [13.3%] diffuse goiter, 7[9.3] solitary nodules, 13 [17.3%] suspicion of malignancy and 7[9.3%] malignanacy. In group B 33[44%] patients were having MNG, 15[20%] diffuse goiter, 10[13.3%] solitary nodule, 6[8%] suspicion of malignancy and 11[14.7%] malignant disease. In group A 39[52%] patients underwent STT, 20[26.7%] NTT, 10[13.3%] TT and 6[8%] hemi-thyroidectomy. In group B 35[46.7%] patients underwent STT, 21[28%] NTT, 12[16%] TT and 7 [9.3%] hemi-thyroidectomy. In group A 3 [4%] patients developed transient paralysis and 1[1.3%] permanent paralysis of RLN. In group B 7[9.3%] patients developed transient paralysis and 3[4%] permanent paralysis of RLN
Conclusion: Preservation of RLN is more likely with exposure and identification of RLN post-operatively
ABSTRACT
Background: Chronic suppurative otitis media [CSOM] is one of the common diseases in routine ENT practice
Objective: To compare the efficacy of topical ciprofloxacin with oral ciprofloxacin 500mg twice daily in achieving dry ear [Medical cure] in Tubo-tympanic type of Chronic suppurative otitis media
Methodology: Study Design: Quasi-experimental study. Place and Duration of Study: The study was carried out at ENT department of Bahawal Victoria Hospital Bahawalpur from 01 January to 30 September 2015. One hundered patients, 11 to 60 years of age of either gender having Tubo-tympanic type of chronic supportive otitis media were included. Patients with previous antibiotic treatment, pregnant or lactating women, history of hypersensitivity to Quinolones [ciprofloxacin], chronic suppurative otitis media of Attico-antral type, known case of DM and hypertension were excluded. Selected patients were divided into two groups [Group A and Group B] by using lottery method. Group A [n=50] was given Ciprofloxacin ear drops and Group B [n=50] was given Oral Ciprofloxacin 500mg twice daily. The patients were followed up to 08 weeks after treatment [at least two follow up visits] and examined otoscopically and under microscope to assess the efficacy. The efficacy of drugs was graded into four grades depending upon the decrease in discharge amount [Poor/no response, satisfactory, good and excellent]. The data was entered and analyzed by using SPSS version 20
Results: The mean age of group Apatients was 27 +/- 5 and in group B was 30 +/- 5 years. Males were 67 [67%] and females were 33 [33%] with ratio of 2:1. Bilateral CSOM in 27 [27%] and Unilateral was found in 73 patients [73%]. Efficacy was excellent in 52%, good in 24%, satisfactory in 8% and poor/ no response in 11% patients of Group A while it was excellent in 36%, good in 24%, satisfactory in 1% and poor/no response in 30% patients of Group B
Conclusion: This study concluded that Topical ciprofloxacin is more effective than oral ciprofloxacin in the medical treatment of tubo-tympanic type of CSOM to obtain dry ear