Analysis of patients in otolaryngology department at Muzaffarabad hospitals

Objective: To assess the work load of the department in terms of individual disease

Study Design: Descriptive study

Place and Duration of Study: This study was conducted at Ear, Nose and Throat [ENT] Department of Shaikh Khalifa Bin ZayedAl Nahyan, Hospital Combined Military Hospital [CMH] Muzaffarabad from Jan 2011 to Jan 2012

Material and Methods: Total of 710 patients was admitted in ENT ward in one-year duration for various pathologies. For easy analysis, they were divided into groups according to the region involved by disease

Results: Two hundred and eighty-five cases [40.14%] were admitted with pathologies of nose and para nasal sinuses making the highest percentage among the groups. The second major group was otology comprising of one hundred and fifty-six [21.97%] cases. One hundred and three [14.50%] cases were from pathologies in oral cavity. Thirty [4.22%] cases from skull base, thirty [4.22%] pathologies of larynx, trachea and bronchi, forty [5.63%] cases were from hypopharynx and esophagus, twenty-four [3.38%] cases were from salivary gland pathologies. Twenty-one [2.95%] cases were from neck region. Tumors were 4[0.56%] and neurological cases were 11 [1.54%] of the total number of cases

Conclusion: Self-analysis/ audit at departmental level greatly enhances the working efficiency of a department and is essential for betterment of the patient and education of trainees as one gets a fair idea about the prevalence of disease in a community and can thus direct the resources accordingly

Correction of caudal septal deviations via closed rhinoplasty approach

Objective: To introduce the combined technique of nasal spine stitching and partial tongue-in-groove for the management of caudal septal deviation and to evaluate the surgical outcome and its efficacy

Study Design: Quasi-experimental study

Place and Duration of Study: Ear, nose and throat [ENT] Department Combined Military Hospital [CMH] Lahore from September 2013 to February 2015

Material and Methods: Ninety three patients with caudal deviation were included in the study. Caudal septal deviation was corrected employing both Modified Kriedel's and Pastorek's technique via endonasal approach. Nasal patency was determined using the alpha-version of "Nasal Obstruction Symptom Evaluation" [NOSE] Scale

Results: NOSE Scale scores were checked pre operatively and three weeks post surgery. Post operatively 88 [94.6%] patients had satisfactory nasal patency [NOSE Scale score fell by 15 points]. Five [5.4%] patients who did not have satisfactory score had revision surgery

Conclusion: Combination of Pastoreks's and Kriedel's technique gives accurate correction of caudal dislocation

Relationship of chromium toxicity with diabetes mellitus and chronic renal failure

To assess the association between diabetes mellitus and chronic renal failure with toxic effects of chromium on the onset of the Chronic Kidney disease. A prospective cross sectional study. This study was carried out at the Jinnah Post graduate Medical Centre and Kidney Centre Karachi during December 20 12 to December 20 13. The present study was conducted on a total of 150 patients [age > 40 years] divided into three groups. Patients in Group I included 50 patients with diabetes mellitus type 2 whereas Group II included 50 patients with diabetes mellitus associated with chronic renal failure [CRF] and Group III consisted of 50 healthy controls. Results showed that levels of fasting blood sugar and HbAlc in both group I and group II were significantly high where as it was lower in controls. Serum urea [125.2 +/- 32.49] and creatinine [7.3 +/- 1.41] levels in patients with DM with CRF were significantly high as compared to patients with DM only and control group. The Creatinine clearance [55.1 +/- 9.61] in patients with DM with CRF was decreased in comparison with DM patients and control group. Serum chromium levels were significantly high in patients with DM with CRF and in patients with DM. Serum chromium level showed significant correlation with glycemic index when the two groups including DM patients and patients with DM accompanied with CRF were compared with the controls, while correlation with renal failure was significant only in group II patients

Lead, hypertension, and chronic renal failure

Chronic kidney disease [CKD], a condition frequently attributed to uncontrolled diabetes and hypertension, has become an economic and public health burden both globally and locally. The present study was designed to investigate the toxic effects of lead and hypertension [HTN] on chronic renal failure [CRF]. It was a cross-sectional, prospective study conducted in Jinnah Postgraduate Medical Centre, Karachi. A total of 150 adults aged >40 years were included, 50 were diagnosed patients of hypertension, 50 were diagnosed patients of hypertension with chronic renal failure, and 50 were normal healthy individuals. Levels of lead in blood samples of HTN and CRF patients were estimated besides the levels of HbA1c, glucose, urea, creatinine and antioxidant enzymes [SOD, catalase, NO, Gluthathione peroxidase] by using kit method. Lead levels were higher in HTN and CRF patients compared to controls. Urea, creatine and creatinine clearance levels were high in patients of HTN with CRF. Glucose and HbA1c levels were higher in HTN, and HTN with CRF patients compared to controls. The activity of antioxidant enzymes was decreased in HTN, and HTN with CRF patients. Lead exposure with HTN can be a cause of CRF

Physical and microbiological analysis of water from different sources of Karachi

A number of diseases are caused by consuming water of poor quality. According to a community health study 30% of all reported cases of illnesses and 40% of deaths in Pakistan are due to waterborne disease. The purpose of the study was to i] to determine the physical quality and presence of total coliforms and Escherichia coli count and also ii] to compare the coliform and Excherichia coli bacteria in drinking water of different towns of Karachi with WHO's recommended values. Retrospective Study. This study was conducted in the Department of Biochemistry in collaboration with Department of Microbiology, Basic Medical Sciences Institute, Jinnah postgraduate medical Centre Karachi during the period of June 2007 to February 2008. Multiple water sample collected from 18 towns of Karachi by different sources like Piped water, hand pumps, Mineral bottles and Filter plants. The 250 milliliters sample for microbiological analysis was collected to perform all the required analyses and to provide for any quality control need, split samples or repeat examination. Statistical Package for social Science [SPSS version 11.0] used for data feeding and analysis. The results were given in the text as number and percentage for qualitative/ categorical variables like E. Coli and coliform and mean and standard deviation for quantitative variables like Physical parameters pH, Temp, DO, Conductivity, TDS]. The pH in tap water samples ranged between 6.8 to 7.6. Temperature recorded at spot ranged between 25- 32 [degree sign] c. The dissolved oxygen varied from 3.6 to 4.8 pm, its permissible limit is 4ppm. In 108 tap water samples MPN of coliform/100 ml water samples were < 10 in 21[19.4%] samples and > 10 in 87 [80.6%] samples. Recovery of E. coli as indicator organisms of fecal pollution in different water samples were found. During the drinking water quality assessment a wide range of pollutions were found and generated very useful baseline information on the current pollution status of supplied water to Karachi which indicates that Karachi is receiving highly polluted water

Glomus tumors

Glomus tumours of the temporal bone occur in the region of the jugular bulb middle ear. They are rare, highly vascular, slow growing tumours and most are benign. Tumours that originate from the jugular bulb and extend to involve the middle ear are referred to as glomus jugular tumours. Those that are found in the middle ear around the otic ganglia in the tympanic plexus are known as Glomus tympanicum. Yhese tumours occur predominantly in women in the fifth and sixth decades of life. Because of the insidious onset of symptoms, these tumours often go unnoticed and there is often a significant delay in diagnosis. Morbidity in these cases is determined by their size and position. 1. To study the age/sex incidence of patients suffering from glomus tumours of the temporal bone. 2. To see various clinical presentations with which these tumours present and their variation according to the age and sex. Our study design was non-inter-ventional descriptive. This study was performed at CMH Rawalpindi and Multan from January 2000 to June 2002. We included ten patients of glomus tumours of the temporal bone in our study. 8 out of these were females and two were males. Though most of the patients belonged to middle age group yet few were also from the younger and older groups. All the patients underwent CT scan with and without contrast, MRI of the requisite site and carotid angiography. We found that these tumours were predominantly present in females, mostly in the middle age group. Individual symptoms were studied in detail and their presence was found to be directly proportional to the increasing age of patients. It is concluded that due to the slow growth of this tumour the diagnosis is often delayed until it is extensive. Therefore clinicians should be more vigilant about this rare disease and must keep it in their differentials