Peadiatric tracheostomy: an experience in Tertiary Care Hospital

Tracheostomy is the surgical procedure originally described in 1[st] century BC. It is the life saving procedure when performed with appropriate indications and surgical technique. Tracheostomy in the pediatric population is a particularly hazardous procedure. Retrospective chart review This study was conducted at the Peoples University of Medical and Health Sciences Hospital Nawabshah between 2004 to 2008. Retrospective review of pediatric tracheostomy done in emergency or elective procedure under general anesthesia or local anesthesia was under taken. Name, age, indications, time of decanulation and follow up were evaluated. 31 Pediatric patients had tracheostomies within study period. There were 19 males and 12 females. Age range was 2 months to 10 years. The most common indication of tracheostomy was upper respiratory tract obstruction due to traumatic causes [54.83%]. 83.87% tracheostomies were done in emergency while 16.12% as elective procedure under general anesthesia or local anesthesia. Complications were encountered in 32.25%of patients. Most frequent complication was granulation tissue formation in the area around stoma [30%]. Complication rate was high in patients below 2 years of age [63%] and in patients having emergency tracheostomy [73.9%]. Decanulation was successfully done in all alive patients [87%]. Overall mortality rate was 12.9%. There was no tracheostomy related mortality. The indications for pediatric tracheostomy are changed from airway obstruction due to infection to trauma. Complication rate of tracheostomy is higher in younger age groups. Mortality and outcome of these patients depends primarily on underlying medical condition of the patient, otherwise pediatric tracheostomy is safe when performed in tertiary hospital settings

Montelukast versus nigella sativa for management of seasonal allergic rhinitis: a single blind comparative clinical trial

To compare the therapeutic role of leukotriene receptor blocker Montelukast with N. Sativa seeds in seasonal allergic rhinitis patients. Comparative uncontrolled single blind clinical assessment was carried out over forty seven untreated adult patients torment from seasonal allergic rhinitis and staring for outpatient management. All patients were chosen from different primary care health centers, registered and were divided in a single-blind approach to obtain Montelukast, 10 mg/day, group I [n=24] and 250 mg/day of N. Sativa, group II [n=23] orally for two weeks. Patients joined-up the study has completed the therapeutic plan. Montelukast and N. Sativa both demonstrated a significant and early decrease in daytime as well as ophthalmic symptoms, while montelukast showed diminished and late effects on nighttime symptoms when compared with N. Sativa. In addition montelukast has also been showing to cause drug allied side effects like headache, dizziness and heart burn. It would come into view that N. Sativa is safe and thoroughly free from threat of adverse effects. So it is a liable management alternative for seasonal allergic rhinitis patients

Otolaryngologic manifestations of gastroesophageal reflux disease

To determine frequency of endoscopic oesophagitis in the patients who complain the chronic laryngopharyngeal disorders in the absence of typical gastroesophageal Reflux Disease [GERD] symptoms. Descriptive study The study was carried out in the department of E.N.T at Nawabshah Medical Centre, Nawabshah over the period of two years [2004 to 2006]. One hundred patients of either sex and in the age group between 25-79 years with symptoms of chronic laryngopharyngeal disorders were selected for study. All patients had physical examination of upper aero digestive tract. Direct laryngoscopy was done to evaluate the status of larynx, however rigid esophagoscopy was done to evaluate the status of esophageal mucosa and biopsies from lower part of esophagus were taken in all patients. Eighty percent of patients with symptoms of chronic laryrigopharyngitis were also suffering from microscopic Oesophagitis. Among the 80% patients 87.5% were having non-erosive oesophagitis while 12.5% were having erosive oesophagitis. In significant number of patients with chronic upper respiratory symptoms resistant to the treatment, there was co existing gastroesophageal disease which could be the cause of the symptoms

Cetirizine and nigella sativa: comparison of conventional and herbal option for treatment of seasonal allergic rhinitis

To compare the efficacy of the second-generation antihistamine cetirizine with Nigella sativa [N. sativa] seeds in management of seasonal allergic rhinitis [SAR]. Comparative uncontrolled clinical trial. Forty untreated adult patients, suffering from seasonal allergic rhinitis, seeking outpatient treatment were selected from different primary care clinics. They were enrolled and randomized in a single-blind manner to receive Cetirizine, 10 mg/day, group I [n=20] and 250 mg/day of N.sativa, group II [n=20] orally for 14 days. Response to treatment was evaluated at the end of the study. All patients completed the treatment. Both study drugs i.e cetirizine and N.sativa were equally effective at relieving the symptoms of seasonal allergic rhinitis; however, the group using cetirizine had more sedation and other adverse effects. It appears that N.sativa is has minimal adverse effects and is therefore a safe treatment option for the patients of seasonal allergic rhinitis

Nagilla sativa: a non-conventional herbal option for the management of seasonal allergic rhinitis

Seasonal allergic rhinitis [SAR] is one of the top reasons for patient visits to primary care physicians because of its bothersome symptoms. This highly prevalent disease also impairs quality of life, sleep, and work. Oral antihistamines are one of the most frequently prescribed medications for the management of SAR but they have their own side effects. Hence the effects of traditional Nigella sativa seeds, on seasonal allergic rhinitis were studied in 20 patients. Daily dosages of 250 mg of seeds for a 15 days period significantly reduced the symptom severity scores of allergic rhinitis in patients. It was concluded that Nigella sativa seeds could be successfully used for seasonal allergic rhinitis

Primary source of infection in tuberculous cervical lymphadenitis: a prospective study

To search for the primary site of infection inpatients with cervical tuberculous lymphadenitis. DESIGN: A prospective study. PLACE and DURATION OF STUDY The study was carried out at the departments of ENT Civil Hospital Karachi, Chest medicine JPMC Karachi and Ojha institute of Chest diseases Karachi, over the period of two years [June 2000 - July 2002] SUBJECT and METHODS: One hundred patients with a clinical suspicion of cervical tuberculous lymphadenitis were included in the study. All Patients had a physical examination of the upper aerodigestive tract. Routine endoscopy and biopsy of the nasopharynx were performed. All of them had excisionallincisional biopsy of the cervical lymph node. Seventy-five patients had histologically confirmed tuberculous cervical lymphadenitis. Culture o f the lymph node specimen showed mycobacterium tuberculosis in 68 [90%]. In 45 [60%] patients with cervical tuberculous lymphadenitis, the primary foci of infection could not be found. Twenty-nine [39%] had radiographic evidence of active or healed pulmonary tuberculosis. Sputum culture from two patients showed mycobacterium tuberculosis. Five patients [6%] had tuberculous nasopharyngitis. In one of them, the tuberculous nasopharyngitis was primary as no other evidence of mycobacterium infection was found. In present study the pulmonary foci are the primary infection site in cervical tuberculous lymphadenitis. The mycobacterial infection of otherparts of the upper aerodigestive tract was not found