Radiological presentation of post primary tuberculosis in adult sputum smear positive patients

Background: Pulmonary Tuberculosis [TB] is traditionally classified into primary and post primary tuberculosis; both have distinct characteristics on radiology. Adetailed knowledge of different radiological patterns is helpful in diagnosis of TB

Objective: To determine the frequency of various radiological presentation of post primary tuberculosis in adult sputum smear positive patients

Methodology: This cross sectional study was carried out at Department of Pulmonology, Sheikh Zayed Medical College / Hospital, Rahim Yar Khan on adult sputum smear positive pulmonary TB patients. A total of 250 new cases of pulmonary TB with no previous history of Anti-Tuberculosis treatment were included in this study. Socio demographic data and findings of X -ray Chest from each sputum smear positive patient were collected and recorded on a predesigned performa. The data was entered and analyzed by using SPSS version 17

Result: Out of 250 patients, 146 were male and 104 were female with mean age of 35.76 +/- 16.25 years. Left lung was most affected in 40.4% cases, right lung in 35.6%, while 24% has bilateral involvement. Duration of illness prior to diagnosis was 3 +/- 1.66 months. Among the radiological presentation, cavitation was seen in 49.2% cases, alveolar consolidation in 42.4%, nodular pattern in 3.2%, reticulonodular pattern in 3.2% and reticular pattern in 2% cases. There was significant association of alveolar consolidation with male gender [0.03] while reticulonodular pattern was significantly seen in female gender [0.007]. Majority of the patients were young; 42.8% were below the age of 30 years and 82% patients were below the age of 50 years and there was a delay of > 03 months in the diagnosis

Conclusion: According to this study, cavitations and alveolar consolidation were the commonest radiological presentations of post primary TB. Majority of patients were young and there was a considerable delay in diagnosis

Foreign bodies in ear - its type, diagnosis and management

OBJECTIVES: To evaluate the presentation, nature and fate of aural foreign bodies

STUDY DESIGN: Descriptive Study

SETTING: E.N.T. and Head and Neck Surgery department, Liaquat University Hospital Hyderabad from June 2014 to May 2015

METHODOLOGY: A prospective study of 224 patients who presented with different aural foreign bodies. All patients having suspected history of aural foreign body and whom who haven't history but during examination foreign body present in ear are included in the study. The patient of all age group of both the genders was enrolled. All the data was collected on a pre-designed Performa. Statistical analysis was carried out using SPSS 16

RESULTS: Out of 224 cases of aural foreign bodies, 50.4% were less than seven years of age, with male outnumber female. 93.3% of patients were having foreign body in one ear and 6.7% have foreign body in both ears respectively. Majority of aural foreign bodies were Beads and pearls that were seen in 30.4%. Most of the cases [87.5%] did not develop any complication during extraction

The complications observed were canal abrasion in 11 [4.9%] patients, otitis externa in 12 [5.3%] and tympanic membrane perforation in 02 [ 0.8%] patients

CONCLUSION: Aural foreign bodies are commonly encountered during otorhinological practice

Various varieties of aural foreign bodies are prevalent at different parts of the world

These cases should be removed under good magnification and illumination and/or sedation/general anesthesia if needed for prevention of complication

Flexible fiberoptic naso-pharyngo-laryngoscopy: indications and outcome

Objective: To find the indications and outcome of flexible fiberoptic naso-pharyngo-laryngoscopy in ENT practice

Study design: Case series

Place and Duration of study: Department of E.N.T. and Head Neck surgery, Liaquat University Hospital Hyderabad, from February 2013 to January 2015

Methodology: All patients with upper airway problems in whom flexible fiberoptic naso-pharyngolaryngoscopy [FFONPL] performed were included

Results: A total of 437 patients were included in this study. There were 228 [52.2%] males and 209 [47.8%] females. The age range was from 8 year to 80 year with mean age of 45.87 year. It was performed for diagnostic purpose in 351[80.3%] patients having voice and swallowing problems. It was possible to identify structural etiology in all cases. It was used in follow up of 73 patients for residual disease who had chemo radiotherapy for different tumors. Of these, in 54 [73.97%] patients the airway was patent to allow the removal of tracheostomy tubes. In 13 cases it was used to facilitate passage of nasotracheal tube in patients with ankylosis of temporomandibular joint. It was successful in 12 cases

Conclusion: FFONPL is an effective and safe tool for various ENT related pathologies

T-cell large granular lymphocytic leukemia: 4 cases

No abstract available.

Sinonasal polyposis and fungus: a growing relationship

To determine the frequency of underlying fungus in nose and paranasal sinuses in patients present with nasal polyposis. A total of 324 patients presented with nasal polyps were included in this study. Data collected from all the patients admitted in ENT department with diagnosis of nasal polyposis. All the relevant information about their presenting symptoms was recorded in a proforma. Post operatively the removed material was sent for histopathology and fungal culture. Later the findings of biopsy and culture reports were also recorded and analysed. Out of 324 patients 159 were males and 165 were females. Underlying fungus was present in 226[69.75%] and out of them, 102[45.13%] were males and 124[54.86%] were females with a P value of 0.039. The mean age was 25.95 +/- 9.32 [15-45] years for the patient with fungus. Aspergillus was the commonest organism found. Underlying fungus was found in a significantly high number of patients presented with nasal polyps and Aspergillus was the commonest organism found

Clinical presentation of dry socket at teaching hospital of Hyderabad city

To find out frequency and clinical presentation of dry socket in Department of Oral and Maxillofacial Surgery Liaquat University of Medical and Health Sciences, Jamshoro. Obseervational study. This study was carried out at Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro from Jan 2011 to June 2012. Age from 11 to 70 years with both gender groups was included in the study. They were observed for the presence of dry socket. Patients with previous history of two or more days of extraction, pain, sensitivity on gentle probing of the extraction socket and empty/ partially empty socket were included in the study. Data was analyzed using SPSS version-13. Total 2300 extractions were included in study; dry socket was recorded in 66 [3.3%] routine dental extraction except 3[rd] molars and 598 [26%] surgical and non-surgical extraction of 3[rd] molar respectively. Majority of the patients belong to 3[rd] decade of life. In oral Surgery practice dry socket is unavoidable, but oral surgeons must identify additional risk factors in patients with particular medical conditions and include this information as a part of the informed consent

Complications of modified radical neck dissection type III in oral squamous cell carcinoma

Modified radical neck dissection type III is considered as relatively safe procedure for management of metastatic cervical lymphadenopathy, with low complication rate. This Descriptive study was conducted to evaluate complications of modified radial neck dissection type III from April 2007 to March 2010 at Department of ENT-Head and Neck Surgery Civil Hospital, Karachi. The surgical record of 115 patients of oral squamous cell carcinoma who underwent Modified Radical Neck Dissection type III was evaluated for frequencies and pattern of complications. Out of 115 patients, age of the patients was ranging from 26 to 66 years [std Dev: +/- 10.62]. 80% of patients were male and 20% of patients were female and male and female ratio was 4:1. The overall complications were 48.7%. Marginal mandibular nerve palsy [15.7%] and seroma [12.2%] were frequent complications. Although complications may occur despite the best efforts to prevent them, proper preoperative planning, early recognition of perioperative complications, and prompt, effective management can minimize the impact of complications that may occur

Chondroblastoma: a clinico-pathological analysis

To determine the clinico-pathological and histological features of Chondroblastoma [CB]. Case series. The Aga Khan University Hospital, Karachi, from 2000 to 2013. The histological slides of all reported cases of CB were retrieved and reviewed for morphological features. Clinical features were noted from surgical pathology reports. Frequency of features was noted. Sixty one cases of CB were identified. Pain was the most common presenting symptom. The age ranged from 10 to 38 years [mean 20 +/- 1.98 years; M: F 2.5:1] with 61% patients in the second decade of life. Forty six cases occurred in long tubular bones; distal femur being most common site. Metaphysis, clavicle, temporal bone and metacarpal were also involved. Histologically, all CBs were composed of round to polygonal cells and scattered osteoclast-type multinucleated giant cells and majority had hemosiderin pigment. Chicken-wire calcifications and coarse calcifications were seen in 85% and 26% of cases respectively. A spindle cell component was seen in 54% of cases. ABC-like areas were seen in 10 cases. Mitosis ranged from 1 to 6/10 HPFs. Recurrence was seen in 2 cases. Recurrent tumor showed similar morphology when compared with the initial tumor. CB is a benign tumor but has potential for recurrence. Males are more affected, second decade is more common and distal femur is most common site. Metaphysis, clavicle, temporal bone and metacarpal were the rare sites of CB. Histological features predictive of recurrence were not separately identified

experience of ear diseases among the medical students of Isra university Hyderabad [Sindh]

Objective: To determine the frequency of ear diseases among the medical students of Isra University

Study design: A Descriptive, Cross sectional study

Place and duration: E.N.T department Isra University Hospital Hyderabad, in two years; from 1 January 2011 to 31 December 2012

Methodology: All medical students of Isra University Hyderabad who visited E.N.T department for complaints related to ears were selected for this study. We did a thorough ENT examination with particular emphasis on otological examination including pneumatic otoscopy, valsalva meanouvre, hearing assessment with tunning fork [512 Hz]. Data were extracted on especially designed proforma and Statistical analysis was carried out using SPSS version 16

Results: 500 students were included in the study; 303 [61%] were females and 197 [39%] were males. Mean age was 22.7 and standard. Deviation +/- 1.521 range from 19 to 27 years. Majority of patients were diagnosed as having impacted wax [29%] or otomycosis [24%]. Some patients [22%] presented with vague otological symptoms but after a complete examination, no ear pathology was found. Majority of patients complained of earache [57%], hearing Impairment [56%] and aural heaviness or blockage [38%]

Conclusion: Although traumatic and infectious diseases of external and middle ear were found, but impacted wax and otomycosis were the most common diseases among the medical students of Isra university

Frequency and clinical presentation of various malignant maxillary tumors

Objectives: To determine the frequency of various malignant tumors of maxilla and to determine the various clinical features of these pathologies at the time of presentation

Study design: A descriptive, Cross sectional study

Place and duration: Joint Study of ENT - Head and Neck Surgery and Maxillofacial Department Isra University Hospital Hyderabad. 02 years from 1[st] January 2011 to 31[st] December 2012

Methodology: Fourteen patients were selected from Out Patient department [OPD] of E.N.T. and Maxillofacial department. Demographic data like age, and sex, clinical presentation like nasal obstruction, epistaxis, cheek swelling, displacement of eye ball and bulging of hard palate were recorded on purposely designed proforma. Biopsy was taken from all patients through endoscope

Results: Out of 14 patients, nine patients [64.3%] were male and five patients [35.7%] were female. Eight patients were diagnosed as squamous cell carcinoma which comprised [57.2%] followed by sarcoma [35.7%] and B-cell lymphoma [7.1%]. Nasal obstruction and epistaxis were most common complaint i.e. 85.7% followed by anosmia, midfacial swelling and altered check sensation 71.4% respectively. 42.8% patients were suffered from exophthalmos and 35.7% were found bulging of hard palate

Conclusion: Among the malignant tumors of maxilla, commonest is Squamous cell carcinoma but other rare entities like sarcomas and lymphomas are not uncommon in our experience

Pulmonary alveolar microlithiasis

Pulmonary alveolar microlithiasis [PAM] is a rare disorder. It is characterized by accumulation of calcium phosphate [microlith] within the alveoli. Knowledge of this condition is important because radiologically it mimics miliary tuberculosis that can lead to the wrong treatment