ABSTRACT
To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Quasi-experimental study. ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Serum cholesterol came to within normal limits in 51 [52%] patients [responsive group], while it remained high in 47 [48%] patients [unresponsive group]. Improvement in tinnitus score in the responsive group was seen in 36 [70.5%] patients and in 2 [4.2%] patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group [p < 0.001]. Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin
Subject(s)
Humans , Male , Female , Hyperlipidemias/blood , Heptanoic Acids , Disease ManagementABSTRACT
To study the outcome of using Improvised ventilating nasal packs compared with Vaseline gauze packs in nasal surgery. A comparative study. Department of ENT, Combined Military Hospital Rawalpindi, from July 2011 to December 2012. One hundred and twenty patients undergoing nasal surgery were divided into two groups of sixty each. After surgery, Group A was packed with Improvised Ventilating nasal packs and Group B with Vaseline gauze nasal packs. Effects of nasal packs in both the groups were studied and compared in terms of control of bleeding, comfort level while in place, and discomfort level while packs were being removed. Patient comfort level was significantly better in Group A as compared to Group B, while there was no significant difference in post operative bleeding control among the two groups. Discomfort level while packs were being removed, was also similar among the two groups. Ventilating nasal packs provide a better alternative to conventional nasal packs in terms of patient comfort after nasal surgery, while they are as good in providing bleeding control
ABSTRACT
To determine the age range, gender distribution, histological types, sites, neck node involvement, and surgery as modality of treatment in diagnosed cases of oral cavity tumours in a tertiary care centre. Descriptive Study. The study was carried out in ENT Department, CMH Rawalpindi for the duration from Dec 2008- Dec 2011. Data of 113 biopsy proven cases of oral cavity tumors who underwent surgery at CMH Rawalpindi, were retrieved from Armed Forces Institute of Pathology's Tumour Registry and from Head and Neck Oncology Forum Registry, and were evaluated. Out of 113 patients with oral cavity tumours, 87 [77%] were male, while 26 [23%] were female, the male: female ratio being 3:1. The mean age of the patients was 59.4 years, ranging from 40 to 75 years. Site distribution of the tumours was: Tongue: 61[54%], buccal mucosa 24 [21%], floor of mouth 18 [16%], and hard palate 10 [9%]. The histology of tumours showed Squamous cell carcinoma in 102 [90%] and tumours of Salivary gland origin in 11 [10%]. Sixty four [56%] of these patients had N0 disease, 10 [9%] had N1 disease, 8 [7%] had N[2s] disease, 27 [25%] had N[2b] disease, 3 [2%] had N[2c] disease, while 1 patient [1%] had N[3] disease. Resection of the tumour along with Supra-omohyoid neck dissection was carried out in 64 [56%] patients, while resection with radical neck dissection was done in 49 [44%] patients. Primary closure was carried out in 62 [55%] patients, while secondary reconstruction was done in 51 [45%] patients. Presentation of oral cavity tumours occur at an advanced age with male preponderance in our population. Early presentation results in lesser local spread, leading to less aggressive surgical approach with selective neck dissection
ABSTRACT
This interventional study was carried out in ENT Department of Combined Military Hospital Rawalpindi, a tertiary care hospital, from January 1993 to December 2000, to determine the sex incidence, laterality and type of congenital meatal atresia, and possible etiological factors; and secondly to determine the results of surgery in terms of hearing gain and incidence of complications while comparing trans-mastoid approach with the anterior approach. 42 patients of both sexes with congenital meatal atresia, up to the age of 25 years were selected by non-probability sampling. A detailed history and a detailed physical examination showed consanguinity as the biggest possible etiological factor [40.4%], male to female ratio of 2.5:1, unilateral to bilateral ratio of 1.6:1, type II atresia in 50%, type I atresia in 35.7% and type III atresia in 14.2%. X-ray mastoids and CT scan showed favourable anatomy in 36 patients who were selected for surgery. Canalplasty with tympanoplasty was carried out in them, via trans-mastoid approach in ten and direct anterior approach in 26 patients. Pre and post-operative Audiological Brainstem Response and Pure Tone Audiometry [over 4 years of age] showed successful surgery in 19 [52.7%] patients having post-operative hearing thresholds of up to 25-30 dB. Success rate was 61.3% with the anterior approach as compared to 30% with the trans-mastoid approach. Post-operative complications as re-stenosis [16.6%], otorrhoea [11.1%] and facial paralysis [2.7%] occurred in 11 [30.55%] patients. Complication rate was 50% with trans-mastoid approach and 27% with anterior approach. Consanguinity must be studied in greater detail as an important possible etiological factor
ABSTRACT
A 4-week-old baby was brought with history of sudden choking, coughing, difficulty in breathing and cyanosis. Plain X-ray neck showed a large screw along with its nut impacted in the nasopharynx, which was retrieved under general anesthesia