Evaluation of dizziness at Jordan University Hospital

This study was performed prospectively to evaluate the dizzy patients in the Neurotology Outpatient clinic at Jordan University Hospital, Amman, Jordan during the period 1993-2000 and to discuss the prevalence and etiology of dizziness. Data were collected from 108 patients [52 males and 56 females] with a mean age of 45.6-years. Diagnosis was made on the basis of history, physical, otolaryngological and neurological examination and confirmed by relevant investigation including laboratory, radiological and audio vestibular tests. Secure diagnosis were made in 98% of patients [14% had one cause alone and 84% had multiple causes]. Cardiovascular disorders accounted for 31.5% of primary and 49% of secondary causes, peripheral vestibular disorders, 25% of primary and 3% of secondary causes, central vestibular disorders 17% of primary and 9% of secondary causes, metabolic endocrine 13% of primary and 38% of secondary causes, cervical osteoarthritis 5.5% of primary and 28% of secondary causes and psychogenic 4.6% of primary and 6.5% of secondary causes. Our findings demonstrate that vertigo is the most common subtype of dizziness [50%]. Multiple causes are more prevalent in older age and the single cause is more prevalent in younger age. Cardiovascular was the most common cause of dizziness followed by vestibular disorders, metabolic and cervical osteoarthritis. Vestibular disorders are primary causes and non vestibular are predominantly secondary causes of dizziness. Hyperlipidemia, diabetes and cervical causes are major secondary contributors to dizziness. We recommend a multi disciplinary setting and application of a comprehensive diagnostic and treatment approach without unnecessary protracted investigative scheme and installment of rehabilitation facilities

Laryngocele: a case report

This is a case report of a 17-year-old male patient who presented with a symptomless swelling on the right antero-lateral aspect of the neck. The swelling was noticed by the patient 7 months earlier. It has been diagnosed medically and radiologically as an external laryngocele. The laryngocele has been successfully excised using an external approach, and the patient is free of symptoms after 9 months. This is a rare condition especially at this age, which seems to be worth publishing

Comparative study of diclofenac sodium and paracetamol for treatment of pain after adenotonsillectomy in children

To compare the analgesic efficacy of diclofenac sodium and paracetamol on post adenotonsillectomy postoperative pain and oral intake. Between January 1999 and July 2000, 80 children aged 3-14 years, underwent tonsillectomy and adenoidectomy for either recurrent tonsillitis or adenotonsillar hypertrophy in Prince Zeid Ben Al-Hussein Hospital and Prince Rashid Ben Al-Hussein Hospital. Forty-one children received diclofenac sodium suppositories [1-3mg/kg] postoperatively, whereas 39 children received only paracetamol syrup [10-15 mg/kg] in 4 divided doses. All children were observed for postoperative pain, oral intake, vomiting, temperature and complications. Children who received diclofenac sodium had significantly less pain, less elevation of temperature, more oral intake, and started drinking significantly sooner than the paracetamol group. Two children in the diclofenac group experienced nausea and vomiting compared to 12 children in the paracetamol group in the first day. The time to first solid intake was significantly earlier in the diclofenac sodium group [p < 0.0001]. With regard to complications, one patient in each group developed secondary hemorrhage, one child developed otitis media in the 2nd group. Each group had one readmission, and 2 children from the paracetamol group had an emergency department visit for pain and dehydration. Diclofenac sodium has a significant effect on decreasing the pain associated with swallowing postoperatively and on the general condition of the patient. Improved oral intake resulted in a lower incidence of nausea and vomiting and allowed safer and earlier hospital discharge