Valsalva manouevre; efficacy in the treatment of eustachian catarrh

To assess the efficacy of Valsalva maneuver in the treatment of Eustachian catarrh. Quasi Experimental Study. Frontier corp Hospital [Quetta] and Sheikh Khalifa Bin Zayad Al Nahyan Hospital [Muzzafarabad] from December 2010 to May 2011. Total of sixty patients of Eustachian catarrh were randomly assigned to two treatment groups. Group A was given Antibiotics, Antihistamine, systemic and nasal decongestants and group B was advised Valsalva maneuver in addition to the above mention treatment. Relief in aural fullness [assessed through tympanometry] and hearing improvement [assessed through audiometry] were compared between these two groups at the end of three weeks of treatment. Audiogram done after three weeks of treatment showed statistically significant hearing and middle ear pressure improvement [assessed through audiogram and tympanogram respectively] in group B

Effect of preoperative dexamethasone on postoperative pain, emesis and haemorrhage in tonsillectomy by dissection method

To compare the effect of single preoperative intravenous dose of dexamethasone on postoperative morbidity that is pain, episodes of emesis, and hemorrhage in patients undergoing tonsillectomy by dissection method with those who do not receive dexamethasone. Randomized control type. ENT Department Combined Military Hospital Rawalpindi, from Feb 2006 to Feb 2007. After getting informed consent a total of 60 patients who fulfilled the probability sampling. Group A received 0.25 mg/kg body weight [maximum 20 mg] of dexamethasone intravenously 10 minutes before start of operation while group B [control group] did not receive any steroid. Pain control had significant difference in both groups with better control rates in group A. Similarly, emesis control was significantly better in group A. There was no significant difference in secondary haemorrhage in the two groups. Single dose of dexamethasone given preoperatively significantly reduces the postoperative morbidity that is pain, episodes of emesis with no effect on secondary hemorrhage in patients undergoind tonsillectomy by dissection method

Diagnostic yield of transbronchial needle aspiration analysis of 30 cases

In our clinical set up transbonchial needle aspiration of lymph node and parenchymal lesions is an underutilized technique. This study was done to highlight the usefulness of this technique in the pulmonologists armamentarium. Thirty procedures were performed on patients with intrathoracic lymphadenopathy or parenchymal lung lesions in this study from October, 2006 to April, 2007. Patients with an easily accessible peripheral lymph node, bleeding diathesis and an already confirmed diagnosis were excluded from the study as were patients with a well visualized biopsiable endobronchial lesion. Nineteen patients [63.3%] on whom transbonchial needle aspirations were performed had intrathoracic lymphadenopathy while 11 [36.6%] had parenchymal lesions without endobronchial lesions which could be biopsied. Adequate samples were obtained in 23 patients [76.6%] chronic granulomatous inflammations which was diagnosed as tuberculosis in corroboration with other clinical and laboratory evidence was seen in 3 cases [10%]. Carcinoma was diagnosed in 6 cases [20%]. Thirteen cases [43%] were reported as normal and inadequate samples were obtained in 7 cases [23%]. Transbronchial Needle Aspiration [TBNA] is an effective method of obtaining cytological material from intrathoracic lymph nodes and parenchymal lesions and can provide a safe alternative to invasive mediastinotomy/mediastinoscopy and open lung biopsya