Epidemiology of vestibular neurinitis in vertigo presenting at tertiary care health care facility in Pakistan

To determine the frequency of vestibular neuronitis in vertigo patients at a tertiary public health care facility in Karachi Pakistan. It is an epidemiological study conducted at Ear Nose Throat, Head and Neck Surgery Department Jinnah Postgraduate Medical Centre [JPMC], a tertiary care hospital in Karachi, Pakistan. The study duration was from Jan 2007 to Dec 2009. The exclusion criteria included hypertension, diabetes mellitus, hearing loss, other cranial nerves deficits, multidirectional non fatiguing nystagmus, long term medication, Truncal ataxia, inflamed tympanic membrane, mastoid tenderness, high grade fever, and nuchal rigidity. Diagnosis of Vestibular Neuronitis [VN] was made on clinical findings. Patients with sudden onset of vertigo with nausea or vomiting, Clinical signs of unsteadiness, Spontaneous and horizontal nystagmus, Absence of other neurological signs and normal otoscopy and normal hearing were included in the study. Four hundred fifty seven patients reported with vertigo. One hundred sixty five were diagnosed as VN and were enrolled for the study. It was found that patients of VN were increasing yearly; younger male population was found to suffer more than others. Highest incidence was between the age group 16 to 30 years. More patients reported during the months of July - August and March - April every year during the change of season i.e. summer to winter or winter to summer. Vestibular Neuronitis was found more in males than females. Younger population was found to suffer more. Peak incidence was noted during the months of July - August every year. Incidence of VN in younger males and during July - August needs more investigation

Prevalence of chronic sinusitis among outdoor psychiatric patients

To assess the prevalence of chronic sinusitis among outdoor psychiatric patients as a number of patients with chronic sinusitis presents with psychiatric symptoms. 5043 cases. Cohort Study. Department of ENT in collaboration with department of Psychiatry, JPMC Karachi. The study duration was six years from January 2002 to December 2007. All cases of psychiatry consultation who agreed, were assessed for history, mental state examination and physical examination with laboratory and radiological investigation. The final diagnosis was based on criteria of ICD-10 for associated psychiatric diagnosis. Out of 5043 cases, 154 [30.05%] cases had chronic sinusitis. Out of 154 cases of chronic sinusitis 85 [55.2%] were male and 69 [44.8%] were female. Majority of the patients 57 [37%] were below primary level of education. As evident from this study, cases with chronic sinusitis can present psychiatric practice as the symptoms resemble or coexist with psychiatric disorders

Flexible nasopharyngo-laryngoscopy in comparison with direct laryngoscopy

Flexible nasopharyngo-laryngoscopy is a valuable tool in the diagnosis of nasopharyngeal, laryngeal and hypopharyngeal pathologies. Previously, the same pathologies were detected by doing examination under general anaesthesia which requires admission and theatre involvement in a busy hospital like Jinnah Post Graduate Medical Centre, this results in delay of the procedure and put extra burden on already constraint resources. This study was conducted to determine the accuracy of flexible pharyngolaryngoscopy in recording the site and extent of abnormality in outpatient clinic notes when compared to the findings at direct laryngoscopy. This study was conducted at ENT department, Jinnah Postgraduate Medical Centre from 1[st] January 2006 to 31[st] December 2007. Prospective study. 148 patients included in this study were selected with the complains of hoarseness, dysphagia, odynophagia, difficulty in breathing and neck nodes. Flexible nasopharyngo-laryngoscopy done in all cases than patients were admitted in ENT department had undergone direct laryngoscopy under general anaesthesia. The findings of both procedures were compared. Accuracy was found to be 87% when the readings of flexible endoscopy were matched with that of direct laryngoscopy

Role of toluidine blue in early detection of oral cancer

Oral cancer is one of the ten most common cancers in the world with marked geographic incidences in occurrence. The range of frequency of this dreadful cancer varies form negligible in Japan to 45% in Sir Lanka, Nepal, India and Pakistan when compared with the over all incidence of all bodily cancers. In Pakistan oral cancer constitute 10% of all malignant tumors standing second to bronchogenic carcinoma in males and breast carcinoma in females. The more early it is diagnosed the better is the prognosis. This prospective study was planned to use Toluidine Blue as a diagnostic material for early diagnosis of oral cancer. Patients with oral lesions having no clinical evidence of oral cancer, but presenting as non-healing oral ulcers more than 6 months or raised margins were selected. They belonged to both sexes and all age groups. Toluidine Blue [ORA SCAN] was used to stain the lesion and biopsy was taken from stained area, 30 patients which in some cases was more than one place. These patients were randomly selected. Histopathology revealed squamous cell carcinoma in twelve patients and dysplasea in five patients. Tuluidine Blue can be used as early diagnostic aid in cancer of oral mucosa