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Aims: To decrease overall treatment time (OTT) and to compare the clinical outcome of interdigitated high-dose-rate intracavitary brachytherapy (HDRICBT) versus sequential HDRICBT with external beam radiotherapy (EBRT) in the treatment of locally advanced carcinoma cervix. Methods: Eighty-two patients with histologically confirmed carcinoma of the cervix, untreated International Federation of Gynecology and Obstetrics Stage IIB–IIIB, were included and randomized into two groups. The study group received EBRT 50 Gy/25 fractions with interdigitated HDRICBT 8 Gy/fraction weekly a total of three fractions. Patients in the control group received EBRT 50 Gy/25 fractions with sequential HDRICBT 8 Gy/fraction weekly a total of three fractions. At the end of the study, results of both groups compared in terms of OTT, acute and late toxicities, and response to therapy clinically. Results: A total of 82 patients were enrolled 41 in each arm. Seventy-two patients completed treatment and were analyzed. Mean OTT in study group and control group was 40 and 60 days, respectively. The median follow-up duration was 10 months (3–18). Most of the acute and late toxicities were of Grade 1 and 2 type and comparable in both study and control groups. Treatment interruption due to treatment-related toxicity was slightly higher in the study group than the control group, but it was statistically insignificant. Os negotiability was not found to be a limiting factor for interdigitated HDRICBT. Conclusion: Interdigitated HDRICBT has equivalent response and toxicities as sequential HDRICBT with the advantage of significant reduction in OTT
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The pharmacognostic and phytochemical investigations on the leaf, stem bark, and fruit of Zanthoxylum armatum were carried out. Macroscopic study of leaf, stem bark, and fruit of Z. armatum revealed some of the characteristic features like size, shape, color, odor and taste of the crude drug. Distinguishing fragments were identified from the powder drug. Leaf, bark, and fruit powder of this plant have higher values of total, acid insoluble, and water soluble ash as compared to the powder of this plant exhausted with ethanol and n- hexane. Extraction values in methanol were highest for leaves [20.10%] and fruit [11%], while bark showed highest value in chloroform [8.5%]. The extractive values varied among other parts with different solvents. Fluorescence analysis of the Z. Armatum leaf, stem bark, and fruit powder with various reagents showed characteristic coloration at day and under UV light. Quantitative phytochemical screening revealed the presence of many bioactive constituents in leaves, such as alkaloids [15.60+/-0.10 mg/g], sterols [71.60+/-0.10mg/g], saponins [21.57+/-0.12mg/g], tannins [34.43+/-0.21mg/g], phenols [11.66+/-0.33mg/g] and flavonoids [13.68+/-0.66mg/g]. Alkaloids [19.60+/-0.10mg/g], sterols [33.83+/-0.29mg/g], saponins [14.78+/-0.10mg/g], tannins [28.62+/-0.13mg/g], phenols [16.48+/-1.33mg/g] and flavonoids [18.33+/-1.22mg/g] were reported form the bark, while fruits were reported to have alkaloids [25.07+/-0.21mg/g], sterols [164.92+/-0.14mg/g], saponins [28.60+/-0.10mg/g], tannins [35.5+/-0.5mg/g], phenols [21.68+/-0.44mg/g] and flavonoids [22.8+/-1.33mg/g]. Z. armatum is an important medicinal plant, traditionally used for various ailments. This study will be helpful in the future pharmacognostic standardization of this important plant
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This study evaluated the prevalence of posttraumatic stress disorder [PTSD] and the severity of PTSD symptoms in survivors, rescuers and witnesses of terrorist attacks on Khyber bazaar, Qissa Khawani bazaar, and All Saints Church in Peshawar city area. Cross-sectional survey is carried out on a sample of one hundred survivors, rescuers and witness of terrorist attacks using structured interviews to assess the severity of posttraumatic stress, five months after the attacks. The study period extended from January 24, 2014 to March 24, 2014 which constitutes a total of period of 8 weeks. PTSD symptoms are measured using Posttraumatic Symptom Scale Interview [PSSI] and conferred to a diagnosis of PTSD at 5 months. Additionally, the severity of PTSD symptoms were determined using PSSI scores, severity ranged from 0-51. Of the one hundred survey respondents, 88% were males and 12% were females. Forty percent [40%] had attained 10 years of education, matriculation, but irrespective of the gender or educational status, all had some degree of PTSD. Sixty-six [66%] percent respondents are diagnosed as having moderate PTSD while 11% of the sample suffered from severe PTSD level. Age, gender, occupation and education level did not have any correlation with PTSD development. The contemporary findings indicate that any person who has witnessed or survived catastrophes of terrorist activities like bomb blast or being exposed to suicide attacks is at risk for developing PTSD, and there is necessity to deliver specialized post-disaster mental health facilities to the people having substantial levels of PTSD after calamities of such great intensity
Subject(s)
Adult , Adolescent , Aged , Female , Humans , Male , Middle Aged , Young Adult , Terrorism , Psychiatric Status Rating Scales , Age Distribution , Risk Factors , Socioeconomic Factors , Cross-Sectional StudiesABSTRACT
Objective: To observe the effect of Citrullus lanatus var. lanatus on albino mice model of anxiety and depression
Methodology: This experimental study was done in the Pharmacology department of Karachi University for a period of 02 months from 5th February-9th April 2016. Watermelon [Citrullus lanatus var. lanatus] was used. Animals were randomly assigned into 4 groups A, B, C and D [n=10]. Group A was control [normal saline]. Group B was treated with Citrullus lanatus juice in a dose of 3 ml/kg, Group C was given 6 ml/kg of juice. Two drugs [Diazepam and Fluxetin] were used as standard and given to group D animals. All doses were administered orally. Level of anxiety and depression among animals was tested by light/dark box test and forced swim test. Data was analyzed statistically
Results: Animals treated with Citrullus lanatus juice showed marked reduction in anxiety which was evident from results of light/dark box test while forced swim test revealed no effect on depression
Conclusion: Citrullus lanatus contains important natural anti-oxidants like lycopene and vitamin C which prevent injury to vital organs like liver, heart and brain from toxic effects of reactive oxygen species. Arginine in Citrullus juice is also precursor of neurotransmitters like Y -Aminobutyric acid [GABA] and glutamate. These results showed that Citrullus because of its components like arginine played an important role in maintaining normal neurological function and ameliorated anxiety and depression
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Present study was aimed to screening the population of 25 wheat genotypes from Baluchistan region of Pakistan along with five commercial cultivars for leaf rust adult plant resistance (APR) through gene postulation using natural inoculation of Puccinia triticina Erikss local pathotype. Infection severity was recorded on scale in comparison with susceptible control "Morroco" cultivar. On the basis of phenotypic score, seven accessions and four varieties (Zardana-89, Sariab-92, Zarlashta-99 and Raskoh-05) with AUDPC values up to 20% were characterized as resistant genotypes. Coefficient of infection (CI) score ranged from 0-10 for some accessions and cultivars showing high level of adult plant resistance. Furthermore, bi-allelic STS marker csLV34 having close linkage with Lr34 (0.4cM). This marker amplified one gene specific allele of 150bp in 21 genotypes, including 19 accessions and two commercial varieties (Sariab-92 and Zarghoon-79) which confirmed presence of Lr34 gene conferring adult plant resistance against leaf rust. The rust pathogenicity scale varied for accessions from resistant to moderately susceptible. However, beside Lr34, phenotypic gene postulation, in combination with marker assisted selection for leaf rust resistance, has revealed presence of some other unknown resistance genes in local wheat germplasm which signified its use in wheat improvement programs both locally and abroad.
O presente estudo teve como objetivo a triagem da população de 25 genótipos de trigo do Baluchistão, região do Paquistão, juntamente com cinco cultivares comerciais para o estudo da resistência à ferrugem da folha em plantas adultas (leaf rust adult plant resistance, APR, em inglês) através da postulação gênica usando a inoculação natural do patótipo local da Puccinia triticina Erikks. A gravidade da infecção foi registrada na escala em comparação ao cultivar de controle suscetível "Morroco". Com base na pontuação fenotípica, sete acessões e quatro variedades (Zardana-89, Sariab-92, Zarlashta-99 and Raskoh-05) com valores de AUDPC (area under the disease progress curve, em inglês) até 20% foram caracterizados como genótipos resistentes. A pontuação do coeficiente de infecção (CI) variou no intervalo de 0-10 para algumas acessões e cultivares evidenciando uma elevada resistência nas plantas adultas. Além disso, o STS marker para o csLV34 bi-alélico demonstrou uma ligação estreita com o Lr34 (0.4cM). Este marcador amplificou um alelo específico do gene do 150bp em 21 genótipos, incluindo 19 acessões e duas variedades comerciais (Sariab-92 and Zarghoon-79) o que confirmou a presença do gene Lr34 conferindo resistência às plantas adultas contra a ferrugem da folha. A escala de patogenicidade da ferrugem para as acessões de resistente a moderadamente suscetível. Contudo, além do Lr34, a postulação gênica fenotípica, em combinação com a seleção auxiliada (ou assistida) por marcadores para a resistência da ferrugem da folha, revelou a presença de outros genes resistentes desconhecidos no germoplasma do trigo local o que justifica a sua utilização em programas de melhoramento do trigo tanto a nível local quanto a nível internacional.
Subject(s)
Triticum , Disease Resistance , Plant Pathology , GenesABSTRACT
The objectives of this study are to evaluate the psychosocial impact of cleft lip and palate [CLP] condition among non-syndrome patients and their parents in Malaysia. Total eighty three CLP patients [age > 10 years] and eighty three parents were selected from university of Malaya medical centre [UMMC] and Hospital Kota Bharu I Hospital Raja Perumpuan Zainab II [HKB I HRPZII] Kelantan Malaysia. The Questionnaires were used for determining impact of CLP condition on psychosocial status of patients and parents. It was found that due to CLP condition majority of patients were teased. In addition, the self-confidence of CLP patients was also adversely affected. Among the parents 22.9% felt upset always, 36.1% felt upset often while 8.4% felt upset sometimes about their child oral cleft in the current study. Only 26.5% of the patients reported that they have problems at school due to their CLP condition. About 54.2% of patients were having very good relationship with other children, 37.3% had reasonably good and 8.4% were having quite good relationship with other children. The prevalence of teasing was quite high among the oral cleft patients. The self-confidence was adversely affected because of the cleft condition among majority of the patients
Subject(s)
Humans , Male , Female , Adult , Child , Cleft Palate/psychology , Social Support , Surveys and Questionnaires , Cross-Sectional Studies , Tertiary Care Centers , Parents , PatientsABSTRACT
Rheumatoid Arthritis [RA] is a common inflammatory autoimmune disease characterized by the synovitis of both small and large joints, which may lead to the destruction of cartilage and bones causing significant disabilities due to erosion of bones surfaces, if left untreated. It is a multifactorial and heterogeneous disease having contribution of both genetic [50-60%] and environmental factors. The unawareness of general public might be a contributing factor in the high prevalence rate of RA world-wide. This review article focuses on the causing factors [genetics and environmental] involved in this devastating disease. We also gave brief overview of the treatment options and animal models of RA. The literature was reviewed using mesh terms in PubMed search "etiology of RA, genetics of RA, environmental factors in RA, Genome Wide Association Studies [GWAS] in RA". The data was thoroughly reviewed and comprehensive information was extracted to help the readers in improving understanding towards the mechanisms, which trigger the outcomes of RA. The more we increase awareness about RA, the better we manage this disease and hence can improve life style and socio-economic status
Subject(s)
Humans , Animals, Laboratory , Arthritis, Rheumatoid/genetics , Environment , Rats , MiceABSTRACT
The tendency of [resin-based composites] RBCs to allow more plaque formation results in secondary caries. Chitosan [CS] inhibits the growth of Streptococcus mutans [S.mutans]; which is most frequently caries causing bacteria. Therefore, CS was incorporated into RBCs to determine its in vitro antibacterial activity against S.mutans. CS was added to flowable and microhybrid RBCs at various concentrations of 0 [control] 0.25, 0.5 and 1.0% by weight. Five disc shaped specimens [15mm diameter, 2mm thickness] were prepared for each experimental and control group. Interaction of cured chitosan modified RBCs with S. mutans biofilms was evaluated using agar diffusion test method. The results of ADT were negative. The experimental RBCs containing CS did not show growth inhibition zone around lawn growth of S.mutans compared to control group. Further experiments are in progress to determine CS modified RBCs antibacterial efficacy by direct contact test. Within the limitations of this study Antibacterial activity of CS modified RBCs is comparable to that of commercial RBCs when evaluated by agar diffusion test method
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Accurate assessment of root morphology is a key to surgical management of impacted teeth. The objective of this study was to determine the diagnostic accuracy of orthopantomogram in determining root morphology of impacted mandibular third molar tooth by taking the surgical findings as gold standard. Patients presenting in Department of Oral and Maxillofacial surgery, Punjab Dental Hospital Ide'Montmorency College of Dentistry, Lahore for impacted mandibular third molar surgery and who consented to be part of the study were included in the study. It was a cross-sectional survey with a sample size of 300 and was carried out from December 2011 to December 2012. All patients were advised an orthopantomogram before the surgery. Pre-operative radiographs were assessed and findings noted. Surgeries were carried out as per standard protocol. Post-operative root morphology was assessed and noted. In case where tooth sectioning was done, crown and root fragments were re-approximated using sticky wax. The sensitivity and specificity values of orthopantomogram in determining the root morphology of impacted mandibular third molars were 33.3% and 92.5%. It was concluded that orthopantomogram is less sensitive and more specific in assessing root curvatures of impacted mandibular third molars
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The aim of this study was to investigate current epidemiology of several types of oral clefts among the patients receiving treatment at two tertiary care hospitals, namely University Malaya Medical Centre [UMMC] Kuala Lumpur, and Hospital Kota Bharu / Hospital Raja Perumpuan Zainab II [HKB/ HRPZII] Kelantan. This study evaluated the records of 526 cleft lip and palate [CLP] patients with or without additional malformations, who came for treatment during 2003 to 2007. Of the total 526 patients registered in the study hospital records during the study period, 338 were from HKB/ HRPZ II and 188 from UMMC. Majority 86.7% of these patients were in the age group
Subject(s)
Humans , Male , Female , Cleft Palate/epidemiology , Tertiary Care Centers , DemographyABSTRACT
Neuralgia inducing cavitational osteonecrosis is a bone disease which leads to neuralgia like pain. The aims of this study were to document the frequency and pattern of presentation of neuralgia inducing cavitational osteonecrosis and differentiate it from trigeminal neuralgia. This case series was conducted from August 2011 to July 2012 at Punjab Dental Hospital, Lahore. Patients having facial neuralgia like pain were assessed by history, clinical and radiographic examination. From these patients, seventy patients with signs and symptoms of neuralgia inducing cavitational osteonecrosis [i.e. oro-facial neuralgic pain with intra-oral trigger zone, previous history of surgical intervention and radiographic evidence of cavitational osteonecrosis in the jaws] were included in the study for surgical debridement and curettage of necrotic bone. Out of seventy patients, 25 were male [35.7%] and 45 were female [64.3%]. Age range was of 18 to 70 years. Positive diagnosis of neuralgia inducing cavitational osteonecrosis was confirmed in 45.7% of cases. Most of the patients were from fourth and fifth decade of life. Mandibular posterior region was mostly involved [61.4%] followed by maxillary posterior region [30%]. Anterior maxilla was involved [7.1%] more than anterior mandible [1.4%]. NICO most often causes sharp, shooting pain and is frequently misdiagnosed as trigeminal neuralgia. Consequently, patients are prescribed unwarranted anticonvulsant drugs and/or a variety of surgical procedures without significant pain relief. Such patients should be diagnosed properly for effective management i.e. surgical debridement of involved region
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The most common impacted tooth is mandibular third molar and knowledge and assessment of its angulation pattern, position and depth in mandibular bone helps in better treatment planning and management of patients. The objective of this study was to enlist the frequency of dental caries and pericoronitis associated with different patterns of impacted mandibular third molars in different age groups and genders. A total of 250 patients with 393 impacted mandibular third molars seen in the Department of Oral and Maxillofacial Surgery, Punjab Dental Hospital, Lahore from October 2012 to March 2013 were included in the study. The age range of these patients was of 20 to 65 years. Patients were assessed by history, clinical and radiographic examination. Patterns of mandibular third molar impactions were assessed by using classification systems developed by Winter and Pell and Gregory on periapical radiographs. Pericoronitis was assessed by patient's history and clinical evaluation of mucosa surrounding the impacted mandibular third molars. Dental caries was assessed by clinical and radiographic evaluation. The most frequent pattern of impaction was mesioangular [37.6%], with Class II ramus relationship [53.2%] and Position A depth [62.8%]. Dental caries was seen in 38.53% of patients mostly associated with mesioangular, Position A, Class I molars. Pericoronitis was seen in 29.36% of patients mostly associated with distoangular, Position A or B, Class II molars. It was concluded that the patients having third molars with the unfavourable angulations, patterns and positions could be considered as the candidates for prophylactic removal of impacted mandibular third molars to prevent dental caries or pericoronitis. Moreover, early diagnosis of percoronitis and dental caries and proper management of third molar is necessary to prevent further consequences
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The Rho GTPases are the sub-group of Ras super family and identified in all eukaryotes. The Rho GTPases effect different cellular signaling pathways involved in a number of diseases such as cancer, neurological and cardiovascular disorders. Members of Rho GTPases including RhoA, RhoC and Rac1 play a major role in regulation of apoptosis in different kind of stress conditions. Here we investigated the Rho GTPase activating protein 15 [ArhGAP15] gene knock-down effect on apoptosis induced by ethanol in bovine fibroblast cells. The bovine Fibroblast cells were treated and transfected with two different concentrations [50 and 100 nM] of ArhGAP15 siRNA for 48 h respectively. Both concentrations of siRNA were effective and the results of RT-PCR revealed an efficient knock-down of ArhGAP15 mRNA in fibroblast cells. Further, the normal cells exposed to a 100 mM ethanol concentration showed a reduction in cell viability and induced the ratio of apoptosis related Bax/Bcl-2 proteins compared with ArhGAP15 siRNA transfected ethanol treated cells. Ethanol also increased caspase-3 expression in normal fibroblast cells compared with transfected cells. The ArhGAP15 knock-down cells treated with ethanol decreased Bax/Bcl-2 ratio and lower caspase-3 protein levels in ArhGAP15 knocked-down cells. Our results suggest that apoptosis induced by ethanol involves the activation of Rho GTPase activating protein 15 and silencing of the said gene protects apoptosis
Subject(s)
Animals , RNA, Small Interfering/genetics , Transfection/methods , bcl-2-Associated X Protein/genetics , RNA, Messenger , Fibroblasts/drug effects , Ethanol/pharmacology , Cell Survival/genetics , Cells, Cultured , Apoptosis/genetics , Caspase 3/genetics , CattleABSTRACT
To find out the frequency of compliance of patients using anti-depressants prescribed at out-patient department. Descriptive cross sectional study. This study was conducted in the out-patient department of Institute of Psychiatry, Benazir Bhutto Hospital, Rawalpindi from September 10,2010 till May 10,2011. One hundred and sixteen patients aged 18 years and above, presenting with moderate depressive illness, able to understand and speak Urdu, taking treatment for at least 4 weeks and belonging to both genders were recruited from out-patient department using consecutive [non-probability] sampling technique. Patients having severe depressive illness with psychotic features and severe agitation were excluded. Antidepressant Compliance Questionnaire was translated and validated through a pilot study and then the Urdu translation was orally administered to each participant for the assessment of compliance with antidepressant medication. Among the participants 74.1% were compliant and 25.9% were non-compliant with anti-depressant medications. This study found a high degree of patient compliance with anti-depressants. The results would help in early recognition of non-compliant patients, so that necessary changes could be made in the treatment plan to ensure better compliance
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A prospective, non-randomized study was carried to assess the role of serial cytological assay in predicting radiosensitivity of squamous cell cancer of oral cavity in patients on fractionated radiotherapy (RT) and to evaluate the relationship of radiosensitivity with the histological grade of oral cancer. We studied 54 histologically proven cases of squamous cell carcinoma on cyclical radiotherapy treatment. Radiosensitivity was assessed using serial scrape smears taken before, during and after treatment with radiotherapy (4 & 8 weeks). Depending on the observed cytological change, patients were grouped in those showing good radiation response (sensitive) and those with poor radiation response (resistant) and their relation to cumulative dose of radiotherapy was analyzed for statistical significance. The changes such as multinucleation, micronucleation, karyorrhexis and cytoplasmic vacuolation occurring in irradiated cancer cells, had a statistically significant dose related increase with radiotherapy (P < 0.05). Less differentiated tumors were less radiosensitive and exhibited increased rate of persistence of dysplastic cells and a higher rate of recurrence (33%) after completion of radiotherapy as compared to well differentiated tumors. We recommend regular use of serial cytological assay as it provides valuable evidence of radiosensitivity and persistence of tumor/dysplastic cells at 8 weeks post-radiotherapy.
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Cochlear implant is a medical treatment option for individuals with severe to profound sensori-neural hearing loss on account of non-functioning cochlea or part thereof. Technology is ever evolving and the candidacy criteria are widening. Appropriate selection of patient, successful implantation of an appropriate device and adequate post-implantation rehabilitation protocol are the key factors that dictate the eventual outcome. Bilateral cochlear implantation in children and combined electro-acoustic stimulation are the new developments in this field of rehabilitation for the deaf. Pakistan Cochlear Implant Programme was started in year 2000 and one hundred and fifty subjects have undergone cochlear implant surgery so far at Karachi, Lahore and Peshawar since. This prospective study was designed to evaluate the development of auditory perception skills and language in children, over a twelve months period, following cochlear implantation. Twenty-one patients were enrolled in this evaluation. These were divided into three groups as per age factor. Group 1 included eleven children of ages less than five years, Group 2 included eight children of ages between five and nine years whereas, Group 3 included two eleven years old children. Furthermore, subjects in Group 1 and 2 were pre-lingual whereas those in Group 3 were post-lingual. The three groups were evaluated using "Evaluation of Auditory Responses to Speech" [EARS]. Improvement in performance on all measures was noticed in all the groups over a twelve months period following implantation. Dynamics of improvement in auditory skills suggested more and rapid development in younger age group. Children of varying ages, both pre and post lingual, did show improvement in the development of auditory perception skills, that was evident more in the younger age group
Subject(s)
Humans , Deafness , Cochlear Implantation , Child , Prospective Studies , Hearing Loss, SensorineuralABSTRACT
The purpose of this work was to evaluate current chelation in thalassaemia major patients. It is a retrospective study. This study was conducted at a charity blood transfusion center in Lahore; from March 2006 to August 2006. One hundred and seventy patients suffering from transfusion dependent thalassaemia major were evaluated for chelation practice and iron overload. Among them 98.2% were found to be either non-chelators or inadequate chelators whereas 82.3% patients had serum ferritin levels above 2500 ng/ml. Growth failure and hepatosplenomegaly were also common. Survival appears to be limited as only 6 patients were older than 20 years. Patients face risks and complications during treatment of thalassaemia major. Urgent and effective measures need be taken to remove the difficulties to improve quality of life in these patients. Involvement of clinical haematologists or physicians in the treatment of thalassaemia major can produce promising results
Subject(s)
Humans , Male , Female , beta-Thalassemia/therapy , Retrospective Studies , Iron Overload/drug therapy , Ferritins/blood , beta-Thalassemia/complications , Survival , Quality of LifeABSTRACT
To evaluate current chelation in thalassaemia major patients. It is a retrospective study. This study was conducted at Sundus Foundation, Shadman, Lahore Pakistan from March 2006 to August 2006. One hundred and seventy patients with transfusion dependent thalassaemia major were evaluated for chelation practice and iron overload. 98.2% were found to be either non-chelators or inadequate chelators whereas 82.3% patients had serum ferritin levels above 2500 ng/ml. Growth failure and hepatosplenomegaly were also common. Survival appears to be limited as only 6 patients were older than 20 years. Patients face risks and complications during treatment of thalassaemia major. Urgent and effective measures should be taken to remove the obstacles for improvement in quality of life in these patients. Involvement of physicians about current concepts in treatment of thalassaemia major can produce promising results
Subject(s)
Humans , Male , Female , Chelating Agents/pharmacology , Iron Overload , Ferritins/blood , Retrospective StudiesABSTRACT
Tonsillectomy is a common operation in both children as well as adults, performed by a variety of techniques that have evolved over the years to ensure the safety of the procedure. Cold dissection and electrodissection are the two mostly used techniques. Bipolar diathermy tonsillectomy was evaluated for its safety and postoperative morbidity. This study was conducted over a period of two years, in the Department of Ear, Nose Throat and Head and Neck Surgery at Ayub Teaching Hospital, Abbottabad, Pakistan. Two hundred and forty-six were enrolled; however, 238 patients completed the full evaluation as the technique had to be modified in 8 patients. All the procedures were performed by the first author thereby ensuring the same expertise level. Operating time, intraoperative blood loss, postoperative algesia, feeding status and time taken getting back to school/work and episodes of secondary bleeding were recorded. Time taken by the procedure ranged from 10 to 20 minutes. Intraoperative blood loss ranged between 2 to 5 ml. Postoperative pain averaged around 3-5 on a 1-10 point scale in 75% of patients. 80% of patients were back to normal diet by day 3 postoperative. Nine [3.6%] patients had a secondary haemorrhage that was managed conservatively and did not need surgical intervention. Bipolar diathermy tonsillectomy is an effective and safe technique, especially in children population. Adequate experience with the technique is mandatory to achieve the desired goals
Subject(s)
Humans , Male , Female , Electrocoagulation , Diathermy , Tonsillectomy/adverse effectsABSTRACT
Foreign body inhalation is one of the life threatening emergencies. It may happen at any age, however, most of these accidents occur in children especially below the age of five. This prospective study was done at Department of Otolaryngology, Head and Neck Surgery, Ayub Teaching Hospital, Abbottabad, from 1 January 2003 to 30 June 2005. a total of Eighty one patients, referred from the casualty and Paediatric unit with suspicion of tracheobronchial foreign body were included in the study. Eighty one were studied. Fifty [61.7%] were male and thirty one [38.3%] were female. Sixty three [77.8%] were below five years, thirteen [16%] were between five and fifteen years and five [6.2%] were above fifteen years. Sixty seven patients [82.7%], presented mainly with chocking, while fifty nine patients [72.8%] had stridor and forty five patients [55.6%] had cough at initial presentation. Seventy two [88.9%] patients had decreased air entry and forty two [51.9%] had wheeze on auscultation, whereas cyanosis was noticed in five [6.2%] patients. Peanut was the commonest foreign body, retrieved in forty five patients [55.6%]. Other foreign bodies were whistle [18.5%], maize seed [13.6%], bean seed [6.2%], nuts [2.55], sewing needle with thread, dice and denture [1.2%] each. Foreign body inhalation is more common in male patients, mostly below five years of age. Chocking is the commonest symptom and decreased air entry on auscultation is the typical examination finding. Peanut has been found to be the commonest type of foreign body