Comparison of BIPP gauze packing versus maxillary antrum packing with Foley's catheter after Caldwell-Luc surgery in terms of re-bleeding and discomfort

Objective: to compare efficacy and discomfort caused by maxillary antrum packing with Foley's catheter versus BIPP gauze packing after Caldwell-Luc surgery

Methodology: this Quasi experimental study was carried out at two centres CMH Kharian and PAF Hospital Faisal, Karachi from June 2012 to June 2014. A total of 46 patients who underwent Caldwell-Luc surgery were included in the study. The cases were divided in two groups of 23 each. In Group A patients, maxillary antrum was packed with Foley's catheter after Caldwell-Luc surgery and in Group B patients, packing was done with BIPP gauze. Results in terms of efficacy and discomfort were observed. Efficacy was assessed by control of bleeding and subjective discomfort was assessed based on VAS [Visual Analogue Scale]

Results: in Group A average age of patients was 36.30[SD+13.52] and in Group B average age of patients was 39.65 [SD+13.84]. There were 56.52% males in Group A and in Group B there were 60.86% males. Whilst the pack was in situ, average pain score in Group A [Foley's catheter pack group] was 4.09 [SD+0.73] and in Group B, average pain score was 4.17[SD+0.83]. On removal of pack, pain caused by BIPP gauze was significantly higher i.e average pain score of Group B was 7.30 [SD+1.10], however that of Group A was 5.13 [SD+1.32] [p<0.001]. There was no case of bleeding after pack removal which showed that both types of packing are equally effective

Conclusion: maxillary antrum/antral packing with Foley's catheter is equally effective as compared to BIPP gauze packing and causes significantly less pain on removal as compared to BIPP gauze pack after Caldwell-Luc surgery

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

To compare the effect of postoperative intravenous dose of dexamethasone on morbidity in patients undergoing tonsillectomy. Randomized control trial. This study was conducted in ENT Department Shaikh Khalifa Bin Zayed Al Nahyan Hospital [CMH] Muzaffarabadfrom 10[th] Jan 2010 to 15[th] Feb 2011. After getting informed consent, a total of 60 patients who fulfilled the inclusion criteria were selected and tonsillectomy by dissection method was carried out. They were divided into two groups of 30 eachusing a random numbers table. Group A received 0.25 mg/kg body weight [maximum 20 mg] of Dexamethasone postoperatively intravenously for 03 days while group B [control group] did not receive any steroid. In group A, 80% patients had mild pain, 16.7% had moderate pain and 3.3% had a severe pain while in group B, 30% patients had mild pain, 6.7% had moderate pain and 63.3% had severe pain [p< 0.05]. In group A, 76.7% patients had mild emesis while in group B, 86.7% had moderate emesis [p< 0.05]. There was an insignificant difference in secondary hemorrhage. Dexamethasone given postoperatively significantly reduces the morbidity that is pain, episodes of emesis thus early recovery to a normal lifestyle with no effect on secondary hemorrhage in patients undergoing Tonsillectomy by dissection method

Comparison of serum immunoglobulin levels before and after adenotonsillectomy

To compare the pre and post-operative serum immunoglobulin levels in patients undergoing tonsillectomy and adenotonsillectomy. Quasi-Experimental Study ENT Department, Combined Military Hospital, Rawalpindi from Febuary 2006 to December 2007 Study included 50 patients of adenotonsillectomy and tonsillectomy. Two patients were excluded, because they did not report to the hospital for postoperative investigations. Preoperative serum IgG and IgA levels were measured two weeks before surgery and post operative samples were taken two months after the surgery. Mean age of the patients was 8.8 years, with maximum patients of 12 years of age [35.4%]. There were 36 [75%] male and 12 [25%] female patients. Tonsillectomy was done in 30 [62.5%] patients and adenotonsillectomy in 18 [37.5%] patients. Mean age of patient in case of adenotonsillectomy was 7.17 year and for tonsillectomy 9.9 years. There was a significant rise in the post operative serum IgA level [p= 0.02] while it was insignificant in case of IgG [p= 0.44]. Our study shows a significant rise in the post operative serum IgA level [p= 0.02]