Outcome of silver nitrate cauterization in controlling anterior epistaxis in children

To assess the outcome of silver nitrate cauterization in controlling unilateral spontaneous anterior epistaxis in children in terms of success on initial attempt and complications like recurrence of bleeding, pain, infection, exposure of septal cartilage, septal perforation and stenosis of the nostrils. Cross-Sectional Descriptive This study was conducted at Department of ENT, Mufti Mehmood Memorial Teaching Hospital, D.I.Khan, from October 2010 to September 2012. All patients having ages between 6-16 years with spontaneous unilateral anterior epistaxis were included in the study. Patients with bilateral anterior epistaxis, posterior epistaxis, post-traumatic epistaxis, and epistaxis due to bleeding diathesis or neoplastic lesions were excluded. Patients were managed by silver nitrate cauterization after packing the nose with ribbon gauze soaked in 4% lidocaine and adrenaline 1:1,000 in equal amounts for 5-10 minutes. Furacin antibiotic ointment was applied to the cauterized area and was continued two times daily for two weeks. All patients were reviewed fortnightly for six weeks. Mean age of the patients was 10.43 +/- 3.23 years with 49 [65.35%] males and 26 [34.65%] females. Silver nitrate cauterization was successful on initial attempt in 69 [92%] patients. Recurrence of bleeding, infection and exposure of septal cartilage were noted in 7 [9.35%], 2 [2.65%] and 1 [1.33%] cases respectively. The increased success rate and decreased post procedure morbidity associated with silver nitrate cauterization make it an effective and safe procedure for managing spontaneous unilateral anterior epistaxis in children

Nasal involvement in cutaneous leishmaniasis

To determine the frequency of nasal involvement in cutaneous Ieishmaniasis and to study demographic and clinical pattern of disease involving nose as well as nasal mucosa. Patients with cutaneous leishmaniasis presented to leishmaniasis clinic situated in the Basic Health Unit for Afghan refugees at Sarai Gambeela, District Lakki Marwat from January 1, 2009 to December 31, 2009 were registered. The patients were diagnosed clinically and confirmed by laboratory demonstration of parasite in a giemsa stained smear prepared from the lesion. Those having lesions primarily on nose, irrespective of age and gender were included in the study. All those cases with primary lesion elsewhere over face and secondarily involving nose [creeping lesion] were excluded. All important clinical details were recorded on a specially designed proforma and patients were given a registration card for the purpose of treatment and follow up visits. Sixty seven out of' 682 [9.82%] cases of nasal leishmanisis were encountered. Male to female ratio was 2:1. Forty nine [73.13%] had solitary lesions and among these fourty four [65.67%] had lesions limited to their nose. Wet type cutaneous leishmnaniasis was seen in 19 [28.36] cases. Seventy three percent of sufferers were less than 30 years of age. Cutaneous leishmaniasis is endemic in Distt. Lakki Marwat. Nose was a common site of involvement. In endemic areas, it should be included in the differential diagnosis of nasal lesions