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Introduction: Chronic sinusitis is a very common problem in ENT practice. Variations have an anatomic and surgical significance, each and every case should be individually studied in detail before surgery to maximize patient benefit and avoid serious complications. Aim: To study the anatomical variations in relation to radiological findings occurring in nose and PNS in chronic sinusitis patients using CT scan PNS and DNE (Diagnostic nasal endoscopic examination). Materials and methods: Study done on 50 patients in duration of study 2 years, cases of chronic sinusitis chronic sinusitis with symptoms such as purulent rhinorrhea, nasal congestion, headache, facial pain or pressure persisting beyond 12 weeks who had not demonstrated symptom resolution despite 3-6 weeks antibiotic therapy, with systemic steroids, decongestants and nasal saline irrigation were included in the study. Results: In this study 42 cases showed anatomical variations out of 50 cases (ranging from 2.3% to 57.1%). Mixed signs and symptoms are most common observation, Incidence of Symptoms ranges from 20% to 90% and Signs ranges from 10% to 90%. More than one sinus bilaterally involved (68%). Conclusion: CT scan of the paranasal sinuses is the investigation of choice. Diagnostic nasal endoscopic examination is the clinical guide to evaluate the disease and the severity of the anatomical abnormality
RESUMEN
Background: Antepartum hemorrhage is defined as any bleeding from or into the genital tract after the period of viability and before the end of second stage of labour. Aim: To study the maternal and perinatal outcome in antepartum hemorrhage. Materials and methods: The present study was a prospective observational study undertaken during a period of 2 years from September 2012 to August 2014 in 50 cases of antepartum hemorrhage. Only patients with APH >28 weeks gestational age willing to participate in study were included. Results: The incidence of antepartum hemorrhage was 3.8%. Abruptio placenta (56%) constituted the largest group. Maximum number of patients was in the age group 20 to 30 years in both abruption (53.5%) and placenta previa (52.5%). In abruption 53.6% and in placenta previa 79% of the patients were multiparous. Majority (56%) of the patients with antepartum hemorrhage had GA of 28 to 34 weeks. Mean period of gestation in APH patients was 33.4 weeks. In abruption, 64% of the patients and in placenta previa 42% were in the age group of 31-34 weeks and 6 days. In the present study, 64% of the patients were anemic at the time of admission. Majority 34% of the anemic patients had Hb of 7.5-9.9 gm. Maximum 35.7% of the patients with abruption had Hb of 5 to 7.4 gm and 42.1% of patients with placenta previa had Hb of 7.5 to 9.9 gm. Pre-eclampsia (36%) was the most common risk factor for APH. The commonest mode of delivery was cesarean delivery i.e. 60%. In abruption majority 53.6% had normal delivery. 89.5% of placenta previa had cesarean section which was the largest group. Post partum hemorrhage was the most common complication observed in 22% of the cases. 5.3% of the patients with placenta previa had placenta accreta. DIC and renal failure were seen in 3.6% each. Majority (64%) of the patients in this study required blood transfusions. 64% of abruption and 68% of placenta previa patients required blood transfusion. IUD or still births were noted in 31% of the cases. Neoantal deaths were observed in 5.8%. Prematurity was the most common complication observed in the present study in 82.8% of the cases followed by neonatal jaundice which G. Sharmila, Prasanna. Maternal and perinatal outcome in antepartum hemorrhage. IAIM, 2016; 3(9): 148-160. Page 149 was observed in 51% of the cases. NICU admissions were present in 8.5% of the cases. In the present study, 56% of the patients had an APGAR score of <7 at 1 min and 63% had an APGAR of 4 to 6 at 5 min. Maximum number of births had birth weight of 1.5-2 Kg. In previa 17, majority (39.2%) of births had birth weight of 1.5-2 Kg and in undetermined majority (66.7%) had birth weight of 2.5-3 Kg. Conclusion: From the present study it can be concluded that antepartum hemorrhage is still a leading cause of maternal morbidity and mortality in our country.