Knowledge of depressive Illness among non- psychiatrist doctors

Objective: To ascertain the knowledge of non-psychiatrist doctors to suspect and diagnose Depressive Illness presenting to them in garb of physical or somatic symptoms

Methodology: This Descriptive cross sectional study was conducted at Social Security hospital in one year, from January 2016- January 2017. A simple questionnaire was developed, asking three basic diagnostic symptoms of depressive illness and the duration of illness needed for its diagnosis. Non-psychiatrist doctors from a tertiary care hospital were given five minutes to complete it in front of the research officer

Results: Three out of forty seven responding doctors knew about the three basic symptoms of depression with the required duration for diagnosis

Conclusions: A vast majority of the practising doctors or general practitioners are unaware of the characteristic features of Depressive Illness. Therefore, non-psychiatrist doctors are unable to suspect or diagnose Depressive illness

Unilateral Meniere's disease; intra tympanic injection of low dose gentamicin in the treatment

ABSTRACT: Meniere's disease is chronic progressive disease with unclear idiopathic etiology and symptomatic improvements with treatment

Objectives: To analyze the efficacy of low dose intratympanic injection of gentamicin for vertigo control in unilateral Meniere's disease. Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM and IMDC Islamabad

Materials and Methods: Gentamicin was used intra tympanically in this multicentre study of 75 patients over a period of 8.5 years between 1[st] January 2005 to 30[th] June 2013 in definite Meniere's disease according to the 1995 Document of American academy of otolaryngology- Head and Neck Surgery [AAO-HNS].All these centers followed same criteria and procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middle ear through the grommet under microscope and followed up for 3 months and two years. The staging of disease [hearing thresholds] the degree of disability [frequency of attacks per month] and the functional level were assessed before and after treatment

Results: Among 75 patients, 41 were female and 34 were males between age ranges of 25 to 70 years. Most of the patients in the study had stage 2 [23/75] and stage 3 [41/75] Meniere's disease. About 68[91%] patients were having good control of vertigo at the end of two year of intratympanic gentamicin without any loss of hearing

Conclusion: A single Low dose intratympanic gentamicin is effective in controlling vertigo in patients with Meniere's disease with no further deterioration in hearing for at least two years follow up

Frequency of secretory otitis media in children of age 3 to 5 years in Rawalpindi and Islamabad

To determine the frequency of secretary otitis media [OME] in the region of twin city and to determine variations related to gender, environment and socioeconomic status. This comparative cross sectional study was carried out for one year from July 2010 to July 2011 at Social Security Hospital, Islamabad and at Holy Family Hospital, Rawalpindi and included 600 children [3-5 years] from schools of Rawalpindi and Islamabad. Schools were divided into three socioeconomic groups, 200 children in each group. Written permission and history of clinical features was taken from parents, two days before visit. Complete examination was done by ENT consultant and Pediatrician. OME was diagnosed clinically and confirmed with tympanometry. Chi- square test was used for analysis. Mean age was 4 years. 73 children were bottle fed. Two children had cleft lip and palate repair. 49 were mouth breather, rhinitis was in 203 children. 18 were with delayed speech and hearing loss and acute upper respiratory tract infection [AURTI] in 63 children. 11 cases were excluded from study due to perforation in tympanic membrane. Tympanometry confirmed OME with type B curve in 69 [11.5%] and with hearing loss of 35-40 dB [mean 37.5dB]. Frequency of OME was 11.5%. OME is a common disease may result in serious morbidity in the form of delayed speech development and poor performance at school due to hearing loss in 3-5 years age group

Choanal atresia treated with transpalatal approach

A case of unilateral choanal atresia [CA] presented in adulthood with unilateral nasal discharge and obstruction, and coloboma of right lower eyelid. Diagnosis of choanal atresia was made with 0o telescope and CT scan. It was treated surgically by transpalatal [TP] approach. Stent was kept for 6 weeks. Few adhesions developed, which were broken. There was no other complication in follow-up

Laryngotracheal reconstruction in total laryngotracheal transection

A case of laryngotracheal trauma [LTT] was brought to hospital in emergency. After securing airway, neck was explored and total laryngotracheal separation together with crushed anterior and posterior tracheal walls was found. Cricotracheal anastomosis and anterior tracheal wall was repaired with perichondrium lined rib graft. Recovery was good, required dilatation once without any serious postoperative complication in close follow-up