Combat trauma experience at forward treatment centre during Swat operation

To have an overview of combat trauma experience at Forward Treatment Centre during Swat Operation. Descriptive study. Forward Treatment Centre of a medical battalion in Swat from Jan 2009 to August 2009. All battle casualties of different age groups operated under general anaesthesia were included in the study. Surgeries performed under local anaesthesia were excluded. Relevant information was recorded in specially prepared proforma. Two hundred and sixty eight surgeries were performed under general anaesthesia over the course of eight months. Twenty two [8.2%] were officers, 12 [4.5%] JCOs and 234 [87.3%] were soldiers. Majority of the casualities were between 20 -30 years of age [86%]. 73.9% of the casualities reached Forward Treatment Centre within 4 hours while 3.3% reached after 24 hrs. Most of the patients sustained injuries due to bullets [50.7%] and splinters [39.9%]. Most of the patients were putting on bullet proof jackets at the time of injury and sustained injuries to the limbs [237/268, 88.4%]. Blood transfusion was carried out in 32 [11.9%] cases. Fifteen [5.6%] cases required less than two and 17 [6.3%] cases required more than two units of blood transfusion. Most of the casualities were sustained by younger age group and were caused by bullets and splinters. Majority of the injuries were sustained on the limbs and less on the chest and abdomen. Blood transfusion and timely evacuation to a Forward Treatment Centre providing effective trauma surgical care to combat casualities saved a number of lives

neglected foreign body in the nasopharynx

Foreign bodies of upper aerodigestive tract in young children are frequently encountered by ENT specialists due to their peculiar habit of putting objects in their mouth. We report a case of foreign body nasopharynx that remained undiagnosed for a long time despite multiple visits to general and ENT OPD's with complaints of complete nasal obstruction and history of foreign body ingestion by a child. A radio-opaque foreign body of the nasopharynx was revealed on X-ray and removed per orally under general anaesthesia resulting in complete resolution of symptoms. The physician must have a high index of suspicion, particularly for persistent symptoms and necessitates further investigation before making diagnosis of a case of rhinosinusitis or empirically prescribing antibiotics

Microflora and antibiograms of discharging ears in a cross - section of population in Quetta, Balochistan

To study the micro flora and the antibiograms of patients with discharging ears due to Otitis externa / Otitis media in Quetta, Balochistan and to analyse and compare the results with other domestic and international studies. Prospective, descriptive study. Department of ENT, Combined Military Hospital, FC Hospital, Saleem Medical Complex and Mideast Hospital Quetta, from January 2003 to June 2005. The ear swabs of 1105 patients with otorrhoea were prospectively analyzed. Antibiotic testing was done using modified Kirby Bauer disc diffusion method. In addition to the usual antibiotics, the two most common topically available antibiotics [gentamicin and Ofloxacin] were also tested. There were 1057 positive cultures for organisms from the 1105 patients with 1125 isolates. The most common causal organisms isolated were staphylococcus aureus [40%] with 10.29% Methicillin resistant staphylococcus aureus [MRSA] positive followed by pseudomonas aeruginosa [38.4%]. Fungi accounted for 3.7% of isolates. Out of the two antibiotics commonly available as topical eardrops, Ofloxacin has a very high overall susceptibility rate [97.3%] to all organisms cultured. Staphylococcus aureus is the commonest organism, replacing pseudomonas aeruginosa in discharging ears. All the isolates cultured were highly sensitive to Ofloxacin / Ciprofloxacin. Thus apart from fungal infection of the ear Ofloxacin eardrops should be the mainstay of treatment