Epistaxis: comparison of chemical cautery with topical vasoconstrictor in adult anterior epistaxis

Background: To compare efficacy of 75% silver nitrate chemical cautery as opposed to topical vasoconstrictor spray (xylometazoline 0.1%) in adult anterior epistaxis.Methods: This randomized controlled trial study was carried out at SMHS Hospital Srinagar from Jan 2019 to Dec 2019. 110 subjects that presented to ENT & HNS emergency with epistaxis and fulfilled the inclusion criteria were selected. Subjects were randomly distributed into two groups. Group-A individuals were treated by cauterization with 75% silver nitrate and Group-B individuals were treated with topical vasoconstrictor spray (xylometazoline 0.1%). All the subjects were reviewed at 1 month and success was determined in terms of control of epistaxis from same side of nose.Results: The mean age of the cohort was 48.5yrs (age range, 17-59). There were total 60 (54.4%) males and 50 (45.4%) females among the cases. Both the groups were comparable as regards the age, sex, duration and frequency of epistaxis. 91.2% cases in Group-A (silver nitrate cautery) and 73.5% cases in Group-B (xylometazoline spray 0.1%) had no further epistaxis at one-month follow-up (p=0.014).Conclusions: Chemical cauterization with silver nitrate is a feasible and safe technique for the treatment of adult anterior epistaxis and is more effective than topical vasoconstrictor spray.

Microbiota Of Pruritic Ears In Kashmir, India

AIM:To identify microflora of external auditory canal in patients with aural itching and to study susceptibility profiles of pathogenic organisms. Materials & Methods: A total of 194 patients with aural itching were selected. An external auditory canal swab was taken. The samples were emulsified in different media for studying different organisms. Culture and sensitivity was done for the pathogenic organisms. Results: Of the total 194 patients, 107 patients had no growth. Of the remaining 84 cases, 55 patients yielded aerobic bacteria and anaerobes were isolated in 04 cases. Of the aerobes isolated, coagulase negative staphylococcus was isolated from 31 patients, staphylococcus aureus from 17 patients and pseudomonas aeruginosa in 07. Fungi were isolated in 29 cases. Conclusion: Our findings suggest that asteatosis should be considered an etiology in patients with pruritic ears after bacterial and fungal infections have been ruled out. Our study showed that a combination of a topical antibiotic/steroid and oral antihistamine is effective in alleviating the symptoms of pruritic ears

Sub Glottic Schwannoma of the Larynx

Schwannomas are rare neurogenic tumors. Their laryngeal location is uncommon.We present a case of subglottic schwannoma which is very rare.

Nasopharyngeal Carcinoma in Children.

Nasopharyngeal carcinoma is rare in children and adolescents. Nevertheless, it is considered to be the only tumour of surface epithelium apithelium children and young adults. Three such cases seen over a period of eight years (1990-1997) are reported with a review of relevant literature.