Tonsillar surface micro flora: does it truly represent pathological tonsillar flora?

Objective: To determine the best method of identifying core tonsillar flora

Study Design: Quasi-experimental study

Place and Duration of Study: ENT Department, Combined Military Hospital, Lahore, from September 2013 to October 2015

Methodology: Eighty-seven patients of recurrent tonsillitis undergoing tonsillectomy were included. All the patients, after being anaesthetised, had surface swabs taken from the tonsillar surface followed by tonsillar aspiration with a 5cc syringe. Following tonsillectomy, the tonsils were sent for culture of core flora. All three specimens from each patient were cultured according to established criteria

Results: The patient population had 33 [37%] female and 54 [62%] male patients. Flora of 12 [13.8%] surface swabs and 68 [78.2%] tonsillar aspirates matched the flora cultured from core of the tonsils. Chi-square test showed this difference to be significant [p-value <0.001]

Conclusion: Tonsillar aspiration gave a much more realistic picture of the tonsillar core flora as compared to surface swabs

Correction of caudal septal deviations via closed rhinoplasty approach

Objective: To introduce the combined technique of nasal spine stitching and partial tongue-in-groove for the management of caudal septal deviation and to evaluate the surgical outcome and its efficacy

Study Design: Quasi-experimental study

Place and Duration of Study: Ear, nose and throat [ENT] Department Combined Military Hospital [CMH] Lahore from September 2013 to February 2015

Material and Methods: Ninety three patients with caudal deviation were included in the study. Caudal septal deviation was corrected employing both Modified Kriedel's and Pastorek's technique via endonasal approach. Nasal patency was determined using the alpha-version of "Nasal Obstruction Symptom Evaluation" [NOSE] Scale

Results: NOSE Scale scores were checked pre operatively and three weeks post surgery. Post operatively 88 [94.6%] patients had satisfactory nasal patency [NOSE Scale score fell by 15 points]. Five [5.4%] patients who did not have satisfactory score had revision surgery

Conclusion: Combination of Pastoreks's and Kriedel's technique gives accurate correction of caudal dislocation

Atorvastatin in the management of tinnitus with hyperlipidemias

To determine the role of atorvastatin in management of tinnitus in patients with hyperlipidemia. Quasi-experimental study. ENT Department, Combined Military Hospital, Rawalpindi, from July 2011 to August 2012. Ninety eight patients of tinnitus with sensorineural hearing loss having hyperlipidemia were included in the study. Their pre-therapy serum cholesterols were measured, and tinnitus scores were recorded on a 'Tinnitus handicap questionnaire'. They were administered tablet atorvastatin 40 mg once daily with low fat diet for 8 months. After 8 months of therapy, patients were purposefully divided into responsive and unresponsive group depending on serum cholesterol levels. Post therapy serum cholesterol levels and tinnitus scores were also recorded after 8 months and compared with pre-therapy records. Serum cholesterol came to within normal limits in 51 [52%] patients [responsive group], while it remained high in 47 [48%] patients [unresponsive group]. Improvement in tinnitus score in the responsive group was seen in 36 [70.5%] patients and in 2 [4.2%] patients of the unresponsive group. Improvement in tinnitus scores was compared in the two groups using Fisher's exact test and were found to be statistically better in the responsive group [p < 0.001]. Tinnitus, in patients having hyperlipidemia, can be successfully dealt with by treating hyperlipidemia with lipid lowering agent atorvastatin

Noise induced hearing loss among artillery soldiers

To determine whether there is a significant difference in hearing threshold of artillery soldiers and non artillery soldiers. A cross sectional comparative study. This study was done at Khyber Rifles Hospital Landikotal over four months time from 10th September 2009 to 31st December 2009. Study group comprised sixty males thirty of whom were engaged in firing of artillery guns and thirty with sedentary jobs. Pure tone Audiometry [PTA] was done for all sixty individuals. Average hearing loss in speech frequencies was statistically more in individuals who were actively involved in firing of artillery guns. [P<0.001] Adequate protection and training should be imparted to individuals involved in firing of artillery guns