Nasal bone fractore

To analyze modes of presentation, types of the nasal fractures and their management. From 01 Apr 2006 to 31 Mar 2007 at Frontier Corps Hospital, Quetta. This descriptive study consists of 50 patients of both sexes and all age groups, managed for nasal bone fractures, presented in emergency as well as in outpatient department. Selection of cases was non probability, convenient type. All patients were admitted in the hospital for evaluation and further management. Every case of nasal fracture was properly evaluated, assessed and was managed accordingly. Diagnosis was based on proper history, thorough clinical examination and radiological confirmation. From this study it was concluded that adults [80%] were affected more than children. Highest incidence was seen in the age group 18-30 years [46%]. The male to female ratio was 3:1. The main aetiological factors in adults were Sports injuries [30%], personal falls [24%], road traffic accidents [22%] and interpersonal assaults [20%] and in children personal falls [24%]. Most of the patients [905] presented within 2 weeks of the nasal trauma. Epistaxis [92%], nasal deformity [76%], pain and tenderness [72%] and nasal obstruction [70%] were main clinical features. Closed reduction under general anaesthesia [80%] was the most common and effective treatment awarded and complications were minimal. Three cases who presented after 1 year of trauma were treated by Septorhinoplasty [1], Septoplasty [1] and SMR [1]. 14% [7] patients were treated conservatively. Nasal bone fractures should not be considered minor injuries until they have been thoroughly assessed. Closed reduction under GA is most effective treatment for the patients presenting within 2 weeks of injury. Prognosis of un-complicated nasal fractures, in general, is good and they heal within 2-3 weeks with good cosmetic and functional results

Chronic suppurative otitis media; frequency of pseudomonas aeruginosa in patients and its sensitivity to various antibiotics

To identify the frequency of pseudomonas aeruginosa in patients of chronic suppurative otitis media and it sensitivity to various antibiotics. A descriptive study. The study was carried out from Nov 2002 to may 2003 at Department of ENT, Head and Neck surgery, Combined Military Hospital, Rawalpindi. A total 150 patients with unilateral or bilateral active Chronic Suppurative Otitis Media from the out patients clinic were included in the study. All patients were evaluated through detailed history and through clinical examination. Pus samples were collected from the discharging ear[s] and sent to pathological laboratory of the hospital for culture sensitivity. In this study, 82% cases yielded pure cultures, 15% yielded mixed cultures while 3% yielded no growth. The pure cultures yielded pseudomonas aeruginosa in 52.5% of the cases, Staph. Aureus in 15%, Proteus SPP in 6.5%, klebsiella in 2.6%, E. Coli in 2%, anaerobes in 1.3%, Aspergillus in 1.3% and Candida in 0.6% of the cases. In mixed cultures, pseudomonas was isolated in 7.3% of the cases, Staph. Aureus in 2.6%, proteus in 2%, Klebsiella in 0.6% and E. Coli in 0.6% of the cases. Pseudomonas was sensitive to Gentamicin in 70% of cases, Amikacin 92%, Ciprofloxacin 95%, Ceftazidime 84%, Cephoperazone 82%, Cefipime 84%, Aztreonam 83%, imipenem 98%, Levofloxacin 97%, Augmentin 67% and chloramphenicol in 56% of the cases. Pseudomonas aeruginosa was the most commonly isolated organism followed by staphylococcus aureus. Pseudomonas aeruginosa is increasingly becoming more resistant to the common dugs. This necessitates the early diagnosis and prompt treatment of the disease so as to avoid the complications of CSOM