Intracranial complications of chronic suppurative otitis media

To study the presentations of various intra cranial complications of chronic suppurative otitis media [SOM]. This prospective and descriptive study was conducted in the department of ENT, Lady Reading Hospital Peshawar from April 2006 to march 2007. All the cases with suspected intra cranial complications were admitted to the department and assessed clinically and radiologically. Audiological, and laboratory investigations were done as well. Out of 50 cases 36 were male and 14 female ranging from 10-40years in age. Complications like meningitis and brain abscesses were more common in males in the 2[nd] and 3[rd] decade of life [72%]. Most of the complications were from atticoantral diseases. The main presenting features were foul smelling otorrhea, headache, and fever, neck stiffness, chloestosteatoma and granulations in the ear. Meningitis [46%], temporal lobe abscess [36%] and extra dural abscess [14%] were the commonest complications. Burr hole aspiration, for intra cranial abscess and radical/modified radical mastoidecomy for SOM were the main surgical procedure carried out for these patients. Otogenic intra cranial complications like meningitis and brain abscesses are still common in spite of advances in the medical sciences. Complications are common in 2[nd] and 3[rd] decade of life. Meningitis is the commonest complication followed by brain abscess Burr whole aspiration with modified, radical mastoidectomy is the main stay of treatment along with parenteral antibiotics

Experience with removal of foreign bodies tracheo-broncheal tree with rigid broncoscope

The aim of the study was to evaluate the presentation and management of different types of foreign bodies in tracheo-bronchial tree [TBT]. The study was conducted from July 2001 to December 2001 at the department of ENT, PGMI, HMC Peshawar. Patients with hlstory of foreign body inhalation were included in the study. Relevant history was recorded. The data collected was age and sex of patients, history of foreign body and type of foreign body inhalation, duration, symptoms and signs of foreign body inhalation. The findings of X-ray chest, treatment given and peri-operative complications and bronchoscopic findings were recorded. Bronchoscopy was done under general anaesthesia. Out of 50 patients, 32 [64%] were less than three years of age. Thirty two [64%] patients reached to the hospital with-in 24 hours. The commonest symptom was chocking sensation in 36 [72%] cases. Radiological changes, suggestive of foreign body tracheo- bronchial tree were observed in 16 [32%] of cases. The commonest foreign body removed was peanut in 27 [54%] cases. Right main bronchus was the common site for foreign body lodgment. Common complications encountered were laryngospasm in 3 cases [6%] and cardiac arrest in 2 cases [4%], with mortality rate of 2% [1 case]. Chocking, stridor, wheeze and coughing are the common presentations of foreign body tracheo-bronchial tree inhalation. Rigid bronchoscopy in experienced hands under general anaesthesia is safe and effective diagnostic and therapeutic procedure

Endoscopic management of ureteric calculi

A study involving 60 patients with ureteric calculi was conducted at the Department of Urology, Lahore General Hospital, from January 1991 to December 1993. The purpose of this study was to evaluate the efficacy and complications of uretero-renoscopy for ureteric calculi. This procedure was performed for fragmentation or removal of stone with the help of auxiliary instruments where possible. The study group predominantly consisted of male patients more than 14 years of age having ureteric calculi larger than 5 mm in diameter. The overall success rate of fragmentation, removal or push/bang of ureteric Galculi was 66.7 percent. In 15 patients although ureteric orifice was negotiated, the calculi could not be accessed either due to failure of visualization [n=8] or due to oedema and narrowing of lumen [n=7]. In five patients [25 percent] we failed to negotiate ureteric lumen due to narrow ureteric orifice. Perforation of ureter [n=1] and mucosal injury [n=1] occurred during the procedure. Fever in postoperative period occurred in three patients