Lymph node biopsies: Evaluation of disease pattern and role of surgery – Our experience from South Punjab, Pakistan

Objective: The objective of the study was to determine the frequency of different pathologies presenting with lymphadenopathy in patients from South Punjab and to evaluate the role of surgery in reaching the diagnosis. Materials and Methods: It was a cross-sectional study done at Recep Tayyip Erdogan Hospital, Muzaffargarh (managed by The Indus Health Network), from August 2014 to October 2017. Those being biopsied at some other hospital and the lymph node dissection biopsy done for a known primary cancer were excluded. Results: Lymph node biopsy was done on a total of 71 patients (56.3% n = 40 males, 43.7% n = 31 females). The mean (standard deviation) age of the patients was 27.30 ± 17.07 years. Open biopsy was performed on 70 cases (98.6%), whereas laparoscopic biopsy was performed on one case (1.4%). The most common pathology found on histopathology report was Tuberclosis (TB) lymphadenitis (49.3%, n = 35), followed by lymphoma (25.4% – Hodgkin's disease [HD] 15.5% and non-Hodgkin's lymphoma [NHL] 9.9%). Conclusion: TB is the most common pathology, followed by lymphoma. HD is more common than NHL. Surgical biopsy is the gold standard. Laparoscopy and other minimally invasive techniques are very safe and useful for excision biopsy of the central lymph nodes.

Prevalence of allergic fungal sinusitis among patients with nasal polyps

Background: Nasal polyps are commonly seen in our routine ENT practice. Allergic Fungal Sinusitis [AFS] is also one of them

Objective: To determine the prevalence of allergic fungal sinusitis among patients with nasal polyps

Patients and Methods: This sectional study was conducted in Department of ENT, Sheikh Zayed Hospital, Rahim Yar Khan from 11[th] July, 2013 to 10[th] January 2014. This study included 84 patients with diagnosis of nasal polyps. All the patients were evaluated for the presence of allergic fungal sinusitis which was described as frequency and percentage. The data was collected in pre designed performa. The data was entered and analyzed by using SPSS version 16

Results: Allergic fungal sinusitis was detected in 9 [11%] patients. The mean age of the patients was 31 +/- 6 years, and all of the patients have, nasal obstruction, post nasal drip and sneezing

Conclusions: Allergic fungal sinusitis is seen commonly among patients with nasal polyps. So, every patient with nasal polyp should be evaluated for the presence of AFS

survey of awareness regarding diabetes and its management among patients with diabetes in Peshwar, Pakistan

To determine and compare the level of awareness regarding diabetes mellitus, its complications and management in male and female diabetic patients of Peshawar, Pakistan. A cross sectional study conducted in Peshawar, from February to July 2013. A well organized questionnaire was used, having fourteen items. The participants were interviewed and the questionnaire was filled by trained persons [Diabetes Educators]. The correct answers were marked as aware and incorrect as unaware, and made conversions to percentage. Total 561 diabetic patients were assessed. The data was analyzed using SPSS v.16 software and excel 2007. The level of awareness regarding diabetes and its management was found inadequate. Amongst, 36.3% male and 13% female diabetics were aware that why glycemic control is important, 63% male and 32.4% females were aware that diabetes could produce some complications. Similarly 23.7% male and 10% female respondents know importance of blood glucose monitoring. Only 181 male and 31 female diabetics were aware of hypoglycemia symptoms and management. Over all level of awareness in female patients as compared to male patients was found low. The overall level of awareness in both male and female diabetics was found low; and comparatively female patients have poorer awareness.

Stridor caused by a rare laryngeal tumour

This report describes stridor caused by a rare laryngeal tumour. The patient had presented to ENT with a midline neck-mass and stridor of acute onset and diagnosed radiologically as a mass in the right lobe of thyroid gland in continuity with enhancing polypoidal mass in trachea at the same level. Total thyroidectomy along with the resection of the mass and tracheal ring was performed, trachea being anastomosed primarily. Histopathology reported it as a paraganglioma of the larynx. The patient has been followed-up for 5 years with no clinical or radiological recurrence of the tumour

Seasonal variation and demographical characteristics of carpal tunnel syndrome in a Pakistani population

To determine the demographic characteristics of gender, age, involvement of hand/hands and seasonal distribution in patients with a neurophysiological diagnosis of carpal tunnel syndrome [CTS]. An observational study. Department of Neurology, Fauji Foundation Hospital, Rawalpindi and PIMS, Islamabad, during December 2006 to July 2009. Cases reported in the months of December and January [winter group] and those reported in the months of June and July [summer group], of any age and gender with electrophysiological confirmation of CTS were included. Those having median neuropathy in the region of elbow, brachial plexopathy and cervical radiculopathy [C6-7] or polyneuropathy were excluded. Nerve conduction study was done in Median nerve. Statistical significance between the two groups [summer and winter] was calculated. Among the 213 patients [320 hands] of CTS, 70 [105 hands] were in summer group and 143 [215 hands] were in winter group. There were 15 [21.43%] males and 55 [78.57%] females in summer group and 22 [15.38%] males and 121 [84.62%] females in winter group. The female hands were 83 [79.05%] and 182 [84.65%] and male hands were 22 [20.95%] and 33 [15.35%], respectively in summer and winter group. Mean age was 44.38 years and 45.16 years. The right hand was affected in 64 [60.95%] and 121 [56.28%]; and the left hand was affected in 41 [39.05%] and 94 [43.72%] in summer and winter groups respectively. Half of the patients had bilateral involvement. The p-values for the NCS variables were not statistically significant. Presentation with CTS was more common in winter at the study centre. Female gender and dominant hand was affected more frequently. There were no significant changes in NCS parameters among the two groups

Concurrent intramedullary spinal cord and intracranial tuberculomas

Tubeculosis commonly involves the nervous system, but involvement of spinal cord in the form of intramedullary tuberculoma is rare and concurrent occurrence of cranial and intramedullary tuberculomas is extremely rare. We report a case of concurrent occurrence of intramedullary tuberculoma with multiple intracranial tuberculomas in a young girl from lslamabad, who presented with one month history of paraplegia and with a sensory level at TB. MRI spine showed a well circumscribed lesion opposite T6, which was diagnosed as intramedullary tuberculoma. On cranial imaging, she was found to have multiple round contrast enhancing lesions which were diagnosed as intracranial tuberculomas based on their typical MRI findings. She had complete recovery with conventional treatment of ATT and steroids, without any surgical intervention. The follow-up MRI of patient showed disappearance and complete resolution of most of the lesions