Combat trauma experience at forward treatment centre during Swat operation

To have an overview of combat trauma experience at Forward Treatment Centre during Swat Operation. Descriptive study. Forward Treatment Centre of a medical battalion in Swat from Jan 2009 to August 2009. All battle casualties of different age groups operated under general anaesthesia were included in the study. Surgeries performed under local anaesthesia were excluded. Relevant information was recorded in specially prepared proforma. Two hundred and sixty eight surgeries were performed under general anaesthesia over the course of eight months. Twenty two [8.2%] were officers, 12 [4.5%] JCOs and 234 [87.3%] were soldiers. Majority of the casualities were between 20 -30 years of age [86%]. 73.9% of the casualities reached Forward Treatment Centre within 4 hours while 3.3% reached after 24 hrs. Most of the patients sustained injuries due to bullets [50.7%] and splinters [39.9%]. Most of the patients were putting on bullet proof jackets at the time of injury and sustained injuries to the limbs [237/268, 88.4%]. Blood transfusion was carried out in 32 [11.9%] cases. Fifteen [5.6%] cases required less than two and 17 [6.3%] cases required more than two units of blood transfusion. Most of the casualities were sustained by younger age group and were caused by bullets and splinters. Majority of the injuries were sustained on the limbs and less on the chest and abdomen. Blood transfusion and timely evacuation to a Forward Treatment Centre providing effective trauma surgical care to combat casualities saved a number of lives

neglected foreign body in the nasopharynx

Foreign bodies of upper aerodigestive tract in young children are frequently encountered by ENT specialists due to their peculiar habit of putting objects in their mouth. We report a case of foreign body nasopharynx that remained undiagnosed for a long time despite multiple visits to general and ENT OPD's with complaints of complete nasal obstruction and history of foreign body ingestion by a child. A radio-opaque foreign body of the nasopharynx was revealed on X-ray and removed per orally under general anaesthesia resulting in complete resolution of symptoms. The physician must have a high index of suspicion, particularly for persistent symptoms and necessitates further investigation before making diagnosis of a case of rhinosinusitis or empirically prescribing antibiotics