Oral submucosal fibrosis in rural sindh

OBJECTIVE: To determine the frequency of complications in Oral Submucus Fibrosis and to evaluate the major risk factors involved in OSF

STUDY TYPE: Observational Descriptive study

SETTING AND DURATION: Dr. Moula Bux Jaffery Memorial Hospital Badin, Sindh from January 2010 to September 2011

METHODOLOGY: Two hundred and eighty cases of OSF diagnosed on clinical base, detailed history and proper clinical examination of all the patients was conducted in ENT clinic and functional fibrosis grading system had applied in study, all the related information was documented on prescribed proforma

RESULTS: Majority of patients was related with more youthful age bunch with male prevalence

Most of the patients found 2nd and 3rd stage fibrosis. 99% patients had a history of taking Paan, CHHALIA and Gutka, 29% patients had developed recurrent mouth ulcers and 2% patient had developed neoplasia while 85% patients have history of recurrent throat infections

CONCLUSION: Major cause of OSF is use of Pan CHHALIA and Guttka. Young age group is more vulnerable. Recurrent throat infection is another burden over society

Epistaxis - a study of etiologies and management at a tertiary care hospital of urban sindh

OBJECTIVE: To highlight different etiologies of epistaxis and their management at the setup of a tertiary care level hospital of urban Sindh

STUDY DESIGN: Descriptive Study

SETTING: Department of E.N.T. and Head and Neck Surgery, Liaquat University Hospital Hyderabad from June 2011 to May 2013

METHODOLOGY: A prospective study of 437 patients presented with epistaxis due to different etiologies and its management at the department of E.N.T. and Head and Neck Surgery, Liaquat University Hospital Hyderabad. The patients of all age groups of both the genders were enrolled. All the data was collected on a pre-designed Performa equipped with all the relevant details. Finally all the collected data was then fed into SPSS VER. 16 to have statistical assistance and to construct different graphs and tables

RESULTS: Spanning over two years period, this study comprised 437 cases. 263[60.2%] were male and 174[39.8%] were female. The age range was 3-77 years with mean age to be 31.66 years. The commonest cause in this study was trauma which affected 155[35.6%] patients. Most of the patients i.e. 324[74.1%] reached us through emergency department. Site of bleeding was anterior in most of the patients, accounting 229[52.4%] patients. Maximum numbers of patients i.e. 163 [37.3%] were managed successfully by anterior nasal packing

CONCLUSION: Epistaxis constitutes the main bulk of emergency cases attending the E.N.T. department. This study observed trauma to be the commonest cause of epistaxis in our set up. Maximum number of cases required anterior nasal packing as the only measure to be effective and successful from management point of view

Traffic noise pollution in Karachi, Pakistan

Objectives: To determine the level of traffic noise in the city of Karachi

Study Design: Descriptive, cross sectional study

Place and Duration: Karachi, August 2008

Materials and Methods: Six different sites were selected from busy locations in different areas of Karachi for study. Same persons made all recordings. Kamplex sound level meter [SLM3] with built-in calibrated condenser microphone was used for all recordings

Inclusion Criteria: Two major roads of the city namely M.A Jinnah Road and Shahrah-e- Faisal were selected for study

Exclusion criteria: Air traffic noise, Railway stations, vendors with their loudspeakers and loud music played on certain vehicles were all excluded from the study

Results: Maximum level of noise was 110 dB [A], recorded from Autorikshaw and Motorcycles [without silencers] and Minibuses. Maximum noise was observed during the peak rush hours between 01.00 p.m. to 03.00 p.m. and 05.00 p.m. to 07.00 p.m. and was in the range of 110 dB [A] with a dip of about 5 - 10 dB [A] between 03.00 p.m. to 05.00 p.m. The noisiest site was found to be M.A Jinnah Road [Merewether Tower and opposite K.M.C building]. The mean values of noise level in the commercial and residential areas were 95.75dB [A] and 60 dB [A] respectively

Conclusion: Karachi is facing an enormous problem of exceedingly high levels of traffic noise, which is significantly higher than all the available international data

clinic pathological study of laryngeal malignancies - an institutional experience

Objective: to determine the risk factors and clinic-pathological pattern of the laryngeal malignancies

Design: descriptive case-series

Setting: department of Otorhinolaryngology - Head and Neck Surgery, Dow Medical College, Civil Hospital Karachi and Dow University of Health Sciences from, March 1998 to March 2009

Methods: all patients of either gender having malignant lesion of larynx were included. Recurrent cases after surgery or chemo radiotherapy and benign Tumours of the larynx were excluded from the study. Patients were studied with particular importance to the risk factors, mode of presentation, topography and histopathology of the tumour

Results: out of 100 patients, 89 were males and 11 were females with male to female ratio of 8.1:1. Majority of the subjects was in 5th decade of their life. Tobacco intake in the form of smoking or chewing was present in 91% . Presenting symptoms were hoarseness, odynophagia, sore throat, dysphagia and dyspnea/stridor. Tran's glottic area was the commonest site [39%] for laryngeal cancer. Squamous cell carcinoma [SCC] found in 98% of patients. Well differentiated category seen in 57% of patients

Conclusions: SCC was the most frequent malignant lesion of larynx. Most of the patients presented in the late stages [stage III and IV]. Commonest presenting symptom was hoarseness. Smoked tobacco [cigarette smoking] was found to be the major risk factor

Frequency of un-safe chronic suppurative otitis media in patients with discharging ear

Objective: To determine the frequency of un-safe chronic suppurative otitis media and its complications in patients with chronic discharging ear

Methods: This study was carried out in the Department of Otorhinolaryngology, Civil Hospital Karachi, Sindh - Pakistan between January 2004 and June 2006. This study included 390 cases of chronic discharging ears attending out patient department. All were examined according to protocol, and relevant investigations were carried out. 107 cases underwent mastoid exploration and were observed for cholesteatoma, granulations, aural polyps and their complications. A structured questionnaire was designed to record all information which was later analyzed

Results: Majority of patients was belonging to poor families. Female-male ratio was 1.2:1. Age range was between 6 months and 70 years. Most of the patients presented with discharging ears. Central perforation was seen in 89% cases. One hundred seven cases [27.5%] underwent mastoid exploration, in which cholesteatoma was found in 11.5% cases. Ossicular damage was the commonest complication in all cases having cholesteatoma, while 1% cases presented with mastoid abscess, 1.5% with exposed facial nerve, 1.2% with exposed sigmoid sinus and 0.25% with Bezold abscess. Intracranial complications were seen in nine patients

Conclusion: Cholesteatoma was found to be associated with most of the complications in cases of un-safe type of C.S.O.M. The complication rate in this study is lesser than that observed in our neighboring countries like Bangladesh, but still higher as compared to the developed countries. Cholesteatoma was also found in two cases having central perforation which is unusual presentation