effect of intraoperative intravenous dexamethasone on immediate post-tonsillectomy morbidity in children

To evaluate the effect of intravenous intraoperative dexamethasone sodium phosphate on immediate post- tonsillectomy morbidity in children. A total of 62 patient aged around 12 years underwent tonsillectomy were randomly assigned to receive either intravenous dexamethasone sodium phosphate [1 mg/kg] or placebo. Outcome Measures Pain scores, oral intake, and emesis on 1[st] postoperative day. A total of 62 patients [32 received intraoperative steroids, and 30 received placebo. On POD 1, pain scores reported by patients [P = .03], were significantly lower in subjects receiving steroids [3.2] than in those receiving placebo [5.8]. Emesis was reduced from a mean of 1.4 [placebo group] to 0.6 episodes [steroid group] [P = .04], Oral intake improved from 41.5% of normal diet [placebo] to 72,6% [steroid group] [P = .007]. When the 2 groups were compared [placebo, steroid], pain scores reported were significantly lower in the steroid group than in the placebo group. Intraoperative dexamethasone reduces immediate post-tonsillectomy morbidity in children

Treatment of secretory otitis media in adults: our experience

Secretory otitis media [SOM] is the usual type of middle ear effusion in adults, characterized by presence of thin [serous] non purulent fluid in the middle ear space. To evaluate the response to conservative medical treatment of serous otitis media versus surgical treatment [myringotomy]. A prospective study enrolling 54 patients with SOM, aged 21-60 years was conducted during the period from the September 2006 to the October 2007 at Al-Kadhimiyia teaching hospital in Baghdad. Medical treatment used for 10-14 days. The response to treatment was evaluated 2 weeks following medical treatment using symptomatic improvement, tympanogram and pure tone audiogram. 39 patients did not respond to medical treatment were treated by myringotomy and aspiration of middle ear fluid [under local anesthesia] was done and the response was evaluated, after 1 and 2 months by using the same above mentioned assessment methods. 72% of the patients didn't improve following medical treatment, 77% of them have bilateral serous otitis media. Myringotomy was done for these non-responders; of whom 95% were improved. Myringotomy was effective, safe and easy method for treating adults with SOM did not improve following conservative medical treatment and, or for those who asked for an immediate relief of their symptoms, with a low recurrence rate

Use of gelfoam for grafting traumatic tympanic membrane perforation

Many procedures using different materials [e.g. gelfoam] have been tried to close the tympanic membrane perforation in an attempt to enhance and hasten the healing process of the tympanic membrane. To evaluate the results of gelfoam patch in patients with recent traumatic perforations of the tympanic membrane of different sizes. This study was performed on [52] patients with traumatic tympanic membrane perforation in Al-Kadhimiyia Teaching Hospital in Baghdad [from January to December 2007]. The perforations were classified into 4 Grades according to size [GI:<25%, GII:25-50% or multiple perforations involving 2 quadrants,GIII:50-75% or multiple perforations involving 3 quadrants, GIV: more than 75%]. After gentle cleansing of the external auditory canal, the perforations were patched with a Gelfoam impregnated with blood taken from the same patient by fine needle aspiration. These patients were followed up at 3 weeks, 6 weeks, and 3 months intervals during which another otological and audiometrical assessment was performed. The closure rates were 100%, 87%, 57% for grades I, II and III perforations respectively. Whereas none of the grade IV perforations were healed. Small perforations needed the least time for closure [average duration was 4.5 weeks], while larger perforations needed longer duration for closure [average duration was 11 weeks]. No correlation was found between closure rate neither with the location of the perforation nor with the age of the patient. Gelfoam patching improves the closure rate of traumatic tympanic membrane perforations. It is technically simple, safe to perform, and suitable as an outpatient procedure and has a good success rate. It is recommended to use this procedure for patients with recent traumatic tympanic membrane perforation especially for small and medium size perforations

effect of 23-valent pneumococcal polysaccharide vaccine on pharyngeal colonization in healthy children under 5 years of age

Streptococcal pneumonia is one of the most common pathogens that cause otolaryngological diseases [otitis media, sinusitis, tonsillitis] and other invasive diseases such as pneumonia, so that decreasing the pharyngeal carriage of pneumococci will eventually decrease the occurrence of these common diseases and hence decrease the morbidity and mortality associated with these diseases. Are to evaluate the pharyngeal carrier rate of pneumococci in healthy children and to demonstrate the effect of 23-valent pneumococcal polysaccharide vaccine on pneumococcal pharyngeal carriage. This prospective study was carried on 100 healthy children under 5 years of age. They were divided into two groups, the control group consisting of 65 children, throat swabs were taken for them, and the vaccinated group consisting of 35 children which received 23-valent pneumococcal polysaccharide vaccine and throat swabs were taken 1 and 6 months after vaccination. The pharyngeal carriage of pneumococci in the control group was 60% while in the vaccinated group was 8.6%. 23-valent pneumococcal polysaccharide vaccine is significantly effective in decreasing the pharyngeal carriage of pneumococci

Carcinoma of larynx, a review of 200 cases from Iraq

This paper studies the pattern and behavior of laryngeal carcinoma in two hundred Iraqi patients admitted to ENT Dept./Saddam College of Medicine Teaching Hospital through the years 1987-1992. The clinical presentation, TNM staging and histopathological behavior is discussed. This study shows that most of the patients [85%] presents for the first time in T3-Stage and required tracheostomy on admission, this might explain the poor prognosis of this type of cancer in our country in comparison with the developed countries; and stresses the need for a multidisciplinary clinics for its management in Iraq