Etiology of Hoarseness of Voice Based on FOL

Background: Hoarseness (dysphonia) is the reason for about 1% of all consultations in primary care. Numerous conditions can cause hoarseness, ranging from simple inflammatory processes to more serious systemic, neurologic, or cancerous conditions involving the larynx. Evaluation of a patient with hoarseness includes a careful history, physical examination, and in many cases, laryngoscopy. This study aimed to analyze the etiology of hoarseness of voice based on a fiberoptic laryngoscope (FOL). Material & Methods: This cross-sectional study was conducted in the Department of ENT, in Bangabandhu Sheikh Mujib Medical College Hospital, Faridpur for 2 years; from January 2017 to December 2018. A total of 75 subjects fulfilling the inclusion criteria were enrolled as study subjects. Data were processed and analyzed using the software SPSS (Statistical Package for Social Sciences) version 11.5. Results: In this study, most of the patients (18, 24.0%) belonged to the age group of 41-50 years, followed by 16 (21.33%) patients in the 61-70 years of age group, and then 15 (20.0%) patients were in 21-30 years of age group. None was from 0-10 years and only 2 (2.66%) patients belonged to the 11-20 years age group. Concerning the sex of the patients, 62 (83.0%) patients were male and the rest 13 (17.0%) were female indicating male predominance. 40 (53.33%) respondents had a smoking habit, and the rest 35 (46.66%) patients did not have a smoking habit. Regarding occupation, most of the patients (24, 32.0%) were farmers, followed by 19 (25.33%) were businessmen, and 10 (13.33%) patients were service holders. Concerning the findings, most of the patients (20, 26.66%) had growth of larynx, followed by 11 (14.66%) patients had polyp/cyst, 10 (13.33%) patients had paresis, 8 (10.66%) patients had nodule, 6 (8.0%) patients had edema, 4 (5.33%) patients had chronic laryngitis, 3 (4.0%) patients had keratosis/leukoplakia and another 3 (4.0%) patients had a phonatory gap. Conclusion: Hoarseness of voice is a symptom, not a diagnosis, and therefore warrants a careful determination of the underlying cause in every case. Fiber optic laryngoscopy was an excellent tool for the diagnosis of hoarseness. Causes of hoarseness included growth in the larynx, polyp/cyst, nodules, edema, chronic laryngitis, keratosis/leukoplakia, and phonatory gaps in this study.

Profile of patients with colorectal cancer

To document the profile of patients with colorectal cancer, modes of management and outcome. Cross sectional prospective study. This study was conducted at DUHS and CHK Pakistan from July 2007 to June 2012. Diagnosis was confirmed on histopathology through procto-sigmoidoscopy and colonoscopic biopsy. Abdominal ultrasounds and CT scan were used to stage the disease. Treatment was planned according to the presentation. Surgical procedure was decided according to the site and stage of the tumor. Neoadjuvant chemo-radiation was given for advance and adjuvant therapy for early tumors. A total of 72 patients were included in the study. Majority of patients [n=29 - 40%] presented with advance disease [stage IV]. Carcinoma rectum was diagnosed in 40 [55.5%] cases, sigmoid colon carcinoma in 12[16.6%], caecal cancer in 10[13.8%], ascending colon [n=6 - 8.3%], transverse colon and anal canal [n=2-2.7%] each. Anterior resection [APR] was performed in 20 [27.7%] cases, low anterior resection in two [2.7%], abdomino perineal resection in eight [11%], laparoscopic assisted APR in two [2.7%], Hartmann procedure and only stoma formation in ten [13.8%] each. Histopathology confirmed poorly differentiated adenocarcinoma in 36 [50%] patients. Overall mortality was 9.7% [n=7]. Majority of the patients diagnosed with carcinoma rectum were young and presented with advance disease

Pattern and presentation of carcinoma stomach

To determine the clinical profile of carcinoma stomach. A case series. A single unit of the Department of General Surgery, Dow University of Health Sciences and civil Hospital, Karachi, from April 2006 to April 2010. Patients with gastric cancer confirmed on histopathology were included in the study. Patients diagnosed with acid peptic disease and benign gastric ulcer were excluded. Variables studied were, age, gender, mode of presentation, presenting complain, endoscopy findings, palpable supraclavicular lymph node, histopathology, stage and treatment. Data was analyzed for descriptive statistics. Total number of patients were 15, including 9 males [60%] and 6 females [40%]; male female ratio was 1.5:1. Mean age was 48.6 +/- 4.47 years, ranging from 26-65 years. Majority of the patients [n=9, 60%] were presented through outpatient department, while the rest presented through emergency. Common presenting complains were vague upper abdominal pain, mass, ascites, peritonitis and hematemesis. On endoscopy tumour was found at the cardiac end in 5 patients [33%], at pylorus and antrum in 6 patients [40%], linitis plastica in 2 patients [13.3%], only body and body and pylorus were involved in 1 patient [6.7%] each. Ten patients [66.6%] presented at stage IV and 3 patients [20%] in stage III. Surgical resection was possible in 5 patients [33.3%]. Total gastrectomy was performed in one patient [6.7%], while subtotal gastrectomy was undertaken in 4 patients [26.7%]. Palliative gastrojejunostomy was performed in 4 [26.7%] and feeding gastrostomy and endoscopic stenting in 2 patients [13.3%] each. Chemotherapy was given to 8 patients [53.3%] patients while radiotherapy to 2 patients [13.3%]. Histopathological diagnosis was diffuse infiltrating adenocarcinoma in 10 [66.6%], infiltrating intestinal type in 3 [20%] and gastric lymphoma in 2 [13.3%] patients. Morality was 13.3%. Majority of the patients with gastric carcinoma were young males, presenting with advanced stage disease. Only 33% tumours were resectable while 53.3% tumours were managed by palliative treatment. Overall morality was 13.3%

Granulomatous mastitis: a case series

To find out the clinical and management profile of granulomatous mastitis [GM]. A case. This study was carried out at Civil Hospital and Dow University of Health Sciences, Karachi and Tuberculosis Clinic at Bantwa Hospital, Karachi, from January 1999 to January 2009. Histopathologically diagnosed cases of GM were studied. Data included, detailed history, examination, clinical diagnosis, ultrasound, mammogram and fine needle aspiration cytology [FNAC]. All patients were initially given antibiotics and corticosteroid for a period of 10 days. All patients were followed for a period of 6 months. Recurrent cases were managed by wide excision and followed for another period of 6 months. Percentage, mean and range values were determined on SPSS version 10. The mean age of the 22 patients was 37.6 years [range=22-52 years]. Right breast was affected in 54.5% and left breast in 45.5% patients. Eighteen [82%] were non-lactating. Patients presented clinically with painful breast lump in 54.5%, painless lump in 45.5% and additional discharging sinuses in 18%. Clinical diagnosis was chronic mastitis in 40.9%, tuberculosis of breast in 36.3% and malignancy in 22.7% patients. Mammography showed an ill-defined mass in 45.5% and asymmetrical density in 31.8%. Diagnosis was confirmed in all patients on histopathology. Recurrence was noted in 2 patients, managed by wide excision, and followed for another period of 6 months without evidence of complications. GM is an uncommon chronic inflammatory disease of the breast. Usually involving a single non-lactating breast in reproductive age group. It clinically mimics tuberculosis and carcinoma. Mammography remains non-conclusive. Excision and wide excision biopsy are both diagnostic and therapeutic in majority of cases. Treatment includes short course of steroids and antibiotic along with close regular surveillance

Spindle cell tumour presenting as an abdominal mass

Hyalinizing spindle cell tumour with giant rosettes [HSTGR] is a rare and recently described tumour that arises most commonly from the peripheral and deep soft tissues. It can present as a large abdominal mass. We report the case of a 60 year old man who presented with abdominal distention. CT scan showed a mass occupying the whole of the abdomen and pelvis. Exploration of abdomen revealed a jelly like mass about 20 x 20 cm in size. Mass was excised completely and confirmed as spindle cell tumour between grade I-II on histopathology

Primary adenocarcinoma of duodenum

Primary duodenal adenocarcinoma [PDC] of the distal half of duodenum is extremely rare. We report a case of a young male with adenocarcinoma of third and fourth part of duodenum presenting with long standing proximal small bowel obstruction with associated weight loss and anemia. Esophago-gastro-duodeno-scopy showed a fungating intraluminal growth in third and fourth part of the duodenum. Computed tomography also showed a solid mass in the third and fourth part of the duodenum. Computed tomography also showed a solid mass in the third and fourth part of the duodenum. Segmental resection of the third and fourth part of the duodenum was performed with single layer extra mucosal duodeno-jejunal anastomosis

Simultaneous duct ectasia of accessory and normally located breast

Accessory breast and duct ectasia are common clinical problems in their own right. However, their coexistence is a rare entity. Duct ectasia is a dilation in one or more of the larger lactiferous duct filled with a stagnant brown or green secretion, which may or may not discharge through the nipple. This material acts as an irritant and leads to periductal mastitis. Duct ectasia may present with subareolar mass, nipple discharge, nipple retraction, non-cyclical mastalgia or mammary fistula. Surgical options are microdochectomy or cone excision of major ducts. This case report describes the presence of duct ectasia in both accessory breast situated in the axilla and ipsilateral normal breast simultaneously