RESUMO
Background : Septal surgery is one of the most common surgical procedures performed by an Otorhinolaryngeal surgeon since ancient times. Various modifications in the approach, changing concept of conserving septal cartilage, use of an endoscope and good antibiotics to control postoperative infection have played a key role in controlling the complication rates but still, one thing which is mostly practiced worldwide is nasal packing in the postoperative period which is a nightmare for many patients, as the pain threshold varies from patient to patient. It also causes dryness of mouth, throat irritation, facial heaviness, headache, excessive watering from eyes, aural fullness. There is a lack of proper evidence to prove whether nasal packing really decreases postoperative hemorrhage as the incision is properly approximated and sutured. The main reason for nasal packing was an approximation of nasal septal flap thereby reducing the chances of septal Haematoma and stabilization of septal flap in the midline. The present study has been taken to study and compare postoperative nasal packing and modified quilting suture of the septal flap without the nasal pack. Material and Methods : This one-year prospective comparative study was conducted on 149 patients who underwent septoplasty with 3 months follow-up. One group had Postoperative nasal packing and the other had only modified septal flap suturing without the nasal pack. Results : Out of the total of 149 patients, 88 underwent nasal packing in the postoperative period and 61 patients had undergone suture of the nasal septal flap without nasal packing. A statistically significant value of VAS score was found in the non-packing group of 61 patients, where the average postoperative VAS score was 1.46 against 3.7 among the packing group of 88 patients. An unpaired t-test was applied and a value of 15.431 was obtained with a pvalue less than 0.001. No cases presented with septal perforation in the postoperative period in patients without a nasal pack and there were 2 cases (2.2%) of septal perforation in the nasal packing group. There was no significant bleeding in the postoperative period in both groups of patients. Conclusion : Stabilization of the nasal septal flap by modified quilting technique is better option after septoplasty with good comfort score.
RESUMO
Background: Cancer of unknown primary (CUP) origin is cancer in which malignant cancer cells are in the body but the site of cancer where it began is unknown. Detailed incidence and time trends of these cancers, specific to various regions in India is needed. This paper aims to summarize and report the incidence of other and unknown (O&U) cancers across India in 27 population-based cancer registries (PBCRs) and to study the trends among these cancers using joinpoint regression analysis. Methods: Data on the incidence of CUP were obtained from the published reports on 27 PBCRs of the National Cancer Registry Programme (NCRP) of the Indian Council of Medical Research (ICMR). A joinpoint regression model was used to analyze the long-term trends of incidence related to CUP based on published data from PBCRs between 1986 and 2014. Annual Percent Change (APC) in incidence rate was estimated for various registries. Results: The northeast region had the highest age-adjusted rate (AAR) for both men (1.76–29.7) and women (1.99–14.68). Age-specific rate (ASR) for both men (39.8–855.7) and women (48.2–470.4) was highest in the northeast region. There is an increase in the incidence rate for all six major registries over the past decade with an exception of women in the Delhi Cancer Registry. There is a decline in incidence rate by 0.14 during 1990–2012 in the female population of the Delhi registry. Conclusion: The increasing incidence trends of CUP is a matter of concern for the healthcare professionals and researchers. There is a need for research and advanced and improved diagnostic tools for the improvement of the status of O&U cancers.
RESUMO
Introduction: Upper and lower respiratory diseases are closelyrelated which has been well documented in literature. Eventhough a relationship between upper and lower airway diseasehas been described, altered pulmonary function in patientswith upper airway diseases is still not fully understood. Thepresent study was conducted to assess the effect of chronicnasal obstruction on pulmonary function and to compare thepulmonary function in same patients after surgical relief ofnasal obstruction.Material and methods: The present study was carried outin the Department of ENT and Head and Neck Surgery andDepartment of Respiratory Medicine, Rohilkhand MedicalCollege and Hospital, Bareilly between November 2017to October 2018. 56 patients with chronic nasal obstructiondue to either deviated nasal septum or chronic rhinosinusitiswith or without nasal polyp underwent pulmonary functiontesting pre and post-operatively at 6 weeks and results werecompared.Results: The most common age group affected was less thanthirty years accounting for more than 50%. Mean age of totalsample size was 24.2 ± 6.98 years. Thirty three (58.9%) patientswere males while 23(41.07%) patients were females. Out of56 subjects, 34(60.71%) patients underwent septoplasty, while22(39.28%) patients underwent functional endoscopic sinussurgery. Clinically and statistically significant improvement inFEV1 and FVC was observed irrespective of age, gender orduration of obstruction.Conclusion: Patients with bilateral nasal obstruction hadworse pulmonary function initially and more significantimprovement after surgery, suggesting an association ofbilateral obstruction with bad prognosis.