Nowsheen Hamdani - Academia.edu (original) (raw)
Papers by Nowsheen Hamdani
Annals of International medical and Dental Research, May 1, 2017
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had reactionary hemorrhage due to the presence of clot in the tonsillar fossa, which were managed with the simple treatment. There were no cases of secondary haemorrhage. Conclusion: Thus we conclude the adult tonsillectomy can be performed as a day care procedure with a careful selection of the case, pre and post-operative management as this will be more economical by reducing the cost as well as hospital stay for the patient
Journal of Evidence Based Medicine and Healthcare, May 9, 2017
BACKGROUND Chronic suppurative otitis media is one among the commonest ENT disease seen in day-to... more BACKGROUND Chronic suppurative otitis media is one among the commonest ENT disease seen in day-today practice. It is seen mainly among low socioeconomic class. MATERIALS AND METHODS The present study was conducted in the Department of ENT, Shadan Institute of Medical Sciences. Fifty patients with CSOM of all age groups and both sexes attending the Outpatient Department of ENT were selected randomly for the study. RESULTS From our study, we found mainly children of age group 10-11 years commonly affected. They belong to poor socioeconomic background. Pseudomonas aeruginosa is the most common organism isolated in the present study. Ciprofloxacin was found to be the most sensitive antibiotic to Pseudomonas aeruginosa. CONCLUSION We noticed that drug resistance is on the rise due to misuse of antibiotics, over-the-counter treatment, inadequate period of therapy and less awareness among public regarding drug resistance. Constant monitoring of antibiotic sensitivity is needed to prevent drug resistance in CSOM.
Journal of Evidence Based Medicine and Healthcare, Mar 31, 2018
Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths... more Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths of the oral mucosa. 1,2 In 1844, Hullihen described the first case of pyogenic granuloma. 3 Hartzell in 1904 is credited with giving the current term of "pyogenic granuloma" or "granuloma pyogenicum." It was also called a Crocker and Hartzell's disease. 4 Cawson et al 5 described it as "granuloma telangiectaticum" due to the presence of numerous blood vessels seen in histological sections. Two forms of pyogenic granulomas, the lobular capillary haemangioma (LCH) and the non-lobular capillary haemangioma (non-LCH). 6 Although it is a common disease in the skin, it is rare in the gastrointestinal tract, except for the oral cavity, 7 and it is mostly found in keratinized mucosa. 8 In this article we report an unusual case of extragingival pyogenic granuloma of the hard palate. A 17-year-old male patient with juvenile diabetes mellitus came to ENT OPD of SIMS and presented with a 2 x 2 cm swelling over hard palate that had progressed over 4 months. The lesion was bosselated, raised globular, with regular margins, yielding on touch which confirmed its non-pedunculated nature, was insensitive to pain and didn't bleed on touch, pale reddish in colour. The surface was smooth no ulcerations were seen and was ovoid in shape (Fig 1). The lesion was associated with recurrent bleeding and occasional pain. Based on the lesions' clinical appearance and other characteristics (Slow progression, lack of lymphadenopathy) A provisional diagnosis of minor salivary gland adenoma or capillary hemangioma was made. The differential diagnosis included pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, haemangioma and fibroma. Patient was juvenile diabetic on insulin 12 units morning and 12 units, RBS monitored for a week normal 98 mg/dl before surgery, PPBS; till 140 mg/dl, CBC within normal range, FNAC showed inflammatory cells the mass was excised perorally with a 0.5 cm margin of healthy mucosa and followed by cauterisation of the base. The wound was closed by rotation flaps with 3/0 vicryl suture and specimen send for histopathology (Figure 2). Histopathology showed areas of parakeratinized epithelium and connective tissue
Journal of Evidence Based Medicine and Healthcare, May 14, 2018
Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7... more Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7.8% of the population. 1 It can be classified as primary atrophic rhinitis which arises de novo or secondary atrophic rhinitis which may occur as a sequela of granulomatous diseases such as leprosy, syphilis, etc., comprises only 1% of the cases. 2 Thus such cases are of clinical importance and rarity. Atrophic rhinitis (AR) is a debilitating chronic nasal mucosal disease of unknown aetiology. The condition is characterized by progressive nasal mucosal atrophy, progressive atrophy of the underlying bone of the turbinates, abnormal widening (roomy) / patency of the nasal cavities (with paradoxical congestion) and viscid secretions and dried crusts leading to a characteristic fetor (ozaena). 3,4,5 On the basis of causes AR can be classified as; Primary Atrophic rhinitis which has decreased markedly in incidence (0.3-1%) and the aetiology is unknown 2,3,6 and secondary atrophic rhinitis is mostly common in developed countries. The most common cause is sinus surgery, it alone comprises of 90% of secondary atrophic rhinitis, common procedures include partial and total turbinectomy (80%), without turbinectomy (10%) and partial maxillectomy (10%), followed by radiation (2.5%), trauma (1%) and granulomatous or infectious diseases (1%). 2,7 The malady of "empty nose syndrome is associated with extensive turbinate surgeries causing secondary Atrophic Rhinitis". 8 Little is known about this secondary form and it remains incompletely characterized. It has occurred in association with chronic granulomatous diseases of the nose including leprosy, sarcoidosis, rhinoscleroma, Wegener's granulomatosis and infectious diseases like TB and syphilis. The onset after treatment with antiangiogenic drug underlines the role of the microvasculature in the pathogenesis. 2,9 While these causes were once common, now only comprise of 1-2% cases, thus rare. 2 Secondary atrophic rhinitis is typically seen in older population. Hansen's disease (Leprosy) is a chronic granulomatous disease caused by Mycobacterium leprae. Leprosy has been officially eliminated in India since 31 st
Medpulse International Journal of Ear Nose and Throat, 2020
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had r...
PARIPEX INDIAN JOURNAL OF RESEARCH, 2022
Introduction : Osteomeatal unit is a functional unit of the anterior ethmoid complex representing... more Introduction : Osteomeatal unit is a functional unit of the anterior ethmoid complex representing the final common pathway for the drainage and ventilation of the frontal, maxillary and anterior ethmoid cells .Osteomeatal complex has become an area of active radiologic and pathophysiologic investigation with the development of endoscopic sinus surgery for inflammatory sinus disease. The aim of this study was to investigate the anatomical vari Aim : ation of the middle turbinate concha bullosa , incidence of concha bullosa and its correlation with nasal septal deviation. based on paranasal sinus imaging. A prospective study was performed in the Department of ENT and Materials and Methods : Head Neck Surgery over a period of 5 years, to determine the prevalence of Concha bullosa in patients who presented to our out patient department with symptoms of nasal obstruction, headache, post nasal drainage and facial pain , and underwent CT scan of Paranasal sinuses. We evaluated 462 CT image...
Journal of Evidence Based Medicine and Healthcare
Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7... more Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7.8% of the population. 1 It can be classified as primary atrophic rhinitis which arises de novo or secondary atrophic rhinitis which may occur as a sequela of granulomatous diseases such as leprosy, syphilis, etc., comprises only 1% of the cases. 2 Thus such cases are of clinical importance and rarity. Atrophic rhinitis (AR) is a debilitating chronic nasal mucosal disease of unknown aetiology. The condition is characterized by progressive nasal mucosal atrophy, progressive atrophy of the underlying bone of the turbinates, abnormal widening (roomy) / patency of the nasal cavities (with paradoxical congestion) and viscid secretions and dried crusts leading to a characteristic fetor (ozaena). 3,4,5 On the basis of causes AR can be classified as; Primary Atrophic rhinitis which has decreased markedly in incidence (0.3-1%) and the aetiology is unknown 2,3,6 and secondary atrophic rhinitis is mostly common in developed countries. The most common cause is sinus surgery, it alone comprises of 90% of secondary atrophic rhinitis, common procedures include partial and total turbinectomy (80%), without turbinectomy (10%) and partial maxillectomy (10%), followed by radiation (2.5%), trauma (1%) and granulomatous or infectious diseases (1%). 2,7 The malady of "empty nose syndrome is associated with extensive turbinate surgeries causing secondary Atrophic Rhinitis". 8 Little is known about this secondary form and it remains incompletely characterized. It has occurred in association with chronic granulomatous diseases of the nose including leprosy, sarcoidosis, rhinoscleroma, Wegener's granulomatosis and infectious diseases like TB and syphilis. The onset after treatment with antiangiogenic drug underlines the role of the microvasculature in the pathogenesis. 2,9 While these causes were once common, now only comprise of 1-2% cases, thus rare. 2 Secondary atrophic rhinitis is typically seen in older population. Hansen's disease (Leprosy) is a chronic granulomatous disease caused by Mycobacterium leprae. Leprosy has been officially eliminated in India since 31 st
Journal of Evidence Based Medicine and Healthcare
Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths... more Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths of the oral mucosa. 1,2 In 1844, Hullihen described the first case of pyogenic granuloma. 3 Hartzell in 1904 is credited with giving the current term of "pyogenic granuloma" or "granuloma pyogenicum." It was also called a Crocker and Hartzell's disease. 4 Cawson et al 5 described it as "granuloma telangiectaticum" due to the presence of numerous blood vessels seen in histological sections. Two forms of pyogenic granulomas, the lobular capillary haemangioma (LCH) and the non-lobular capillary haemangioma (non-LCH). 6 Although it is a common disease in the skin, it is rare in the gastrointestinal tract, except for the oral cavity, 7 and it is mostly found in keratinized mucosa. 8 In this article we report an unusual case of extragingival pyogenic granuloma of the hard palate. A 17-year-old male patient with juvenile diabetes mellitus came to ENT OPD of SIMS and presented with a 2 x 2 cm swelling over hard palate that had progressed over 4 months. The lesion was bosselated, raised globular, with regular margins, yielding on touch which confirmed its non-pedunculated nature, was insensitive to pain and didn't bleed on touch, pale reddish in colour. The surface was smooth no ulcerations were seen and was ovoid in shape (Fig 1). The lesion was associated with recurrent bleeding and occasional pain. Based on the lesions' clinical appearance and other characteristics (Slow progression, lack of lymphadenopathy) A provisional diagnosis of minor salivary gland adenoma or capillary hemangioma was made. The differential diagnosis included pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, haemangioma and fibroma. Patient was juvenile diabetic on insulin 12 units morning and 12 units, RBS monitored for a week normal 98 mg/dl before surgery, PPBS; till 140 mg/dl, CBC within normal range, FNAC showed inflammatory cells the mass was excised perorally with a 0.5 cm margin of healthy mucosa and followed by cauterisation of the base. The wound was closed by rotation flaps with 3/0 vicryl suture and specimen send for histopathology (Figure 2). Histopathology showed areas of parakeratinized epithelium and connective tissue
MedPulse International Journal of ENT
Annals of International medical and Dental Research
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had reactionary hemorrhage due to the presence of clot in the tonsillar fossa, which were managed with the simple treatment. There were no cases of secondary haemorrhage. Conclusion: Thus we conclude the adult tonsillectomy can be performed as a day care procedure with a careful selection of the case, pre and post-operative management as this will be more economical by reducing the cost as well as hospital stay for the patient
Journal of Ayub Medical College, Abbottabad : JAMC
Chronic suppurative otitis media (CSOM) is a prevailing and notorious infection in developing cou... more Chronic suppurative otitis media (CSOM) is a prevailing and notorious infection in developing countries causing serious local damage and threatening complications. Early and effective treatment based on the knowledge of causing micro organisms and their sensitivity results in good clinical recovery and prevents from damage and complications. Pseudomonas aeruginosa is most common pathogen causing CSOM in Pakistan. The objective of this study is to identify incidence of Pseudomonas aeruginosa involved in CSOM and sensitivity against commonly prescribed antibiotics. A total of 263 patients with unilateral or bilateral chronic suppurative otitis media (CSOM) were enrolled in the study at Department of ENT, Karachi Medical and Dental College & Abbasi Shaheed Hospital, Karachi, Pakistan from December 2004 to May 2006. Sterile cotton swabs were used to collect pus from discharging ears and plated on Blood agar and MacConkey agar for 24 to 48 hours. Antibiotics susceptibility was tested by ...
International Journal of Advanced Research
Background: Chronic Rhinosinosinusitis (CRS) is one of the common diseases affecting people globa... more Background: Chronic Rhinosinosinusitis (CRS) is one of the common diseases affecting people globally with significant negative impact on quality of life. The objective of this study is to compare the efficacy of CT and nasal endoscopy finding for the evaluation of CRS in patients with persistant complains despite appropriate medical therapy. Methods: Patients attending ENT OPD of SIMS, with any complains of CRS for more than 4 weeks not responding to medical treatment. Patients are selected by Random sampling method. Results: The commonest major presenting symptom among the patients was observed as nasal obstruction and headache the minor factor. Males were affected more commonly on nasal endoscopy , the most common finding was congested nasal mucosa and mucopurulent nasal discharge .Frontal cells most commonly seen on Ct scan and maxillary sinus was most commonly involved .DNS is seen in both DNE and CT scan. Conclusion: CRS can be reliably identified using AAO-HNS Task force criteria 1997.Diseased ,oedematous or congested nasal mucosa ,purulence , pathological secretions or mucous in middle meatus and early polypoid changes have nonspecific features on coronal CT and endoscopy has essential role in diagnosing this pathology , is an outpatient procedure , relatively economic with no radiation hazard , however there are certain limitations of DNE which includes patients with gross DNS , constricted middle meatus , certain anatomical variants and presence of hidden air spaces like sphenoid sinus , ethmoidal bulla , haller cells , frontal cells ,posterior ethmoidal cells,etc .Hence we conclude that both are complimentary to each other.
Annals of International medical and Dental Research, May 1, 2017
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had reactionary hemorrhage due to the presence of clot in the tonsillar fossa, which were managed with the simple treatment. There were no cases of secondary haemorrhage. Conclusion: Thus we conclude the adult tonsillectomy can be performed as a day care procedure with a careful selection of the case, pre and post-operative management as this will be more economical by reducing the cost as well as hospital stay for the patient
Journal of Evidence Based Medicine and Healthcare, May 9, 2017
BACKGROUND Chronic suppurative otitis media is one among the commonest ENT disease seen in day-to... more BACKGROUND Chronic suppurative otitis media is one among the commonest ENT disease seen in day-today practice. It is seen mainly among low socioeconomic class. MATERIALS AND METHODS The present study was conducted in the Department of ENT, Shadan Institute of Medical Sciences. Fifty patients with CSOM of all age groups and both sexes attending the Outpatient Department of ENT were selected randomly for the study. RESULTS From our study, we found mainly children of age group 10-11 years commonly affected. They belong to poor socioeconomic background. Pseudomonas aeruginosa is the most common organism isolated in the present study. Ciprofloxacin was found to be the most sensitive antibiotic to Pseudomonas aeruginosa. CONCLUSION We noticed that drug resistance is on the rise due to misuse of antibiotics, over-the-counter treatment, inadequate period of therapy and less awareness among public regarding drug resistance. Constant monitoring of antibiotic sensitivity is needed to prevent drug resistance in CSOM.
Journal of Evidence Based Medicine and Healthcare, Mar 31, 2018
Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths... more Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths of the oral mucosa. 1,2 In 1844, Hullihen described the first case of pyogenic granuloma. 3 Hartzell in 1904 is credited with giving the current term of "pyogenic granuloma" or "granuloma pyogenicum." It was also called a Crocker and Hartzell's disease. 4 Cawson et al 5 described it as "granuloma telangiectaticum" due to the presence of numerous blood vessels seen in histological sections. Two forms of pyogenic granulomas, the lobular capillary haemangioma (LCH) and the non-lobular capillary haemangioma (non-LCH). 6 Although it is a common disease in the skin, it is rare in the gastrointestinal tract, except for the oral cavity, 7 and it is mostly found in keratinized mucosa. 8 In this article we report an unusual case of extragingival pyogenic granuloma of the hard palate. A 17-year-old male patient with juvenile diabetes mellitus came to ENT OPD of SIMS and presented with a 2 x 2 cm swelling over hard palate that had progressed over 4 months. The lesion was bosselated, raised globular, with regular margins, yielding on touch which confirmed its non-pedunculated nature, was insensitive to pain and didn't bleed on touch, pale reddish in colour. The surface was smooth no ulcerations were seen and was ovoid in shape (Fig 1). The lesion was associated with recurrent bleeding and occasional pain. Based on the lesions' clinical appearance and other characteristics (Slow progression, lack of lymphadenopathy) A provisional diagnosis of minor salivary gland adenoma or capillary hemangioma was made. The differential diagnosis included pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, haemangioma and fibroma. Patient was juvenile diabetic on insulin 12 units morning and 12 units, RBS monitored for a week normal 98 mg/dl before surgery, PPBS; till 140 mg/dl, CBC within normal range, FNAC showed inflammatory cells the mass was excised perorally with a 0.5 cm margin of healthy mucosa and followed by cauterisation of the base. The wound was closed by rotation flaps with 3/0 vicryl suture and specimen send for histopathology (Figure 2). Histopathology showed areas of parakeratinized epithelium and connective tissue
Journal of Evidence Based Medicine and Healthcare, May 14, 2018
Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7... more Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7.8% of the population. 1 It can be classified as primary atrophic rhinitis which arises de novo or secondary atrophic rhinitis which may occur as a sequela of granulomatous diseases such as leprosy, syphilis, etc., comprises only 1% of the cases. 2 Thus such cases are of clinical importance and rarity. Atrophic rhinitis (AR) is a debilitating chronic nasal mucosal disease of unknown aetiology. The condition is characterized by progressive nasal mucosal atrophy, progressive atrophy of the underlying bone of the turbinates, abnormal widening (roomy) / patency of the nasal cavities (with paradoxical congestion) and viscid secretions and dried crusts leading to a characteristic fetor (ozaena). 3,4,5 On the basis of causes AR can be classified as; Primary Atrophic rhinitis which has decreased markedly in incidence (0.3-1%) and the aetiology is unknown 2,3,6 and secondary atrophic rhinitis is mostly common in developed countries. The most common cause is sinus surgery, it alone comprises of 90% of secondary atrophic rhinitis, common procedures include partial and total turbinectomy (80%), without turbinectomy (10%) and partial maxillectomy (10%), followed by radiation (2.5%), trauma (1%) and granulomatous or infectious diseases (1%). 2,7 The malady of "empty nose syndrome is associated with extensive turbinate surgeries causing secondary Atrophic Rhinitis". 8 Little is known about this secondary form and it remains incompletely characterized. It has occurred in association with chronic granulomatous diseases of the nose including leprosy, sarcoidosis, rhinoscleroma, Wegener's granulomatosis and infectious diseases like TB and syphilis. The onset after treatment with antiangiogenic drug underlines the role of the microvasculature in the pathogenesis. 2,9 While these causes were once common, now only comprise of 1-2% cases, thus rare. 2 Secondary atrophic rhinitis is typically seen in older population. Hansen's disease (Leprosy) is a chronic granulomatous disease caused by Mycobacterium leprae. Leprosy has been officially eliminated in India since 31 st
Medpulse International Journal of Ear Nose and Throat, 2020
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had r...
PARIPEX INDIAN JOURNAL OF RESEARCH, 2022
Introduction : Osteomeatal unit is a functional unit of the anterior ethmoid complex representing... more Introduction : Osteomeatal unit is a functional unit of the anterior ethmoid complex representing the final common pathway for the drainage and ventilation of the frontal, maxillary and anterior ethmoid cells .Osteomeatal complex has become an area of active radiologic and pathophysiologic investigation with the development of endoscopic sinus surgery for inflammatory sinus disease. The aim of this study was to investigate the anatomical vari Aim : ation of the middle turbinate concha bullosa , incidence of concha bullosa and its correlation with nasal septal deviation. based on paranasal sinus imaging. A prospective study was performed in the Department of ENT and Materials and Methods : Head Neck Surgery over a period of 5 years, to determine the prevalence of Concha bullosa in patients who presented to our out patient department with symptoms of nasal obstruction, headache, post nasal drainage and facial pain , and underwent CT scan of Paranasal sinuses. We evaluated 462 CT image...
Journal of Evidence Based Medicine and Healthcare
Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7... more Atrophic rhinitis is an uncommon disorder in modern societies and its incidence varies from 0.3-7.8% of the population. 1 It can be classified as primary atrophic rhinitis which arises de novo or secondary atrophic rhinitis which may occur as a sequela of granulomatous diseases such as leprosy, syphilis, etc., comprises only 1% of the cases. 2 Thus such cases are of clinical importance and rarity. Atrophic rhinitis (AR) is a debilitating chronic nasal mucosal disease of unknown aetiology. The condition is characterized by progressive nasal mucosal atrophy, progressive atrophy of the underlying bone of the turbinates, abnormal widening (roomy) / patency of the nasal cavities (with paradoxical congestion) and viscid secretions and dried crusts leading to a characteristic fetor (ozaena). 3,4,5 On the basis of causes AR can be classified as; Primary Atrophic rhinitis which has decreased markedly in incidence (0.3-1%) and the aetiology is unknown 2,3,6 and secondary atrophic rhinitis is mostly common in developed countries. The most common cause is sinus surgery, it alone comprises of 90% of secondary atrophic rhinitis, common procedures include partial and total turbinectomy (80%), without turbinectomy (10%) and partial maxillectomy (10%), followed by radiation (2.5%), trauma (1%) and granulomatous or infectious diseases (1%). 2,7 The malady of "empty nose syndrome is associated with extensive turbinate surgeries causing secondary Atrophic Rhinitis". 8 Little is known about this secondary form and it remains incompletely characterized. It has occurred in association with chronic granulomatous diseases of the nose including leprosy, sarcoidosis, rhinoscleroma, Wegener's granulomatosis and infectious diseases like TB and syphilis. The onset after treatment with antiangiogenic drug underlines the role of the microvasculature in the pathogenesis. 2,9 While these causes were once common, now only comprise of 1-2% cases, thus rare. 2 Secondary atrophic rhinitis is typically seen in older population. Hansen's disease (Leprosy) is a chronic granulomatous disease caused by Mycobacterium leprae. Leprosy has been officially eliminated in India since 31 st
Journal of Evidence Based Medicine and Healthcare
Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths... more Pyogenic granuloma (PG) is an inflammatory hyperplasia involving a large range of nodular growths of the oral mucosa. 1,2 In 1844, Hullihen described the first case of pyogenic granuloma. 3 Hartzell in 1904 is credited with giving the current term of "pyogenic granuloma" or "granuloma pyogenicum." It was also called a Crocker and Hartzell's disease. 4 Cawson et al 5 described it as "granuloma telangiectaticum" due to the presence of numerous blood vessels seen in histological sections. Two forms of pyogenic granulomas, the lobular capillary haemangioma (LCH) and the non-lobular capillary haemangioma (non-LCH). 6 Although it is a common disease in the skin, it is rare in the gastrointestinal tract, except for the oral cavity, 7 and it is mostly found in keratinized mucosa. 8 In this article we report an unusual case of extragingival pyogenic granuloma of the hard palate. A 17-year-old male patient with juvenile diabetes mellitus came to ENT OPD of SIMS and presented with a 2 x 2 cm swelling over hard palate that had progressed over 4 months. The lesion was bosselated, raised globular, with regular margins, yielding on touch which confirmed its non-pedunculated nature, was insensitive to pain and didn't bleed on touch, pale reddish in colour. The surface was smooth no ulcerations were seen and was ovoid in shape (Fig 1). The lesion was associated with recurrent bleeding and occasional pain. Based on the lesions' clinical appearance and other characteristics (Slow progression, lack of lymphadenopathy) A provisional diagnosis of minor salivary gland adenoma or capillary hemangioma was made. The differential diagnosis included pyogenic granuloma, peripheral ossifying fibroma, peripheral giant cell granuloma, haemangioma and fibroma. Patient was juvenile diabetic on insulin 12 units morning and 12 units, RBS monitored for a week normal 98 mg/dl before surgery, PPBS; till 140 mg/dl, CBC within normal range, FNAC showed inflammatory cells the mass was excised perorally with a 0.5 cm margin of healthy mucosa and followed by cauterisation of the base. The wound was closed by rotation flaps with 3/0 vicryl suture and specimen send for histopathology (Figure 2). Histopathology showed areas of parakeratinized epithelium and connective tissue
MedPulse International Journal of ENT
Annals of International medical and Dental Research
Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon b... more Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had reactionary hemorrhage due to the presence of clot in the tonsillar fossa, which were managed with the simple treatment. There were no cases of secondary haemorrhage. Conclusion: Thus we conclude the adult tonsillectomy can be performed as a day care procedure with a careful selection of the case, pre and post-operative management as this will be more economical by reducing the cost as well as hospital stay for the patient
Journal of Ayub Medical College, Abbottabad : JAMC
Chronic suppurative otitis media (CSOM) is a prevailing and notorious infection in developing cou... more Chronic suppurative otitis media (CSOM) is a prevailing and notorious infection in developing countries causing serious local damage and threatening complications. Early and effective treatment based on the knowledge of causing micro organisms and their sensitivity results in good clinical recovery and prevents from damage and complications. Pseudomonas aeruginosa is most common pathogen causing CSOM in Pakistan. The objective of this study is to identify incidence of Pseudomonas aeruginosa involved in CSOM and sensitivity against commonly prescribed antibiotics. A total of 263 patients with unilateral or bilateral chronic suppurative otitis media (CSOM) were enrolled in the study at Department of ENT, Karachi Medical and Dental College & Abbasi Shaheed Hospital, Karachi, Pakistan from December 2004 to May 2006. Sterile cotton swabs were used to collect pus from discharging ears and plated on Blood agar and MacConkey agar for 24 to 48 hours. Antibiotics susceptibility was tested by ...
International Journal of Advanced Research
Background: Chronic Rhinosinosinusitis (CRS) is one of the common diseases affecting people globa... more Background: Chronic Rhinosinosinusitis (CRS) is one of the common diseases affecting people globally with significant negative impact on quality of life. The objective of this study is to compare the efficacy of CT and nasal endoscopy finding for the evaluation of CRS in patients with persistant complains despite appropriate medical therapy. Methods: Patients attending ENT OPD of SIMS, with any complains of CRS for more than 4 weeks not responding to medical treatment. Patients are selected by Random sampling method. Results: The commonest major presenting symptom among the patients was observed as nasal obstruction and headache the minor factor. Males were affected more commonly on nasal endoscopy , the most common finding was congested nasal mucosa and mucopurulent nasal discharge .Frontal cells most commonly seen on Ct scan and maxillary sinus was most commonly involved .DNS is seen in both DNE and CT scan. Conclusion: CRS can be reliably identified using AAO-HNS Task force criteria 1997.Diseased ,oedematous or congested nasal mucosa ,purulence , pathological secretions or mucous in middle meatus and early polypoid changes have nonspecific features on coronal CT and endoscopy has essential role in diagnosing this pathology , is an outpatient procedure , relatively economic with no radiation hazard , however there are certain limitations of DNE which includes patients with gross DNS , constricted middle meatus , certain anatomical variants and presence of hidden air spaces like sphenoid sinus , ethmoidal bulla , haller cells , frontal cells ,posterior ethmoidal cells,etc .Hence we conclude that both are complimentary to each other.