Determinants of variable hearing loss in patients with chronic suppurative otitis media

To determine the impact of ear discharge, duration size and site of tympanic membrane perforation on hearing loss. Cross-Sectional prospective study. Baqai Medical College and Abbasi Shaheed Hospiatl, Department of Ear Nose and Throat and Head and Neck Surgery from December 2010 to November 2011. Sixty six patients of chronic suppurative otitits media [CSOM] aged between 09 to 60 years of age were included in the study. After history and examination, pure tone audiometry was done .Statistical analysis of the collected data is done using SPSS 16 program. Patients with 107 perforated tympanic membrane, 40 males and 26 females were included in the study. Bilateral tympanic membrane perforation were seen in 41 patients, right sided perforation in 10 and left sided in 15 patients respectively. Out of total 107 perforations, 58 were large central[54.2%]and 49 were small[45.8%]. 100 perforations [93.5%] were anteriorly located and 07 [6.5%] were posterior. The size of the perforation was not a determinant of hearing loss though the site of the perforation was associated with significant degree of hearing loss. Hearing loss increased with the chronicity of the disease. The location of perforation on the tympanic membrane and the duration of ear discharge have significant effect on the magnitude of hearing loss while the size of perforation does not affect the hearing level significantly

Post tonsillectomy quality of life in adults

Objective: to determine the health related quality of life benefits derived from tonsillectomy in adult patients of chronic or recurrent tonsillitis

Patients and methods: a cross sectional study of 85 adult patients carried out in ENT department of Abbasi Shaheed Hospital, Karachi from January 2010 to February 2011 with the written and informed consent of patients. All were of age 18 years or greater and of either sex with the diagnosis of chronic tonsillitis or recurrent tonsillitis. There complete correspondence addresses with phone numbers were noted and they all were called back again after a lapse of 6-months post-operation to fill in the questionnaire, Glasgow Benefit Inventory [GBI]. Analysis of data was done by SPSS version 11.0

Result: good scores were noted on the Glasgow Benefit Inventory. Total score was +45.29 [p-value <0.0001]. The subscale scoring was general subscale score +44.10 [p-value <0.0001]; social subscale score, no change i.e. 0 and physical health subscale score +79.62 [p-value <0.0001]

Conclusion: the result thus proves that post-tonsillectomy the HRQOL is improved and the procedure of tonsillectomy is beneficial in terms of improved quality of life

Clinical profile of patients with presenting hoarseness

To describe the causes of voice disorder [hoarseness] among general population attending E.N.T department in Abbasi Shaheed Hospital. It is the descriptive study of 100 patients, who enrolled from out patient department and admitted in E.N.T department of Abbasi Shaheed Hospital. The data was collected as per the specially designed Performa. This study was done in Abbasi Shaheed Hospital, Karachi. Most of the patient with hoarseness 38 [38%] were observed between 5-15 years followed by 16-24 years old 26 [26%] patients. The most common cause of hoarseness was vocal cord nodules 35 patients [35%] followed by acute laryngitis, 22 patients [22%] and chronic non specific laryngitis 14 patients [14%]. Hoarseness due to carcinoma of larynx, 13 patients [13%]

Comparison between dissection and bipolar diathermy method tonsillectomy

To compare dissection method and diathermy method tonsillectomy in terms of intraoperative mean blood loss, time taken for surgery and frequency of post operative bleeding. It was a grass experimental study carried out at Liaquat National Hospital, Karachi from January 2004 to January 2005. Patients of ages between 5 years and 25 years were selected from the out patient department. Sampling technique was convenient sampling. Sample was of 100 patient. First 50 patients were selected for dissection method [Group A] and the last 50 patients for bipolar method tonsillectomy [Group B]. Data collection procedure was interview and observational facts. Data was analyzed by using SPSSS version 10. For mean comparison, student's test was used. Significance of the test was taken at p<0.05. The difference in result between dissection method tonsillectomy and diathermy method tonsillectomy was statistically significant [P<0.001] in terms of intraoperative blood loss and time taken for surgery. Regarding postoperative hemorrhage, the difference between diathermy and ligation was insignificant. Tonsillectomy with bipolar diathermy was a better and safer technique as compared to ligation method especially in terms of intraoperative blood loss and time taken for surgery. The frequency of postoperative bleeding was similar in both methods

Correlation between traffic noise induced hearing loss [NIHL] and occupation

To examine the subjects who are more prone to traffic noise exposure such as auto rickshaw drivers, traffic constables and shop keepers in central business area in Karachi [Pakistan]. This was hospital based prospective study comprising of 200 subjects. The results were obtained by testing the subjects which were investigated on the basis of interviews by [a] completing performa [b] Pure tone audiometry [PTA]. Correlation between traffic NIHL and occupation was found statistically significant with P<0.001 distributed as 15 [34.1%] in auto rickshaw drivers, 34 [40%] in shopkeepers and 29 [34.1%] in traffic constables. The fact that road traffic is the most significant source of noise pollution in Karachi was established by investigating our subjects. They had significant degree of hearing impairment i.e. 42%

Fractured tracheostomy tube in the tracheo-bronchial tract: a rare occurrence. Case report

We report a very rare occurrence of fracture of a metallic tracheostomy tube that lodged in the tracheo-bronchial tract of our male patient and caused him a great deal of distress, anxiety with minimal of respiratory embarrassment, if any. The tracheostomy was done earlier as the patient presented in the emergency department with stridor and was found to have a supraglottic growth! After the emergency tracheostomy, admission was offered with subsequent direct laryngoscopy and biopsy he was discharged with a metallic bivalve tracheostomy tube in place to return with the histopathology report but he never returned becoming a treatment defaulter only to present with the broken tracheostomy tube in the airway, later

Cystic hygroma: an unusual presentation in adult

We report a case of a 22 years old male patient suffering from cystic hygroma [CH] probably post-traumatic in origin. He presented with an asymptomatic, cosmetically disfiguring and a painless swelling involving the right side of the neck