Incidence of Ulcerative Colitis (UC) and Crohn’s Disease in Thyroid Disorders

Aim: In patients with ulcerative colitis (UC) and Crohn’s disease (CD), an increase in thyroid dysfunction has been reported compared to normal people. This study was held to assess the thyroid disease prevalence in the inflammatory bowel disease patients group. Study Design: A retrospective study. Place and Duration: In the Medicine Department of Isra University Hospital, Hyderabad for one-year duration from March 2018 to March 2019. Methods: Total of 155 patients were included (120 UC, 35 CDs) and 63 healthy control subjects. Patients with free T3 (FT3), T4 (FT4), anti-TPO serum and TSH were evaluated retrospectively and with the group of control were compared. These patients were examined using nuclear imaging (scintigraphy) and thyroid ultrasound. Results: 42.9 ± 12.4 years was the average age of patients with IBD (76 women). The control group consisted of 42 women and 40.9 ± 12.1 years was the average age. In 18 patients (9.5%, 8 women, 6 men) out of 155 patients with inflammatory bowel disease, thyroid disease was diagnosed. The thyroid disorders frequency was higher in IBD group than in the group of control (18/155 vs. 1/63, p=0.042). There was no substantial dissimilarity in the frequency of thyroid orders in cases of CD and UC (5/40 vs. 13/115, p=0.912). In 4 (2.7%) IBD patients, Hashimoto’s thyroiditis were noted. Conclusion: According to many studies issued in the literature, we have noted a greater fraction of thyroid disease in inflammatory bowel disease patients.

Performance and Carcass Traits of Broiler Chickens Reared on LEDs vis-a-vis CFL as a Growth Promotor

The present study was conducted to compare the performance of broiler reared under two different light sources and three different light colours. For this purpose, 120, two-week-old IBL-80 (Indian Broiler Ludhiana-80) broiler chicks were randomly distributed in four different treatment groups viz. TLEDB-G (first 2 wks, blue LED then switched to green LED for the next 2 wks), TLEDG-B (first 2 wks, green LED then switch to blue LED for the next 2 wks), TLEDW (White LED) and TCFL (CFL light; Control) with 3 replications and 10 birds in each experimental unit was applied. The effects of different lights on performance (BW, BWG and FCR), carcass traits and its economic impact on broiler chickens were investigated in the present study. The results show that performance and carcass traits of broiler birds of blue-green and green blue LED light group was at par to that of CFL group whereas benefit cost ratio of birds of TLEDB-G (1.13) was found highest among different treatment groups. Therefore, use of a combination of monochromatic Blue-Green or Green-Blue LED light could be a better alternative source of light than CFL light in terms of birds’ performance, economics and energy saving

Types of maxillary tumours and the resulting post-surgical defects in patients at a teaching hospital

To report the frequency of the types of maxillary tumours and the resulting post-surgical defects based on Aramany classification. Study design, duration and setting: This descriptive study was done during the period of 5 years [2005-11] at the Otorhinolaryngology and Head and Neck Surgery Unit, Khyber Teaching Hospital Peshawar. A pre-structured proforma was used for data collection. Data recorded included patients' age, gender, type of maxillary tumour, type of maxillectomy and approach for resection, Post-surgical defect based on Aramany classification for acquired maxillary defects, neck dissection, radiotherapy, and prosthetic rehabilitation. Data were computed for descriptive statistics including frequencies, percentages and mean values. Patients [n=53] had a male to female ratio of 1.7. Some 26.4% patients belonged to the age group of 31-40 years. Maxillectomy was done for inverted papilloma, a benign tumour in 1.9% patients as compared to malignant squamous cell carcinoma in 66% patients. Maxillary resection for fibrous dysplasia was done in 3.8% patients who were relatively younger. Maxillectomy in all cases was performed using Weber-Fergusson incision approach. Surgical resection resulted in Armanay calls I defect in 73.58% patients. In 92.5% patients a surgical obturator was provided to patients at the time of maxillectomy. Maxillectomy was mainly performed for resecting malignant tumours using Weber-Fergusson incision with the fitting of immediate surgical obturator. The resulting defect was mainly Aramany Class I defects

Foreign body nose in children presenting at a tertiary care teaching hospital in Pakistan

To determine the patient management factors and patient outcomes in pediatric patients of foreign bodies in nose. This descriptive study was performed in ENT Department, Khyber Teaching Hospital, Peshawar from February, 2006 to January, 2007. Two hundred fifty seven cases of foreign bodies in nose in patients upto 12 years of age were included. Personal data, clinical features, investigations, management details and complications were recorded on a pre-designed proforma. In younger non cooperative cases foreign bodies were removed under general anesthesia, while in cooperative children it was removed without anesthesia by using suction, use of forceps and foreign body hook. Among 257 cases of foreign bodies in nose 48.46% were between 4 to 8 years, with male preponderance i.e. 63%. Unilateral and bilateral presentations were seen in 95% and 5% cases respectively. Most common foreign body types were plastic beads, pearls, pieces of sponge and small round objects. There were two cases of alkaline battery lodged in the nose. General anesthesia had high success rate. Round shape foreign bodies and younger children are associated with poor outcome with removal attempts made under direct visualization. These cases should be referred directly to otolaryngologists for removal under general anesthesia

Otorhinolaryngological manifestations of tuberculosis

Tuberculosis, one of the oldest disease in man, is even today, a leading cause of human suffering and loss of life. TB has the potential to infect any organ in the body due to lympho-haematogenous dissemination. Therefore, this study was conducted to know the manifestations of the disease in various regions of Otolaryngology. The study was conducted in the ENT department, Khyber Teaching Hospital, Peshawar. Duration of study was two years from January, 2005 to December, 2006. A total of 100 patients presented with primary head and neck TB during the study period. Most of these [97%] had tubercules cervical lymphadenpthy. Age ranged from 8 to 55 years. The mean age was 31.5 years. Thirty six were male and 64 were female. Sixty five patients were diagnosed by FNAC examination and 32 required biopsy and histopathological confirmation. One patient each of laryngeal TB, cervical spine TB and retropharyngeal abscess [TB] were diagnosed by MRI. TB is a challenging disease, its diagnosis requires a high index of suspicion. FNAC is a reliable and easy way to diagnose, however, gold standard is biopsy for histopathology

Presentation and diagnosis of allergic fungal sinusitis

Allergic fungal sinusitis [AFS] is a form of fungal disease that has recently been considered a distinct clinicopathologic entity. Other forms of fungal sinusitis include acute-fulminant [invasive], chronic indolent [invasive] and mycetoma [non-invasive]. Objectives were to assess the presentation and to describe the diagnostic techniques for allergic fungal sinusitis in our setup. Descriptive study was conducted in the Department of ENT and Head and Neck Surgery, Khyber Medical College and Khyber Teaching Hospital, Peshawar from January 2002 to April 2008. Twenty-three cases of allergic fungal sinusitis [ASF] were selected for the study. Data like, name, age, sex, address, clinical features, labs [Eosinophil count] and imaging studies [CT and/or MRI] were recorded, including the pre- and postoperative treatment, operative findings and postoperative results, recurrence of disease were also recorded. Surgical procedures were performed on all cases followed by medical treatment. Study revealed that AFS is a disease of younger age, mainly occurring in 2[nd] and 3[rd] decade of life, with male to female ratio 1:1.3. Allergic rhinitis [91%] and nasal polyposis [91%] were important associated factors. Nasal obstruction [96%], nasal discharge [91%], post-nasal discharge [87%] and unilateral multi sinus extension were important clinical features. Increased eosinophil count and increased IgE level was found in 78% cases. Histopathological analysis showed fungal hyphae in all cases and aspergillus was predominant organism on culture. Orbital erosion was seen in 78% and skull base erosion was observed in 9%. Recurrence of disease was seen in nine cases. Allergic fungal sinusitis [AFS] is a disease of young immunocompetent adults. Nasal obstruction, nasal discharge, nasal allergy and proptosis were the most common presentations. Initial diagnosis of allergic fungal sinusitis requires high index of suspicion in patients presenting with chronic rhinosinusitis, such cases should be properly evaluated. Differentiation from invasive forms of fungal sinus disease is crucial

Role of postoperative medical treatment in the management of allergic fungal sinusitis

To evaluate the effectiveness, of postoperative medical treatment in the management of allergic fungal sinusitis with orbital and/or skull base erosion. Descriptive study. This study was conducted in the Department of ENT and Head and Neck Surgery, Khyber Medical College and Khyber Teaching Hospital Peshawar between January 2002 and April 2007. Eighteen cases of allergic fungal sinusitis with orbital and/or skull base erosion were selected for the study. Demographic data like, name, age, sex, address, clinical features, labs and imaging studies were recorded, clinical data including the pre and post-operative medical treatment, operative findings and postoperative results, recurrence of disease were recorded. All patients were divided into three groups on the basis of postoperative medical treatment. Study revealed that Allergic Fungal Sinusitis [AFS] is a disease of younger age, mainly occurring in 2[nd] and 3[rd] decade of life, with male to female ratio 1:1.25. The recurrence was 100% in group-l who were on oral antifungal therapy postoperatively. The recurrence of disease was 40% in patients of group-2 who were on topical nasal steroid, antihistamine and saline irrigation postoperatively. The recurrence rate was much lower 11% in group-3 patients who received oral and topical nasal corticosteroids postoperatively. AFS is a disease of young immunocompetent adults. Surgical debridement and drainage combined with topical and oral corticosteroids can lead to resolution of disease in majority of the cases and prevent recurrences. Antifungal medication has no role in the treatment of allergic fungal sinusitis

Evaluation of auditory perception skills development in profoundly deaf children following cochlear implantation

Cochlear implant is a medical treatment option for individuals with severe to profound sensori-neural hearing loss on account of non-functioning cochlea or part thereof. Technology is ever evolving and the candidacy criteria are widening. Appropriate selection of patient, successful implantation of an appropriate device and adequate post-implantation rehabilitation protocol are the key factors that dictate the eventual outcome. Bilateral cochlear implantation in children and combined electro-acoustic stimulation are the new developments in this field of rehabilitation for the deaf. Pakistan Cochlear Implant Programme was started in year 2000 and one hundred and fifty subjects have undergone cochlear implant surgery so far at Karachi, Lahore and Peshawar since. This prospective study was designed to evaluate the development of auditory perception skills and language in children, over a twelve months period, following cochlear implantation. Twenty-one patients were enrolled in this evaluation. These were divided into three groups as per age factor. Group 1 included eleven children of ages less than five years, Group 2 included eight children of ages between five and nine years whereas, Group 3 included two eleven years old children. Furthermore, subjects in Group 1 and 2 were pre-lingual whereas those in Group 3 were post-lingual. The three groups were evaluated using "Evaluation of Auditory Responses to Speech" [EARS]. Improvement in performance on all measures was noticed in all the groups over a twelve months period following implantation. Dynamics of improvement in auditory skills suggested more and rapid development in younger age group. Children of varying ages, both pre and post lingual, did show improvement in the development of auditory perception skills, that was evident more in the younger age group

Preservation of residual hearing in cochlear implanted patients

Aim of this study is to investigate the preservation of residual hearing after the cochlear implant surgery. Lahore and Peshawar during the period 2001 to 2007. Eighteen patients out of an overall of 150 subjects, who underwent Cochlear Implant surgery in Lahore and Peshawar during the period 2001 to 2007, were enrolled for this study. Hearing threshold has been measured in this group of patients following cochlear implantation with Medel Combi 40+ device for the last six years. The assessment was carried out within the first post-operative month as well as at later stage, between six and 72 months, post-operatively. All Eighteen patients in our cochlear implant program who could give good pure tone audiometry results used hearing aids before implantation. The pure tone acoustic thresholds at 250, 500, 1000, 2000 and 4000 Hz were obtained using the standard audiometrical procedures before and after cochlear implantation. Hearing preservation could be achieved in 16/18 patients [86%]. In two patients partial preservation was possible [14%]. These results indicate that it is possible to partially preserve residual hearing during cochlear implant surgery

Post-tonsillectomy and adenotonsillectomy morbidity and complications at district headquarter hospital daggar

Tonsillectomy or adenotonsillectolny is one of the commonly performed operations in ENT practice. Morbidity and complications associated with tonsillectomy and adenotonsillectomy include severe otalgia, pyrexia, odynophagia and haemorrhage. A prospective study was undertaken from April 1996 to April 2001 to report the experience regarding postoperative morbidity/complications in tonsillectomy and/or adenotonsillectomy. A total of 1500 patients undergoing tonsillectomy or adenotonsillectomy for chronic/recurrent tonsillitis or adenotonsillar hypertrophy were included. These patients received antibiotic in the form of amoxycillin and clavulanic acid and non-salicylate analgesics for 7 days postoperatively. 100 patients were lost to follow up. Seventy% of patients were female and thirty% males with maximum number of patients between the age of 11-22 years. Postoperative complications developed in 25 out of 1400 patients, 14 of them developed post-operative bleeding and 9 developed postoperative infection. Conclusions: It was found that postoperative morbidity / complications were less in this study with regard to secondary haemorrhage, operative site infection, intensity and duration of postoperative pain, postoperative pyrexia and time for return to normal activities