diagnostic value of fine needle aspiration cytology in masses of the salivary glands

To determine the sensitivity and specificity of fine needle aspiration cytology in masses of the various salivary glands. The study included 49 cases. It was conducted at the Departments 0f ENT, Hayatabad Medical Complex, Peshawar and Saidu Teaching Hospital, Saidu Sharif, Swat from January 1, 2002 to December 31, 2009. Patients undergoing Fine Needle Aspiration Cytology followed by open biopsy were included in the study. The results obtained on FNAC were compared with those obtained on biopsy findings of the respective specimens and the specificity and sensitivity of FNAC were calculated from the data. The FNAC findings in salivary glands were; Benign 38, Malignant 7 and Suspicious 4. The biopsy findings were; Benign 33 and Malignant 16. Comparison of FNACs and biopsy in the salivary glands taken as True Negative, True positive, False Negative and False Positive respectively was; 32, 10, 6 and 1. The Sensitivity and Specificity for FNAC were calculated at 62.50% and 96.97% respectively. The results of this study show that FNA cytologic diagnoses in the salivary gland tumours are reliable and treatment can be planned on its basis. However, owing to a higher number of false negative cases occurring in this study, it is recommended that a negative cytology report should be viewed with suspicion. The diagnosis should be confirmed by open biopsy if clinical suspicion persists

Evaluation of aetiology and efficacy of management protocol of epistaxis

Epistaxis is one of the commonest medical emergencies. It affects all age groups and both sexes. The cause may be local or systemic but in majority it is spontaneous and idiopathic. Trauma is considered to be a major aetiological factor. Various treatment protocols are utilized to control epistaxis derpending upon the type, severity and cause of bleeding. This descriptive study was designed to evaluate the aetiology and efficacy of management protocol of epistaxis in a tertiary care setting. 313 patients underwent prospective evaluation by consultant and non-consultant doctors with considerable experience in Ear, Nose and Throat [ENT] emergencies management. Standard principles were followed in the management. This study demonstrated a bimodal distribution with incidence peaks in below 25 years and above 50 years of age. Males were affected twice more than the females [2.15:1.04]. Anterior nasal bleeding was noted in majority of the patients. Anterior nasal packing was the most effective method of controlling anterior epistaxis. While posterior bleeding was controlled by posterior nasal packing with Foley's catheter. The most common cause was found to be trauma, followed by hypertension. It may be concluded from this study that epistaxis is the most common ENT emergency, affecting all age groups. It has a bimodal age presentation and affects males twice more than females. Anterior bleeding is more common than posterior bleeding. Epistaxis may be controlled with chemical/electro-cautery if the bleeding point is visible. In case of failure to localize or access a bleeding point or profuse bleeding, anterior nasal packing can effectively control majority of epistaxis. Foley's catheter is a good option that can be used for posterior nasal packing. Gelfoam may be used for controlling epistaxis in cases of bleeding disorders, when there is mucosal ooze

Management outcome of secretory otitis media

Secretory otitis media is a common otological manifestation, that most of the time is left undiagnosed on account of unawareness and negligence in seeking early medical attention for trivial ailments. Untreated, it might end up in serious consequences in the form of poor speech and intellectual development and permanent anatomical disabilities within middle ear cleft, The objectives of the study were to determine most affected age group, the common etiological factors, to access the efficacy of medical and surgical treatment and finally to find out the complication associated with the surgical procedures. This study was conducted in the ENT, Head and Neck Surgery department of the Ayub Teaching Hospital, Abbottabad from January 2001 to December 2003.Only the diagnosed cases of SOM were included in the study. After detailed history, clinical examination, routine investigations and special investigations such as pure tone audiogram and tympanometry were carried out to confirm the diagnosis of SOM. All patients were initially treated by medical therapy. In cases of failure, underwent myringotomy with or without ventilation tube insertion and where indication present adenotonsillectomy and antral lavage was done. Follow up of cases was carried out from 18-24 months. It included 87 patients, 58 were males [66.6%] and 29 females [33.3%]. Majority of the patients were between 5-8 years [62%]. The most common aetiological factor was rhinosinusitis [36.7%] followed by hypertrophic adenoids [34.5%]. All patients were initially given medical treatment. Out of 87 patients,30 patients [34.4%] improved and 57 patients [65.5%] had no response and underwent surgery. Surgical procedures included myringotomy with and without ventilation tube insertion, adenotonsillectomy and antral lavage. It is concluded from this study that conservative treatment has a definite role and should be tried before any surgical step is taken however surgery is the treatment of choice in more resistant cases

experience of 42 cases of Bronchoscopy at Saidu Group of Teaching Hospitals, Swat

The objectives of our study were to find out the frequency in terms of age and sex of the patients, type and site of foreign bodies, clinical manifestations and management with rigid ventilating bronchoscope. It was a descriptive study carried out in the department of otolaryngology and head and neck surgery at Saidu Teaching Hospital swat, and was conducted from March 2005 to March 2006. A total of 42 cases collected from March 2005 to March 2006, admitted through casualty, OPD and referred by pediatric unit. All of them subjected to bronchoscopy as an emergency as well as an elective procedure. A total of 42 cases were included in the study. In 37 cases [88.09%] foreign bodies were removed successfully, while 4 cases [9.52%] were having no foreign body, only mucous plug was removed. One patient [2.32%] died due to cardiac arrest