Type-I Tympanoplasty By Underlay Technique - Factors Affecting Outcome.

BACKGROUND: Type-I Tympanoplasty is an operation which is widely done to close a persistent tympanic membrane perforation after clearing the disease from the middle ear. It is very safe and effective procedure. The success rate varies in different setups and there are some confounding factors which affect the result of Type-I tympanoplasty like the size, type and location of perforation. By conducting this study, we aimed to calculate the success rate of Type-I Tympanoplasty in Ayub Teaching Hospital and assess which confounding factors affect the success rate. METHODS: This case series study was conducted at Ayub teaching hospital from 1st January 2014 to 31st December 2015. All the patients who presented with dry ears, no nasal disease and persistent tympanic membrane perforations during this period were operated upon and overall success rate was calculated. In addition, the relationship between the site of perforation, size of perforation and the type of perforation and the success rate of Type-I Tympanoplasty was also calculated. RESULTS: One hundred and thirteen patients were included in this study. Out of these 91 (80.5%) showed complete healing after surgery. Anterior perforations were found to fail the procedure in 41.7% of the cases, while central perforation failed in only 5.4% of the cases. In cases of marginal perforations healing was significantly decreased, i.e., only 47.1% while it was 94.9% in cases where annulus was not involved. Larger perforations also showed poor surgical outcome. 100% of the small perforation healed completely while only 58.3% of the large perforations showed successful result after surgery. When p-value was calculated all of these findings were more than 95% significant. CONCLUSIONS: There is a significant association between the healing of tympanic membrane after Type-I Tympanoplasty and site, size and type of perforation. Anterior perforations, marginal perforation and large perforations reduce the chances of successful outcome of Type-I Tympanoplasty.

Oral Corticosteroid Therapy For Sudden Sensorineural Hearing Loss And Factors Affecting Prognosis.

BACKGROUND: Sudden sensorineural hearing loss (SSNHL) is considered an otologic emergency globally. Aetiology is unknown in most cases but still the disease is believed to be caused by inflammation of the cochlea; therefore, steroids are considered beneficial due to their anti-inflammatory effect. METHODS: This study was conducted on 62 patients of sudden sensorineural hearing loss (SSNHL) in Ayub Medical Complex, Abbottabad. The patients were given prednisolone and their response to the therapy was monitored. Factors like age of the patient, gender, degree of hearing loss and duration of symptoms at initial presentation were recorded and their effect of response of the patient was also noted. RESULTS: The research subjects were 62 patients. Majority of the patients suffered from moderate to moderately severe hearing loss. Age and gender did not influence the response to the treatment. While the patients who presented earlier after the onset of disease and the patients who had milder degree of hearing loss at presentation had a better response to therapy. CONCLUSIONS: Oral corticosteroid therapy is a good therapeutic option for the treatment of sudden sensorineural hearing loss (SSHNL). The response to therapy is better in patients with milder hearing loss and those who present early to the otologist for treatment.

Network analysis of transcriptomics data for the prediction and prioritization of membrane-associated biomarkers for idiopathic pulmonary fibrosis (IPF) by bioinformatics approach.

Idiopathic pulmonary fibrosis (IPF) is a rare yet crucial persistent lung disorder that actuates scarring of lung tissues, which makes breathing difficult. Smoking, environmental pollution, and certain viral infections could initiate lung scarring. However, the molecular mechanism involved in IPF remains elusive. To develop an efficient therapeutic arsenal against IPF, it is vital to understand the pathology and deviations in biochemical pathways that lead to disorder. In this study, we availed network analysis and other computational pipelines to delineate the prominent membrane proteins as diagnostic biomarkers and therapeutic targets for IPF. This study yielded a significant role of glycosaminoglycan binding, endothelin, and GABA-B receptor signaling pathway in IPF pathogenesis. Furthermore, ADCY8, CRH, FGB, GPR17, MCHR1, NMUR1, and SAA1 genes were found to be immensely involved with IPF, and the enrichment pathway analysis suggests that most of the pathways were corresponding to membrane transport and signal transduction functionalities. This analysis could help in better understanding the molecular mechanism behind IPF to develop an efficient therapeutic target or biomarkers for IPF.

Seasonal Variation Of Acute Otitis Externa Presenting To Ayub Teaching Hospital, Abbottabad.

BACKGROUND: Otitis Externa is a common inflammatory condition of external ear. It is more common in patients having predisposing conditions like trauma, swimming, patients using hearing aids, certain skin pathologies and immunocompromised patients. Increased humidity in rainy season increases the predisposition to otitis externa. METHODS: This descriptive study was carried over the duration of one year in ENT department of Ayub Teaching Hospital, Abbottabad. Patients of all ages and both genders suffering from acute otitis externa were included in the study after taking informed consent. All the information's were recorded in predesigned proforma and then finally evaluated by using SPSS program. RESULTS: The mean age of the patients presenting to us was 39.84±14.48 years (Range 1-78 Years) more commonly in male patients (54.14%). The disease was most commonly seen in rainy season, presenting unilaterally and affecting young adults of age ranging from 31-40 years. CONCLUSIONS: Prevalence of otitis externa is more common in humid climate. Precautionary measures should be taken in rainy and humid condition such as avoidance of self cleaning the ear.

Pattern Of Presentation Of Nasal Foreign Bodies, An Experience With 155 Patients.

BACKGROUND: Children commonly present to outpatient department with foreign bodies in the nose. Sometimes the history is straightforward but not infrequently presentation is with a foul-smelling unilateral discharge and obstruction. Most of the foreign bodies are inert and do not cause any local tissue reaction but some of these can cause serious complications. The frequency of the different types of foreign bodies is not known in our setup. Our study aims to determine the types and frequencies of different foreign bodies in our catchment area so as to make the attending surgeon aware of the different possibilities he may have to encounter. Also, we aimed to make the general public aware of the hazards which the foreign bodies can create. METHODS: This descriptive cross-sectional study was carried out at Department of ENT of Ayub Teaching Hospital Abbottabad, from 1st June to 30th November 2017. During the period of study, patients presenting in outpatient department with nasal foreign bodies were included in the study. We recorded patients' age and gender. Types of foreign bodies recovered from the nose were documented and their frequency was calculated. RESULTS: A total of 155 patients were included in the study. 60% of the foreign objects were inserted in the nasal passage by male children. Children below the age of 4 years comprised more than 55% of the cases. Mean age 4.5±2.36 years. Right nostril was predominantly involved (58%). Various seeds were commonly retrieved (40%). Plastic beads were the second most common foreign bodies (21.2%). Other foreign bodies found were buttons (9%), dry batteries (1.2%), stones (9%), toy pieces (4.5%), and food particles (10%). CONCLUSIONS: The commonest nasal foreign objects in children were organic seeds followed by plastic beads.

Establishment of hybridized focus measure functions as a universal method for autofocusing.

Exact focusing is essential for any automatic image capturing system. Performances of focus measure functions (FMFs) used for autofocusing are sensitive to image contents and imaging systems. Therefore, identification of universal FMF assumes a lot of significance. Eight FMFs were hybridized in pairs of two and implemented simultaneously on a single stack to calculate the hybrid focus measure. In total, 28 hybrid FMFs (HFMFs) and eight FMFs were implemented on stacks of images from three different imaging modalities. Performance of FMFs was found to the best at 50% region sampling. Accuracy, focus error, and false maxima were calculated to evaluate the performance of each FMF. Nineteen HFMFs provided >90% accuracy. Image distortion (noise, contrast, saturation, illumination, etc.) was performed to evaluate robustness of HFMFs. Hybrid of tenengrad variance and steerable filter-based (VGRnSFB) FMFs was identified as the most robust and accurate function with an accuracy of ≥90% and a relatively lower focus error and false maxima rate. Sharpness of focus curve of VGRnSFB along with eight individual FMFs was also computed to determine the efficacy of HFMF for the optimization process. VGRnSFB HFMF may be implemented for automated capturing of an image for any imaging system.

Ziehl-Neelsen sputum smear microscopy image database: a resource to facilitate automated bacilli detection for tuberculosis diagnosis.

Ziehl-Neelsen stained microscopy is a crucial bacteriological test for tuberculosis detection, but its sensitivity is poor. According to the World Health Organization (WHO) recommendation, 300 viewfields should be analyzed to augment sensitivity, but only a few viewfields are examined due to patient load. Therefore, tuberculosis diagnosis through automated capture of the focused image (autofocusing), stitching of viewfields to form mosaics (autostitching), and automatic bacilli segmentation (grading) can significantly improve the sensitivity. However, the lack of unified datasets impedes the development of robust algorithms in these three domains. Therefore, the Ziehl-Neelsen sputum smear microscopy image database (ZNSM iDB) has been developed, and is freely available. This database contains seven categories of diverse datasets acquired from three different bright-field microscopes. Datasets related to autofocusing, autostitching, and manually segmenting bacilli can be used for developing algorithms, whereas the other four datasets are provided to streamline the sensitivity and specificity. All three categories of datasets were validated using different automated algorithms. As images available in this database have distinctive presentations with high noise and artifacts, this referral resource can also be used for the validation of robust detection algorithms. The ZNSM-iDB also assists for the development of methods in automated microscopy.