scholarly journals EXPERIENCE OF DOING ENDOSCOPIC SINUS SURGERY FOR CHRONIC MAXILLARY SINUSITIS WITHOUT PRE-OPERATIVE CT-SCAN IN A PERIPHERAL HOSPITAL

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S534-38
Author(s):  
Adnan Asghar ◽  
Sohail Aslam ◽  
Syed Muhammad Asad Shabbir Bukhari ◽  
Umar Ijaz ◽  
Shahid Iqbal ◽  
...  
Keyword(s):  
Ct Scan ◽  
Endoscopic Sinus Surgery ◽  
Goodness Of Fit ◽  
Maxillary Sinusitis ◽  
Cross Sectional Study ◽  
Sinus Surgery ◽  
Military Hospital ◽  
P Value ◽  
Cross Sectional ◽  
Chronic Maxillary Sinusitis

Objective: To determine frequency of our complications of endoscopic sinus surgery without pre-operative CT-Scan and to compare this frequency with other similar studies done with the help of pre-operative CT-Scans. Study Design: Cross sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital Skardu Pakistan, from Jun 2017 to Jun 2019. Methodology: Total 69 patients (116 Sides) were operated under general anesthesia by using 0 and 30 degree endoscopes to address the Maxillary sinusitis. Frequency of complications was compared to other studies by applying chi-square test for goodness of fit. The complications were also correlated to ages of patients by applying Spearman correlation analysis. Results: Mean age was 29.75 ± 10.9 years (range 15-75). Overall complications rate was 4.3% (5 out of 116 sides, 95% confidence interval 4.23-4.4). Peri-orbital ecchymosis and peri-orbital emphysema were most commonly occurring complications (4.3%). This complication rate was compared to few other studies, which proved that difference was not statistically significant. Correlation of occurrences of orbital complications with the age proved that there was no statistically significant correlation (Correlation coefficient r=-0.085, p-value 0.276). Conclusion: Isolated chronic maxillary sinusitis refractory to medical treatment can be treated by endoscopic sinus surgery without pre-operative CT-Scan.

Computed tomography assessment of the ethmoid roof based on Keros classification in Iraqi patients undergoing functional endoscopic sinus surgery

2021 ◽  
Vol 4 (2) ◽  
pp. 365-370
Author(s):  
Baseem Natheer Abdulhadi ◽  
Ali Ibrahim Shyaa ◽  
Laith ALTamimi
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Cross Sectional Study ◽  
Common Type ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
P Value ◽  
Type I ◽  
Cross Sectional ◽  
And Gender ◽  
The Right

Background: Among the most popular methods employed to classify the depth of the olfactory fossa is Keros classification. This study aims to assess Keros classification of the ethmoid roof, any possible association between Keros types and gender, and the incidence of asymmetry between right and left sides among Iraqi patients.  Methods: A retrospective cross-sectional study was conducted at Al-Shaheed Gazi Al-Hariri Teaching Hospital, Medical City, Baghdad, Iraq. The archived reports and the CT scans images (nose and paranasal sinuses) of 126 patients who have undergone functional endoscopic sinus surgery between January 2019 and January 2020 were reviewed. Univariate and bivariate statistical analysis was performed using SPSS version 24. The statistically significant was considered at less than 0.05. Results: More than half of patients were females (54.0%) with a mean age of 31.52 ± 11.38 (SD) years (range: 10-57 years). Among the total patients, the mean depth of olfactory fossa (OF) was 3.58 ± 0.02 mm. Results showed that Keros type I was the most common type (71.0%), followed by type II (27.4%) and type III (1.6%) respectively. The difference in the olfactory fossa depth between the right and left sides was ≥ 1 mm in 16 (12.7%) patients and < 1 mm in 110 (87.3%) patients. Moreover, there was no significant relation between symmetry/asymmetry and gender ( p-value > 0.05). Conclusion: Keros type I was the most common type, which carries the lowest risk of inadvertent intracranial injury during endoscopic sinus surgery; besides the relatively low percentage of asymmetry in the depth of the two olfactory fossae among patients, surgeons should always be cautious during surgery to avoid iatrogenic injury concerning the thin lateral lamella of the cribriform plate.

A Cross Sectional Study of Sinonasal Pathologies and Their Endoscopic Surgical Management

2020 ◽  
Vol 7 (43) ◽  
pp. 2442-2447
Author(s):  
Shahul Hameed A ◽  
Abdul Salam R.T ◽  
Dilna Dilna
Keyword(s):  
Ct Scan ◽  
Skull Base ◽  
Paranasal Sinuses ◽  
Endoscopic Sinus Surgery ◽  
Cross Sectional Study ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional

BACKGROUND In recent times, due to advancement in sinus endoscopes and sinus surgery instruments and the acquirement of skills, the variety of sinonasal diseases being treated and the indications for transnasal endoscopic approaches have increased dramatically. They include chronic rhinosinusitis and sinonasal polyposis to sinonasal tumours, skull base and orbital pathology. We wanted to study the role and outcome of endoscopic sinus surgery in the management of sinonasal disease. METHODS A cross sectional study was conducted among 200 patients attending the Department of ENT, Govt. Medical College, Kozhikode, over a period 2 years with sinonasal diseases. Demographic details, ENT examination, CT scan Paranasal Sinuses (PNS) and endoscopic examination of the nasal cavity were performed in all patients. Clinical signs were recorded and classified according to their pathologies. All the patients were subjected to functional endoscopic sinus surgery. Operative methods and results were recorded. RESULTS Among the 200 patients, 144 (72 %) were males and 56 (28 %) were female patients in the present study. Among the 200 patients, 126 (63 %) were in the age group of 21 to 50 years. 40 / 200 (20 %) patients belonged to the age group of 0 to 20 Years. 34 / 200 (17 %) patients belonged to the age group of 51 to 70 years. CONCLUSIONS The diseases of the nose and paranasal sinuses ranged from inflammatory aetiology to neoplasms. Use of conventional tools for diagnosis and management of such a variety of diseases had their own limitations and demerits. Whereas endoscopic view of the disease sites was exceptionally clear and well-illuminated, giving an added edge to the ability to inspect the recesses with angled distal endoscopes. Definition of micro anatomical sites was well defined by the CT scan especially around osteo-meatal complex, and its anatomical variants. Functional endoscopic sinus surgery was an excellent and safe procedure. The prognosis in surgically treating sinonasal pathologies with FESS was good in terms of lesser morbidity and minimal chances of recurrence. KEYWORDS Sinusitis, Endoscopic Sinus Surgery, CT Scan PNS, Skull Base Surgery, Sinonasal Tumours

Ultrastructural ciliary changes of maxillary sinus mucosa following functional endoscopic sinus surgery: an image analysis quantitative study

2003 ◽  
Vol 117 (4) ◽  
pp. 273-279 ◽  
Author(s):  
Ahmed Bassiouny ◽  
Ahmed M. Atef ◽  
Mahmoud Abdel Raouf ◽  
Safaa Mohamed Nasr ◽  
Magdy Nasr ◽  
...  
Keyword(s):  
Image Analysis ◽  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Quantitative Methods ◽  
Maxillary Sinusitis ◽  
Functional Endoscopic Sinus Surgery ◽  
University Hospital ◽  
Sinus Surgery ◽  
Chronic Maxillary Sinusitis ◽  
Sinus Mucosa

This was a study of the effect of functional endoscopic sinus surgery (FESS) on the ciliary regeneration of maxillary sinus mucosa in patients with chronic maxillary sinusitis, using objective quantitative methods. Twenty specimens from the mucosa of both the superolateral wall and the ostium of the maxillary sinus were sampled during FESS and then six to 12 months later. They were light examined first by light microscopy and then by scanning electron microscopy in combination with image analysis software in order to study the cilia under higher magnification and to calculate proportion of the field that was ciliated. Samples were taken and studied at Cairo University hospital. This study showed that the maxillary sinus mucosa in chronic sinusitis is capable of regeneration and could return towards normal with the improvement of ventilation and drainage of the maxillary sinus following FESS. There were no significant changes in the degree of glandular hyperplasia, goblet cells or pathological glands after surgery.

scholarly journals MILK AGGRAVATES ASTHMA – THE TRUTH OR THE PERCEPTION

2020 ◽  
Vol 70 (6) ◽  
pp. 1691-95
Author(s):  
Muhammad Khalid Azam Khan ◽  
Shazia Naz ◽  
Abdul Latif Khattak ◽  
Nauman Kashif ◽  
Syed Karamat Hussain Shah Bukhari ◽  
...  
Keyword(s):  
Positive Response ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
P Value ◽  
Sectional Study ◽  
Cross Sectional ◽  
Medicine Department ◽  
Milk Substitute ◽  
Dyspnea Score ◽  
Drinking Milk

Objective: To assess the notion that milk can cause or aggravate asthma and break this myth. Study Design: A cross sectional study. Place and Duration of Study: Medicine department, Combined Military Hospital Lahore, from Jan 2019 to Dec2020. Methodology: A survey was conducted whereby known asthmatics were questioned about their opinion weather milk aggravates their asthma. Those who confirmed their positive response were exposed to milk and some liquid resembling milk, and their Lung functions were tested after each drink. The 42 patients who considered milk as the primary aggravator were called for the study for spirometry Results: A total of 600 people from the general population were surveyed. Two hundred and six (34.3%) of them were illiterate, 394 (65.6%) were educated from middle to graduates. In the first milk/milk encounter, the combined dyspnea scale showed increase of 50.3% and improvement of 0.008% in FEVI/FVC. In the second substitute/milk encounter, the dyspnea score showed an increase of 61.8% and an increase of 0.90% in FEVI/FVC. In the third milk/substitute encounter the dyspnea score showed a decrease of 22.9% and the FEVI/FVC decreases by 5.5%. In the 4th substitute/substitute encounter, dyspnea scores decreased by 8.4% while the pre and postencounter FEVI/ FVC scores were 2726 and 2711 with 0.55% decrease with insignificant p-value >0.05. Conclusion: Drinking milk or milk substitute has negligible effect on the spirometric parameters.

scholarly journals COMPARISON OF MANIFESTATIONS OF GIARDIA AND ASCARIS INFESTATIONS BETWEEN BOTH GENDERS PRESENTING WITH DIARRHEA

2020 ◽  
Vol 70 (6) ◽  
pp. 1681-85
Author(s):  
Kanwal Jehanzeb ◽  
Zia Ul Haq ◽  
Saeed Zaman Khattak ◽  
Sajid Ali Shah ◽  
Munir Akmal Lodhi ◽  
...  
Keyword(s):  
Sampling Technique ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
P Value ◽  
Common Symptom ◽  
Chi Square ◽  
Cross Sectional ◽  
Worm Infestation ◽  
Number Of Patients ◽  
Common Parasite

Objective: To assess the occurrence and intensity of Giardia and Ascaris infestations in children of both genders reporting with diarrhea. Study Design: Comparative cross sectional study. Place and Duration of Study: Paediatrics department, Combined Military Hospital, Gilgit, from Jul 2016 to Jul2018. Methodology: Patients of either gender with worm infestation were included in the study. Patients more than13 years old were excluded. The sampling technique used was non probability consecutive sampling. The stoolexamination (R/E) for the diagnosis of worm infestation was done. Stratification was done with regards to age,mother education, gender, type of water used and post stratification chi square test was applied. p-value was0.613 when calculated for the manifestation between both genders. p-value ≤0.05 was considered significant. Results: Total number of patients in our study was 100. Among them, males were 65 (65%) and females were 35(35%). Mean age of patients in our study was 4.20 ± 2.61 years (Mean ± SD). Abdominal pain being most common symptom in 43 (43%) of patients. Majority of the patients were from 2 to 10 years of age, 79 (79%). Helminthic infestation was the most common observed in 52 (52%) whereas Protozoal infestation was observed in 48 (48%) patients. The most common parasite isolated was Giardia 41 (41%) followed by Ascaris 36 (36%). p-value of 0.613 was found between both gender. Conclusion: In our study Helminthic infestation was more common. The most common parasite isolated wasGiardia followed by Ascaris.

scholarly journals COMPLIANCE TO SURVIVING SEPSIS CAMPAIGN HOUR–1 BUNDLE–A CROSS SECTIONAL STUDY AMONG PHYSICIANS INVOLVED IN CRITICAL CARE IN PAKISTAN

2021 ◽  
Vol 71 (1) ◽  
pp. 249-54
Author(s):  
Rehana Feroze ◽  
Muhammad Tariq ◽  
Abdul Wasay Toor
Keyword(s):  
Work Experience ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
P Value ◽  
Sectional Study ◽  
Surviving Sepsis Campaign ◽  
Cross Sectional ◽  
Sepsis Bundles ◽  
Critical Patients ◽  
Sepsis Bundle

Objective: To determine physician’s compliance to surviving sepsis campaign updated Hour-one bundle incritically ill patients in Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital Lahore MedicalCollege, from Jun to Aug 2019. Methodology: This study was carried out among physicians managing critical patients in intensive care units.Participants were asked to fill out a 16-questions survey (work experience, qualification and individual components of surviving sepsis campaign hour-1 bundle. Data was collected using online access to survey and by sending hard copies. Results: Questionnaire was sent to 230 physicians while only 63 responses were received (response rate 27%).Only 45 (71%) respondents were aware of the updated Hour-1 bundle. There was no institutional protocolfor compliance to sepsis bundles in thirty three (55%) responses. 52% respondents used Systemic inflammatoryresponse syndrome (SIRS) criteria to diagnose sepsis while quick Sequential Organ Failure Assessment (qSOFA)was used by 36% respondents. Overall compliance to hour-1 bundle components was only 60%. Lactate levelswas not measured by 35 (55%) respondents while 24 (38%) did not obtain blood cultures before administeringantibiotics. Crystalloid and nor epinephrine was used by all respondents. Overall compliance with all the components of sepsis bundle had strong correlation with post-graduate qualification (p-value 0.001-0.049). Conclusion: Poor compliance to updated sepsis guidelines was one of the major reasons of high sepsis relatedmortality in Pakistan.

scholarly journals Accuracy of cranial ultrasound in the diagnosis of hydrocephalus in children under 6 months of age keeping CT scan as a gold standard

2020 ◽  
pp. 3-7
Author(s):  
Rabia Akram ◽  
Amna Khalid ◽  
Wasif Farman ◽  
Fazal Hussain Shah ◽  
Hina Baig ◽  
...  
Keyword(s):  
Ct Scan ◽  
Gold Standard ◽  
Cross Sectional Study ◽  
Military Hospital ◽  
Cranial Ultrasound ◽  
Cross Sectional ◽  
X Ray Computed ◽  
Keywords Hydrocephalus ◽  
Sensitivity Specificity ◽  
Ct And Mri

Background: CT and MRI modalities are considered a gold standard for the diagnosis of hydrocephalus. The more readily available and cheap options like sonography are being sought out for the diagnosis of this entity. Objectives: To determine the accuracy of cranial ultrasonography in the diagnosis of hydrocephalus keeping CT scan as a gold standard. Study design: Cross-sectional study Place and duration of study: Department of Pediatrics, Combined Military Hospital, Rawalpindi, from 01-01-2017 to 30-06-2017 Materials and Methods: A total of 121 children with a clinical diagnosis of hydrocephalus were selected and subjected to ultrasound of the head. Subsequently, a CT scan of the head was done and both modalities were compared. The diagnostic accuracy of the ultrasound was determined to keep CT findings as to the gold standard. Results: The mean age was 51.36 ± 34.01 days. The male gender was dominant as 81 (66.9%) patients were males. Ultrasonography of the head detected 93 (76.9%) patients with hydrocephalus while CT scan detected 90 (74.4%). Sensitivity, specificity, PPV, NPV and accuracy of USG to diagnosed hydrocephalus were 88.9%, 58.1%, 86.0%, 64.3% and 80.99% respectively Conclusion: Ultrasonography of head is a valuable screening tool for the diagnosis of hydrocephalus. Keywords: Hydrocephalus, Tomography, X-Ray Computed, Ultrasonography

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