Background & Objectives: Generally, the blockage of upper respiratory tract in children is seen with the hypertrophy of adenoids and tonsils. Normally for patients with adenoid hypertrophy (AH), Adenoidectomy with or without Tonsillectomy is carried out, however it has its own complications like haemorrhage and recurrence of adenoid tissue. Consequently, therapeutic approach has increased extraordinary consideration rather than surgical procedure. The inflammatory process proposed for AH has prompted the utilization of anti-inflammatory drugs to treat this issue. The objective of this study was to assess the impacts of Montelukast sodium in children with enlarged adenoids. Methods: A randomized controlled trail was performed from April 2018 to March 2019 in the Otorhinolaryngology clinic of Dr. Akbar Niazi Teaching Hospital, Islamabad. In this randomized, placebo treatment-controlled trial, 60 children aged 4-12 years meeting inclusion criteria were isolated into two groups. The study group was treated with Montelukast sodium 5mg consistently for three months while the control group got placebo treatment for a similar timeframe. A questionnaire was filled by parents/ guardians of every child before and after the intervention to evaluate the severity of sleep discomfort, snoring and mouth breathing. Results: Following 3 months of treatment, significant reduction in size of the adenoids was seen in 76% of study group compared with just 3% of control group getting placebo treatment. Conclusion: Montelukast sodium seems to be effective in the reduction of the size of adenoids and improvement in clinical manifestations. It can be viewed as a viable option in contrast to surgical treatment in children with hypertrophy of adenoids. doi: https://doi.org/10.12669/pjms.37.2.2670 How to cite this:Naqi SA, Ashfaq AH, Umar MA, Karmani JK, Arshad N. Clinical outcome of Montelukast Sodium in Children with Adenoid Hypertrophy. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.2670 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objectives: To observe the relationship of nasal foreign bodies in terms of patient’s age as well as the type of foreign body and removal technique. Materials and Methods: This retrospective cross-sectional study was conducted in ENT department, Akbar Niazi Teaching Hospital, Islamabad from April 2017 to May 2018. A total of 120 patients selected by non-probability consecutive sampling technique with inclusion criteria of all children less than 12 years with foreign body in nose were recruited for this study after taking written informed consent. Patients who had concurrent nasal infections and trauma were excluded. Children age, gender, site, type of foreign body and removal technique were recorded. Data was analyzed by using SPSS version 21. Results: A total of 120 patients were presented with nasal foreign bodies, 107 cases were successfully dealt with in OPD while 13 patients were admitted for removal under general anaesthesia. The commonest affected age group was 2-5 years (78.33%) with more females (55.75%) than males (44.25%). Organic type of foreign body was 55.8% and inorganic type of foreign body was 44.2%. Seeds and small nuts (35%) were found to be the commonest types of nasal foreign body. The correlation between age groups, types of foreign body, removal technique and site of foreign body was significant (p value ≤ 0.05). Conclusion: Nasal foreign bodies are commonly faced problem in children, specially in 2-5 years of age. They are largely harmless but complications can occur if neglected. Prevention remains the best option while for non-cooperative and attempted cases, removal under general anaesthesia is safe and preferred.

Background: Flexible laryngoscopy is less operator/patient dependent diagnostic procedure with magnified field and well tolerated diagnostic procedure. Flexible laryngoscopy is tolerable diagnostic procedure with clear and magnified visualization of interior larynx. Aim: To audit the flexible laryngoscope in outpatient department in our local setting. Methods: A retrospective audit survey was carried out in Outpatient ENT Department of Akbar Niazi Teaching Hospital, Islamabad between June 2021 and May 2022. Total 85 patients with age range 10-80 years, with history of laryngopharyngeal symptoms and preoperative evaluation of thyroidectomy patients were selected. After getting detail history of flexible naso-pharyngo-laryngoscopy and findings were documented and analyzed. Under local anesthesia, spray in the nose and throat gargles. The laryngoscope passed through nose and nasopharynx into the laryngopharynx, and assessing all the structures. Data was analyzed through SPSS v 22. Results: The patients mean age was 28.96±9.14 years. Among all the patients 49(57.64%) were female and 36(42.3%) were male. The population highest percentage 26(30.5%) were 21-30 years old. The laryngeal complaint of hoarseness was highest with 38.8% indicated after flexible laryngoscope procedure according to other symptoms. According to diagnosis made on flexible laryngoscopy, the vocal nodules were highest with 15.3% detected. The diagnostic tools in diagnosis of laryngeal pathologies, its availability and cost effectiveness led to limited access of the patients to such sophisticated diagnostic procedure. Conclusion: Flexible laryngoscopy gives detailed visualization of the larynx and don’t leave the examiner inconclusive about laryngeal pathologies. Keywords: Clinical audit; Diagnostic equipment; Laryngoscopy; Nasopharyngeal diseases; Outpatient clinics, hospital.

Background: The discipline of otorhinolaryngology specialty is a very promising field all over the globe. This field is equipped with modified lifestyle as compared to general surgery field. However, otolaryngology is a flexible, promising and important field but still its trend is decreasing all over the world across the undergraduate’s professionals. Aim: To determine the frequency of otolaryngology specialty choice being taken by 4th year MBBS students. Methods: A descriptive cross-sectional study was conducted in otorhinolaryngology department of Islamabad Medical and Dental College, Islamabad from January to December 2020. The answers were obtained through the Likert scale-5 having the following components, as strongly agree, agree, not sure, disagree, strongly disagree. Results: A 100 undergraduate students participated in this survey. All students were of 4th year MBBS. 20% students were agreed and 40% not sure about the question regarding taking up otorhinolaryngology as a career choice and 15% strongly agreed for this. Conclusion: The study concluded that the graduates are not sure whether they want to choose otorhinolaryngology as their final career choice. We suggest that it should be one of the compulsory rotations during the internship. Keywords: Otorhinolaryngology; Specialty; Undergraduate medical education; Postgraduate; Career choice.

Aim: To determine the audiometric findings, prevalence of age related hearing loss and association of hearing loss with gender in patients of 60 years and above. Setting and duration of study: This study was conducted in the Department of ENT at Shifa Foundation Community Health Centre (SFCHC), Shifa International hospital, Islamabad, over a period of 5 years from September 2014 to September 2019. Methods: A total of 149 patients were included in the study. All the patients were subjected to audiometry after taking informed written consent. Information regarding the past medical history of all participants regarding ear and hearing disorders and risk factors was taken and recorded. All this information along with demographic information was recorded. Results: The mean age of the participants was 70.72 ± 7.09 years. Most 46 (30.9%) of the patients were between 60 to 65 years old. The proportion of male participants 76 (51%) was slightly higher. In our study sample, 142 (95.3%) of the participants had high-frequency hearing loss, and 129 (86.6%) participants had low-frequency hearing loss. Mostly 62 (41.6%) participants had sloping curve. Most 125 (83.9%) participants were diagnosed with both types of hearing loss. Among male patients flat curve showed a significant (P-value < 0.05) relationship with age and in female patients, flat curve and neither flat curve nor sloping curve showed significant (P-value < 0.05) association with different age brackets. Conclusion: High-frequency hearing loss was the most common type of hearing loss among older patients. Majority of the patients were diagnosed with both types of hearing loss. High-frequency hearing loss was found to be significantly associated with different age brackets. Keywords: Hearing loss, Audiometric findings, High Frequency Hearing Loss,

Background: Acute pharyngitis is the inflammation of the mucous membrane of oropharynx which is caused by various infectious organisms like bacteria, viruses and fungi. The other less common seen causes include allergies and gastro-esophageal reflux disease. Aim: To look for range of microorganisms involved in causing acute pharyngitis on throat swab specimens. Methods: After getting consent all the pharyngitis patients attending ENT Department at Akbar Niazi Teaching Hospital (ANTH), Islamabad from January to June 2017 were included in the study. From total of 100 patients throat swabs were obtained by established aseptic method and were sent for culture. The organisms involved were recognized by biochemical tests & their propensity to antimicrobial agents was established by established methods. Data was entered and analyzed by using SPSS v.21. Results: Out of 100 specimens’ microorganisms were identified in 25 specimens while 75 specimens had no growth. Streptococcus pyogenes was the frequently seen organism 9(90%), while the list was followed by Staphylococcus aureus 14(56%) and Candida albicans 3(12%). In 40% single pathogen was identified with Streptococcus pyogenes in 9 samples (90%) and Staphylococcus aureus in 1(10%), whereas 60% of the culture reports were that of the mix infection. Conclusion: The study concluded that streptococcus pyogenes and staphylococcus aureus were responsible for majority of single organism infections, while candida albicans together with these bacteria were isolated from mixed infections. Keywords: Pharyngitis; Streptococcus pyogenes; Throat; Microorganisms.

Objective: To analyze treated head and neck malignancies with reference to frequency of cervical metastases and frequency of nodal recurrence following neck dissection and/ or radiotherapy for cervical metastases.Patients and Methods: This observational prospective study was conducted at ENT Department, Pakistan Institute of Medical Sciences, Islamabad over a period of 16 months. Study population was comprised of 15 cases of either gender and any age, with treated head and neck primary who developed metastatic neck disease and were included through non-probability sampling technique. Patients with primary site recurrence or distant metastases were excluded from the study. They were treated with neck dissection, radiotherapy or both for neck disease and followed up for a 1 year. Clinical data including age, gender, site and histopathology of treated primary tumor, nodal involvement both clinical and histopathological, treatment and post treatment result were recorded. Data was collected, tabulated and analyzed using Microsoft excel worksheet.Results: Out of total 15 cases, 17% patients were with N1 disease, 33% patients with N2a disease, and 50% were with N2b disease. Total 3 (20%) patients received radiotherapy (2 being unfit for surgery and 1 due to refused consent) and 12 (80%) patients underwent surgery. Out of these 12, 3 underwent RND, 7 MRND and 2 SND. Total 20% (3) developed recurrence.Conclusion: Combination of RND or MRND and radiotherapy is highly effective in controlling neck disease in controlled primary tumors.