Objectives: To study treatment outcome of positional vertigo in adult patients of 15-40 years of age. Place and duration of study: This study was conducted at ENT department of Chaudhary Muhammad Akram Teaching & Research Hospital, Lahore and Kuwait Teaching Hospital, Peshawar from June 2019 to June 2020. Material and Methods: 50 patients with diagnosis of benign positional vertigo were included in the study. Patients were treated and their outcomes were analyzed. Results: 50 patients of age between 15-40 years were included in the study. The analysis of treatment outcome showed that 35 patients (70%) showed maximum improvement in vertigo with medical treatment, 10 patients (20%) showed improvement in their symptoms with positional exercises and 5 patients (10%) showed improvement by combined treatment. Conclusion: Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vestibular disorder and presents as brief, episodic, positional provoked vertigo. The diagnosis can be made through clinical history along with diagnostic maneuvers and it can have a considerable impact on the quality of life. The medical treatment with vestibular dilators and vestibular suppressant is best option, with particle repositioning maneuver (Epley maneuver) for resistant and recurrent patients. Key words: Vestibular exercises, Dizziness, Positional vertigo, Dis equilibrium
Aim: The main objective of this study was to determine the effect of bilateral nasal packing on systemic blood pressure in patients treated with septoplasty surgical procedure. Study Design: Retrospective study. Place and Duration: This study was conducted at the department of ENT/ Head & Neck Surgery, Lady Reading Hospital MTI, Peshawar and Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore for duration of one year from October 2020 to September 2021. Methods: One hundred and two men and women who had undergone nasal septoplasty following a clinical assessment were included in this research. From 18 to 48 years of age, the patients comprised this group. Detailed information about each patient, such as age, gender, and place of residence, was gathered after informed consent was obtained from each patient. Group C had no nasal packing placed, whereas typical anterior nasal packing was used in Group D. Both groups were evenly split. A 24-hour ambulatory monitoring of blood pressure was performed on all patients before to and during septoplasty. SPSS 23.0 was used to do statistical analysis on all of the data. Results: 60 (58.8%) of the 102 patients were male, and 42 (41.2%) of the patients were female. A total of 41 (40.2 percent) patients were under the age of 30, 35 (34.3 percent) were between the ages of 31 and 40, and 26 (25.5 percent) were above the age of 40. Rural residents comprised 52% of the patients. Study participants in Group D were found to have higher mean blood pressure (p-Value 0.05) following septoplasty therapy than those in Group C (P-Value >0.05). Group D patients had bleeding, vestibulitis, and septal perforations as a result of their nasal packing procedure. Conclusion: It is determined that bilateral nasal packing was associated with an elevation in either systolic or diastolic blood pressure in individuals who had septoplasty treatment. Patient who did not get nasal packing showed no statistically significant change from the rest of the group. Keywords: Septoplasty, Bilateral Nasal Packing, Systemic blood pressure
Objective: To determine the nasal patency after reducing the size of hypertrophied inferior turbinate with medication and surgery. Study Design: Prospective comparative study. Place and Duration of Study: Department of Ear, Nose, Throat, Head and Neck Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar Pakistan, from Jan to Dec 2019. Methodology: This study was conducted at the After-sample size calculation using an online sample size calculator (OpenEpi) and after obtaining informed consent patients were divided into two groups. Patients in group A were put on medicine only and in group B surgery was conducted to reduce the size of hypertrophied inferior turbinate. Data were analyzed using SPSS version 25 and p<0.05 was considered significant. Results: This study comprised of total 86 patients, in the age range 15-55 years with mean ± SD age 33.47 ± 9.57 years. Males were 47 (54.7%) and females were 39 (45.3%) with male to female ratio of 1.2:1. In group A, males were 22 (25.25%), females were 21 (24.41%), while in group B males were 25 (29.1%) and females were 18 (20.3%). There was no statistically significant difference in nasal patency between the two groups before treatment (p=0.59) and after 10 days of treatment (p=0.69). However, at the end of one month, there was a statistically significant difference in nasal patency between the medically treated and surgically treated groups of patients (p=0.023).Conclusion: Surgical treatment is significantly effective than medical treatment alone.
Objective: To calculate the surgical outcomes of different approaches of tympanoplasty type 1 in terms of air bone gap closure, wound healing, and postoperative pain. Study Design: Prospective cross-sectional study. Place and Duration of Study: Department of ENT, Head and Neck Surgery, Medical Teaching Institute (MTI), Lady Reading Hospital (LRH), Peshawar, Pakistan from Jun 2018 to May 2020. Methodology: Size of sample was 75 patients divided into three groups. Consent was obtained from all the patients included in study. After proper evaluation and relevant investigation pre- and post-operative PTA was performed. Tympanoplasty type-1 was performed by the same surgeon by the three approaches following established otological surgical protocol. Collected data was entered in SPSS-25 for analysis. Results: All 75 patients were divided into three equal groups. Male were 55 (73.3%), females were 20 (26.7%). Male: female ratio was 2.7:1. Majority of patients presented in 2nd and 3rd decades of life 31 (41.33%) and 28 (37.33%) respectively. Preoperative mean ± SD, ABG in groups A, B and C were 37.60 ± 11.28 dB, 37 ± 9.68 dB and 31.80 ± 12.40 dB, respectively. No significant difference was found amongst the three groups regarding pre-operative and post-operative ABG (p=0.85 and p=0.4), respectively. Mean ± SD, wound healing time in Groups A, B and C were 1.00 ± 0.00, 1.80 ± 0.40 and 1.76 ± 0.43 respectively with p=0.0001 and similarly postoperative pain with p=0.001. The wound healing time and post-operative was statistically better (p<0.05) in group A (Transmeatal approach) than other groups........
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