Aims: To find out the prevalence and profile of chronic suppurative otitis media (CSOM) in district level of Bangladesh. Methods: This was a prospective cross sectional study which was carried out patients of chronic suppurative otitis media attended in OPD of 250 Bedded General Hospital, Gopalganj. A total number of 200 patients of CSOM were randomly selected from OPD irrespective of sex and religion during period of July 2015 to June 2016. Age ranging 0- 60 years and person residents of Gopalganj and adjacent districts. Results: In this study 60.5% were male and 39.5%female. Male Female ratio 3:2. Majority of respondents were age group is 11 to 20 years. (36.5%). Mean age of patient 29.98 years. Maximum families 52% had monthly income of TK 10,000 to 15,000 and maximum patients were dependant (37.5%). 5- 6 family members were highest group (60%), 60% respondent lived in Kacha house, 75% lived in rural area and 35% respondents used to bath in pond. The majority of clinical features were otorrhea (100%), deafness (32%), otalgia (42%), itchy ear (10%), tinnitus (50%), odor from ear (10%) and vertigo (5%). Most of ears (90%) were tubotymponic type of CSOM and medium size perforation were maximum (32.5%). Conclusion: Prevalence of CSOM is still high in rural area of our country and community found in younger age group. Improvement of socio-demographic factors, health awareness campaign, improved health education and easy accessibility to health care facilities can reduce the incidence of disease. Bangladesh J Otorhinolaryngol; October 2016; 22(2): 102-109
Objectives: To evaluate morbidity of different modalities of treatment in advanced carcinoma larynx (stage III and IV). Methods: It was a cross sectional study conducted among selected 70 patients of advanced carcinoma larynx treated by different modalities of treatment from April 2009 to April 2010 in different tertiary hospitals in Dhaka. Results:The age of the patients ranged from 30 to 79 years (mean ± SD = 54±10.94), maximum age incidence 5th decade. Almost all were male, habituated in betel nut and leaves chewing and smoking. Mostly (60%) from poor socioeconomic group. 70% cases were supraglottic and 30% cases were glottic carcinoma. Nature of lesion was exophytic 71.43% and ulcerative 28.57%. 22.86% had neck node metastasis. Histopathologically 60% were moderately differentiated and grade II squamous cell carcinoma (SCC). In the total laryngectomy patient pharyngocuteneous fistula (30%), wound infection (10%), haematoma (10%), stomal recurrence (10%), stenosis is tracheostomy (10%), recurrent chest infection (10%) and pharyngeal stenosis (10%) were the morbidities. Mucositis or painful erythematous reaction in larynx and pharynx (95%), periconditis (2.5%), dryness of mouth and throat (100%), loss of test (100%), subcutaneous fibrosis (32.5%), nausea vomiting, skin rashes and alopecia (100%) were the morbidities of chemoradiotherapy and radiotherapy. After analysis the major and minor morbidities of different, modalities of treatment there was no significant (p > 0.05) difference among those modalities. Conclusion: The difference between the morbidity of single modality and combined modalities had not significant. So the combined modalities approach may be advocated for the treatment of advanced carcinoma larynx where required. DOI: http://dx.doi.org/10.3329/bjo.v20i2.22021 Bangladesh J Otorhinolaryngol; October 2014; 20(2): 66-74
Background and aim of study: Pain on propofol injection (POPI) is a common problem. None of the commonly used methods completely attenuate the pain. Inflammatory response to propofol contributes to the pain. This study was conducted to compare the efficacy of dexamethasone in attenuation of pain following intravenous injection of propofol. Materials and methods: A total of 80 adult patients were scheduled in this study with either sex, ASA (American Society of Anesthesiologists) grade I and II, for routine elective surgical procedure under general anesthesia. The patients enrolled were divided randomly into two groups of 40 patients each. Group I received 0.15 mg/kg of intravenous dexamethasone in 5 ml normal saline and Group II (placebo group) received 5 ml of 0.9% intravenous normal saline, following exsanguination and occlusion of the vein of the arm. This was followed by 0.5 mg/kg of propofol intravenously.The patients were asked to report their pain during injection of propofol according to the McCririck and Hunter scale. Results: The incidence of pain experienced in dexamethasone group was 45% patients and in saline group was 70% patients (p<0.05). The severity of POPI was also lower in dexamethasone group than the saline group (p<0.05). The incidence of mild and moderate pain in dexamethasone groups versus saline group was 30% versus 45% and 15% versus 25% respectively p<0.05. There was no severe pain recorded in any groups. Conclusion: Pretreatment with intravenous dexamethasone (0.15 mg/kg) before injection of propofol is effective and safe in reducing the incidence and severity of pain on propofol injection (POPI). Bangladesh J Otorhinolaryngol; April 2019; 25(1): 28-33
Background: Propofol is an intravenous (IV) anesthetic agent, can irritate the skin, mucous membrane and venous intima. The main drawback is the pain at injection site following its intravenous injection. Objectives: This study was performed to evaluate the effect of intravenous nitroglycerine on pain in patients following propofol injection. Materials and Methods: Eighty adult patients of both sexes, aged 20-50 years, according to American Society of Anesthesiologists (ASA) physical status were divided into two equal groups (n=40) to receive 200 mcg intravenous nitroglycerine diluted in 10 ml saline (group A) and 10 ml normal saline as placebo (group B) at an ambient operating room temperature in a randomized and double blinded fashion to compare the pain-relieving effects of the drugs during propofol injection before the patients lost consciousness. The pain on propofol injection was assessed according to the Mc Crirrick and Hunter scale. Results: The overall incidence and severity of pain were significantly less in Groups A (nitroglycerine group) than group B (placebo group) (p< 0.05). The incidence of mild and moderate pain in Group A versus group B was 25% vs 45% and 15% vs 30% respectively (p<0.05). The incidence of score '0' (no pain) was higher in Group A (60%) than Group B (25%) (p<0.05). Conclusion: Pretreatment with 200 mcg nitroglycerine with venous occlusion for one minute is effective pretreatment in alleviating propofol injection pain when compared to placebo. KYAMC Journal Vol. 10, No.-4, January 2020, Page 202-205
Objectives: To see the hearing outcomes following Type III tympanoplasty with stapes columella grafting after canal wall down mastoidectomy and find out the recurrence rates in patients undergoing this procedure. Methods: This prospective observational study includes 120 cases undergoing Type III tympanoplasty with stapes columella grafting following canal wall down mastoidectomy for cholesteatoma at a tertiary care center from 2018 to 2020. Patient charts were reviewed for demographic data, diagnosis, and operative details. Patients were included in statistical analysis if they were found to have undergone the aforementioned procedure. Evaluation of hearing improvement was made by comparing preoperative air-bone gap (ABG) and ABG at follow-up at 6 months and 1 year postoperatively. Results: One hundred and twenty patients were included for this study. Erosion of the otic capsule, posterior fossa plate, or tegmen was noted in 20% of cases, highlighting disease severity. One hundred and two (85%) had undergone prior otologic surgery. Mean time to short-term follow-up was 6 ± 3 months. The average short-term ABG was 25 ± 12 dB HL; 36% achieved an ABG <20 dB and thirteen had follow-up at least 1 year postoperatively (mean = 33 ± 16 months). At longer-term follow-up, mean ABG was 24 ± 11 dB HL. Hearing remained stable over time (P = .26). Conclusion: In some patients undergoing canal wall down mastoidectomy for advanced or recurrent cholesteatoma, Type III tympanoplasty with stapes columella grafting yields marginal hearing benefit. Bangladesh J Otorhinolaryngol 2021; 27(2): 145-151
Aim: To find out the tonsillitis patients and also find out its sociodemographic characteristics in district level of Bangladesh. Method: This was a prospective cross sectional study, which was carried in out patients of tonsillitis attended in OPD of 250 Bedded General Hospital, Gopalganj. All the patients of acute tonsillitis, chronic tonsillitis and adenoid hypertrophy were selected from OPD irrespective of sex during the period of July 2015 to June 2016. Age ranges from 0-90 years and person residents of Gopalganj and adjacent districts. Result: In this study 45.54% were male and 54.46% were female. Male female ratio 1:1.2.Majority of patients were age group 0-15 years (55.97%) Mean age of patient 45 years. Maximum family had monthly income TK 10,000 to 20,000 and maximum patients were dependent (30%) 5-6 family members were highest group, 60% patients lived in katcha house, 75% lived in rural area 35% patients used to bath in pond and majority of patients primary and JSC qualification. The majority of signs and symptoms were sore throat (100%), red, swollen tonsil (26%); white pus filled spots on the tonsil (38%); swollen lymph node in neck (60%) and bad breath (halitosis) (38%). Conclusion: Tonsillitis is still high in rural area of our country and commonly found in younger age group. Thus improvement of related socioeconomic factors, health awareness campaign, improved health education and early accessibility can reduce the incidence of disease. Bangladesh J Otorhinolaryngol; October 2017; 23(2): 180-186
Purpose: To analyze and realize the importance of the Eustachian tube dysfunction (ETD) in the pathogenesis of the middle ear infections as to raise the awareness amongst the Otolaryngologists consider the tubal dysfunctions in the management of the otitis media. Materials and methods: 50 patients of aural discharge, aural fullness, aural pain, hearing loss and tinnitus along with nasal obstruction were selected from July 2013 upto December 2013 in the outpatient department (OPD) of Otorhinolaryngology - Head and Neck Surgery dept. of Dhaka Medical College Hospital under a specific prospective study protocol. All patients of aural fullness, hearing loss, aural pain, tinnitus, aural discharge along with nasal obstruction with or without sore throat were included; patients of sensorineural hearing loss, primary external ear pathology, ear malignancy and congenital ear diseaseswere excluded. Results: 58% patients were below 20 years, 50% were children, 64% were male and 36% female. 62% patients got aural fullness, 60% hearing loss 40% mild, 14% moderate, 6% severe conductive and 8% mixed), 26% tinnitus, 32% aural discharge and 30% aural pain and amongst the patients of otitis media with effusion (OME), 100% got hearing loss, 73% aural fullness, 33% tinnitus, 27% aural pain and 13% dizziness. 78% patients got septal deviation, 58% hypertrophied inferior turbinates (HIT), 32% enlarged adenoids (EA), 62% allergic rhinitis, 26% acute upper respiratory tract infection (URTI), 4% nasal polyps and 48% sinusitis/mucosal thickening and amongst the children, 64% got enlarged adenoids, 56% HIT, 76% septal deviation (SD), 24% acute URTI, 4% antrochoanal polyp, 20% adenoid with HIT and 44% adenoid with SD. Regarding findings in the patients of enlarged adenoid, 37.5% patients got eustachian tube dysfunction (ETD) and 62.5% got hearing loss due to OME as well as acute otitis media (AOM), chronic otitis media (COM) and it showed that mild adenoid caused ETD occasionally on URTI but mild adenoid with HIT caused OME. Conclusion: The obstructive nasal lesions are intermingled with otitis media, so this association should be sought out and underlying nasal lesions must be managed if any as a part of treatment of the otitis media. Bangladesh J Otorhinolaryngol 2021; 27(2): 159-169
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