Objective: To study how the COVID-19 is affecting the treatment and management of other ailments. Try to find a strategy to resume elective OR lists.Introduction: We overviewed the effect of COVID-19 on the elective surgical lists of otorhinolaryngology in the ENT Department of Holy Family Hospital, Rawalpindi.Materials and Methods: The data from Jan 2020 to July 2020 was collected. It is a descriptive study analyzing the data, 3 months before and 3 months after the imposition of lockdown in the whole of Pakistan due to a surge in COVID-19 cases. The data was collected from the operation dating register of OPD and elective operative lists of ENT OT. Data were analyzed by Microsoft excel spreadsheet version 7. Results: There was an overall 92% decrease in the elective surgical procedures done in the ENT dept. of Holy family Hospital during the COVID-19 lockdown period. The procedures done in the COVID lockdown period were mostly emergency procedures and lifesaving procedures.Conclusion: COVID-19 has badly impacted the elective surgical procedures and in turn the health of the patients presenting to ENT OPD with various diseases which were treated surgically before COVID lockdown.Recommendations: To prevent this from happening again during the 2nd wave of COVID-19, we could opt for multiple precautionary measures to avoid the spread of infection and continue the provision of our surgical services to the patients.
Background: Angiofibroma is a rare histologically benign tumor that is an unencapsulated, highly vascular tumor.1 It shows very aggressive behavior due to local invasiveness and is associated with various symptoms.2 Angiofibroma is almost always seen in young adolescent males.2 Along main pathogenesis is unknown, but it is considered to be associated with sex hormones mainly testosterone and estradiol.3 In a study conducted from 1995 to 2012 all patients were male.4 Major symptoms include nasal obstruction and epistaxis and surgical removal of the tumor as a whole is considered the treatment of choice.5 There have been very few individual case reports of angiofibroma in females 6-9 which were confirmed with radiological testing and histopathology report of the samples taken. Case presentation: We present a rare case of nasopharyngeal angiofibroma in a young female as confirmed by computed tomography scan findings and histopathology reports of the sample by well-qualified pathologists. Conclusion: The case is being reported to increase awareness among medical professionals and encouraging further workup on the pathogenesis of angiofibroma.
Objective: To compare the efficacy of chemical versus electrical cautery in the management of patients presenting with anterior epistaxis in terms of frequency of bleeding. Materials and Methods: Study Design = Randomized Control Trial (RCT)Study Setting = ENT Department Benazir Bhutto Hospital, RawalpindiDuration = 6 monthsSampling Technique = Consecutive (Non Probability) A Randomized Control Trial (RCT) of six months was done after the approval of the Ethical Committee. A total of 90 cases of anterior epistaxis were randomly divided into two groups: A (electrical cautery) and B (chemical cautery) using a random number trial with 45 in each group respectively. Informed consent was taken from all patients. Patients were explained about the procedure and its risk-benefit ratio. A detailed history was taken about epistaxis from patients presenting in an emergency. The site of bleeding was assessed. Pulse and blood pressure of patients were monitored. Patients were treated on an emergency basis. The nasal cavity was inspected with the help of a nasal speculum and suction of any blood clots was done. Bleeding points were identified and sprayed with lidocaine. The bleeding area was cauterized with a silver nitrate stick or electrical cautery for a few seconds. Antibiotic ointment was applied at the site of cautery to both groups. The patient was discharged on cessation of bleeding. A Performa was given to patients to fill 48 hours, 1 week, and 2 weeks after the procedure containing questions regarding relief of symptoms. Recurrent bleed was diagnosed on a history of separate bleed from nose post-procedure that was sudden in onset, with an identifiable bleeding point on inspection by speculum, total duration of all episodes in previous 24 hours less than 30 minutes.Results: A total of 90 cases (45 in each group) were taken. The mean age was calculated and found 34.42±8.70 in Group-A and 34.29+8.94 years for group B., The male patients were 32 (71.11%) in Group-A and 30 (66.67%) in Group-B while females were 13 (28.89%) in Group-A and 15 (33.33%) in Group-B, efficacy between chemical and electrical cautery in patients with reference to frequency of bleeding was 42 (93.33%) in Group-A and 35 (77.78%) in Group-B, the p value was calculated as 0.03 which shows a significant difference. Conclusion: This study concluded that the efficacy of electrical cautery is significantly higher than chemical cautery in the management of epistaxis. However, some other trials on larger sample size are required to validate the findings of this study.
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