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Objective: to determine of vitamin D administration in preventing recurring benign paroxysmal positional vertigo events. Study Design: Quasi experimental study. Place and Duration of Study: Department of ENT, Combined Military Hospital, Rawalpindi Pakistan, from Jul 2021 to Jan 2022. Methodology: Study was conducted on 80 patients who were diagnosed with recurrent benign paroxysmal vertigo. Patients were enroled in two groups (Group A and B) by lotery method. Vitamin D supplements and canal repositioning manoeuvre were administered to patients in Group A, while just canal repositioning procedure was given to patients in Group B. Patients were told to folow up over six months. Vitamin D supplement consumption and BPPV atacks were tracked over 6-month folow up period. Results: In folow-up period, most patients in Group A 24(60.0%) had no episodes of vertigo, whereas 10(25.0%) had single episode of vertigo. Furthermore, none of the patients experienced three episodes. Many patients in Group B 19(47.5%) developed one or more episodes. The difference between both groups was statisticaly significant (p<0.05). Conclusion: Low vitamin D levels are found in most individuals with benign paroxysmal positional vertigo events. Vitamin D supplementation significantly decreased the frequency and recurrence of benign paroxysmal positional vertigo events, according to the findings. [ABSTRACT FROM AUTHOR]

Objective: To assess the use and efficacy of Concurrent Chemoradiotherapy for a T3N0 Laryngeal Cancer as a Laryngeal Function Preservation modality. Study Design: Prospective Study design Place and Duration of Study: CMH Rawalpindi, Pakistan from January 2022-January 2023. Methodology: The sample size was n=24, having TPF-CCRT from January 2022 to January 2023 was chosen by using a purposive sampling technique. Individuals were having abnormalities of T3 glottis without vocal cord fixation. Along with MRI, the pretreatment evaluation also comprised clinical, endoscopy, and ultrasound examinations with or without fine needle pick cytology samples. Moreover, F-fluoro-2-deoxy-D-glucose positron emitting tomography was used for whole-body CT scanning. The UICC TNM grading method was used to grade the tumors as grade 15. Results: Twelve out of 24 patients had grade 1 tumor (50%), eight had grade 2 tumors (25%), and four had grade 3 tumors (25%). There had been complete resolution among 17 (70%) of patients, while the disease remains persistent disease in 7 (30%) patients. 95% of patients found with good speech and breathing. 95% of patient organs remain preserved. All 24 patients received CCRT. Four individuals (20%) without tumor regression received surgery following 40 Gy of RT. Others received RT with a 66 Gy median total dose. Conclusion: The study found that effective cancer control is possible with CCRT, and its effects are manageable in 70% of patients with tolerable toxicity. However, in 30% of cases, it fails, requiring salvage laryngectomy. However, the search for a viable strategy with tolerable toxicity and functional status is underway. [ABSTRACT FROM AUTHOR]

Objective: To compare the outcome of Type-1 tympanoplasty procedure in patients given intranasal steroids post-operatively versus those not given intranasal steroids after procedure. Study Design: Quasi-Experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi. Pakistan from May 2021 to May 2023. Methodology: A total of 464 patients, 232 of which were given intranasal steroids (Group-A), and 232 who were not given intranasal steroids (Group-B) were made part of this research. Upon inclusion, all pre-operative demographics were documented. Patients in post-operative follow up period were assessed for condition of tympanic membrane and improvement of hearing ability. Results: In current study, post-operatively, in patients who were given intranasal steroids, graft take-up frequency was 227(97.84%) and residual perforation was 5(2.16%) was better than in patients who were not given intranasal steroids, which came to 224(96.55%) and 8(3.45%), respectively (p=0.399). In terms of post-operative WHO grade of hearing impairment distribution (p<0.001) and post-op hearing status (p=0.005) difference between patients who were given intranasal steroids and those not given intranasal steroids was statistically significant. Conclusion: Addition of intranasal steroid spray to the treatment regimen following tympanoplasty is provides better outcomes in terms of higher graft take-up frequency and an improvement in hearing from preoperative levels. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To assess the role of conventional plain X-rays in managing fish bone impaction in throat, after eating commonly consumed species of fish in Pakistan. METHODS: This cross-sectional descriptive study was conducted at Combined Military Hospital Muzaffarabad, Pakistan. X-ray of bones from eight different species of commonly eaten fish were taken (in-vitro) and then compared to X-ray of same bone kept in oral cavity of a volunteer (in-vivo), in order to assess the effect of soft tissue and bony super imposition on radio opacity of fish bone and its clinical impact. The radiographs were taken using Siemens 500 MAS machine with an exposure of 65 kV for adults. Both the in vitro and in vivo radiographs were reviewed by thirty doctors of varied echelons ranging from interns to consultants of varying specialties (ENT, Radiology, Internal medicine, general surgery). RESULTS: Bones of seven fish species were 100% identified on in-vitro film while one fish type (drum fish) was identified by 93.3% (n=28/30) observers. Whereas, in-vivo identification of same bones ranged from 0.00% to a maximum of 33.33%. On in-vivo films, the maximally visualized fish bones were Mahseer and Butter fish (n=10/30; 33.3% each) followed by Catla/Indian carp, Eel, Pomfret and Cobia (n=5/30; 16.6% each). Croaker/drum fish could not be visualized by any observer on in-vivo films. CONCLUSION: Conventional plain X-rays alone cannot be relied upon for diagnosing fish bone impaction in upper aero-digestive tract. [ABSTRACT FROM AUTHOR]

Objective: To compare the frequency of post-operative adhesions after endoscopic sinus surgery with and without intranasal silastic splint. Study Design: Quasi experimental study. Place and Duration of Study: Research was conducted at department of ENT, Combined Military Hospital Muzaffarabad, from Sep 2016 to Mar 2017. Methodology: This study involved 62 patients of both genders aged between 15-60 years undergoing endoscopic sinus surgery who were randomly allocated into two treatment groups. Patients in groups-A received silastic splint in addition to anterior nasal packing while those in group-B received anterior nasal packing alone. Outcome variable was frequency of post-operative adhesions which was noted and compared between the groups. Results: The mean age and SD of the patients was 33.58 ± 11.11 years. The mean duration of symptoms was 11.81 ± 3.20 months. Both the study groups were comparable in terms of mean age (p=0.910), mean duration of symptoms (p=0.876) and age (p=0.866), gender (p=1.000) and duration of symptoms (p=1.000) groups. Postoperative adhesions were observed in 5 (8.1%) cases and all of them belonged to study group-B. The frequency of post-operative adhesion formation was significantly higher in patients receiving anterior nasal packing alone (16.1% vs. 0.0%; p=0.020) as compared to those receiving silastic splint in addition to anterior nasal packing. Similar difference was observed across various age, gender and duration of symptoms groups. Conclusion: The use of silastic splint was associated with significant reduction of post-operative adhesions in patients undergoing endoscopic sinus surgery regardless of patient's age, gender and duration of symptoms. [ABSTRACT FROM AUTHOR]

Hematidrosis or hematohidrosis is an extremely rare clinical phenomenonin which a spontaneous recurrent painless and self-limited bleeding from skin in any part of the body, with diverse causal etiologies and inconstant success to different current management modalities. Our case studies report the clinical finding of two cases of a very rare ontological hematohidrosis. It is an extremely rare medical condition, with very few cases reported in literature. [ABSTRACT FROM AUTHOR]

Objective: The objective is to compare the efficacy of Epley's maneuver and vestibular sedative, prochlorperazine maleate in the management of benign paroxysmal positional vertigo (BPPV). Study Design: Randomized Control Trial. Place and Duration of Study: ENT department, Combined Military Hospital, Rawalpindi from 1st May 2011 to 1st November 2011. Patients and Methods: After consent, 60 patients of BPPV fulfilling the inclusion criteria were randomly allotted two groups. Group A was treated with Epley's maneuver (n=30) while group B with prochlorperazine maleate (n=30). Outcomes were analyzed on disappearance of vertigo at follow-up examination. Results: 24 (80%) cases managed by Epley's maneuver showed relief of symptoms while only 14 (47%) treated by prochlorperazine maleate showed recovery after 15 days. Conclusion: Epley's maneuver was more effective than vestibular sedatives like prochlorperazine maleate in treating patients of BPPV. [ABSTRACT FROM AUTHOR]

Objective: Investigate the role of serrated turbinates, radiographic abnormalities, and existing literature in aiding the diagnosis of Allergic Fungal Sinusitis (AFS). Study Design: Cross-sectional study Place and Duration of Study: ENT Department Combined Military Hospital, Rawalpindi, Pakistan from Jan 2020 to July 2023. Methodology: One hundred and twenty individuals with computerized tomography scans were included. Patients identified as having Allergic Fungal Sinusitis (AFS) following tests for allergies and/or fungi were placed in the first group, while those identified as having rhinosinusitis (other than AFS) were placed in the second group. CT scans were examined for polyps, bone degradation, the serrated appearance of the turbinate, and CT hyper-density. Results: While comparing the radiology of AFS and non-AFS, it was discovered that the presence of serrated turbinate was prevalent in AFS (p<0.05), with no differences in terms of bone degradation, polyps, or CT hyper-density (p>0.05). The mean age was 36.81±11.24 years. There were 120 patients; 86(72%) were AFS (-ve), and 34(28%) were AFS (+ve) individuals. Out of them, 19(16%) of the AFS (+ve) patients were females, whereas 15(12%) were males. Conclusion: Serrated turbinates may serve as helpful radiological signals in the diagnosis of AFS. For assessing bone erosion in relation to other structural changes, it is important to specify bone density for sinus opacification. [ABSTRACT FROM AUTHOR]

Syphilis is a chronic, systemic and sexually transmitted infectious disease affecting most of the organs in the body. A young African man presented with vertigo, unsteadiness of gait and a skin rash suggestive of secondary syphilis. Diagnosis was confirmed on serology and was treated with two shots of long-acting penicillin, following which his symptoms settled.