Background :To assess the effectiveness of tonsillectomy in the management of guttate psoriasis. Methods: In this descriptive study, fifty patients with psoriasis, along with chronic tonsillitis were ...included. All subjects who showed the signs of any systemic disease were excluded from study. Patients underwent tonsillectomy and then the effects of tonsillectomy on skin patches were observed in all the patients. Results: The patient’s age ranged between 13-27 years. Majority (60%) were males. Forty four percent showed complete cure after tonsillectomy while 12% showed partial cure. Conclusion: Tonsillectomy does have a beneficial effect on course of psoriasis.
Background: To evaluate the various aspects of recurrent ethmoidal polypi and to ascertain the treatment modality with the least recurrence, Method: The study was conducted on 110 patients over a two ...year period (February 2003 to January 2005). All presented in the OPD of Holy Family Hospital Rawalpindi with recurrent ethmoidal polypi. A proforma was allocated to every patient to record, present and past history of the disease, H/O allergy, upper respiratory tract infections and family history. Previous treatment modalities either medical or surgical and number of recurrences were noted. Thorough ENT examination and relevant investigations were carried out. Results: There was predominance of male (68%) and adult patients (70%). Most of the patients presented in winter season, with nasal obstruction (87%), rhinorrhoea (81%), PND (49%) sneezing (43%) and headache (42%). Previously patients had undergone conservative treatment in 25% and simple polypectomies in 64%. Case recurrence was treated with medical treatment (anti histamines and topical steroids), with 52.7% success. Repeated polypectomy followed by topical steroids was successful in 60%. 4 patients required external ethmoidectomy followed by antihistamines with 100% results. Conclusion: In most of the patients recurrence of polypi can be treated by medication and meticulously performed simple polypectomy followed by antihistamines and or local steroids. About 5 to 10 percent patients require extensive surgical operations. External ethmoidectomy is the final court of appeal with 100% results.
Tracheobronchial Foreign Bodies M. Musharaf Baig
Journal of Rawalpindi Medical College,
06/2007, Letnik:
11, Številka:
1
Journal Article
Recenzirano
Odprti dostop
foreign bodies, the means by which they gain access and the measures by which accidental aspiration can be prevented. Methods: Bronchoscopy was performed in 39 patients who presented with a suspicion ...of foreign body aspiration during a three-year period (Jan 2002 – Dec 2004) in the Department of ENT, Holy Family Hospital, Rawalpindi. Results: The common symptoms were sudden onset of dyspnoea and cough. Whistle was commonest object removed (46.15%). Majority of patients were above ten years of age (38.46%). Left main bronchus was the commonest site of involvement. Conclusion: Foreign body aspiration should be suspected when there is sudden onset of respiratory symptoms, even in the absence of a history of aspiration. Emergency bronchoscopy facility should be available in all hospitals. Mass awareness should be created through electronic media and family physicians, to decrease the incidence of such accidents.
The optimal amount of protein intake in critically ill patients is uncertain.
In this post hoc analysis of the PermiT (Permissive Underfeeding vs. Target Enteral Feeding in Adult Critically Ill ...Patients) trial, we tested the hypothesis that higher total protein intake was associated with lower 90-d mortality and improved protein biomarkers in critically ill patients.
In this post hoc analysis of the PermiT trial, we included patients who received enteral feeding for ≥3 consecutive days. Using the median protein intake of the cohort as a cutoff, patients were categorized into 2 groups: a higher-protein group (>0.80 g · kg–1 · d–1) and a lower-protein group (≤0.80 g · kg–1 · d–1). We developed a propensity score for receiving higher protein. Primary outcome was 90-d mortality. We also compared serial values of prealbumin, transferrin, 24-h urinary nitrogen, and 24-h nitrogen balance on days 1, 7, and 14.
Among the 729 patients included in this analysis, the average protein intake was 0.8 ± 0.3 g · kg–1 · d–1 1.0 ± 0.2 g · kg–1 · d–1 in the higher-protein group (n = 365) and 0.6 ± 0.2 g · kg–1 · d–1 in the lower-protein group (n = 364); P < 0.0001. There was no difference in 90-d mortality between the 2 groups 88/364 (24.2%) compared with 94/363 (25.9%), propensity score–adjusted OR: 0.80; 95% CI: 0.56, 1.16; P = 0.24. Higher protein intake was associated with an increase in 24-h urea nitrogen excretion compared with lower protein intake, but without a significant change in prealbumin, transferrin, or 24-h nitrogen balance.
In the PermiT trial, a moderate difference in protein intake was not associated with lower mortality. Higher protein intake was associated with increased nitrogen excretion in the urine without a corresponding change in prealbumin, transferrin, or nitrogen balance. Protein intake needs to be tested in adequately powered randomized controlled trials targeting larger differences in protein intake in high-risk populations.
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