scholarly journals Anatomical Variations of the Paranasal Sinuses and the Nasal Cavity

2019 ◽  
Vol 21 (1) ◽  
pp. 7-11
Author(s):  
Kundan Kumar Shrestha ◽  
K Acharya ◽  
RR Joshi ◽  
S Maharjan ◽  
D Adhikari

Computed tomography (CT) of the para-nasal sinuses (PNS) has nowadays become the investigation of choice for the diagnosis of sinonasal diseases. Numerous sinonasal anatomic variants exist and are frequently seen on CT scans. A sound knowledge of these variations is important not only for diagnosis but also for planning surgery in order to avoid complications. The aim of this study is to investigate the frequency of these variations in patients with sinonasal symptoms and also to determine their relation to sinonasal disease if any. A total of 76 patients were included in the study from August 2017 to July 2018 of which 43 (56.6%) were males and while 33 (43.4%) were females with male to female ratio of 1.3:1. The ages of patients ranged from 14 to 72 years with a mean age of 33.2±14.2 years. Out of 76 patients, 68 (89.5%) had at least one type of anatomical variation while 8 (10.5%) had no variation. Only one variation was seen in 39 (51.3%) patients while 29 (38.2%) had two or more variations. The most common variant was deviated nasal septum (DNS), occurring in 49 (64.5%) patients followed by concha bullosa (CB) and agger nasi cell (AN) seen in 15 (19.7%) and 14 (18.4%) patients respectively. Genderwise, anatomical variations were seen more in males but the difference was not statistically significant. Some variations were seen more on the right side while others on the left. Some variations were present bilaterally. The difference was not statistically significant. The presence of DNS was statistically significant in the study population (p value 0.012 in nonparametric chi square test). The age group 14 to 30 years showed maximum variations though not significant statistically. Therefore, during management of patients with sinonasal symptoms, these variations need to be addressed, if required, surgically. Proper knowledge of both common and uncommon sinonasal variations in our community could help in better surgical planning and overall management of sinonasal disorders.

2016 ◽  
Vol 5 (2) ◽  
pp. 118-122 ◽  
Author(s):  
Mohammed Jasim Aljuboori ◽  
Hussien Ali Al-Wakeel ◽  
Lor Yen Fang ◽  
Navenithamaria Eirutharajan ◽  
Santhanalaxmi A Balachandran

ABSTRACT Objectives Previous studies showed there were variations in the interforamina distance of mental foramen between races. The aim of our study is to determine the interforamina distance of mental foramen among Malaysian populations. Materials and methods A total of 503 orthopantomogram (OPG) radiographs were observed. Interexaminer calibration was estimated using the Kappa-Cohen formula. A sheet of transparent paper was superimposed on the panoramic film and the mental foramen was traced on it by using a fine marker pen. A vertical line marking the midline was drawn passing between the maxillary central incisors, the mandibular central incisors, or the nasal septum by using a ruler. The distance of the mental foramen from the midline was then recorded from both the left and the right side. The data were analyzed using chi-square test. Results According to our inclusion and exclusion criteria, 110 OPGs have been excluded and 393 OPGs were selected. In the Malay population, the most common interforamina distance for a male is between 55 and 60+ mm (n= 73, 54.8%). Also, the most common interforamina distance for a female is 55 to 60+ mm (n = 84, 50%). In the Chinese population, the most common interformina distance for a male is between 55 and 60+ mm (n=60, 66.8%). Similarly, the most common interforamina distance for a female is between 55 and 60+ mm (n= 73, 53.8%). Among the Indian population, the most common interforamina distance for a male falls between 55 and 60+ mm (n= 53, 43.4%) and for a female as well (n=50, 54%). According to the chi-square test, the results show that the study is statistically insignificant since the p-value is >0.05 for both the male and female population. Conclusion There is no relationship between the interforamina distance and the ethnicity. The most common interforamina distance for all the races falls between 55 and 60+ mm. How to cite this article Al-Juboori MJ, Saini R, Al-Wakeel HA, Fang LY, Eirutharajan N, Balachandran SA. Evaluation of the Intermental Foramina Distance among Malaysian Population by using Orthopantomogram Radiograph. Int J Experiment Dent Sci 2016;5(2):118-122.


2020 ◽  
Vol 27 (08) ◽  
pp. 1595-1601
Author(s):  
Shahid Rasool ◽  
Salman Azhar ◽  
Talha Munir ◽  
Mian Sajjad Ahmad ◽  
Rizwan Abbas ◽  
...  

Hepatic encephalopathy (HE), a syndrome observed in some patients with cirrhosis, with depressed level of consciousness. Lactulose as well as lactitol has been used in the treatment of HE. Lactitol is comparable to lactulose in the treatment of HE with fewer side effects and better tolerated. However, literature showed equal efficacy of both drugs. So we conducted this trial to find better drug to implement its use in future. Objective: To compare the effectiveness of lactulose and lactitol in patients with acute hepatic encephalopathy. Study Design: Randomized Controlled Trial. Setting: Department of Medicine OPD and Emergency (East, West, North, South), Mayo Hospital, Lahore. Period: 6 Months June 2017 to Dec 2017. Material & Methods: 570 patients were included through non-probability, consecutive sampling after informed consent. Initial grade of HE was assessed and patients were randomly divided in two groups by using lottery method i.e. lactulose or lactitol. Patients were admitted to ward for management and kept under observation for 5 days. After 5 days, HE grades was measured again, then improvement in grade of HE (effectiveness) was measured. All data was entered and analyzed by using SPSS version 21.0. Chi-square was applied to compare both groups for effectiveness taking p-value≤0.05 as significant. Results: In this study the mean age of the patients was 44.22 ±11.81 years, the male to female ratio of the patients was 2.4:1. The mean duration of the cirrhosis of the patients was 3.73±1.61 months. In our study the effectiveness was achieved in 538 (94.39%) patients, out of which 263 cases were from lactulose group and 275 were from lactitol group and the difference was significant (p<0.0.5). Conclusion: Our study results concluded that Lactitol is better choice for the treatment of patients with acute hepatic encephalopathy as compared to lactulose. More efficacy was achieved in lactitol group patients than in lactulose group patients.


2015 ◽  
Vol 22 (09) ◽  
pp. 1212-1216
Author(s):  
Abdul Salam Memon ◽  
Shahida Khatoon ◽  
Riaz Ahmed Memon ◽  
Afzal Junejo

Objectives: To study mean platelet volume (MPV) in acute appendicitis andits correlation with leukocyte count. Study Design: Case control study Place and Duration:Department of Surgery, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabadfrom January 2013 to February 2014. Subjects and Methods: Subjects with clinical suspicionof acute appendicitis were selected according inclusion and exclusion criteria. A sample of 49acute appendicitis patients and 37 controls were studied. The Blood samples were collected insodium citrate vacutainers and processed on Sysmex KX 21 analyzers. The main analysis wasthe comparison of the difference of MPV between acute appendicitis and controls. Data wasanalyzed on SPSS version 21.0 by student’s t-test, Chi-square test and Pearson’s correlation (r)was used to evaluate association of MPV with platelet counts and leukocytes. A p-value of ≤0.05was taken significant. Results: The mean platelet volume and leukocytes were significantlyelevated in patients with acute appendicitis. MPV and leukocytosis in controls and cases werenoted as 7.93±2.1 vs. 9.10±2.9fl (p=0.0001) and 6980±120 vs. 13980±340 μL-1 respectively.MPV was positively correlated with leukocytosis (r=0.419) (p=0.0001), while Platelets showeda negative correlation. Conclusion: Elevated MPV and leukocytosis are observed in acuteappendicitis. MPV may be exploited for clinical diagnosis of acute appendicitis but in a properclinical context along with leukocytosis.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S432-36
Author(s):  
Sohail Aslam ◽  
Syed Muhammad Asad Shabbir Bukhari ◽  
Adnan Asghar ◽  
Naeem Riaz ◽  
Iftekhar Yousaf ◽  
...  

Objective: To comparison was made between standard (control group) nasopharyngeal sample collection technique for RTPCR and modified technique and the outcome was compared in terms of the proportion of positive results of Rt-PCR tests. Study Design: Double blinded randomized clinical trial. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital Karachi Pakistan, from June and July 2020. Methodology: This study was a newly developed modified technique for nasopharyngeal sampling for RT-PCR tests of COVID-19 suspects. Target population included all patients who developed COVID-19 related symptoms and/or also had history of recent travel or closed contact with Covid-19 patients. Total 1500 nasopharyngeal PCR tests were done by a team of trained technicians. Systemetic probability sampling technique was utilized. Subjects were divided into two groups by using even and odd serial numbers. Proportion of positive test results were compared between two groups by using chi square test. Results: Results were collected for 3000 nasopharyngeal swab sample for RT-PCR testing. Mean age was 31.68 ± 11.89 years. In study group with modified technique, 470 tests were found positive for a total of 1500 samples while only 297 out of 1500 samples were detected positive in control group with standard technique. Chi square test applied to assess the difference between this proportion and it proved that the difference was highly statistically significant (p-value <0.00). Conclusion: we interpret that modified samples collection technique is relatively safe for sample collector of Covid-19 PCR which has got potential benefits to get more genuine results of these......


2017 ◽  
Vol 24 (01) ◽  
pp. 64-68
Author(s):  
Muhammad Paryal Tagar ◽  
Khawar Saeed Jamali ◽  
Mujeeb Rehman Abbasi ◽  
Sarang Tagar

Objectives: Determine the frequency of bile duct injuries during open andlaparoscopic cholecystectomy procedures. Study Design: Prospective Observational Study.Place and Duration of Study: This study was conducted at surgical department of multiplehospitals and compares the results Civil Hospital Naushahro Feroze, Liaquat University HospitalJamshoro and Civil Hospital Karachi and NaushahroFeroze, August 2014 to December 2015.Methods: All 320 patients were equally divided for open cholecystectomy and Laparoscopiccholecystectomy. Demographic profile and detailed Clinical examination were recorded. Allpatients were evaluated for Cholelithiasis underwent preoperative investigations. All patientswere resuscitated and optimized before intervention. Inclusion criteria were diagnosed caseof gallstones, age > 20 years and both gender selected for open cholecystectomy andLaparoscopic cholecystectomy and assessed the frequency of bile duct injury during bothprocedures. Exclusion criteria were of carcinoma of gall bladder, stone in CBD and obstructivejaundice. Chi square test was applied for p-value. Results: 320 cases of gallstone wereundertaken for operative laparoscopic cholecystectomy and open cholecystectomy procedure.Most of the patients were 208(65%) female, male to female ratio were 1:7.2. Gall stonecommonly reported in 3rd and 4th decade 186(58.13%) cases in between 36-50 years. The meanage was 39.8+5.90years. Abdominal ultrasound revealed that multiple stone 253(79.1%) casesas compared to single stone. Other common findings of thick wall gallbladder139 (43.44%)cases while ultrasonologist reported impacted gallbladder stone in 23(7.19%) cases. Commonbile duct injury more occur in open procedure 24(7.5%) cases as compared to laparoscopiccholecystectomy 15 (4.7%) cases and Chi square test was applied for p-value <0.001.Conclusion: The Laparoscopic procedure has decreased rate of complications and bile ductinjury day by day due to improved learning curve.


2020 ◽  
Vol 2 (2) ◽  
pp. 20-25
Author(s):  
Sona Pokhrel ◽  
Bhuwan Raj Pandey

Introduction: Computed tomography (CT) has nowadays become the investigation of choice for diagnosis and evaluation of anatomical variations of the nose and paranasal sinuses. Methods: A cross sectional study was conducted in the Department of Radiology of Lumbini Medical College Hospital from June 2019 to May 2020. Total of 130 patients were enrolled for the study. All patients were subjected to Siemens Somatom scope 16 slice CT scan. Each scan was studied for the presence of agger nasi cell, concha bullosa, deviated nasal septum, haller cell, onodi cell, uncinate process variation and type of olfactory fossa. Results: The mean age of patients was 36. 86 ±12.06 years. There were 76 males (58.5%) and 54 females (41.5%) with male: female ratio of 1.4:1 with highest range in age group of 31 to 45 years (46.9%). Anatomical variation between male and female was statistically not significant (p>0.05). The most common anatomical variation noted was nasal septal deviation (73.1%), then agger nasi cell (59.3%), concha bullosa (24.6%), paradoxical medial turbinate (7.7%), onodi cell (6.9%), uncinate process variation (5.4%) and least was haller cell (4.6%). Most of the scans had more than one anatomical variation, which was statistically significant (p<0.05). The most common type of olfactory fossa depth was Keros type II (61.5%). Conclusion: Computed tomography of the paranasal sinus has improved the visualization of anatomical variation hence radiologist must pay close attention to variants.  


Author(s):  
Emmanuel A. Adelusi

Introduction: Though changing patterns of tooth extraction have been reported in the literature which included the age, gender, tooth type and indications for extraction, there is still paucity of studies that have examined the variation and changes in the pattern of tooth extraction over a period of time in a given nation. We therefore accessed the pattern and indications of tooth loss in the patients who presented at oral surgery clinic for intra-alveolar tooth extraction over a twelve month period. Methods: This is a prospective cohort study of adult patients tooth extraction between September 2015 and August 2016. Patients’ demographic and clinical data were collected with a structured questionnaire. Data were analyzed using statistical package for social sciences (SPSS) version 23.0. Variables were subjected to Pearson’s chi-square test and P <0.05 was considered statistically significant. Results: A total of 240 adults age range between 18 to 75 years of age with mean age of 36.64 years were included in the analysis. Maxillary teeth (231) and mandibular teeth (326) were extracted in 203 and 263 patients respectively. Caries and its sequelae, 223(93%) were the predominant indication for tooth extractions. Lower second molar (25%), and upper third molar (20%) had the highest frequencies. More female (126, 52.5%) than male (114, 47.5%) had extraction done, the difference is however not statistically significant (X2 =1.67, P Value = 0.195) Conclusions: Dental caries and its sequelae are the most frequent cause of tooth extraction. Tooth extraction was more in Patients in the fourth decade as well as in the Female gender, even though the difference between male and female is not statistically significant. And there is increased in number of male who had extraction done compared to what obtained in the past decades. Left side of the mouth appeared to be more affected.


2017 ◽  
Vol 3 (3) ◽  
pp. 19
Author(s):  
Alief Ilman Zaelany ◽  
Ida Srisurani Wiji Astuti ◽  
Ika Rahmawati Sutejo

Scabies disease caused by Sarcoptes scabiei var. hominis mites has become a problem in a whole world especially in developing countries like Indonesia. Scabies has a very contagious nature especially in places with dense population levels like Islamic boarding school. Permethrin which is a drug of choice for scabies has a fairly expensive price so it is less effective when used in mass treatment. In Indonesia, sulfur preparations, especially 10% sulfur soap and 2-4 ointment are easy to obtain because the price is affordable and available at the community health clinic. The purpose of this study is to know the difference in effectiveness of 10% sulfur soap and 2-4 ointment as a single treatment and combination on scabies disease. In this clinical trial study, treatment was performed on 3 groups, 10% sulfur soap group (n=36), 2-4 ointment group (n=36) and combination group (n=36). The examination was done on days 8, 15 and 22. Data analysis using SPSS version 23 with chi-square test. The results showed that the highest recovery rate was in combination group (week-1 (22,22%), week-2 (63,89%) and week-3 (94,44%)) followed by 2-4 ointment group (week-1 (11,11%), week-2 (72,22%) and week-3 (88,89%)) and 10% sulfur soap group (week-1 (2,78%), week-2 (52,78%) and week-3 (75,0%). The results of the analysis comparing the 10% sulfur soap group with the combination group showed p value on all consecutive examinations p=0,013, p=0,339 and p=0,022. In the comparison 2-4 ointment group to the combination group obtained p value on all examinations respectively p=0,206, p=0,448 and p=0,394. The conclusion is combination therapy had the highest cure rate and statistically significant (p=<0,05) was obtained in comparison of 10% sulfur soap to combination at week-1 and week-3 examination. Keywords: scabies, comparison of the effectiveness, 10% sulfur soap, 2-4 ointment, combination, Islamic boarding school


2021 ◽  
Vol 15 (11) ◽  
pp. 3116-3118
Author(s):  
Gulsher . ◽  
Riffat Zahid ◽  
Syed Mehmood Ali ◽  
Muhammad Naveed Shahzad ◽  
Amer Latif ◽  
...  

Objective: To compare the frequency of post dural puncture headache with Quincke 25G and Quincke 27G of spinal needles for spinal anesthesia. Design of the Study: It’s a Randomized control trial. Study Settings: This study was carried out Department of anesthesiology and Intensive Care Unit, Shaikh Zayed Hospital Lahore from 29-08-2020 to 01-03-2021. Material and Methods: In this prospective study 100 patients were enrolled who were decided to undergo spinal anesthesia. Two groups were made by randomization. In patients of group I, anesthesia was administered by using 25G quincke needle while 27G quincke needle was used for patients in group II. Evaluation of patients was with regard to development of postoperative PDPH within 3-days. Groups were compared by using Chi-square test and a P-value<0.05 was taken statistically significant. Results of the Study: PDHD was seen in 14 (28%) patients in group I and in 4 (8%) patients in group II. Statistically, the difference between the two groups was significant (p<0.05).. Conclusion: Due to less frequency of PDPH with 27G needle, it should be given preference for applying spinal anesthesia over 25G needle. Keywords: Spinal anesthesia, post dural puncture headache; quincle needle.


2015 ◽  
Vol 22 (12) ◽  
pp. 1586-1590
Author(s):  
Sunil Kumar ◽  
Awais Bashir ◽  
Raheel Ahmed

Objectives: To determine the frequency of various neurological manifestationsof Wilson’s disease in patients presenting to tertiary care facility. Study design: Cross sectionalstudy. Setting: Neurology ward, JPMC, Karachi. Period: 14-03-2012 to 13-09-2012. Patientsand Methods: A total of 150 diagnosed patients of Wilson’s disease between the age 15 and55 years were recruited. Structured questionnaire was used to collect the data regardingneurological manifestations of Wilson’s disease along with slit lamp examination for kayser-Fleischer rings. Data were entered and analyzed in SPSS version 17. Chi-Square test was usedas test of significance. Results: Mean age + S.D of patients was 38.7 + 8.23 years. Most of thepatients (42%) belongs to age between 41 to 50 years. Male to female ratio was 2:1. Tremorwas the most common neurological manifestation (88.7%) followed by dysarthria in 77.3%,dystonia was present in 59.3%, chorea in 36%, and Parkinsonism in 28.7%. All patients hadthe Kayser-Fleischer ring positive. Upon stratification of gender, tremor & dysarthria were morecommon in males as compared to females. Only dysarthria was significantly noted to increasewith increasing age up to 5th decade of life and decreased after age of 51 years. (P value< 0.001). Conclusion: Neurologic manifestations are very common in patients of Wilson’sdisease, tremor being the most common with male predominance.


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