Readmissions after day care surgery In ent : A tertiary care experience

BACKGROUND: Re-admission following day care surgery in ENT (Ear, Nose & Throat) results in significant morbidity to patient & massive load to hospital & also raises the question on the safety of day care surgery. Only a small number of published studies emphases on return to hospital within 30 days following day care surgery in otorhinolaryngology especially from our region. This study was carried out to determine the frequency of re-admission after day care surgery in ENT. METHODS: We prospectively studied consecutive patients who underwent ENT procedures [i.e., septoplasty, tympanoplasty type I & functional endoscopic sinus surgery (FESS) for deviated nasal septum (DNS), chronic suppurative otitis media tubotympanic (CSOM TT) variety & ethmoidal nasal polyposis (ENP) respectively] as day care surgery case under general anaesthesia at the Section of Otorhinolaryngology and Head & Neck Surgery, Aga Khan University Hospital & Liaquat National Hospital, Karachi from January 2015 to December 2016. All patients aged 20- 60 years of both genders were included in the study. SPSS software version 20 was used for data compilation and analysis. p-value less than or equal to 0.05 was taken as significant. RESULTS: In the phase of 24 months, total 317 cases met the inclusion criteria & were included in the study. There were 205 males & 112 females in the study population. One hundred & twenty-two patients having DNS, 128 having CSOM TT & 67 suffering from ENP & underwent septoplasty, tympanoplasty type I & FESS respectively. Complications were observed in a total of 7 (2.2%) patients in our study group & required re-admission within 1 month of surgery. Stratification was done between re-admission & all effect modifiers, with all showing insignificant results. CONCLUSIONS: Our results demonstrate that ENT surgeries (septoplasty, tympanoplasty type I & FESS) are safe procedures which can be performed as a day care case with acceptably low readmission rates

Evaluation of Silkworm Lines against Variations in Temperature and RH for Various Parameters of Commercial Cocoon Production

Eleven inbred silkworm lines (M-101, M-103, M-104, M-107, Pak-1, Pak-3, Pak-2, Pak-4, PFI-1, PFI-2, and S-1) were evaluated for various parameters of cocoon production under different temperature and relative humidity conditions (25±1, 30±1, and 35±1 °C in combination with 55, 65, and 75% RH for three hrs during 4th and 5th instar. The experiment was laid out in factorial design with three replications. Significant variations in the performance of silkworm lines were noticed due to influence of temperature and RH treatment on 4th and 5th instar larvae. The silkworm lines performed significantly better when the larvae were reared at 25±1 °C with 70–80% RH while almost all the silkworm lines showed poor performance at higher temperature exposures for 3 hrs. Exposures to lower humidity (55%) during larval rearing in 4th and 5th instar at different temperatures (25±1, 30±1, and 35±1 °C) resulted in lowering the cocoon production. The cumulative evaluation index values for different traits showed that Pak-4 (61.42) was the best line followed by M-101 (59.15), Pak-2 (56.37), Pak-3 (52.83) PFI-I (52.62), and M-107(50.03). The study clearly underlines the importance of optimization of environmental conditions during larval rearing in relation to commercial cocoon production. The investigations strongly recommend that temperature and relative humidity in the range of 25-26 °C and 70–80%, respectively, are mandatory for excellent results of cocoon production and Pak-4, M-101, Pak-2, Pak-3, PFI-I, and M-107 were suitable for commercial rearing

Thyroid gland neoplasms; histopathological pitfalls as a consequence of FNAC: a tertiary care hospital experience

Fine-needle aspiration cytology (FNAC) is one of the useful procedures for the investigation of thyroid swellings. FNAC is a minimally invasive procedure, is cost effective, and a gold standard for diagnosing thyroid lesions. Haemorrhage, thrombosis, and infarction are known common complications of FNAC. Post FNAC infarction in thyroid gland has been known as a rare phenomenon. Here, we report the case of a young female who underwent FNAC that showed Hurthle cell neoplasm (Bethesda 3). Four weeks later, she underwent right thyroid lobectomy and the final histology showed extensive necrosis and haemorrhage which is a diagnostic dilemma and hampered our diagnosis. Keywords: Hurthle cell neoplasm, FNAC, Thyroidectomy, Thyroid neoplasm

Pott’s Puffy Tumor Elicited by Klebsiella Pneumoniae: An Uncommon Clinical Entity

A lesser-known clinical non-neoplastic entity was first described in 1775, known as Pott’s puffy tumor (PPT). PPT is characterized by frontal bone osteomyelitis with an associated subperiosteal abscess. The diagnosis is usually confirmed with a computed tomography scan of the paranasal sinuses. Early treatment is the law as there is imminent substantial morbidity if left untreated. Herein, we presented a case of a 27-year-old male with a Pott’s puffy tumor due to Klebsiella Pneumoniae that was effectively treated with surgery and antibiotics for a total of 3 weeks. Even rare it is a terrifying complication, making it fundamental importance to make an early diagnosis and a correct surgical combined with medical management

Evaluation of Silkworm Lines against Variations in Temperature and RH for Various Parameters of Commercial Cocoon Production

Eleven inbred silkworm lines (M-101, M-103, M-104, M-107, Pak-1, Pak-3, Pak-2, Pak-4, PFI-1, PFI-2, and S-1) were evaluated for various parameters of cocoon production under different temperature and relative humidity conditions (25±1, 30±1, and 35±1 • C in combination with 55, 65, and 75% RH for three hrs during 4th and 5th instar. The experiment was laid out in factorial design with three replications. Significant variations in the performance of silkworm lines were noticed due to influence of temperature and RH treatment on 4th and 5th instar larvae. The silkworm lines performed significantly better when the larvae were reared at 25 ± 1 • C with 70-80% RH while almost all the silkworm lines showed poor performance at higher temperature exposures for 3 hrs. Exposures to lower humidity (55%) during larval rearing in 4th and 5th instar at different temperatures (25 ± 1, 30 ± 1, and 35±1 • C) resulted in lowering the cocoon production. The cumulative evaluation index values for different traits showed that Pak-4 (61.42) was the best line followed by M-101 (59.15), Pak-2 (56.37), Pak-3 (52.83) PFI-I (52.62), and M-107(50.03). The study clearly underlines the importance of optimization of environmental conditions during larval rearing in relation to commercial cocoon production. The investigations strongly recommend that temperature and relative humidity in the range of 25-26 • C and 70-80%, respectively, are mandatory for excellent results of cocoon production and Pak-4, M-101, Pak-2, Pak-3, PFI-I, and M-107 were suitable for commercial rearing