Baharudin Abdullah

The effect of Tualang honey in enhancing post tonsillectomy healing process. An open labelled prospective clinical trial.

INTRODUCTION Tonsillectomy is a common operative procedure performed for tonsillar hypertrophy complicates with recurrent tonsillitis. Among the post tonsillectomy morbidities, post operative wound healing is of utmost importance to be effectively managed as it will interfere with patient recuperation from surgery. Tualang honey has been shown to accelerate wound healing in postoperative patients. OBJECTIVE The aim of this study was to investigate the effect of Tualang honey in enhancing healing process in post tonsillectomy patients. METHODOLOGY In this open labelled prospective study, the selected paediatric patients were randomized into two groups. The 35 subjects in the Tualang honey-antibiotic group received 3 mls of Tualang honey intraoperatively followed by 4 mls of oral Tualang honey three times daily for seven days. Concurrently, 25mg/kg of intravenous Sultamicillin was given three times daily for two days followed by oral Sultamicillin twice daily for five days. The 28 subjects in the antibiotic only group received intravenous at 25mg/kg Sultamicillin kg for two days followed by oral Sultamicillin twice daily for five days. The healing process was assessed at day 1, day 3, day 7 and day 14 postoperatively by semiquantitative endoscopic photograph examination of both tonsillar fossae. RESULTS The average ages for the treatment group and the control groups were 9 and 11 years old respectively. Wound healing was significantly faster in the treatment group in both tonsillar fossae compared to the control group (left: p-value = <0.001; right: p-value = <0.001). CONCLUSION Tualang honey has positive effect in enhancing healing process in post tonsillectomy patient. It is easy to use topically, safe to consume orally and available at low cost locally. Overall it can be used as an excellent adjunct therapy for post operative patients.

Noise-Induced Hearing Loss Among Quarry Workers in a North-Eastern State of Malaysia: A Study on Knowledge, Attitude and Practice

OBJECTIVES Noise is known to be one of the environmental and occupational hazards listed in the Factory and Machinery Act 1967. Quarries with loud deafening sounds from trucks and machineries pose the risk of noise-induced hearing loss to workers. This study was designed to assess the knowledge, attitude and practice towards noise-induced hearing loss and to determine the prevalence of noise-induced hearing loss and its associated factors among quarry workers in a north-eastern state of Malaysia. METHODS A cross-sectional study was conducted at six quarries in a north-eastern state of Malaysia, with 97 consented respondents who answered a validated version of a questionnaire and underwent pure tone audiogram. The respondents were male, aged between 18 to 50 years, working in the quarry area for at least 6-months duration with no family history of ear diseases. RESULTS The mean percentage scores of knowledge, attitude and practice were 44 (11), 70 (10) and 28 (16) percent, respectively. The prevalence of noise-induced hearing loss was found to be 57 (95% CI: 47, 67) with 46 (84%) having mild and moderate noise-induced hearing loss, and 34 (62%) involved both ears. Multiple logistic regressions showed that age and practice score were the associated factors with odd ratios of 1.1 (95% CI: 1.1, 1.2; p<0.001) and 0.9 (95% CI: 0.8, 1.0; p=0.008), respectively. CONCLUSION The knowledge, attitude and practice scores of the respondents were poor and the high prevalence of noise-induced hearing loss was contributed by factors such as poor practice and old age.

A videoendoscopic evaluation of the upper airway in South East Asian adults with obstructive sleep apnea.

ObjectivesWe aimed to evaluate the severity of upper airway obstruction at the retropalatal and retroglossal regions in obstructive sleep apnea (OSA) patients.MethodologyThis is a descriptive cross-sectional study at the Sleep Clinic, Department of Otorhinolaryngology–Head and Neck Surgery. Flexible nasopharyngolaryngoscopy was performed in seated erect and supine position. Retropalatal and retroglossal regions were continuously recorded during quiet breathing and Muellers maneuver in both positions. Captured images were measured using Scion Image software and narrowing rate was calculated. Level of each site was classified based on Fujita classification and severity of obstruction using Sher scoring system for Muellers maneuver.ResultsA total of 59 patients participated in this study. Twenty-nine (49.2%) participants had type 1 (retropalatal) obstruction, 23 (38.9%) had type 2 (retropalatal and retroglossal), and seven (11.9%) in type 3 (retroglossal) obstruction. Fifty (84.7%) of the patients have severe obstruction at the retropalatal region in supine position (SRP) followed by 35 (59.3%) at retropalatal region in erect position (ERP), 27 (45.8%) at retroglossal region in supine position (SRG) and eight (13.5%) at retroglossal region in erect position (ERG). The average oxygen saturation showed significant association in ERP (P = 0.012) and SRP (P < 0.001), but not significant in ERG and SRG.ConclusionsVideoendoscopy utilizing flexible nasopharyngolaryngoscopy and Scion Image software is reliable, minimally invasive, and useful as an office procedure in evaluating the multilevel obstruction of upper airway in OSA patients. The retropalatal region has more severe obstruction compared with retroglossal region either in erect or supine position.

Image-guided system endoscopic drainage of orbital abscess caused by methicillin-resistant Staphylococcus aureus in an infant.

Highlights • Orbital abscess in infant requires prompt treatment.• MRSA is an increasingly common organism causing orbital abscess in infants.• Surgical drainage of orbital abscess is indicated when presence of persistent infection clinically or radiologically despite systemic antimicrobial therapy.• Image-guided endoscopic drainage of orbital abscess in infant provides a safer surgical technique.

Primary endoscopic endonasal dacryocystorhinostomy for pediatric nasolacrimal duct obstruction: A systematic review

Background Epiphora secondary to nasolacrimal duct obstruction is common in the pediatric age group. The mainstay treatment among these young patients has been conservative. Once epiphora becomes recalcitrant, however, an external or an endonasal approach is considered. Objective Endoscopic dacryocystorhinostomy (EDCR) entails creating an opening from the lacrimal sac directly into the nasal cavity to counteract nasolacrimal duct obstruction. We reviewed the literature to determine the effectiveness and the safety of primary EDCR to treat pediatric nasolacrimal duct obstruction. Method A literature search was conducted by using a number of medical literature data bases for the period from 1995 to 2016. The following search words were used either individually or in combination: epiphora, nasolacrimal duct obstruction, endoscopic dacryocystorhinostomy, powered endoscopic dacryocystorhinostomy, laser-assisted endoscopic dacryocystorhinostomy, children, congenital, acquired, presaccal obstruction, and postsaccal obstruction. In addition, a few articles were identified based on the experience and information provided by the senior authors (B.A., S.H., D.Y.W.). The search was conducted over a 1-month period (January 2017). Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and the Cochrane Handbook for Systematic Reviews of Interventions were followed when possible. Results Only 10 original clinical research articles were selected based on our objectives and selection criteria. All the studies were at level of evidence III: nonrandomized and noncomparative prospective or retrospective case series. Altogether, 313 patients with ages that ranged from 4 months to 18 years were enrolled. A total of 352 EDCRs were performed that were either single sided (n = 313) or bilateral (n = 39). The most common causes of the obstruction were classified as congenital, followed by idiopathic, and then acquired. A meta-analysis was not performed because of the heterogeneity of the patient groups and variability of the methods used to measure outcomes. Conclusion Analysis of the results indicated that EDCR was an effective, safe therapeutic approach to treating nasolacrimal duct obstruction in pediatric patients. It should be considered as an alternative procedure to external dacryocystorhinostomy after a failed conservative treatment.

EEG alpha power: An indicator of visual fatigue

There have been reports that some people who watch 3D movies experience motion sickness symptoms. In this research work, the change in dynamics of mental activity of subjects is evaluated to understand the reason behind the sickness. Cortical activity of the brain recorded from subjects who watch a stimulus (movie) on 2D and 3D TV. We propose that brain waves recorded using EEG device can be analysed using signal processing techniques and statistical methods. This will help in distinguishing between viewers of 2D and 3D stimulus, as well as being helpful in finding brain related areas that are active during the prevalence of motion sickness.

Successful endoscopic excision of nasal plasmacytoma: lesson learnt

Case s tudy: Herein, we are reporting a case of sinonasal plasmacytoma in an elderly man who presented with a four month history of unilateral nasal blockage. Rigid nasoendoscopy revealed benign looking polypoidal mass occupying entire right nasal cavity with no evidence of any polypoidal mass seen over the left nostril. Computer tomography revealed homogenous soft tissue mass over right nasal cavity with minimal mucosal thickening in bilateral maxillary, ethmoid, sphenoid and left frontal sinus.

Juvenile psammomatoid ossifying fibroma of the ethmoid sinus: A rare case report

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, aggressive benign bony tumour that has been distinguished from a larger group of ossifying fibromas (OF) based on age of occurrence, most common site of involvement, and its clinical behaviour.We reported a case of asymptomatic 14 year old boy who had incidental finding of left ethmoidal bony mass on his CT brain imaging done for post traumatic cerebral concussion. The diagnosis of juvenile psammomatoid ossifying fibroma (JPOF) was made based on radiological and histological findings.

Nasal Irrigation as Treatment in Sinonasal Symptoms Relief: A Review of Its Efficacy and Clinical Applications

Nasal irrigations have been used for centuries without any scientific data to determine its efficacy. Despite their widespread use, much confusion exist about the mechanism of action, preparation, indications and therapeutic advantage of nasal irrigations. Anecdotal evidence and poorly controlled studies add to the confusion. Recent evidence provides strong scientific justification of the benefits and advantages of using nasal irrigations in sinonasal symptoms relief. The present review of the evidence based literature highlights its efficacy and clinical applications.

Tracheotomy as a surgical access for removal of bullet in the trachea: A case report

Abstract Gunshot tracheal injury with retained bullet fragment inside the trachea presents a challenge for removal. The treatment of the tracheal injury depends on the magnitude of the tracheal wound and the presence of injury to adjacent organs. The surgical removal may require both bronchoscopy and an open trachea exploration. We report a case of a gunshot injury to the trachea which requires a tracheotomy for a successful bullet removal.