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Frequency of diseases presenting in ENT OPD at Ayub Teaching Hospital Abbottabad

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Introduction: Patient presents with ear, nose and throat diseases in ENT OPD to otolaryngologist/ENT specialist. ENT diseases are serious public health problems because of their universal distribution the morbidities which they cause due to inherent physiological function that take place in head and neck region. Objectives of our study were to know frequency of ENT diseases in patients presenting at ENT OPD at Ayub Teaching Hospital Abbottabad. Methods: A cross sectional study was done in Ayub Teaching Hospital Abbottabad from December 2015. to August 2016. Patients presenting at ENT OPD of Ayub Teaching Hospital Abbottabad were selected for study. Data about their ENT problems and concerned information were collected from them through well structured questionnaire. Data after collection was entered and analysed using SPSS-16. Results: The minimum age is 1 and maximum age is 80 years. Out of total 250 patients, 129 (51.6%) were males and 121(48.4%) were females, majority of patients 181 (72.4%) were from Abbottabad and majority of patients 165(66.0%) were poor. The most common cases in ENT OPD were bilateral ear wax 15.2% followed by acute otitis media 13.2% and allergic rhinitis 13.2%. Conclusion: It is concluded from our research that most common problems of ENT disorders are bilateral ear wax, allergic rhinitis, acute otitis media, chronic supporative otitis media and deviated nasal septum. The most common causes are infection, poor hygiene and poor nutrition.
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FREQUENCY OF DISEASES PRESENTING IN ENTOPD
AT AYUB TEACHING HOSPITAL ABBOTTABAD
Qayyum Fahad Shah,1Fayyaz Salma2
1Ayub Medical College, Abbottabad, Pakistan
2Al-Muslim Public School Battagram, Mansehra, Pakistan
Primljen/Received 30. 01. 2019. god. Prihva}en/Accepted 06. 06. 2019. god.
Abstract: Introduction: Patient presents with ear,
nose and throat diseases in ENT OPD to otolaryngolo-
gist/ENT specialist. ENT diseases are serious public
health problems because of their universal distribution
the morbidities which they cause due to inherent physi-
ological function that take place in head and neck re-
gion. Objectives of our study were to know frequency
of ENT diseases in patients presenting at ENT OPD at
Ayub Teaching Hospital Abbottabad.
Methods: A cross sectional study was done in
Ayub Teaching Hospital Abbottabad from December
2015. to August 2016. Patients presenting at ENT OPD
of Ayub Teaching Hospital Abbottabad were selected
for study. Data about their ENT problems and concer-
ned information were collected from them through
well structured questionnaire. Data after collection
was entered and analysed using SPSS-16.
Results: The minimum age is 1 and maximum age
is 80 years. Out of total 250 patients, 129 (51.6%) were
males and 121 (48.4%) were females, majority of pati-
ents 181 (72.4%) were from Abbottabad and majority of
patients 165 (66.0%) were poor. The most common ca-
ses in ENT OPD were bilateral ear wax 15.2% followed
by acute otitis media 13.2% and allergic rhinitis 13.2%.
Conclusion: It is concluded from our research
that most common problems of ENT disorders are bila-
teral ear wax, allergic rhinitis, acute otitis media, chro-
nic supporative otitis media and deviated nasal septum.
The most common causes are infection, poor hygiene
and poor nutrition.
Key words: Frequency, ENT diseases, Otitis media,
ENT OPD patients of Ayub Teaching Hospital, Abbottabad.
INTRODUCTION
Patient presents with ear, nose and throat diseases
in ENT OPDto otolaryngologist/ ENT specialist (1).
The pattern of ENT diseases is quiet variable depend-
ing on age and group varying from community to com-
munity. They may be congenital or acquired in origin.
Acquired diseases may be infectious, inflammatory,
neurological and vascular or they may be due to some
trauma. Complications occur in hearing, breathing,
phonation, swallowing, speech, olfaction, taste and
protection of lower respiratory tract (2).
In ENT OPD the most presenting ear diseases are
ear infection, conductive hearing loss, otitis externa
and chronic otitis media (3). The otitis media is the
most common disease in young patient because of its
more horizontal orientation in children than adults (4).
In a survey done by WHO chronic suppurative otitis
media (CSOM) was reported to be the most common
cause of hearing loss in children in developing countri-
es. Survey on prevalence of CSOM have shown the
global burden of illness from CSOM involves 65-330
million individuals 60% of whom suffer from signifi-
cant defect (5). In ear diseases oral medication respon-
se is excellent while surgical intervention is less frequ-
ently required (6).
Diseases of nose which presents the ENT OPD are
nasal deformities, tumours, disease of nasal vestibule,
nasal septum deviation, nasal polyps, rhinitis, epistaxis,
etc. Causes of nasal diseases are trauma, nose surgery
and infections. Complication that occurs due to nasal di-
seases are meningitis, cavernous sinus thrombosis and
septal abscess (7). Acommon problem of nose affecting
60 million Africans each year is epistaxis. Most of its ca-
ses are minor and manageable but some presents as a life
threatening problem. Common local causes are trauma,
anatomical deformities and tumours. Cardiovascular di-
seases and hypertension are its systemic causes (8). Epi-
staxis is a common problem in children in Kiesselbach
area due to local irritation in children (9). Epistaxis is
initially treated by first aid measures but other times
need some special measures to treat (10).
DOI: 10.24125/sanamed.v14i2.315
UDK: 616.2(549)"2015/2016"
2019; 14(2): 175–180 ID: 278334476
ISSN-1452-662X Original article
Most common throat diseases in outdoor patient
department are sore throat, tonsillitis, pharyngitis and
cancers. Causes of throat disease are usually a viral in-
fection but other causes include allergies. Complication
of throat diseases is acute rheumatic fever; acute glome-
rular nephritis and peritonsillar abscess formation (11).
Second most common cancer of the respiratory tract is
the laryngeal cancer. Risk factor for this type of cancer is
cigarette smoking, alcohol consumption and may be hu-
man papilloma virus 16 and helicobacter pylori (12). In-
cidence of multiple primary tumours in head and neck
region ranges from 10-35 percent (13).
In head and neck malignancies laryngeal cancer ac-
counts approximately for 20% of all cases. Treatment
for laryngeal include total laryngectomy (Tl), alone or
with neck dissection (ND), radiotherapy alone (RT), TL
followed by RT and combined chemotherapy (14).
Children going to schools are more prone to ENT di-
seases because of cross infections. This chronic problem
not only hampers developmental progress and school
performance but also cause physical and emotional suffe-
ring (15). Foreign bodies in ear usually found in children
below age of ten years it may be iatrogenic or accidental.
Tracheobronchial foreign bodies are the major cause of
mortality and morbidity in paediatric age group (16).
It has been concluded from a study carried out in
India that smoking is the main cause of middle ear dis-
eases in children and adults .Among adults hearing loss
is more common with smoking (17).
According to a study done in Peshawar the inci-
dence of common ENT diseases presenting in OPD are
chronic tonsillitis 37%, CSOM 14%, rhinitis due to de-
viated nasal septum 67%.
A study done on prevalence of allergic rhinitis in
Oman showed that 7% patients with nasal symptoms
attended the ENT OPD (18). A study performed in
France on allergic rhinitis and it`s affect on sleep sho-
wed that sleep impairment was significantly worse
with allergic rhinitis. Everyday living is also impacted
by allergic rhinitis due to lack of sleep (19). Studies
showed that aeroallergens are the primary triggers for
respiratory tract diseases (20).
Asthma is a worldwide common disease in chil-
dren and adults (21). According to a report of WHO
asthma a life threatening disease roughly effect 100 and
150 million people around the globe and over 180,000
deaths occur from this condition annually. About 8% of
Swiss population suffers from asthma. There are about 3
million asthmatics in Japan and 4 million in Germany. A
rough estimate in India indicates a prevalence of betwe-
en 10% and 15% in 5-11 year old children (22). The pre-
valence of asthma in Pakistan is increasing day by day
with an annual increase of 5% of which 20% to 30% are
children between 13 and 15 years of age. Nearly 20 mil-
lion people about 12% of Pakistani adult population are
suffering from disease (23).
According to a study done at Military Hospital At-
tockotomycosis (a fungal ear infection common in trop-
ical countries) is a common condition often seen in ENT
OPD and in this study its prevalence is about 7% among
patients who presented with sign and symptoms of otitis
media. Its various predisposing factors are humid clima-
te, presence cerumen, instrumentation of ear and increa-
se use of antibiotics (24). Otitis media with effusion is
also a common medical in Indian children and its preva-
lence has been quoted 16.6% in children of age 5 to 7
(25). According to a report of WHO 5% of world popu-
lation 360 million people has disabling hearing loss (a
person who is not able to hear as well as someone with
normal hearing _hearing threshold of 20 decibel or be-
low in both ears is to have hearing loss) (26).
A study done on symptoms of ENT diseases sho-
wed that headache was the main symptom in patients
presented in ENT OPD (27).
A study done on ear ,nose and throat diseases sho-
wed that common ear, nose and throat disorders were
seen in patients aged < 15 years are otitis media, obstruc-
tive adenoids and foreign bodies in the ear whereas hear-
ing loss, rhino sinusitis and tumours were the common di-
sorder of ENT in patient aged 16 years and above (28).
Chronic rhino sinusitis (CRS) a clinical syndrome
characterized by mucosal infection of nose and parana-
sal sinuses is one of the most prevalent chronic disea-
ses worldwide. It is the second most chronic condition
in United States, affecting one in seven American
adults (29). In USA prevalence of sinusitis is estimated
to be 14% of global population. Patients with particular
disease more often develop sinusitis such as 25-30% of
allergic patients, 43% of asthmatic patients, 37% of pa-
tients with transplants and 54-68% of patients with
AIDS (30). Studies from tertiary care centres indicate a
high prevalence of fungal rhino sinusitis in India. This
was found in 70% young males in 10-39 years age gro-
up from rural India (31).
MATERIAL AND METHODS
This was a cross sectional descriptive type of study
at Ayub Teaching Hospital Abbottabad. The study was
done over a period from December 2015 to June 2016.
The sample size was 250. Non Probability convenient
sampling. Patients with different ENT diseases present-
ing at ENT OPD of Ayub Teaching hospital Abbottabad
were included. All patients who are in emergency condi-
tion were excluded. Data was collected using a structu-
ral questionnaire after pretesting. The data after collec-
tion was entered and analyzed using statistical software
SPSS-16. Mean and standard deviation were calculated
176 Qayyum Fahad Shah, Fayyaz Salma
for quantitative variables like age, monthly family inco-
mes etc. while frequencies and percentages were calcu-
lated for categorical variables like gender, socioecono-
mic etc. Results were displayed as tables and graphs.
RESULTS
Table 1. Gender of patients
Table 1 shows that out of total 250 patients, 129
(51.6%) were males and 121 (48.4%) were females.
Table 2. Socioeconomic status
Table 2 shows that majority 165(66%) of patients
were poor, 72 (28.8%) belonged to middle class and 13
(5.2%) were from upper class.
Figure 1 shows that out of 250 patients, 28 (11.2%)
were laborer, 21 (8.4%) were businessman, 54 (21.6%)
were government servant, 18 (7.2%) were housewife, 8
(3.2%) were farmers, 77 (30.8%) had other jobs and 44
(17.6%) had no jobs.
Table 3 shows that out of total 250 patients, 33
(13.2%) were suffering from acute otitis media, 21
(8.4%) had acute pharyngitis, 11 (4.4%) had acute sinusi-
tis, 13 (5.2%) had acute tonsillitis, 33 (13.2%) had aller-
gic rhinitis, 38 (15.2%) had bilateral ear wax, 10 (4.0%)
had chronic pharyngitis, 27 (10.8%) had chronic suppo-
rative otitis media, 26 (10.4%) had chronic tonsillitis, 20
(8.0%) had deviated nasal septum, 7 (2.8%) had epistaxis
and 11 (4.4%) were suffering from otitis externa.
Figure 2 shows that out of total 250 patients, 193
(77.2%) patients had duration of illness below 1 year,
46 (18.4%) had 1 to 5 years, 7 (2.8%) had 6 to 10 years
and 4 (1.6%) had above 10 years duration of illness.
Table 4. Nature of visit
Table 4 shows that out of total 250 patients, 117
(46.8%) patients had first visit to hospital and 133
(53.2%) patients were follow up.
FREQUENCY OF DISEASES PRESENTING IN ENT OPD AT AYUB TEACHING HOSPITAL ABBOTTABAD 177
Frequency Percentage (%)
Male 129 51.6%
Female 121 48.4%
Total 250 100%
Frequency Percent
Poor 165 66.0%
Middle 72 28.8%
Upper 13 5.2%
Total 250 100.0%
Figure 1. Occupation
Table 3. Diagnosis
Frequency Percent
Acute otitis media 33 13.2%
Acute pharyngitis 21 8.4%
Acute sinusitis 11 4.4%
Acute tonsillitis 13 5.2%
Allergic rhinitis 33 13.2%
Bilateral ear wax 38 15.2%
Chronic pharyngitis 10 4.0%
Chronic supporative otitis media 27 10.8%
Chronic tonsillitis 26 10.4%
Deviated nasal septum 20 8.0%
Epistaxis 7 2.8%
Otitis externa 11 4.4%
Total 250 100.0%
Figure 2. Duration of illness
Nature of visit Frequency Percent
First 117 46.8
Follow up 133 53.2
Total 250 100.0
Figure 3. Any treatment taken before
Figure 3 shows that out of total 250 patients, 142
(56.8%) had taken medical treatment, 9 (3.6%) had ta-
ken surgical treatment, 4 (1.6%) had taken other treat-
ment and 95 (38.0%) had taken no treatment before.
DISCUSSION
The pattern of ENT disease is quiet variable de-
pending on age & group varying from community to
community. A prospective cross sectional study of all
consecutive patients coming to otolaryngology clinic
in Oman was done on allergic Rhinitis and associated
co morbidities. In this study allergic Rhinitis was noted
in 48% of patients. According to our study out of 250
cases 33 patients (13.2%) were of allergic rhinitis. The
difference in result is due to sample size which is small
in our study (18).
A study done in India on the Prevalence of preven-
table ear disorders in primary school children (aged 5
to 12 years) through pro-forma questionnaire in 15718
primary school children. Most common ENT disorders
seen in these children were Ear wax in 7.93%, chronic
otitis media in 4.79% & 3.66% suffered from otitis me-
dia with effusion. Acute otitis media was detected in
0.65% children and foreign bodies were found in
0.34%. According to our study, out of 250 patients of
bilateral ear wax are (15.2% , chronic otitis media
10.8% and acute otitis media 13.2%. Difference in re-
sults is due to sample size and age groups (32).
In our study patient occupational classes showed
that there were more patients in lower occupational
classes than in those in upper classes. Same results are
showed by a study done in England by SL Isaac et al
(33). A prospective study carried out at ENT depart-
ment of KMC Peshawar Pakistan from April 2011 to
May 2012 a total of 32800 patients showed the distri-
bution of diseases systemically that is ear diseases we-
re 47%, 36% Nasal complaints and 17% Laryngop-
haryngeal. In our study ear diseases are 43.6%. Nasal
complaints are 28% and 28.4% complaints are of
Laryngopharyngeal problems. The difference in frequ-
ency distribution is due to large size (4).
A prospective study was conducted at tertiary care
hospital in Peshawar Pakistan. Most of the ENT disor-
ders were diagnosed in those infants were Pharyngitis
(30%) Otitis media 29.33%, tonsillitis (25.33%) and
Nasal Obstruction (5.3 %.) This study shows that ENT,
diseases are more common in children (34). In our
study cases of tonsillitis are 16%, Pharyngitis 12.4%
and otitis media 24%. Results are different because of
difference in age group.
A study done in Nepal on prevalence of ENT dise-
ases in children shows that low socioeconomic status,
overcrowding & joint families might be responsible for
the high prevalence of ENT diseases (35).
CONCLUSION
From this study, frequency of ENT diseases
among patients presenting at ENT OPD at Ayub Teach-
ing Hospital Abbottabad, we concluded that 15.2% pa-
tients had bilateral ear wax, 13.2% had allergic rhinitis
and acute otitis media, 10.8% had chronic suppurative
otitis media, 10.4% had chronic tonsillitis, 8.4% had
acute pharyngitis, 8% had deviated nasal septum, 5.2%
had acute tonsillitis, 4.4% had acute sinusitis and otitis
externa, 4% chronic pharyngitis and 2.8% had epista-
xis. The main determinant is that ENT diseases are mo-
re in males and lower socio-economic families because
of poor nutrition, poor housing and poor hygiene.
This study shows that allergic rhinitis, bilateral
ear wax acute and chronic suppurative otitis media
and pharyngitis are the common ear, nose and throat
disorders.
Abbreviations
ENT — Ear, Nose and Throat (Otorhinola-
ryngology)
OPD — Outpatient department
SPSS — Statistical Package for the Social Sci-
ences
WHO — World health organization
CSOM — chronic supprative otitis media
TL — Total laryngectomy
ND — Neck dissection
RA — Radiotherapy alone
CRS — Chronic rhino sinusitis
USA — United States of America
AIDS — Acquired immunodeficiency syndrome
Conflict of Interest
No author has any potential conflict of interest.
Financial Disclosure
The work received no external financial support.
Licensing
This work is licensed under a Creative Commons
Attribution 4.0 International (CC BY 4.0) License.
178 Qayyum Fahad Shah, Fayyaz Salma
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FREQUENCY OF DISEASES PRESENTING IN ENT OPD AT AYUB TEACHING HOSPITAL ABBOTTABAD 179
Sa`etak
U^ESTALOST OBOLJENJA KOD PACIJENATA PREGLEDANIH
U ORL AMBULANTI U AJUB UNIVERZITETSKOJ BOLNICI ABBOTTABAD
Qayyum Fahad Shah,1Fayyaz Salma2
1Ayub Medical College, Abbottabad, Pakistan
2Al-Muslim Public School Battagram, Mansehra, Pakistan
Uvod: Pacijent se ambulantno javlja specijalisti
otorinolaringologije zbog poreme}aja uva, grla i nosa.
Oboljenja koja zahvatuju regiju uha, grla i nosa su
ozbiljni javno zdravstveni problem prvenstveno zbog
njihove univerzalne distribucije morbiditeta, koja za-
hvata region glave i vrata. Ciljevi na{e studije bili su da
se uo~i frekventnost ORL bolesti kod pacijeata, koji se
javljaju specijalisti otorinolaringologije u Ajub Uni-
verzitetskoj Bolnici Abotabad.
Metod: Ova studija izvedena je u Ajub Univerzi-
tetskoj Bolnici Abotabad u periodu od decembra 2015.
do avgusta 2016. godine. Pacijenti koji su se javili spe-
cijalisti otorinolaringologije u Ajub Univerzitetskoj
bolnici Abotabad bili su uklju~eni u studiju. Podaci ve-
zani za ORL simptomatologiju, kao i ostale informaci-
je od zna~aja, bili su sakupljani kroz dobro strukturisan
upitnik. Podaci nakon sakupljanja su kompjuterski
uneti i obra|ivani koriste}i SPSS-16.
Rezultati: Najmla|i pacijent je imao 1 godinu, a
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(51,6%) su bili mu{karci, a 121 (48,4%) `ene. [tavi{e
ve}inu pacijenata, 181 (72,4%) ~inili su stanovnici
Abotabada i ve}ina njih je bila niskog materijalnog sta-
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pove}ane u{ne masti (15,2%), na drugom mestu su
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i oni sa alergijskim rinitisom, koji je imalo 13,2% is-
pitanika.
Zaklju~ak: Mo`e se zaklju~iti iz na{e studije da
je naj~e{}i problem ORL patologije obostrano zapu{e-
nje spolja{njeg u{nog kanala u{nom masti, alergijski
rinitis, akutni otitits media, hroni~ni supurativni otitis
media i devijacija nosne pregrade. Naj~e{}i uzrok su
infekcije, slaba higijena i smanjena uhranjenost.
Klju~ne re~i: u~estalost, ORL bolesti, otitis media.
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180 Qayyum Fahad Shah, Fayyaz Salma
Correspondence to/Autor za korespondenciju
Dr. Shah Fahad Qayyum
Gohar Sons, Peeple Chowk
Nowshera cantt.
Pakistan
tel: 00923439149039
email: sfask2013ªgmail.com
... It is also supported by a study in Pakistan and India, the most common ear cases are impacted cerumen. 15.2% of ENT OPD in Pakistan has been found, 13.2% had allergic rhinitis and acute otitis media, 10.8% had chronic suppurative otitis media, 4.4% had acute sinusitis and otitis externa (8,9) . The most common nasal diseases recorded at outpatient visits were sinusitis, rhinitis, nasal polyps, nasal deformities, tumors, nasal vestibular disease, epistaxis, and others. ...
... The second was epistaxis 20%, chronic rhinosinusitis 11.85% followed by acute rhinitis 11.48%, allergic rhinitis 9.62%, and vestibulitis seen in 8.51% (9) . This result is in line with a study in Pakistan which stated that diseases of the nose accounted for the least percentage compared to the ear and throat (8) . ...
... In line with the results of a study in Nigeria with children aged <18 years as research subjects, it was stated that cases of impacted cerumen (16.9%) were the most common ear cases recorded in the ENT OPD (14) . Slightly different from the research of Pakistan, ear disease is said to be the majority disease with cerumen impaction as the most common disease reported 15.2%, but the second position is occupied by cases of allergic rhinitis and acute otitis media 13.2%, chronic suppurative otitis media 10.8%, and otitis externa only contributed as much as 4.4% including the least reported ear disease (8) . Otitis externa is an acute or chronic inflammation of the ear canal caused by bacterial, fungal, and viral infections. ...
Article
Background: Ear, Nose, and Throat diseases are one of the most common health problems in the community and is very important because of its morbidity that can cause physiological function disorders. The pattern of disease in patients with ear, nose and throat complaints varies, depending on each region, patient characteristics such as gender, age, and the underlying etiology or pathological process of the disease. Objective: This study was conducted to determine the 10 most common ENT diseases on the Outpatient Department of ENT at Bali Mandara General Hospital over two-years period. As well as studying variations in disease patterns based on gender and age group of the patient in Badung region, Bali. So that future treatments and disease trends can be studied and managed better. It will also assist in the further reconstruction of the health care system. Method: This study was taken retrospectively based on medical record from the last two years during the period of January 2020 to September 2022, with the research subjects being outpatients who visited and checked themselves at the Ear, Nose, and Throat Department, Bali Mandara General Hospital. Result: Total of ENT patients from 2020-2022 is 1,517. Which in 2020, the most frequently reported ENT disease was Coronavirus Infection 220 patients (31.34%) with male and female gender in the same ratio. This disease is most often experienced by the age group of 21-30 years. In 2021, the most frequently reported ENT disease was otitis externa with 104 patients (25.55%) followed by impacted cerumen 69 patients (16.95%) with male more frequent than female. This disease is most often experienced by the age group of 21-30 years. Meanwhile, impaction of cerumen 109 (26.72%) followed by otitis externa 95 (23.28%) was the most common disease found in the period of January - September 2022. It was more common in male than female, and at age group > 51 year. Conclusion: From 2020 to 2022 the most common diseases experienced by patients with ENT complaints were otitis externa and impacted cerumen. Coronavirus infection, acute nasopharyngitis, hypertrophy of nasal turbinates, and chronic tonsillitis only appeared once as diseases that were included in the top 10 most common diseases in 2020, 2021 and 2022, respectively. Key words: Epidemiological Profiles, Otorhinolaryngology, ENT diseases, Outpatient Department
... 6 The predominance of males in this study›s patient population (56%) is consistent with global trends observed in other studies, which have also reported a higher prevalence of ENT disorders among males (51.6%). 5,7 Another study also reported similar male predominance (52.8%). 6 However, it is worth noting that the proportion of male patients in this study is higher than reported in some other studies, indicating potential variations in gender distribution across different populations. ...
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Introduction: Otorhinolaryngology, dealing with disorders of the ears, nose, throat, and related structures, poses significant health challenges. However, there is a dearth of extensive clinical and epidemiological data on these ailments in the specific geographic area under study. Understanding the characteristics of otorhinolaryngology diseases is crucial for effective healthcare planning and resource allocation. Objective: This study aimed to determine the clinical and epidemiological profile of otorhinolaryngology diseases at a tertiary hospital in Morang District, Nepal. Methodology: An observational descriptive cross-sectional study was conducted at the Otorhinolaryngology department of a tertiary hospital in eastern Nepal from January 15 to February 15, 2024. Data from 600 patients presenting at the department over one month were meticulously analyzed. Results: The median age of patients was 28 years, with the most prevalent age group being 21- 30 years (23%). A majority (56%) were male, and belonged to the Brahmin/Chhetri caste (44.3%). Most patients (85%) initially visited the hospital through OPD, with ear-related issues (35.2%) being the most common complaint. Epistaxis (10.3%) was the most frequent diagnosis, followed by allergic rhinitis (9%) and ear wax issues (8.2%). The prevalence of carcinoma was 12(2%). The majority (77.3%) underwent medical treatment. Outpatient admissions were observed in 68(13.3%) of cases, with emergency admissions accounting for 42(62.6%). Conclusion: Epistaxis, allergic rhinitis, and ear wax problems were commonly encountered. Most patients underwent medical treatment, with only a minority requiring hospital admission, primarily through outpatient services.
... Ear, Nose and Throat (ENT) diseases accounts for 25-40% of all hospital patients and are serious public health problems because of their universal distribution, the morbidities which they cause due to inherent physiological function that take place in head and neck region. 1,2 Consultation is the act of seeking assistance from another physician(s) or health care professional(s) for diagnostic studies, therapeutic interventions, or other services that may benefit the patient. 3 Subspecialty consultations are a necessary part of comprehensive medical care and are important in facilitating the exchange of information, knowledge and expertise between doctors that aids in better patient management. ...
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IntroductionENT cases are very common accounting for 25-40% of all hospital patient. Subspecialty consultations are a necessary part of comprehensive medical care that provide an opportunity for interactions between doctors and the exchange of knowledge and expertise that helps in quality patient management. MethodsA descriptive cross-sectional study was conducted among patients asked for consultation in the Department of ENT and Head & Neck Surgery, Manipal Teaching Hospital from March 2022 to November 2022. Diagnosis made by ENT surgeon after relevant investigations was recorded. Analysis of diagnostic accuracy by non-ENT surgeons was carried out. ResultsOut of 8019 cases seen in the department of ENT and Head & Neck Surgery from 15th March 2022 to 25th November 2022, 400 cases were asked for consultations. Consultations were more frequently asked from Internal medicine and subspeciality followed by Emergency and Pediatrics department. The most common complaint in consultation sheet was throat pain. The commonest ENT and Head & Neck Surgery diagnosis was Allergic Rhinitis, followed by Presbyacusis and Acute Tonsillitis. Two hundred and twenty cases were asked for consultations with diagnosis from the primary department, out of which 183 had correct diagnosis. Conclusions Different departments do have difficulties in identifying and addressing ENT and Head & Neck Surgery cases and there is benefit from ENT and Head & Neck Surgery consultations. Furthermore, ENT and Head & Neck Surgery consultations do have high educational value for other departments and plays a vital role in patient management.
... The study revealed the prevalence of ENT diseases were higher in female patients than male patients which is not consistent with what was found in literature. [6][7][8][9] We found that otologic diseases were the commonest ENT pathology(73%), followed by throat pathology(14•6%).Our findings were consistent with what several papers had reported. [6][7]10 . ...
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Background: The distribution of diseases in society varies across communities and geographical places. Diseases of the ear, nose, and throat (ENT) pose severe public health issues in both rural and urban populations.Objective: To determine the demographic disease pattern in the ENT and Head and Neck Surgery (HNS) Out Patient Department(OPD).Materials and Methods: This retrospective study is based on patient’s medical records who attended the Out Patient Department of Otorhinolaryngology, Khwaja Yunus Ali Medical College and Hospital (KYAMCH). The study records covered 2312 patients who visited the Out Patient Department from September 2019 to August 2020 were included in this study.Results: Study of patients in light of their diagnoses of chronic tonsillitis in 367 (15.87%), followed by chronic pharyngitis affected 347 (15.01%) patients, allergic rhinitis in 135 (5.74%), acute/chronic adenotonsillitis with otitis media with effusion in 133 (5.75%), and otitis externa in 123 (5.32%) individuals. In a broad heading, if the tonsils are mainly affected, it’s called tonsillitis; if the throat is mainly affected, it’s called pharyngitis.Conclusion: High prevalence of chronic tonsillitis and pharyngitis among ENT illnesses. The most prevalent ENT conditions include chronic suppurative otitis media (CSOM/COM) 11.63%, allergic rhinitis, acute and chronic adenotonsillitis, otitis media with effusion (OME), otitis externa and acute tonsillitis. KYAMC Journal Vol. 14, No. 01, April 2023: 43-47
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Background: Nepal is a landlocked and developing country with 34.6% children under 14 years of ageas well a big population under the line of poverty. Socioeconomic status, family type, overcrowding and provision of health care facilities act as risk factors for ENT disorders. There is a lack of data on pediatric ENT disorders from various Nepalese populations. This study was undertaken to determine the hospital prevalence of ENT disorders in pediatric population and their relationship with socio-demographic factors.Objectives:This study was undertaken to determine the hospital prevalence of ENT disorders in pediatric population and their relationship with socio-demographic factors in a tertiary care hospital in Nepal.Methods: This is a prospective analytic study, conducted at Department of ENT, Head & Neck Surgery between January 2010 and December 2010 in the Ear, Nose and Throat (ENT) Department, Gandaki Medical College Charak Hospital, Pokhara, Nepal. All patients aged 16 years or younger presented ear diseases to the ENT clinic of the hospital seen by ENT surgeons were enrolled into the study.Results: Among 1632 children, ENT diseases were found to be more common among male children (60%). The male to female ratio is 1.5:1. Most of the children were living in joint family (64.16%). Diseases of auditory system (57.84%) were the most common group of ENT problems among the pediatric population, followed by pharyngo-esophageal (23.53%) and nasal disorders (18.63%). Most common otologic disorder was ear wax (40.9%). Among problems associated with nose, rhinitis (23.4%) was most common. Pharyngitis was troubling (44.8%) of our study population.Conclusion:Improvement of health education, socioeconomic status and health facilities will be helpful in reducing the prevalence of ENT diseases. A study on the prevalence of the Ear Nose throat and Head and Neck diseases in developing country like Nepal can provide basic data which can be relevant and beneficial to the development of medical ENT curriculum in the regional setup and subsequent medical practice.
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Allergic rhinitis (AR) is a global health problem and its impact on health related quality of life for patients is substantial, and the economic impact often underestimated. The prevalence of allergic rhinitis in Oman is unknown. This study aimed to estimate the prevalence of AR and associated co-morbidities among adults in Oman. Its secondary objective was to identify knowledge gaps in the literature with the aim of directing future research. A prospective, cross-sectional study of patients who presented to the outpatient otolaryngology clinic at Sultan Qaboos University Hospital with nasal symptoms between June 2010 and June 2011 was conducted. A total of 887 patients were seen with nasal complaints. Among them 127 patients were diagnosed with non-infective rhinitis, the mean age of presentation was 27 years. AR was noted in 48% of patients, and non-allergic rhinitis in 52%. The prevalence of AR was 7%, with females being more affected than males, and age ranging from 18 to 51 years. Prevalence of perennial AR was 84% compared to seasonal AR which was 16%. The most common perennial antigens were house dust mites (80%) followed by cockroaches (67%). All patients diagnosed with seasonal AR were found to be sensitive to Russian thistle. The prevalence of chronic rhinosinusitis in patients with AR was 34%. The prevalence of AR in the adult population presenting with nasal symptoms was found to be 7%, with associated chronic rhinosinusitis present in a third of these patients. However, there appears to be substantial knowledge gaps regarding the association of other comorbidities, like otitis media, bronchitis and bronchial asthma, the long-term outcomes of medical management, and indication of surgical intervention in patients with AR. Future research in AR among Omani patients should aim to address these issues.
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Objectives : The aim of this study was to determine the frequency of otomycosis, the clinical presentation, predisposing factors and treatment outcomes. Methods: This observational study was conducted at ENT department of Combined Military Hospital Attock, from October, 2010 to September, 2012. Convenient sample comprising 180 patients of both sexes and all age groups were selected from ENT OPD. The frequency, predisposing factors and most common symptoms of otomycosis were recorded. The response to different antifungal agents was also observed. Results were recorded in percentages. Results: There were 180 patients with documented diagnosis of otomycosis. There were 107 (59%) males and 73 (41%) females. The age of patients ranged from 1½ years to 75 years with a mean age of 38.5 years. Mean follow up time was 2 years. Most common presenting symptom was hearing loss (77.7%) followed by pruritis (68.8%) and otalgia (40%). We prescribed 1% clotrimazole drops or lotion in 58% patients and 2% salicylic acid in 31% cases. Both of these agents are effective. Topical 1% clotrimazole drops yielded highest resolution rate with lowest recurrent rate. Overall 149 (83%) patients were improved with initial treatment and 31 (17%) did not respond to initial treatment. Eight (4.4%) patients had a history of otological procedures. Four (2.2%) patients had canal wall down procedures that resulted in mastoid cavity. To analyse the efficacy of 1% clotrimazole and 2% salicylic acid we applied Z-Test to calculate the difference between 2 proportions of patients before treatment with those patients who remained uncured after treatment. Conclusion: Otomycosisis commonly presented with decreased hearing, pruritis, otalgia & otorrhoea. It usually resolves with local toilet of ear and instillation of antifungal agents. Eradication of disease is difficult in presence of a mastoid cavity and metabolic diseases like diabetes mellitus.
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Chronic rhinosinusitis (CRS) is one of the most common chronic medical conditions, with a significant impact on patient quality of life. CRS is broadly classified into two groups: CRS with nasal polyposis (CRSwNP) and CRS without NP (CRSsNP). Clinically, the major subtypes of CRSwNP may be divided into eosinophilic chronic rhinosinusitis (e.g., allergic fungal rhinosinusitis and aspirin-exacerbated respiratory disease [AERD]) and nasal polyps associated with neutrophilic inflammation (e.g., cystic fibrosis [CF]). CF is characterized by mutation of the gene encoding the CF transmembrane conductance regulator. Functional endoscopic sinus surgery is usually required for most NP patients with increased frequency in patients with AERD. This study provides a review of the epidemiology and major classification of CRSwNP. A review was performed of the literature regarding different subtypes of CRSwNP. Many definitions of CRSwNP exist and estimates of prevalence vary. CRSwNP is a clinical syndrome with a heterogeneous inflammatory profile. Of the subtypes associated with eosinophilic inflammation, AERD remains the most recalcitrant to medical and surgical therapeutic interventions.
Article
Objective: To identify the frequency of allergic diseases and the causative factors in patients of all the four provinces of Pakistan as well as from Rawalpindi and Islamabad. Methodology: Secondary data for the year 2007 was analyzed. Skin prick was the method adopted for analyzing the response of the patients to allergies. Results: The results were analyzed and it was found that allergic rhinitis (24.62%) and urticaria (24.04%) were the most common diseases. When city and province data was analyzed it was found that allergic rhinitis was the main allergic disease of Islamabad, NWFP (Khyber Pakhtunkhwa) and Sindh. Similarly urticaria was the commonest allergic disease of Rawalpindi and Baluchistan. Mixed cases of respiratory diseases were common in Punjab and NWFP (Khyber Pakhtunkhwa). Pollen, dust and Paper mulberry were the main aero allergens involved in triggering the disease beside thresher and raw cotton allergens as detected through IgE mediated skin prick test. Conclusion: It is concluded that allergy presents with a wide variety of clinical manifestations. Allergic Rhinitis was the main disease but cases of bronchial asthma and mixed respiratory allergies were also not less. Urticaria was the main skin disease. Aeroallergens were the main causative or triggering factor for respiratory tract allergies and their role was also present in urticaria and eczema cases as compared to food allergens which were playing minimal role.
Article
OBJECTIVE:To determine the topographical distribution and extent of disease in cases of carcinoma larynx treated in our set up and to compare it with similar studies conducted at other centres. SETTING: Department of ENT (Unit II), Liaquat University Hospital Hyderabad, Sindh - Pakistan from January 1999 to May 2003. METHODS: This study included one hundred cases of carcinoma larynx. Separate proforma for each patient was filled to collect data. Proforma included variables such as personal data, habits, findings on clinical examination, endoscopic findings, and histopathological and radiological reports. RESULTS: One hundred cases of carcinoma larynx were included in this study. Age of the patients varied from 19 to 80 years, but majority of patients belonged to age group between 40 to 60 years. Majority of cases i.e. 92 were male while others female. Male to female ratio was 11:1. The majority of cases belonged to lower socioeconomic class (80%). Most of the male patients were smokers. There were 56% supraglottic, 34% transglottic and 10% glottic tumours. According to the TNM classification of UICC, 54% patients belonged to stage IV, followed by 25% of stage III, 14% of stage II and 7% of stage I. CONCLUSIONS:This study found that majority of patients were male, between 40 to 60 years of age and smokers. Male to female ratio was 11:1 Squamous cell carcinoma was the most common followed by tranglottic tumor, while pure glottic involvement was less common as compared to other studies.
Article
Objective: To know the incidence of various Ear, Nose,and Throat diseases in patients attending ENT OPD. Material and Methods: This study was conducted in the Department of ENT & Head & Neck Surgery of Khyber Teaching Hospital, Peshawar Pakistan from April 2011 to May 2012. The data of all the patients was collected and were registered. These patients were divided into 3 major groups according to the involvement of Ear, Nose and laryngopharynx. Results: A total of 32800 patients were seen during the study period and about 2733 patients seen per month. The distribution of system wise diseases were 47% ear diseases, 36% nasal complaints and 17% with laryngopharyngeal problems. Conclusion: It is concluded that the maximum number of patients were of ear diseases followed by Nasal problems while laryngopharyngeal diseases were least found.
Article
A descriptive epidemiological study of fungal rhinosinusitis (FRS) was conducted in rural north India in the form of house-to-house survey of villages of two districts each of Punjab and Haryana provinces using a clinical case definition of chronic rhinosinusitis (CRS). The suspected cases were investigated further in the laboratory to confirm FRS. Air and environment were sampled in different seasons to find Aspergillus spore count. The prevalence of chronic FRS cases was at 0.11% of the population and Aspergillus flavus was the predominant (97.6%) agent of all types of chronic FRS. The chronic FRS patients were classified as allergic FRS 41 (56.1%), chronic granulomatous FRS 13 (17.8%), eosinophilic FRS 11 (15.0%), fungal ball 7 (9.5%) and chronic invasive FRS 1 (1.3%). Aspergillus spores were present in large numbers (~20%) in air with significantly higher counts of A. flavus during winter months in the wheat-thrashing areas of Punjab as compared to Haryana (P = 0.0079). The present study identified high prevalence (27.5% of CRS cases) of chronic FRS cases in rural north India and its possible association with wheat harvesting seasons. © 2015 Blackwell Verlag GmbH.
Article
The compositions and abundances of the microbiota in the ecological niche of the human throat and the possible relationship between the microbiota and laryngeal cancer are poorly understood. To obtain insight into this, we enrolled 27 laryngeal carcinoma patients and 28 subjects with vocal cord polyps as controls. For each subject, we simultaneously collected swab samples from the upper throat near the epiglottis (site I) and tissue samples from the vestibulum laryngis to the subglottic region (site II). The microbiota of the throat were fully characterized by pyrosequencing of barcoded 16S rRNA genes. We found 14 phyla, 20 classes, 38 orders, 85 families, and 218 genera in the throats of enrolled subjects. The main phyla were Firmicutes (54.7%), Fusobacteria (14.8%), Bacteroidetes (12.7%), and Proteobacteria (10.6%). Streptococcus (37.3%), Fusobacterium (11.3%), and Prevotella (10.6%) were identified as the three most predominant genera in the throat. The relative abundances of 23 bacterial genera in site I were significantly different from those in site II (P < 0.05). The relative proportions of 12 genera largely varied between laryngeal cancer patients and control subjects (P < 0.05). Collectively, this study outlined the spatial structure of microbial communities in the human throat. The spatial structure of bacterial communities significantly varied in two anatomical sites of the throat. The bacterial profiles of the throat of laryngeal cancer patients were strongly different from those of control subjects, and several of these microorganisms may be related to laryngeal carcinoma.