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Article
Langerhans’ cell Histiocytosis of Temporal Bone -Case Report-

Author: Nadhim Omran Khadhim*,
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2013 Volume: 6 Issue: 2 Pages: 1689-1693
Publisher: Kerbala University جامعة كربلاء

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Abstract

A 3 year old child presented with a history of progressive abdominal distentionassociated with low grade fever and discharging left ear for the last 6 months. Hewas diagnosed as a case of chronic suppurative otitis media. He was not respondingto the medical treatment. He then developed left post-auricular soft not tender swelling withaural granulation tissue and hepatosplenomegaly. Clinical and histological examinationconfirmed the diagnosis of Langerhans’ cell histiocytosis. His condition responded very wellto steroids and chemotherapy. This case report to highlight this condition as a possible causeof chronic suppurative otitis media and requires imaging and histological examinations fordefinitive diagnosis and appropriate treatment.Key words: Langerhans cell histiocytosis (LCH), temporal bone, chronic suppurative otitismedia, hepatosplenomegaly. Complete Blood Picture (CBP)


Article
Rhinoscleroma in Karbala -- Case Report --

Authors: Ahmed Abdullah Alwan --- Nadhim Omran Khadhim --- Haider Jebur Kehiosh
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2016 Volume: 9 Issue: 2 Pages: 2582-2587
Publisher: Kerbala University جامعة كربلاء

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Abstract

a 14 year old boy presented with a history of progressive nasal obstruction with frequent bleeding episodes, for the last three months. The otolaryngological examination revealed slight dilated and flattened nose with grey red lobulated mass filling only the right side of the nose with no extension to the postnasal space. The mass excised completely and send for histopathology and the result was highly suggestive of chronic granulomatous inflammation of sinonasal cavity. The condition recurs six months later and the patient presented with the same lesion filling both sides of the nose. The patient underwent complete excision of the mass. The pathological report consistent with rhinoscleroma. The patient received ciprofloxacin with good improvement. He has remained asymptomatic up to the last visit six months following treatment and has shown no evidence of recurrence. This case report to raise awareness of this condition among physicians and aid in early diagnosis so as to reduce morbidity.


Article
Outcome of Endoscopic Endonasal Dacryocystorhinostomy in Karbala, Iraq

Authors: Nadhim Omran Khadhim --- Ahmed Abdullah Alwan --- Imad Salih Mehdy
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2017 Volume: 10 Issue: 2 Pages: 2702-2708
Publisher: Kerbala University جامعة كربلاء

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Abstract

background: Dacryocystorhinostomy (DCR) is an operation that has been used for the past 100 years. Endoscopic endonasal DCR is less invasive than external DCR; therefore, it has rapidly gained acceptance for the treatment of intractable nasolacrimal duct obstruction and chronic dacryocystitis. Many ophthalmologists still believe that external DCR is the gold standard treatment for nasolacrimal duct obstruction. However, because incision of the facial skin is required, patients are reluctant to undergo external DCR.Objectives: To analyze the results of Endonasal Endoscopic Dacryocystorhinostomy regarding complications and success rate. Methods: A prospective study was carried out on 26 patients at Department of Otolaryngology, Al-Hussian Teaching Hospital, Karbala during the period September 2013 to November 2016. Patients presented with epiphora and diagnosed with chronic nasolacrimal duct obstruction were included in this study. Endonasal Endoscopic Dacryocystorhinostomy was performed under general anaesthesia. Patients were followed up for at least 6 months after the removal of dacryocystorhinostomy tube. Complications during and after the procedure were recorded. Results: Out of total 26 patients 23 (88%) were females and 3 (12%) were males (F:M=7.7:1). The age range was 6 to 60 years with a mean age of 33 years. The duration of symptoms ranged between 8 months to 6 years. There were only 2 (8%) patients had bilateral symptoms while the other 24 (92%) patients had unilateral symptoms. Average duration of endoscopic DCR was 60 minutes. DCR tube was removed 6 months after operation in 24 (92%) patients and in 2 (8%) patients, it was removed after 3 months. Complications encountered during and after surgery were, haemorrhage in 4 (15%), ecchymosis in 2 (8%), nasal adhesions in 2 (8%), granulations at osteotomy site in 1 (4%), retrograde tube displacement in 2 (8%) patients. Overall, 24 (92%) patients were symptom-free 6 months after the removal of the tube. Out of the remaining 2 (8%) patients, one patient underwent revision surgery and was symptom-free 6 months after the removal of the tube whereas the other refused revision surgery. Overall success rate of endonasal DCR was 25 (96%). Conclusions: Endonasal Endoscopic Dacryocystorhinostomy is an effective procedure with high success rate and minimal complications.


Article
Spindle Cell (Sarcomatoid) Carcinoma of the Larynx -- Case Report --

Authors: Nadhim Omran Khadhim --- Ihsan Hadi --- Ahmed Abdullah Alwan --- Haider Jebur Kehiosh
Journal: Karbala Journal of Medicine مجلة كربلاء الطبية ISSN: 19905483 Year: 2014 Volume: 7 Issue: 1 Pages: 1829-1835
Publisher: Kerbala University جامعة كربلاء

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Abstract

A 56 year old male patient presented with a history of recurrent attacks of progressive hoarseness and stridor for the last 9 months, he underwent six laryngeal surgery and the biopsy results were negative for malignancy except the last pathology report which revealed the diagnosis of spindle cell carcinoma of the larynx confirmed by immunohistochemistry. The patient refuses radiotherapy and went to India where they failed to diagnose the disease. The presented case demonstrates that spindle cell carcinoma or sarcomatoid carcinoma is very rare malignant tumor of the larynx but should be suspected in spindle cell tumours of the larynx and awareness of the pathologist to the unusual immunohistochemical presentation of this tumor with the use of expanded immunohistochemical markers panel.

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