Allergic fungal rhinosinusitis is a disease of young, immunocompetent individual. Skull base and orbital erosion are seen in one-third of cases. Bone erosion is 6.8 times more common in males than females. Orbital erosion is 1.5 times more common than skull base erosion. Endoscopic surgical debridement and drainage combined with topical steroids leads to resolution of disease in the majority of cases, without resorting to systemic antifungal agents, craniotomy or dural resection.

OBJECTIVES: To determine the frequency of underlying fungus in nose and paranasal sinuses in patients present with nasal polyposis. METHODOLOGY: A total of 324 patients presented with nasal polyps were included in this study. Data collected from all the patients admitted in ENT department with diagnosis of nasal polyposis. All the relevant information about their presenting symptoms was recorded in a proforma. Post operatively the removed material was sent for histopathology and fungal culture. Later the findings of biopsy and culture reports were also recorded and analysed. RESULTS: Out of 324 patients 159 were males and 165 were females. Underlying fungus was present in 226(69.75%) and out of them, 102(45.13%) were males and 124(54.86%) were females with a P value of 0.039. The mean age was 25.95 ± 9.32 (15-45) years for the patient with fungus. Aspergillus was the commonest organism found. CONCLUSION: Underlying fungus was found in a significantly high number of patients presented with nasal polyps and Aspergillus was the commonest organism found.

Objectives: (1) Recognize the frequency of level V neck node involvement in T3-T4 oral squamous cell carcinoma. (2) Analyze the need of level V neck dissection with N0 - N1 neck in T3-T4 oral squamous cell carcinoma (SCC). Methods: Noninterventional, descriptive study from January 2011 to August 2012 at Dow University of Health Sciences & Civil Hospital Karachi, Pakistan, a tertiary care teaching hospital. Sampling was nonprobability and purposive. Histopathologically proven cases of squamous cell carcinoma of oral cavity with T3-T4 lesion and N0-N1 neck on basis of clinical examination and computed tomography scan findings were included in this study. All patients underwent modified radical neck dissection type-I along with excision of the primary growth. Results: Forty-nine patients fulfilling selection criteria were assessed on the basis of histopathological reports. At level I, metastatic lymph nodes were positive in 12 patients; 4 had positive nodes at level II and 2 each at level III and IV. However, none were positive at level V. Primary lesion was involving cheek in 40 and tongue in 9 cases. Histopathology revealed moderately differentiated SCC in 33 and well-differentiated SSC in 16 patients. Conclusions: Our study suggests that level V neck dissection is not needed in oral SCC with N0-N1 neck even in T3-T4 lesions. However, as the sample size is small, further study with a larger number of cases is required to establish future guidelines for the extent of neck node clearance in oral cancer.