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Objective: To determine the frequency of common complications of thyroid surgery by two types of surgeons. Study Design: Comparative cross sectional. Place and Duration of Study: Combined Military Hospital Rawalpindi & Combined Military Hospital Peshawar, from Jan 2013 to Dec 2017. Methodology: This study was conducted to assess the role of surgical skills in complications of thyroid surgery. Surgeons performing surgery for more than 5 years were considered expert and less than 5 years of experience were considered trainee for this specific surgery. Complications by both were analyzed by SPSS-21 and descriptive statistics were applied. Results: A total of 482 surgeries were performed. Out of 407 were female and 75 were males. Mean age was 43.55 ± 10.9 years. Expert surgeons performed 300 cases and 16 (5.3%) experienced some complication in 6 months of follow up.182 cases were performed by surgeons with lesser experience and 14 (7.5%) cases developed complications over the period of follow up. Recurrent laryngeal nerve paralysis occurred in 2 (0.67%) of experienced surgeons cases while 6 cases (3.2%) of less experienced surgeons had the similar complication. Conclusion: While the overall complication rates are not much different between experienced and lesser experienced surgeons, the rate of recurrent laryngeal nerve paralysis is significantly more, though still within the acceptable international complication rate for this particular surgery. [ABSTRACT FROM AUTHOR]

Objective: To investigate the symptoms of COVID-19 disease cases which according to published scientific literature mainly includes upper respiratory track symptoms. Study Design: Case series study. Place and Duration of Study: It was carried out at ENT department, Pakistan Naval Ship Shifa, Karachi, from Mar 2020 to Jun 2020. Methodology: It was from March, 2020 to June, 2020. Patients included in study were above the age of 10 years who were able to give us the details about their symptoms, contact and recent travel history and cooperated for their nasopharyngeal swabs for COVID-19 RT PCR tests. Probability, convenient, sampling technique was used for our study. Frequencies of age, gender, clinical symptoms of patients were analyzed by using descriptive statistics of SPSS. Results: This study included 231 patients with COVID -19 positive nasopharyngeal swabs for RT-PC, out of which 200 were males and 31 were females. Mean age is 38.23 ± 14.77 years. Among the airway symptoms, multiple symptoms like fever, cough, myalgia were seen in 84 cases (36.4%) and cough was found in 22 (9.5%) of patients. Fever with cough was seen in 21 (9.2%) of patients. 58 (25.1%) cases were asymptomatic and were carriers. History of contact was positive in 122 (52.8%) of cases. Conclusion: COVID patients have fever, cough and myalgia as the most common symptoms and such patients should be assessed with care and as per the standard guidelines of institutions. [ABSTRACT FROM AUTHOR]

Objective: To see graft uptake success rate in platelet rich fibrin aided underlay myringoplasties using temporalis fascia graft compared to conventional underlay myringoplasties. Study Design: Double blind randomized controlled trial study. Place and Duration of Study: ENT department, Pakistan Naval Ship Shifa Hospital, from Jan to Jun 2019. Methodology: Sixty cases with dry central tympanic membrane perforations were recruited. The patients suffering from sensori-neural hearing loss and co-morbidities like diabetes were excluded. The sampling technique was probability simple random. Patients were divided into two groups by lottery method. Statistical analysis was performed by using SPSS. The chi square test was applied to calculate p-value. Results: Out of total 60 patients 38 were males and 22 were females. Study group's (Fibrin) mean age was 31.77 ± 12.43 years and Control group's mean age was 27.53 ± 11.41 years. All the patients in platelet rich fibrin group had successful graft uptake at 2 months follow-up. In control group with conventional technique 23 out of 30 patients had successful graft uptake and rest 7 patients had different issues leading to graft rejection. Conclusion: In under lay myringoplasty procedure, application of platelet rich fibrin on temporalis fascia graft edge and perforation edges has significantly improved the successful uptake rate of graft. [ABSTRACT FROM AUTHOR]

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi-square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion: We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. [ABSTRACT FROM AUTHOR]

Objective: To compare the efficacy of Epley manoeuvre and Semont manoeuvre in the management of benign paroxysmal positional vertigo. Study Design: Randomized controlled trials. Place & Duration of Study: ENT Department Combined Military Hospital (CMH) Kharian and Gilgit from March 2005 to February 2010. Material and Methods: Hundred cases of benign paroxysmal positional vertigo (BPPV) were selected on Dix- Hallpike test by non probability convenient sampling technique and randomly divided into two groups of 50 cases each. Patients in group-1 were treated by Epley manoeuvre and patients in group-2 were treated by Semont manoeuvre. The patients were examined on first day, 3rd day, 7th day and after 01 month and clinical results were observed. Results: In group-1, 68% cases showed immediate resolution of symptoms, 74% cases on 3rd day, 80% cases on 7th day and total 82% cases recovered completely after one month. In group-2, 62% cases showed immediate resolution of symptoms, 68% cases on 3rd day, 74% cases on 7th day and total 78% cases showed complete recovery after 1 month. There was insignificant difference between the two groups regarding recovery at different follow ups. Conclusion: It was concluded that Epley and Semont manoeuvres are equally effective in the management of BPPV. [ABSTRACT FROM AUTHOR]

Objective: To look for the complications of tracheostomy and factors correlated with presence of these complications at a tertiary care teaching hospital of Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: ENT department, Operation Theater, Emergency department and Critical Care Unit of Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Apr to Oct 2019. Methodology: Sixty nine patients who underwent tracheostomy were included in the analysis. Final decision regarding offering the procedure of tracheostomy to the patient was made by consultant ENT specialist in liaison with the primary treating physician. Patients were assessed for the complications during the procedure, immediately after the procedure, 48 hours after the procedure and one week after the procedure. Results: Out of sixty nine patients included in the study, 8 (11.6%) patients underwent emergency tracheostomy while 61 (88.4%) underwent elective tracheostomy. Ten (14.5%) had undergone percutaneous procedure while 59 (85.5%) had undergone open surgical procedure. Hemorrhage was the commonest complication reported followed by dislodgement. With Pearson chi-square test, we found that increasing age (45 years) and emergency tracheostomy had strong association with the presence of complications among the patients undergoing tracheostomy. Conclusion: Tracheostomy emerged as a safe procedure with mostly minor self-limiting complications. Surgeon performing this procedure should be aware of these common complications and should give information care to the patients prior to the procedure. Patients who are elderly or undergoing emergency tracheostomy should be dealt with special care while doing this life saving procedure. [ABSTRACT FROM AUTHOR]

Objective: To do a comparison of the possibility of post-operative hemorrhage with and without nasal packing among the patients undergoing septoplasty. Study Design: Comparative study. Place and Duration of Study: Ear, nose, throat (ENT) Department, Pakistan Naval Ship, Shifa Hospital Karachi, from Apr 2019 to Oct 2019. Methodology: Ninety two patients who underwent septoplasty due to deviation of nasal septum at ENT department of Pakistan Naval Ship Shifa were included in the analysis. Random division of patients was done in both the groups. Group one did not undergo nasal packing after the surgery and group two underwent nasal packing after the surgical procedure. Chi-square was used to see the difference in post-operative hemorrhage, headache, discomfort and septal perforation between the two groups. Results: Out of 92 patients, 61 (66.3%) patients were male while 31 (33.7%) were female. Post operative bleeding was found in three (6.5%) patients in group one while 13 (28.2%) patients in group two had bleeding after the procedure. It was found that post-operative bleeding, headache and discomfort was statistically significant in the group 2, who’s patients had nasal packing after the procedure of septoplasty due to deviated nasal septum. Conclusion: Post-operative hemorrhage, headache and discomfort were more common among the patients with nasal packing as compared to those without nasal packing. Nasal packing after septoplasty should be discouraged without any obvious indication in the patients undergoing septoplasty. [ABSTRACT FROM AUTHOR]