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Objective: To determine the frequency of malignancy in patients presented with Parotid swelling. Material and Methods: This study was conducted in Otolaryngology department, Khyber Teaching Hospital, Peshawar, Pakistan from January 2018 to December 2019. One-twenty six Patients of age 18 to 68 years with Parotid swelling were included. Patients with history of Parotid surgery and inflammatory conditions were excluded. Results: Out of 126 patients, males were 76 (60.31%) and females 50 (39.69%). Malignancy in male patients was 20 (15.87%) as compared to females which was 13 (10.32%). Conclusion: Malignancy was found in 10-15% of patients who presented with Parotid swelling which necessitates biopsy in all such patients. [ABSTRACT FROM AUTHOR]

Objective: To review the literature systematically on tonsillectomy by harmonic scalpel with a view of comparing its postoperative hemorrhagic rate with the conventional methods for tonsillectomy. Data Sources: Cochrane Library, Medline, Embase, CINAHL, INAHTA, CRD (Centre for Review and Dissemination, York, UK), and related databases. papers were considered irrespective of language of publication. Review Methods: Inclusion and exclusion criteria were applied independently by two reviewers with a third reviewer available for adjudication. The papers were quality assessed using Chalmers' criteria. Eleven randomized controlled trials (RCT) were included in the final review with 5 RCTs comparing harmonic scalpel tonsillectomy with "cold steel" tonsillectomy and 6 RCTs comparing harmonic scalpel with "hot" tonsillectomy techniques. Results: All studies were underpowered to detect a significant difference in the postoperative hemorrhagic complication between harmonic scalpel and the comparator tonsillectomy techniques. The heterogeneity of studies made quantitative combination of results impossible. Conclusion: The evidence reviewed is of low quality and does not support any significant difference in postoperative hemorrhage rates when harmonic scalpel is compared with other tonsillectomy techniques. As studies have numerous methodological flaws and incorporate biases and confounding factors, these results need to be interpreted with caution. Larger and better-conducted studies would be needed in order to compare the safety of harmonic against conventional tonsillectomy methods. The need for a large sample size might make an RCT impractical; therefore a large, well-controlled cohort study could be more suitable. [ABSTRACT FROM AUTHOR]

Objective: To find out presenting complaints of mucormycosis in the nose and paranasal sinuses and its treatment Material and Methods: This case series was conducted in the Department of ENT, Khyber Teaching Hospital, Peshawar, and Abaseen Medical Centre Peshawar, Pakistan, from May 2020 to March 2021. A total of 12 patients were included. Among them, 08 patients were admitted in Khyber Teaching Hospital, and 04 patients were treated at Abaseen Hospital, Peshawar. In addition, literature was reviewed, and results compiled. Results: Among 12 cases, 3 (25%) were females, and 9 (75%) were males. The age range was 55 to 80 years. All patients were diabetic Type 2. At the time of presentation, 35% of patients presented with uncontrolled diabetes mellitus in whom immediate medical opinion was sought. Before doing surgery, their blood glucose levels was within normal limits. In 83.3 % of cases, there was complete nasal obstruction, while in 17%, there was partial nasal obstruction. There were right maxillary sinusitis in 8 (66.6%) cases, and in 4 (33.33%) patients, there was left maxillary sinusitis. In 2 Patients, all of the paranasal sinuses were involved except frontal sinuses. Nearly all the patients had severe headache as well. Conclusion: Mucormycosis was commonly seen in elderly diabetic patients, mostly involving the nose and paranasal sinuses. [ABSTRACT FROM AUTHOR]

Objectives: To compare the operative time and postoperative outcomes in thyroid surgeries using ultrasonic cutting with conventional diathermy dissection. Material and Methods: This prospective study was conducted in Abaseen Hospital, Peshawar, Pakistan from April 2018 to December 2018. Ethical approval was taken from the hospital administration. After taking informed consents from the patients, these were divided into two groups by lottery system. The patients operated with Ultrasonic Cutting device (UCD) were labelled as Group A and Conventional Diathermy dissection (CDD) as Group B. The operative time and outcome of thyroid surgeries were assessed and compared between the two groups. Results: Total of 4 males and 15 females underwent thyroid surgeries during the study period with age ranging from 25 to 70 years, the operative time in Ultrasonic Cutting device (UCD)was less than Conventional Diathermy dissection (CDD) group (100.15 minutes vs 150 minutes p=0.06).The cumulative mean amount of drain was found to be less in UCD group, the difference was statistically significant (80.5 ml vs 133.05 ml p=0.00018).The drain was removed earlier in UCD group, this comparison was also statistically significant (2.5 days in UCD group vs 3.02 days in CDD group, p=0.00007).The mean pain score was fond to be statistically significant on all the postoperative days in UCD group. Conclusion: Less operative time, reduce postoperative pain and minimal complications were recorded in patients who undergone thyroid surgery by Ultrasonic Cutting Scalpel than Conventional method. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the presentation and types of foreign bodies in tracheobronchial tree and difficulties encountered in their removal at a Tertiary Care Hospital. Material and methods: This retrospective, descriptive study was carried out at the department of ENT and Head & Neck surgery Khyber Teaching Hospital Peshawar-Pakistan from July 2015 to June 2017. A total of 142 confirmed or suspected cases of foreign body tracheobronchial tree were included in the study from OPD, accident & emergency department (A&E) and referred from pediatric department. Detailed history and clinical examination was performed, X-Ray chest and base line investigation were done in all cases. Rigid bronchoscopy was done under general anesthesia in all cases, and different types of foreign bodies were removed. Difficulties encountered during bronchoscopy were bleeding, slip of foreign body and difficult to remove foreign body. Results: Out of 142 cases 94 (66.2%) were males and 48 (33.8%) were female in the age range of 01 year to 10 years. The duration between inhalation and hospital arrival was 12 hours to 2 weeks. In 90 (63.3%) cases vegetative foreign bodies were retrieved followed by plastic 30 (21.12%) and metallic 20 (14%). In 4 cases removal was difficult due to bleeding and oedema and were refered to thoracic department after tracheotomy. Conclusion: Early diagnosis and proper management along with awareness regarding pediatric home care is stressed upon to reduce morbidity and mortality. [ABSTRACT FROM AUTHOR]

Objective: To determine the clinical outcome of Rigid Bronchoscopy in patients with Tracheobronchial Foreign Body inhalation. Material and Methods: This study was conducted in Otolaryngology department, Khyber teaching hospital, Peshawar of one year duration from January 2018 to December 2019. Total 90 Patients of age 4 months to 14 years on clinical suspicion of foreign body bronchus were included, while patients with history of bronchial asthma, pulmonary tuberculosis and radio opaque foreign body bronchus were excluded. Results: Among 90 patients 60 (66.66 %) were males and 30 (33.33 %), were female patients. Confirmed foreign body bronchus was found in 80 (88.89%), in which male were 53 and female patients were 27. Foreign body was found more common in 35 (39%) of cases in less than 3 years of age. Conclusion: Rigid bronchoscopy is gold standard in treating foreign body Tracheobronchial tree. [ABSTRACT FROM AUTHOR]

Objective: To know the outcome of tonsillectomy by Harmonic scalpel in terms of bleeding and pain. Material and Methods: This was a case controlled study, conducted in the department of otorhinolaryngology and head and neck surgery, Khyber Teaching Hospital-Peshawar-Pakistan. The study period was from June 2017 to June 2018, A total of 40 patients were enrolled in the study. Patients of both sexes with age range of 5 to 40 years presented with chronic tonsillitis were included while those patients who presented with sinusitis and tonsillitis, pharyngitis with tonsillitis, with deviated nasal septum and tonsillitis were excluded from the study. Results: A total of forty patients were enrolled in the study, the youngest age was 5 years and the oldest was 40 years. Twenty five (62.5%) were male and 15(37,5%) were female patients. In all the patients main indication for the operation was chronic tonsillitis. One patient had huge tonsil of the right side in oldest age group and a suspicion of malignancy arosed for which both of the tonsils of this patient was subjected to histopathology to rule out the malignancy, but the biopsy report suggested chronic tonsillitis. The time taken for the operation was from 4-10 minutes, In the 30 cases the time taken was from 4-8 minutes and in the rest it was upto 10 minutes. Conclusion. Harmonic Scalpel used in tonsillectomy caused no or minimal bleeding per operatively, so it is a safe procedure although is costly. [ABSTRACT FROM AUTHOR]