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Objective: To investigate the viability of utilizing preoperative serum vitamin D levels as a predictor of postoperative transient hypocalcemia in patients who were undergoing total thyroidectomy in our population. Study Design: Prospective Observational study. Setting: Shifa International Hospital Islamabad, Pakistan. Period: 1st July 2020 to 30th June 2022. Material & Methods: All the data was collected prospectively. Patients are divided into two groups depending on the pre- operative vitamin D levels. The preoperative vitamin D levels are checked on the day of admission before the surgery. After the surgery, their post-operative serum calcium levels are checked at 6 hours, 24 hours and 48 hours. Intact PTH levels are also checked after the surgery and correlation of transient hypocalcemia with intact PTH levels is also checked. Results: Our results strongly predict that serum Vitamin D levels and intact parathyroid hormone (PTH) levels are diagnostic indicators of transient hypocalcemia in post thyroidectomy patients. Conclusion: Our study shows: Pre-operative vitamin D is an early indicator of hypocalcemia in post-thyroidectomy patients. Serum intact parathyroid hormone levels is an early indicator of hypocalcemia in post-thyroidectomy patients. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effect of tracheostomy on COVID positive patients and the risk included in the procedure for the patient and health care workers. Study Design: Retrospective Observational Study. Setting: Shifa International Hospital Islamabad, Pakistan. Period: 30th May 2020 to 15th February 2022. Material & Methods: The tracheostomies were performed in COVID ICU at bed side by ENT team. This is a study of 22 patients mostly with multiple comorbidities who presented to the hospital with symptoms of SARS-COVID-19. The changes in their ventilation were recorded before and after the tracheostomy. The health care workers included in the study were also kept under observation for any possible cross infection. Results: Eight out of twenty two patients were weaned off from ventilator. There was decrease in partial pressure of oxygen after the procedure but the mortality rate was high. None of the members of operating team, ICU team, anaesthesia team was infected with the virus. Conclusion: Our study shows that although tracheostomy helps in weaning off from ventilator, it has no role in weaning off COVID patients. There is no benefit of tracheostomy for a COVID positive patients. Furthermore, if adequate personal protective equipment's are used, there is no risk of spread of infection from patient during the procedure of tracheostomy. [ABSTRACT FROM AUTHOR]

This case report aims to present an unusual case of a plunging ranula that extended to the superior vertebral body of the T4 vertebrae, we will be elaborating on the patient presentation, investigations, diagnosis, and treatment of the lesion, while also talking about the adversities faced while diagnosing and treating the patient. The rarity of this condition and an atypical presentation makes this a difficult case to diagnose and vigilant treatment is needed to prevent any complications associated with the condition and ensure a successful treatment and recovery. [ABSTRACT FROM AUTHOR]

Objectives: To compare double-density sign on non-contrast computed tomography scan of paranasal sinuses with fungal sinusitis on histopathology., Methods: This prospective study was conducted at the Shifa International Hospital, Islamabad, Pakistan, from July 1, 2021, to June 30, 2023, and comprised patients of either gender aged 20-60 years who were set to undergo functional endoscopic sinus surgery. Demographic characteristics and non-contrast computed tomography scan findings were recorded preoperatively, while microbiological and histopathology results were recorded post-operatively. The microbiological finding was taken as the gold standard. Data was analysed using SPSS 23., Results: Of the 201 patients, 123(61.2%) were males and 78(38.8%) were females. The overall mean age was 41.62±8.52 years. The diagnostic accuracy of a double-density sign on computed tomography scan showed sensitivity 90%, specificity 90.8%, positive predictive value 84%, and negative predictive value 94.4%., Conclusions: A higher rate of sensitivity and specificity indicated that non-contrast computed tomography scan was an effective modality that could be used for the diagnosis of fungal sinusitis.

Giant cell tumour is a growth predominantly found in long bones of the body. Giant cell tumour has a rare occurrence in the head and neck. A case of a 31 year old male with no known comorbidities at the ENT Department, Shifa International Hospital, Islamabad presented with anterior neck swelling and hoarseness of voice. Patient was diagnosed as having Giant Cell Tumour of Larynx (GTCL) proven on FNA cytology and post-operative biopsy. GCTL is an uncommon entity with only 45 reported cases in the world.