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Objective: To compare the cold steel method and bipolar diathermy in tonsillectomies in terms of posttonsillectomy hemorrhage. Study Design: Randomized Controlled Trial. Setting: Department of ENT, Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad. Period: 29th October 2020 to 1st June 2022. Methods: A total of 102 patients of both genders with ages 3 to 59 years undergoing tonsillectomy were included. Patients undergoing antiplatelet therapy, experiencing bleeding diathesis, possessing a high anesthetic risk, having uncontrolled medical conditions, suffering from anemia, or currently dealing with acute infections were not included in the study. Patients were divided into two groups A & B. Group A patients were operated by the Cold steel method and Group B were operated by Bipolar diathermy. All the surgeries were performed by the same surgical team. Both tonsils were fully exposed by Boyl Devi's mouth gag under general anesthesia. Complete removal of both tonsils was done with the Cold steel method in group A and by using Bipolar diathermy in group B. Post-operative hemorrhage (occurring 24 hours after surgery) without the necessity to return to the operation theatre for intervention was assessed. Results: The mean age of patients in group A was 20.0 ± 13.83 years and in group B was 19.12 ± 13.17 years. The majority of the patients 79 (77.45%) were between 3 to 30 years of age. Out of 102 patients, 63 (61.76%) were males and 39 (38.24%) were females with male to female ratio of 1.6:1. Frequency of secondary hemorrhage in Group A (cold steel method) was found in 01 (1.96%) while in Group B (bipolar diathermy) was 06 (11.76%) (p-value = 0.050). Conclusion: This study concluded that the frequency of post-tonsillectomy hemorrhage is higher in patients operated by bipolar diathermy as compared to the cold steel method. [ABSTRACT FROM AUTHOR]

Objective: To determine the frequencies of different esophageal foreign bodies ingested by children presenting to Ayub Teaching Hospital Abbottabad. Study Design: Cross-sectional study. Setting: Department of Otorhinolaryngology, Ayub Teaching Hospital Abbottabad. Period: 2nd July 2020 to 31st December 2022. Methods: Following the application of inclusion and exclusion criteria, a total of 168 patients, aged between 6 months and 11 years, presenting with suspected esophageal foreign bodies, were included in the study after obtaining written consent. Socio-demographic information, clinical history, and symptoms were carefully recorded. Diagnostic procedures included neck X-rays, extended to the chest, and abdominal X-rays as necessary. Rigid esophagoscopy, performed under general anesthesia, was utilized to confirm and remove foreign bodies. Subsequently, the nature and type of the extracted foreign bodies were identified and documented using a standardized pro forma. Results: The mean age of the patients was 5.63 ± 3.097, ranging from 1 to 11 years. Regarding the gender distribution, 105 (62.5%) were male, and 63 (37.5%) were female. When considering the types of foreign bodies, 129 (76.8%) presented with coins, 12 (7.1%) with metallic objects, 7 (4.2%) with battery cells, and 9 (5.4%) with fruit seeds. Additionally, there were a few cases of chicken bones, fish bones, and safety pins, accounting for 9 (5.4%) in the category of other foreign bodies. Conclusion: This study underscores the frequent occurrence of esophageal foreign body ingestion in young children, particularly males under the age of 5, with coins identified as the predominant culprits. [ABSTRACT FROM AUTHOR]

The present study aimed to develop a validated RP-HPLC method for the simultaneous determination of timolol maleate (TM), moxifloxacin hydrochloride (MOXI), diclofenac sodium (DS) and dexamethasone (DEXA) in human plasma, bovine aqueous humor and pharmaceutical preparations. The chromatographic separation was studied using the C18 column. The chromatographic conditions, such as composition, pH, the flow rate of mobile phase, the temperature of column, wavelength of absorption and injection volume of the sample, were studied. The method was validated to confirm specificity, linearity and accuracy in accordance with an International Conference on Harmonization guidelines. The optimum conditions for separation included mobile phase 0.05 M monobasic phosphate buffer: acetonitrile (65:35 v/v), pH of buffer adjusted to 6.2 and the flow rate of 1 mL/minute. The optimum temperature of the column was found to be 35°C, absorption wavelength 265 nm and injection volume 50 μL. The baseline separation of all four drugs with good sensitivity, resolution, and a less than 15 min run time was achieved. The retention time of TM, MOXI, DS and DEXA were 4.3,5.7,9.9 and 13.5 minutes respectively. The limit of detection (LOD) values were 6.2, 4.8, 0.8 and 1.2 ng/mL for TM, MOXI, DS and DEXA, respectively, whereas their respective limit of quantification (LOQ) values was: were 42.6, 26.8, 5.6 and 6.2 ng/mL. The coefficient of variation for intra-day and inter-day were in the range of 0.32–1.57 and 1.29–3.07%, respectively. The method was found to be sensitive, precise and accurate in human plasma and bovine aqueous humor and can be applied for the quantification of these compounds in plasma, aqueous humor and pharmaceuticals. [ABSTRACT FROM AUTHOR]

Toll-like receptors (TLRs) are innate immune receptors that mediate the inflammatory response during HCV infections. The goal of this study was to evaluate the association of TLR9 gene polymorphism (rs5743836) in Pakistani patients infected with genotype 3a of HCV. Total 500 subjects were recruited, 400 HCV patients and 100 healthy individuals. Genotyping of TLR9 (-1237T/C, rs5743836) was carried out in 400 HCV patients (323 interferon responders and 77 interferon non responder) and control group by applying High resolution melting (HRM) curve assay. No remarkable differences in distribution of genotype between HCV (p<0.0001; OR= 3.21, 95% CI= (2.514.12) and control groups (p<0.0001; OR=0.092, 95%CI= (0.0580.14) were observed. In conclusion TLR9-1237T/C gene polymorphism may not be considered as a molecular risk for patients with HCV in Pakistan. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the clinical and laboratory presentation and outcome of COVID-19 patients admitted to a public sector hospital in Pakistan. Methodology: This is a retrospective, cross sectional chart review of COVID-19 patients admitted to Dr. Ruth K.M Pfau Civil Hospital Karachi Isolation Ward from 28th February till May 28th 2020. Results: Out of 306 admitted patients, 216 (70%) tested SARS CoV-2 positive of whom median age was 45. COVID- 19 was asymptomatic in 35 (16.2%), non-severe in 112 (51.9%), severe in 55 (25.5%) and critical in 14 (6.5%) patients. Severe/critical as compared to asymptomatic/non-severe disease was associated with co-morbidities (37 [53.6%] vs 35 [23.8%], p value <0.001), shortness of breath (50 [72.5%] vs 34 [23.1%], p value <0.001). Median [IQR] values demonstrated lower oxygen saturation (90 [87-92] vs 97 [97-98], p value <0.001) and lower absolute lymphocyte counts (1.3x109/L [0.9-1.82] vs 1.7x109/L [1.1-2.2], p value <0.001) with higher neutrophil to lymphocytic ratio (5.2 [3.3-8.4] vs 2.5 [1.6-3.7], p value <0.001), lactate dehydrogenase level (360U/L [271-566] vs 296U/L [207-377], p value <0.001), C-reactive protein (89mg/L [36-179] vs 19mg/L [0.9-91], p value <0.001) and ferritin level (580mg/L [331-1021] vs 341mg/L [163-679], p value <0.001). Of 216 patients, 2 (0.9%) died in the ward, whereas 13 (6%) were shifted to ICU of whom 12 died. Overall mortality was 14 (6.5%). Conclusion: In COVID-19 patients admitted to a public sector hospital, severe disease was associated with co-morbidities and elevated inflammatory markers. Mortality was very high in those that required ICU care. [ABSTRACT FROM AUTHOR]