To evaluate the hearing status of COVID-19 patients and compare with control group. Prospective study carried out in 9 institutes. The pure tone audiogram and impedance audiometry of COVID-19 patients performed initially and at 3 months follow up. The control group consisted COVID-19 negative individuals with no history of ear related diseases. The average of air and bone conduction threshold (AC and BC) were compared between the COVID-19 patients and control group using independent t-test with a p value of less than 0.05 considered significant. Total of 331 patients, age 32 ± 4.3 years, 66.7% males and 33.3% females were included in the study. There were 80 individuals in the control group. Aural symptoms were, tinnitus in 1.8%, aural fullness in 1.4%, hearing loss in 3. 9%, and ear ache in 1.8% were present initially, resolved at 3 months follow up. The impedance audiometry demonstrated type B and type C curve in 5.1% and 1.15% ears, and out of these 64.7% and 40% improved at 3 months follow up respectively. No significant difference observed between the average AC and BC of the COVID-19 patients and control group. The COVID-19 infection may present with aural symptoms; however, it was concluded that there was no significant difference in the hearing status of the COVID-19 positive patients in comparison to the control group. The presence of some changes in the normal functioning of the eustachian tube and middle ear in the COVID-19 infection was also highlighted.

Background Tuberculosis (TB) of the middle ear cleft (MEC) is a rare extra-pulmonary manifestation. Signs and symptoms of tuberculous otitis media are indistinguishable from that of non-tuberculous otitis media making early diagnosis difficult. Objectives To study the clinical presentations, complications and effective diagnostic modalities in tuberculosis of middle ear cleft. Methods We retrospectively studied 10 patients diagnosed with chronic otitis media, unresponsive to 2 months conventional treatment. Pure tone audiogram, High resolution computed tomography (HRCT) of temporal bone, and AFB staining of ear discharge were done. All patients underwent mastoid surgery. AFB staining and histopathological examination of granulation tissue removed from the middle ear and mastoid were also done. Results Clinical findings were mastoid swelling, facial palsy and post-aural fistula 3,4 & 2 patients respectively. All patients had persistent ear discharge and three had vertigo. Hearing loss was of moderate conductive type in five, sensorineural type in three and mixed type in two. HRCT of temporal bone revealed soft tissue density in MEC in 9 and evidence of bone destruction in 6 cases. Diagnosis of TB was confirmed either by (a) demonstration of AFB in ear discharge (4 patients)/tissue removed during surgery (4 patients) or (b) by demonstration of tuberculous granulomas with necrosis on histopathological examination of tissue from MEC (8 patients). Conclusion Tuberculosis should be suspected in all cases of chronic otitis media unresponsive to conventional treatment particularly in endemic areas. Histopathological examination and AFB staining of tissue removed during mastoid surgery are reliable diagnostic methods.

To study the incidence of the smell and taste disturbance in the COVID-19 patients and a follow up at 4 months to observe for the duration of resolution of these symptoms. This is a multicentric prospective study carried out in 3 different countries, from April, 2020 to January, 2021. The COVID-19 positive patients, aged between 15 and 60 years, were inquired about the presence of any smell or taste related symptoms. The same patients were followed up with the telephonic interview after 2 months and then after 4 months, respectively. The duration of resolution of the smell and taste disturbance symptoms was noted. Total of 188 COVID-19 positive patients, average age 33.1 ± 1.7 years, 54.2% males and 45.8% female were included in the study. The smell disturbance was present in 60.6% (hyposmia 36.1%, anosmia 20.2%, and parosmia 4.2%) and taste disturbance in 28.7% of patients (hypogeusia 20.2%, ageusia 6.9%, and parageusia 1.6%). There was improvement of anosmia by 97.4, hyposmia by 95.6%, parosmia by 100%, ageusia by 100%, hypogeusia 94.8%, and parageusia by 66.7%, at 4 months follow up. The present study concludes that the smell and taste disturbances are one of the main early presenting features of the COVID-19 infection. The temporary effect of the COVID-19 infection on the olfactory and gustatory pathway was also highlighted with more than 95% patients improving at 4 months of follow up.

INTRODUCTIONRapid advancement in the medical technology has lead surgeons to use newer surgical instruments. Given the significant vascularity of the thyroid gland and the relatively small operative field, meticulous hemostasis has and will always be an important prerequisite for a successful outcome in thyroid surgery.1 Hemostasis in thyroid surgery is achieved by means of the conventional clamp-and-tie technique, diathermy, hemostatic clips, and recently, the UCCD.2-4 The ultrasonic technology was introduced in early 1990s and has four main functions of cutting the tissues, cavitation, co-aptation and coagulation of tissues. 5 Since the adoption of the UCCD into modern surgical practice, its utility for a wide variety of operations has been well documented.An ultrasonic based device when activated using ultrasound waves of a high-frequency (55 kHz) that can cut vessels of diameters up to 5 mm. 6 The active blade vibrates in longitudinal way against an inactive blade resulting in cutting and coagulation. The temperature ABSTRACT Background: The objective of this study was to compare the operative time and postoperative outcomes in thyroid surgeries using the ultrasonic cutting and coagulation device with conventional diathermy dissection. Methods: This study was a prospective, interventional, cohort study. The patients were randomized in two groups by lottery system. The patients operated with ultrasonic device were labeled as Group A: UCCD and by conventional diathermy as Group B: CDD. The operative time, postoperative drain volume, pain score on VAS and complications were assessed and compared in between the two techniques of surgery. Results: Total of 18 males and 58 females underwent thyroid surgery with age ranging from 17 to 75 years. The operative time in UCCD group was less than CDD group (93.29 min vs. 106.59 min; p=0.06). The cumulative mean amount of drain was found to be less in UCCD group, this difference was statistically significant (77.86 ml vs. 138.05 ml; p=0.00018). The drain was removed earlier in UCCD group, this comparison was also statistically significant (2.49 days in UCCD group vs. 3.02 days in CDD group; p=0.000009). The mean pain score was found to be statistically significant on all the postoperative days in UCCD group. Conclusions: The patients experienced less pain and complication while using UCCD as technique for surgery. Hence, ultrasonic device using both cutting and coagulating mode at the same time is efficient in hemostasis and lesser post-operative pain, and found to be advantageous.

INTRODUCTIONChewing tobacco (CT) use is very common in India. Over 90% of the global smokeless tobacco use burden is in South-East Asia and about 100 million people in India and Pakistan use smokeless tobacco. 1,2 CT in traditional form is consumed as betel quid mixture of areca nut, slaked lime, and flavoring agent wrapped in betel leaf and tobacco commercial preparations (TCPs) such as gutka, zarda, khaini, mishri, etc., contain the pieces of areca nut coated with powdered tobacco, sweetening and flavoring ingredients in addition to other spices such as saffron, cardamom, etc. which are very popular and highly addictive. These TCP are very popular among adults and children as well. [3][4][5][6] Though the government has taken a stand on banning this CT products sale, substitutes such as supari mix packets which contain a mixture of areca nut, lime, spices, and condiments are sold along with a free packet of CT, in the form of zarda or khaini. Since these products are not ABSTRACT Background: Around 34.6% of Indian population consumes tobacco. The tobacco consumption is higher in some vulnerable population such as drivers, daily wage laborers, and policemen. Tobacco consumption is known to cause oral cancers, and screening for oral cancer in these individuals is known to reduce mortality from cancer. The study was designed to assess the determinants of tobacco use and the prevalence of oral precancerous lesions in autorickshaw drivers. Methods: This is a cross-sectional study among auto-rickshaw drivers at Bareilly (UP). A total of 450 auto-rickshaw drivers were enrolled in the study, of which 225 auto-rickshaw drivers were interviewed during morning hours and remaining half at night time using a semi-structured questionnaire. All were screened for oral cancer/precancerous lesions. Results: Nearly 64.44% of auto-rickshaw drivers were consuming tobacco in any form. Long working hours, working at night, and family members consuming tobacco were significant risk factors for tobacco use among auto-rickshaw drivers. 56 (19.31%) auto-rickshaw drivers were detected to have oral precancerous lesions. Conclusions: It was very evident that long hours of driving and infrequent shifts played a greater role in acquiring the habit. Behavioral counselling and new laws need to be formed to limit the working hours in drivers to have an effective tobacco control.

Pretrained language models have shown success in various areas of natural language processing, including reading comprehension tasks. However, when applying machine learning methods to new domains, labeled data may not always be available. To address this, we use supervised pretraining on source-domain data to reduce sample complexity on domainspecific downstream tasks. We evaluate zeroshot performance on domain-specific reading comprehension tasks by combining task transfer with domain adaptation to fine-tune a pretrained model with no labelled data from the target task. Our approach outperforms Domain-Adaptive Pretraining on downstream domain-specific reading comprehension tasks in 3 out of 4 domains.

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Introduction: Surgeons must maintain detailed and accurate operative notes as it is important not only for safe patient care but also for research, audit and medicolegal purposes. But literature has shown that many operative notes are incomplete and illegible. Audit and feedback is a useful strategy to improve such practices which our department has been following. Our aim is to study its effectiveness by comparing the quality of operative notes of 2016 with that of 2014. Methods: Total 96 operative notes, 48 each of the year 2014 and 2016 were studied under 22 parameters including 18 suggested by “Good Surgical Practice” guideline. Each operative notes was analyzed by a single observer for completeness. Parameters of the operative notes of two different years were compared and given the status of either improved, deteriorated or unchanged. Results: Only parameters related to patient identification, date, surgeon’s fullname, postoperative plan were complete in both the years. In comparison to earlier year, in 2016 improvement was seen in parameters such as postoperative diagnosis, details of tissue removed, authors details, closure details, operation time and operative difficulties/ complications and deterioration was seen in hospital number, preoperative diagnosis, procedure, fullname of anesthetist, fullname of scrub nurse, operative findings and signature of the surgeon. Conclusion: Improvement in the quality of the operative notes was not adequate with audit and feedback strategy alone. Hence to increase the effectiveness, other methods such as computerized operative notes and aide-memoire should also be introduced.