Introduction: One of the bulk number of operations carried out at otorhinolaryngology department across globe is Tonsillectomy. With the advent of refined surgical tools along with surgical approaches, the conventional methods are now taken over by these new interventions. The study aims to explore the use and advantages of BiZact LigaSure tonsillectomy as compared to the old conventional method. Material & Methods: A comparative  study was conducted using non-probability purposive sampling technique at Aziz Fatimah Hospital, Faisalabad. 100 participants were divided in two groups. Group A (50 patients) underwent BiZact LigaSure tonsillectomy and Group B (50 patients) with conventional cold steel method. Per-operative variables such as Blood loss and Operative time and Post-operative variable such as Pain was assessed. The data was analyzed in SPSS 20 using independent t- test. Results: The mean age in group A and B was 12, 12 respectively. The blood loss calculated in Group A patients undergoing BiZact LigaSure tonsillectomy was 0.390.15 ml and in Group B 15.92.65 ml. The mean operation time in group A and B was calculated as 4.260.66 and 32.385.56. Both of these variables were recorded as highly significant as the P value = 0.000. Pain was assessed using the VAS pain scale. Post-operative pain variable was also recorded as highly significant variable. Conclusion: The study concludes that BiZact ligaSure tonsillectomy is more effective and safe procedure than the conventional cold steel method. This new intervention significantly reduces the blood loss during surgeries, operative time and post-operative pain.

Objective: To study the presentation, diagnosis, and treatment options in Eagle’s Syndrome in a tertiary care hospital. Material and Methods: The study was conducted at the ENT department of District Headquarter Hospital, Rawalpindi from 1st January 2016 to 31st March 2019.  All the patients who presented in outpatient (OPD) of the ENT department with pain around the ear and throat and diagnosed as a case of Eagle’s syndrome were included in the study. All the data of gender, age, CT scan findings, pain score, and management were noted on a predesigned proforma. Percentages and frequencies were calculated for all the data by using SPSS 21 version. Results: A total of 12 patients were included in the study, with 5 (42%) females and 7 (58%) males. The patient’s age range was from 24 to 68 years. Sharp, sudden onset, nerve-like pain was the major symptom in all cases. The length of the styloid process in 6 patients was between 3-4 cm and in 6 patients between 4-5 cm on a 3-dimensional computerized tomography scan. 100% of patients were managed surgically. In Group A (50%) styloidectomy was done after tonsillectomy while in other Group B (50%) patients styloidectomy was done by tonsil sparing technique. The relief of pain was a little better in patients of Group B. Conclusion: Sudden onset, sharp, shooting pain in the jaw area, around-ear, and in the throat with no other co-morbid should be investigated for Eagle’s syndrome. 3 dimensional CT scan is the best modality to see the length of the styloid process. Styloidectomy with tonsil sparing technique is a little better than tonsillectomy and gives early and permanent relief from this painful condition.

Objectives: Global COVID-19 epidemic has been therapeutic challenge. Convalescent plasma is observed to improve clinical outcomes. This research aims to study whether convalescent plasma therapy reduces the mortality and duration of hospitalization in moderate to severe Covid. Study Design and Setting: This interventional study was conducted after ethical approval at RIUT COVID-19 center from1stJune-30th Nov 2020. Methodology: Hundred Covid patients included; Total 100 hospitalized adult SARS Cov-2 PCR positive with moderate to severe disease who agreed for convalescent plasma transfusion were included. Fifty in plasma transfusion group and fifty in conventional therapy group. Those with contraindications for plasma transfusion, delayed presentation, indoor stay <5 days were excluded. Convalescent plasma was obtained from donors with prior documented SARS CoV-2 infection meeting donor eligibility criteria. 50 cases received convalescent plasma and50 received conventional therapy. Hospital stay and outcome documented. Results: Amongst 100 Covid cases; 44 females and 56 males; mean age 57.88+11.95 years, 74% had moderate covid and 26% severe. Fifty cases received conventional therapy for Covid and 50 received plasma transfusion. Both groups comparable for gender, age, smoking, obesity, and disease severity. Invasive ventilation administered in 25% and was associated with mortality (p=0.004). Mortality observed in 29 cases; 20(69%) in plasma transfusion group Vs. 09(31%) in conventional therapy group (p=0.015). The hospital stay was comparable between two groups The relative risk ratio was 2.22 with 95% CI (1.12-4.39). Conclusions: There was no therapeutic benefit in Covid patients treated with convalescent plasma as compared to conventional treatment

Acute otitis media (AOM) is the commonest disease of childhood. High incidence of AOM might be due to immature Eustachian Tube and immaturity of immune system. Exclusive breast feeding is protective against acute otitis media, however, improper breastfeeding  position can increase AOM occurrence in infants. This study aims to assess the association of improper breastfeeding position with occurrence of Acute otitis media in infants and to assess association of Maternal educational levels with feeding positions. 220 breastfed infants satisfying inclusion criteria with diagnosed AOM were enrolled. Study was conducted over a period of 6 months from August 2019 to January 2020. Demographic details and Detailed history regarding feeding positions and maternal educational levels were obtained through a Self-structured proforma from parents. Data analysis was done through descriptive statistics and chi square test and p value less than 0.5 was set significant. Out of 220 infants, 123(55.90%) were male and 97(44.10%) were females. AOM was more common in male infants than female infants, however it was not statistically significant(p=0.169). The mean age for enrolled infants(1-12months) was 6.90(±3.413). Statistically significant association between increase incidence of AOM and breastfeeding position was found(p=0.032). We also found a statistically significant association between maternal educational levels and breastfeeding position (p= 0.000). In this study, we have noted that Breastfeeding in supine position is associated significantly with increase in incidence of AOM. Feeding positions are statistically associated with Maternal Educational levels.

Objective: The study aims to evaluate the outcomes of transnasal endoscopic surgical repair of CSF rhinorrhoea.Materials and Methods: After approval from the institutional ethical committee (DME-396-18) and patient consent, a descriptive study of 27 patients with cerebrospinal fluid rhinorrhea was conducted at Aziz Fatimah Trust Hospital Faisalabad from August 21, 2018, to February 7, 2021. Transnasal endoscopic surgical repair of Cerebrospinal fluid leak was performed by using multilayer technique using a graft from the inferior turbinate. The data collected were analyzed using SPSS 20.Results: The most common site of the CSF leak was the left side of the cribriform plate (n=19,70%). The most common etiology was spontaneous (n=16,59%). At the same time, traumatic CSF leak (n=16,59%). was the second common etiological factor. The surgical procedure used in the study reported a 93%(n=25) success rate. The success rate was 97.5% on revision surgeries.Conclusion: Transnasal endoscopic surgical repair of CSF leak is one of the most effective and safe surgical interventions. Multilayer technique is not only safe but also has lesser complications. Moreover, this minimizes the risk for the development of secondary wounds as compared to other surgical processes.