Speech recognition has become one of the most significant parts of human-computer interaction due to emergence of new technologies such as smartphone, smart watch and many modern technologies, therefore the need of an ASR for local languages is felt. The basic aim of this paper is to develop an isolated digits recognition for Pashto language, using deep CNN. The database of Pashto digits from 0 to 9 with 50 utterance for each digits is used. Twenty MFCC features extracted for each isolated digit and fed as input to CNN. The network has been used for the proposed system is deep up to 4 convolutional layers, followed by ReLU and max-pooling layers. The network has been trained on the 50% of data and the rest of the data was used for testing. The total average of 84.17% accuracy was achieved for testing which show 7.32% better performance as compared to existing similar works.

Background: COVID-19 has had a wide impact on the mental health of college students. This study aims to explore the relationship between time perception, risk perception, and the mental health of college students during COVID-19 through a questionnaire survey.Subjects: One thousand two hundred and eighteen college students, 449 male and 769 female, who studied online during the COVID-19 epidemic were selected.Methods: Time Perception Scale, Risk Perception Scale, and SCL-90 were used to investigate the relationship using correlation analysis.Results: During the COVID-19 period, mental health problems of college students were widespread, and 65.93% of college students reported moderate to severe mental health problems. The correlation analysis showed that risk perception, time perception, and the mental health of college students were significantly related. Risk perception played a partial mediating role between present enjoyment and mental health, and risk perception played a partial mediating role between future time perception and mental health.Conclusion: In the case of sudden public crises, we should pay close attention to the mental health of college students, adjust their attitude toward the present and the future, and pay attention to their perception of risk so as to improve their mental health level under crisis.

Infantile fibrosarcoma is very rare tumor and seldom occurs in oral cavity. Overall good prognosis is reported in more than 80% cases. We present a 5-month old female patient with swelling of the tongue for four months. This was excised completely. Histopathology and immunohistochemistry revealed it as infantile fibrosarcoma of grade II.

Aim: To determine the improvement of hearing after grommet insertion in patients with secretory otitis media. Study Design:A Quasi-Experimental study. Place and Duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of two years from February 2019 to February 2021. Methods: The study was performed on 48 ears with secretory otitis media. Before the operation,evaluation of both ears along with tympanmontometry and Pure Tone Audiometry were performed. Documentation ofhearing loss was done pre-operatively. During the operation accomplished under GA, a grommetwas placed in the anterior inferior quadrant of the tympanic membrane. After the surgery, PTA was repeated in the postoperative period before the patient was discharged from the hospital. Results:Our study included 28 patients with secretory otitis media and a total of 48 ears. Of the ears, 27 (56.25%) were male and 21 (43.75%) were female. Both ears were affected in 21 patients. Two patients had unilateral ear involvement. The right ear was affected in 26 cases (51.1%) and the left ear in 22 cases (48.9%). 7-55 years was the age range of the patients and 14.10 ± 9.11 years was the mean age. The degree of preoperative hearing loss was mild (20-40 dB) in 5 (10.41%) ears, moderate (40-60 dB) in 37 (77.1%) ears and severe (60-80 dB) in 6 (12.5%) ears. The degree of postoperative hearing loss was mild (20-40 dB) in 36 ears (75%), moderate (40-60 dB) in 11 ears (22.9%) and severe (60-80 dB) in one ear (2.1%). Hearing improvement was not seen in 8 (16.6%) ears, an improvement of 5-10 dB in 34 (70.8%) ears, and an improvement of 10-20 dB in 6 (12.5%) ears. There was a statistically significant difference between preoperative and postoperative hearing loss in the ears, the hearing loss was significantly less after grommet insertion; p = 0.017. Conclusion:The insertion of Grommet provides a significant improvement in hearing in patients with secretory otitis media. Keywords:Pure tone audiometry, Tympanometry, Middle ear, Secretory otitis Media and Grommets.

Objectives: This study aimed to evaluate the quality of life (QoL) of substance use disorder (SUD) patients in Khyber Pakhtunkhwa, Pakistan. Design: A cross-sectional study Setting and Participants: 500 substance use disorder patients were selected from the seven drugs rehabilitation centers of Khyber Pakhtunkhwa, Pakistan. Methods: This study was carried in seven drugs rehabilitation centers of Khyber Pakhtunkhwa, Pakistan between August 08, 2019, and December 2020. A cross-sectional study design was used to assess the QoL among 500 substance use disorder adult patients who were taking initial rehabilitation treatment via a convenient sampling technique. The WHOQOL-BREF Field Trial Version was used to measure the QoL. Results: This study found that more than 75% (very poor: 27.8%, poor: 49.8%) substance use disorder patients had a poor perception of the QoL, 81% (very dissatisfied: 33.8%, dissatisfied: 47.2%) patients were dissatisfied with the overall perception of the health. The four domains of QoL of SUDs patients were also disturbed. Conclusion: The current finding of this study illustrated that people with SUDs need more attention for their QoL and well-being. Keywords: Substance Use Disorder, quality of life, perception of the health, well-being

Objective: The aim of this study is to determine the effectiveness of intranasal splints in preventing nasal adhesion. Study Design: Descriptive case series Place and Duration: The study was conducted at ENT department of Lady Reading Hospital Peshawar and Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore for the duration of six months April 2021 to September 2021. Methods: There were 120 participants of both sexes in this research. In this study, the patients ranged in age from 16 to 50 years old. Patient demographics, such as gender, age, and height/weight were logged with their informed written consent. During general anesthesia, a patient with a deviated nasal septum and septoplasty was selected for the procedure. Immediately following the septoplasty treatment, the patient had intra-nasal splints and nasal packing placed. The nasal packing was removed on the second postoperative day, while the nasal splints were removed on the 15th day after surgery. After a three-week follow-up, frequency of nasal adhesion was calculated. Data were analyzed 24.0. Results: Among 120 cases, 75 patients, 59.2% were between the ages of 26 and 40.The mean age of the patients was 26.34±7.51 years with mean BMI 23.07±9.44 kg/m2. Most of the cases were 67 (55.8%) male and 53 (44.2%) were females. Nasal obstruction was found among 53 (44.2%) patients, frequency of rhinorrhea was 33 (27.5%) and mixed symptoms were found in 20 (16.7%). At final follow up prevalence of nasal adhesion was found in 9 (7.5%). Conclusion: According to the findings of this study, intranasal splints were an efficient and safe treatment for preventing nasal adhesion after septoplasty. Keywords: Septoplasty, Intra nasal adhesions, Deviated nasal septum, Intra nasal splints

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Objective: To understand the frequency, causes, and treatment of post-tracheostomy hemorrhage. Study Design: A prospective study of tracheostomy cases. Place and duration: ENT, Head & Neck Surgery department of Lady Reading Hospital MTI, Peshawar and Azra Nahid Medical College, Lahore for duration of one year from July 2019 to June 2020. Methodology: All hospitalized patients who underwent tracheostomy and had bleeding during this period were included. The parameters specified were demographics, time since surgery, degree of bleeding, causes of bleeding, and treatment. A total of 208 patients who have done with tracheostomy were selected. Results: Tracheostomy was performed in a total of 208 patients, 142 men and 66 women. Their ages ranged from 20 to 70 years old. 22 patients (10.6%) had postoperative bleeding, most of them have oozingfrom or around the stoma, but 5 patients were taken to the operating room for hemostasis. Three of them had Tracheo- innominate artery fistula and two died before undergoing surgery. One of the three trachea-innominatefistulae were successfully treated by a cardiac surgeon. The remaining cases required diathermy, transfixing thyroid isthmus or vein descent or relegation of veins. Conclusions: Hemorrhage after tracheostomy is not uncommon in intensive practice, bleeding occurred in 10.5% of our cases. Hemorrhage occurs because of inadequate hemostasis, aspiration trauma, infection, coagulopathy and granulation. Rarely, there may be massive and life-threatening bleeding from tracheo-innominate fistula that requires aggressive and urgent exploration. In such a situation, an experienced cardiac surgeon and anesthesiologist is very important and can lead to a better result. Key words: Tracheostomy, post-tracheostomy hemorrhage, Tracheo-innominate artery fistula (TIF)