Objectives: This study aims to investigate the frequency and management of complications of chronic suppurative otitis media (CSOM). Patients and Methods:Out of 376 patients with CSOM, 44 patients (25 males, 19 females; mean age 48.5±3.5 years; range 21 to 76 years) meeting study criteria were enrolled in this descriptive cross sectional study which was conducted at the Department of Ear Nose and Throat, Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar. All newly diagnosed patients having CSOM with complications were enrolled. The complications were treated first. Intracranial abscesses were evacuated by neurosurgeons. Radical and modified radical mastoidectomy were performed. Results:Majority of the patients presented in the second and third decade of life (21-30 years: 27.27%, 31-40 years: 18.18%). Most of the patients (59.1%) had lower socioeconomic status. Canal wall down mastoidectomy was the most common (79.5%) procedure performed. Cholesteatoma was the most common operative finding (100%). Among extracranial complications, subperiosteal abscess was the most common finding (38.63%), while extradural abscess outnumbered (22.72%) in intracranial complications. Conclusion Bulgular:Hastaların çoğu yaşamlarının ikinci ve üçüncü on yılında başvurdu (21-30 yaş: %27.27, 31-40 yaş: %18.18). Hastaların çoğunun sosyoekonomik durumu düşüktü (%59.1). Açık mastoidektomi en yaygın uygulanan işlemdi (%79.5). Kolesteatom en yaygın ameliyat bulgusuydu (%100). Ekstrakraniyal komplikasyonlar içinde subperiostal apse en yaygın bulgu iken (%38.63) intrakraniyal komplikasyonlarda ekstradural apse daha çoktu (%22.72).Sonuç: Kronik süpüratif otitis media komplikasyonları yaygın olarak düşük sosyoekonomik durumu olan daha genç insanları etkiler. Beyin cerrahlarıyla işbirliği yapılması bu enfeksiyonun başarıyla yönetilmesinde yardımcı olabilir.Anahtar Sözcükler: Ekstrakraniyal komplikasyonlar; intrakraniyal komplikasyonlar; süpüratif otitis media.

The objective of this study was to determine the management of rigid esophagoscopy for extraction of foreign bodies (FBs) upper digestive tract in a tertiary care hospital. This descriptive study was conducted at the Department of ENT, Head and Neck Surgery, Postgraduate Medical Institute, Lady Reading Hospital Peshawar from January 2008 to December 2010. This study included 380 patients. After taking detailed history, thorough examination and investigations, a well informed consent was obtained. Rigid esophagoscopy was performed under general anesthesia. The data was analyzed using the statistical program for social sciences (SPSS version 17). Our study with total duration of 3 years included 380 cases constituting 227 male and 153 female, with male:female ratio of 1.48:1. The age of the patients ranged from 1 to 80 years with mean age of 39.39 ± SD 6.81 years. The clinical features of these patients were mainly dysphagia for solids (72.89%) followed by throat pain (18.15%). Site of impaction of FBs was that in 303 cases (79.73%) cricopharynx, in 61 cases (16.05%) mid-esophagus and in 16 cases (4.21%) pyriform fossa was involved. Rigid esophagoscopy was performed in all cases and a variety of FB was extracted from upper digestive tract. The commonest FB was coin 58.42% followed by meat bolus 17.10%. It is concluded from this study that the commonest FB upper digestive tract in children is coin while in adults is meat bolus in this part of the world. Rigid esophagoscopy is still the technique of choice for its extraction and its complication can be minimized if performed by expert hands.

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Objective:To determine incidence and characteristics of traumatic Tympanic Membrane perforation in a tertiary care hospital.Methods:This descriptive cross sectional study was conducted at the Department of ENT, MTI/LRH, Peshawar from August to December 2017. After well informed consent a detailed history was taken; thorough examination of ENT was carried out. Pure Tone Audiometry (PTA) of all included patients was performed by same senior audiometrician. The data were collected on predesigned proforma and were analyzed using SPSS (16 versionResults:This study included 48 patients; Male 34, Female 14 with Male: Female ratio of 2.24:1. The mean age was 26.75 ± SD 9.88 Years. Majority of the patients (24, 50%) were in 3rd decade of life. The commonest cause of perforation of tympanic membrane was slap (35, 72.9%). Perforation of the Tympanic membrane was found more on left side (24, 50%), involving anterio-inferior site (18, 37.5%), while medium sized perforation was frequent finding (27, 56.2%). Single perforation was commonest observation (45, 93.8%), conductive hearing loss was the most common finding (38, 79.2%), and mild degree hearing loss was commonest (24, 50%).Conclusion:Traumatic tympanic membrane perforation is common in young male. Slap was the commonest cause of traumatic perforation affecting left ear more than right ear. Inferior quadrant of the tympanic membrane was commonly involved and mild degree and conductive type of hearing loss was common.

Agricultural waste based low cost oxidized activated carbon (OSD) and un-oxidized activated carbon (USD) samples were prepared from saw dust of Ziziphus jujube by chemical activation with phosphoric acid (H 3 PO 4 ). The activated carbon was used for the removal of toxic metal ions such as cadmium(II) and lead(II) from aqueous solutions. The effect of pH (2-9), initial concentration (70-100 mg/L), contact time (5-700 min), activated carbon dose (0.1-1.0 g) and temperature (298-328 K) was investigated. In addition, the kinetic study was performed at pH 6, while the carbon dose of 0.1 g was used for 40 mL solution of 70 mg/L at four different temperatures (298, 308, 318 and 328 K). The adsorption efficiency of USD was found higher than OSD. Comparatively higher uptake of Pb(II) ions was observed by each carbon sample. Pseudo-second order equation best fitted the experimental data. As such, both activated carbon samples (USD and OSD) exhibited higher adsorption capacities and faster kinetics which revealed their commercial usefulness.

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.

Fruits are a natural source of antioxidants which inhibit the production and accumulation of high reactive oxygen species (ROS), whereas heavy metals may initiate the production of ROS. Therefore, the most commonly used fruits such as apple, apricot, banana, cherry, grapes, guava, lemon, mango, orange, peach and pomegranate were analysed for the most toxic heavy metals (Cr, Co, Ni, Cd and Pb). Acid digestion method was used for metal extraction. The metal analysis was carried out using Flame Atomic Absorption Spectrophotometer (FAAS) (Perkin Elmer AAS-700). The results showed that the observed concentrations of all the five metals are much lower than that of the World Health Organization (WHO)'s maximum permissible limits. Although the obtained values are lower than the WHO standards, the effect of prolonged exposure to sub-limital levels of toxic metals are not known, therefore close monitoring of heavy metals in fruit and other food commodities remains important.