Introduction  Foreign body in airway is a common emergency in ENT practice. As we know, Rigid Bronchoscopy is the method of choice for removing it, although at times it leads to specialists performing unnecessary bronchoscopy, exposing patients to hazards of general anesthesia.Objective  The objective of my study is to calculate sensitivity, specificity, positive predictive value, odds ratio from the clinical and radiological signs, comparing with the gold standard, the rigid bronchoscope procedure.Method  This is a prospective analytical study designed at University Teaching Hospital and conducted over a period of 18 months, from March 2011 to August 2012. Data collection was broadly classified into three different categories: (1) Symptomatology, such as presence or absence of choking, cyanosis, and difficulty in breathing; (2) Clinical signs, such as the presence or absence of air entry, crackles, and rhonchi 3. Chest X-ray findings were suggestive of a foreign body.Results  There were a total of 40 rigid bronchoscopies performed under general anesthesia for the diagnosis and therapeutic reasons. Among 40 patients who underwent rigid bronchoscopy, 32 (80%) were found to have varieties of foreign bodies in their airway while 8 patients (20%) had negative bronchoscopy. The history of choking is the only clinical symptoms which came out to be statistically Significant (p = 0.043) with odds ratio of 5.Conclusion  Rigid bronchoscopy is the gold standard technique for diagnosis and procedure of choice to remove FB from airway. Regardless, it still presents a small chance of negative result, especially when there is no history of aspiration.

INTRODUCTION: Adenoid is thought to be one of the causes of otitis media with effusion, though it is controversial. Grading the adenoid by rigid nasal endoscope in patients with otitis media with effusion may justify adenoidectomy in otitis media with effusion in the future. METHODS: A prospective study was carried out at GMS Memorial Academy of ENT and head neck studies from 15th December 2005-April 2007. Study group comprised of 32 children with otitis media with effusion and control group of 28 children with clinically normal ear and nose. Rigid nasal endoscope was used for grading of adenoid in study and control group. The severity of otitis media with effusion was assessed by preoperative air-bone gap and thickness of the fluid aspirated from middle ear during ventilation tube insertion. RESULTS: In the study group 13 out of 32 had grade 4 adenoid hypertrophy. This grade 4 adenoid hypertrophy was found to be statistically significant in children with otitis media with effusion (P < 0.0002). In control group 15 out of 28 had grade 1 adenoid hypertrophy which was significant in the same group (P < 0.002). Air-bone gap and thickness of fluid did not correlate with the increasing grade of adenoid hypertrophy. CONCLUSIONS: Grade 4 adenoid hypertrophy was statistically found to be significant with otitis media with effusion but severity of hypertrophy were not reflected by hearing loss and thickness of fluid. Keywords: adenoid hypertrophy, myringotomy , otitis media with effusion, ventilaiton tube insertion.

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.

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