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.

An outbreak of Covid-19 occurred in Wuhan, China initially in December 2019. Over the next few months, the wide spread of SARS-CoV-2 had been reported in all continents and the transmission in utero from an infected mother to fetus debating yet was observed.1,9 Objectives: To determine risk of vertical transmission of corona virus in neonates of SARS COVID-2 positive mothers. Study Design: A Cross-Sectional study. Place and Duration of Study: Pediatric department of Pakistan Air Force (PAF) Hospital, Islamabad, Pakistan. The study conducted during 01-03-2020 to 31-08-2020. Methodology: After taking informed consent, Nasopharyngeal swab for PCR for SARS-CoV-2 was taken one week before delivery. Confirmed COVID positive pregnant ladies were included irrespective of symptoms of COVID-19 infection and any other medical illness. Neonates born to COVID-19 positive mothers were admitted in NICU, and Performa was filled for neonates after PCR done 24 and 48 hours respectively. Results: Total 14(87.5%) out of 16 COVID positive mothers were asymptomatic. 16(100%) neonates were negative for Sars-COV-2 at 24 hours and 48 hours. Conclusion: This study concluded with no evidence of transmission of COVID-19 from infected mothers. Keywords: Vertical transmission, COVID-19, neonate, infected mother.

Objective: This study was carried out to assess the prevalence of overweight, obesity, and risk factors among young adults in Pakistan. Study Design: A cross-sectional anthropometric study in local population to assess the prevalence of overweight, obesity, and risk factors among young male and female. Place and Duration: Present study was conducted in 25 high schools of Lahore, Islamabad and Karachi from January 2022 to November 2022. Methodology: In this study 1000 young adults (500 girls and 500 boys) of age 15-17 years were selected and used population-based stratified cluster sampling method. To determine the prevalence of overweight and obesity, the participant’s body mass indices (BMI) were compared to the BMI guidelines for Pakistani children and adolescents. In order to gather information about the study group's sociodemographic traits, Internet use, TV watching, physical activity, and family history of obesity, a standardized questionnaire was administered. Results: According to the findings, there were 8.9% of teenagers who were obese overall (9.6% of females and 7.2% of boys). It was shown that BMI went up when computer use did. Compared to their peers who were of normal weight, a higher percentage of overweight and obese teenagers watched TV and used computers for longer than two hours each day. It was discovered that the patients with normal weight participated more frequently in regular physical activity. 59.6% of the households of overweight adolescents were obese. Practical Implication:It will spread awareness among community about obesity prevalence in young adults and the risk factors associated with them ,controlling methods and things to prevent. Conclusion: Comparatively it was concluded that Pakistan has lower frequency of adolescent obesity than several developed countries. The usage of computer, mobile, television, physical exercise, and family dynamics are all significant risk factors for obesity. Keywords: Adolescent, Obesity, Body mass indices, Risk factors, Anthropometric

Background: Chronic hepatitis C infection has both hepatic and extra-hepatic symptoms, both of which are influenced by the inflammatory response triggered by HCV. Chronic HCV induces inflammation that manifests itself in the liver and beyond. Persistent HCV infection may be associated with reduced pulmonary functions especially in patients with high viremia levels. Objective: The objective of study was to examine restricted pulmonary function in chronic hepatitis C patients during different phases. Study Design: Cross-sectional study Place and Duration: Department of Medicine Social Security Teaching Hospital Ferozepure Road Lahore. From 01.02.2022 to 30.08.2022. Methods: There were 94 cases of chronic hepatitis included in this study. After gaining the participants' informed consent, we documented their age, sex, BMI, and smoking status in detail. Patients underwent for abdominal ultrasound. The anti-HCV antibody test was run with a third-generation ELISA (Ortho HCV ELISA) kit using 3 ml of blood and pulmonary function test were performed to eavaluate restrictive lung disease. Data was entered and analyzed in SPSS 24.0 and presented as frequency and percentages. Results: Among 94 cases, 57 (60.6%) were males and 37 (39.4%) were females. Mean age of the patients was 46.9±4.53 years and mean BMI was 25.4±6.29 kg/m2. Majority of the cases 51 (54.3%) had rural residency. There were 64 (68.1%) cases had smoking history. We found that 17 (18.1%) cases had severe HCV, 45 (47.9%) cases had moderate and 32 (34.04%) patients had mild HCV. There were 37 (39.4%) cases had restrictive pulmonary function among all cases. Among 37 cases of pulmonary disease, majority had severe HCV infection. Conclusion: We concluded in this study that the patient with HCV infection had higher incidence of restrictive pulmonary disease. Majority of the patients were males and had smoking history. Severe cases of HCV mostly had restrictive disease. Keywords: HCV, Restrictive Pulmonary Disease, Males, Smoking

PURPOSE:Effective treatment with Continuous Positive Airway Pressure (CPAP) for Obstructive Sleep Apnea Syndrome (OSAS), in pilot studies, has been associated with a decrease in utilization of health care resources and costs. However, this benefit has not been studied in a veteran's population. We want to evaluate changes in health care utilization in veterans diagnosed with OSAS and treated with CPAP.METHODS: This is a retrospective review of 122 patients diagnosed with OSAS using a fullnight polysomnogram at the Memphis VAMC. Data obtained from Computerized Patient Record System (CPRS) included: demographics, number of visits to primary care physician (PCP), emergency room (ER), hospital admissions, and number of sub-specialty consults, OSAS severity, and compliance with CPAP. The observation period for the events was one-year, preand-post, CPAP treatment. Paired Student t test was used to compare variables a p ≤; 0.05 was considered significant. RESULTS:Between January 1, 2006 and December 31, 2007, 180 medical records were reviewed. Due to incomplete data in some, only 122 were included in the final analysis. The mean age (yrs) was 57 ± 10; 52% were Caucasian, 42% were African-Americans, and 6% others. Most patients (84%) were smokers. The five most common comorbidities were: Hypertension (68%), Dyslipidemia (50%), Muscle-skeletal problems (40%), Diabetes Mellitus (36%), and Depression (29%). Mean ± SD for BMI was 34.8 ± 7.2; for Epworth-Score was 12 ± 7; and for Apnea Hypopnea Index (AHI) was 32 ± 31 events per hour.CONCLUSION: CPAP therapy for OSAS may decrease the use of health care resources such as primary care physician and emergency department visits in a population of veterans. CLINICAL IMPLICATIONS:If we are able to achieve effective CPAP therapy for OSAS we could potentially decrease the number of visits to the emergency room and/or primary care physician which could have a significant impact on health care costs.