Background: Chronic suppurative otitis media (CSMO) is an important cause of preventable hearing loss, particularly in developing world. The objective of this trial was to compare efficacy of 2% acetic acid versus 0.3% ciprofloxacin ear drops in achieving dry ears in CSMO in adult population of Islamabad, Pakistan. Materials & Methods: This trial was conducted at Department of ENT, HBS Medical College, Islamabad, Pakistan from March 2018 to February 2019. With alpha 5%, beta 20% and power of study 80%, sample size was calculated 47 for each group. All adult patients of CSOM, having ear discharge for more than three months were eligible. Patients with aural poly, external auditory canal pathology, ear malignancy, having mastoid surgery in preceding 12 months or having used antibiotics in last one week were excluded. Experimental group received 2% acetic acid, twice daily while control group received 0.3% ciprofloxacin eardrops twice daily. At two weeks, achievement of dry ears was noted. Sex and age in years were matching variables. Primary end point was achieving dry ears, which was compared between the two groups using McNemar chi-square test. Results: Experimental group included 30 (63.8%) men and 17 (36.2%) women and control group included 32 (68%) men and 15 (32%) women. Mean age of experimental group 36±2.14 years was matching to the control group 36±2.59 years. Dry ears were achieved in 35 (74.47%) patients in experimental group and in 11 (23.40%) patients in control group. The efficacy of 2% acetic acid was significantly higher than 0.3% ciprofloxacin eardrops in achieving dry ears (p

Introduction: Situs inversus is a rare autosomal disorder with transposition of abdominal and thoracic organs. The prevelance is low upto 0.04%. Investigating the disease and performing surgical procedure is difficult because of difficult anatomy. We hereby report a case of symptomatic gallstones in 86 years old patient incidentally diagnosed as case of situs inversus after appropriate investigations. We also include a review of literature.

Objective: This comparative cross-sectional study was conducted in the Departments of Trauma and Neurosurgery, Ayub Teaching Hospital, Abbottabad, Pakistan from September 2021 to February 2022 to study predictive factors of outcomes in acute subdural hematoma evacuation.Methodology: A total of 101 patients with confirmed diagnosis of acute subdural hematoma (ASDH) who underwent surgical evacuation by consultant neurosurgeon were included in the study. A detailed clinical proforma was designed to document all the clinical and demographic details of these patients at the time of admission. Glasgow Coma Scale outcome score (GOS) was used to assess the outcome of patients after the surgery. Sociodemographic and clinical parameters were associated with outcome of surgery in our study participants.Results: Out of 101 patients, 55 (54.5%) were males and 46 (45.5%) were females. Mean age was 43.66±19.66 years with 7.39 as mean Glasgow Coma Scale (GCS) at presentation. Road traffic accident (RTA) 62 (61.4%) was most frequent mechanism of injury followed by fall from height (19.8%) and history of assault (13.9%). In our study, 59 patients had poor outcomes while 42 had good outcomes. Elder age, low GCS at presentation, and use of oral anticoagulant were associated with poor outcomes while pupillary reaction had no effect on the outcome after application of test of significance.Conclusion: More than half of the patients managed with surgical evacuation for acute subdural hematoma as per guidelines at our neurosurgical unit had poor outcomes according to Glasgow Coma Scale. In this study, advancing age (>60 years), low GCS score at presentation, and use of oral anticoagulation therapy emerged as significant risk factors for poor outcomes in participants. Pupillary reaction had no effect on outcomes as per this study but this needs further evaluation in future studies.