Objective: To determine the sensitivity of ACR-TIRADS scoring by comparing its results with those obtained on biopsy of respective specimens. Method: This prospective study including N=205 patients with thyroid nodules was conducted in ENT Department of MTI Hayatabad Medical complex, Peshawar during the period from May 1, 2019 to April 30, 2022. Preoperative ultrasonography with assigning of TIRADS scores was performed in all patients. Appropriate thyroidectomies were performed in these patients and specimen biopsied. Pre-op TIRADS scores were compared with biopsy results. To determine the sensitivity of TIRADS, TR1 and TR2 were considered ‘benign’ and TR3, TR4, TR5 were considered ’malignant’ for comparison with biopsy results. Results: The mean age of patients was 37.68 years with standard deviation of ±11.52. The M: F ratio was 1:3.5. Nineteen patients (9.27%) had solitary thyroid nodules & 186 (90.73%) had multinodular goiters. TIRADS scoring was benign for 171 (83.41%) and malignant for 34 (16.58%) nodules. The biopsy results revealed 180 (87.80%) nodules to benign and the rest as malignant. The sensitivity, specificity and diagnostic accuracy were calculated at 80%, 92.77% and 91.21% respectively. Chi square test and p-value determination showed that there was a strong positive concordance between TIRADS scores & biopsy results which is highly significant (p=.001). Conclusion: The Ultrasonographic ACR-TIRADS scoring and risk stratification system is highly sensitive for detecting malignancy in thyroid nodules. It is, therefore, a reliable technique in the initial assessment of thyroid nodules and decisions can safely be based on its results. In cases of doubt, clinical judgment should be exercised before making final decision. doi: https://doi.org/10.12669/pjms.39.3.7313 How to cite this: Anwar K, Mohammad AY, Khan S. The sensitivity of TIRADS scoring on ultrasonography in the management of thyroid nodules. Pak J Med Sci. 2023;39(3):870-874. doi: https://doi.org/10.12669/pjms.39.3.7313 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

OBJECTIVES To determine the frequency of tinnitus & hearing impairment in adolescent and young adult earphone users with smartphones and other personal listening devices.METHODOLOGY This prospective & descriptive study involving children with glue ears was conducted in the ENT Department of Medical Teaching Institute, Hayatabad Medical Complex, Peshawar, from Jan 1, 2022, to Sep 30, 2022. Personal listening device (PLD) users aged 12-25 years with complaints of tinnitus and hearing impairment were examined. Conductive hearing loss was excluded by audiological testing. The frequency of resultant hearing loss and tinnitus was calculated. The information obtained was analyzed using SPSS v 26.0 for windows. A Chi square test was performed to determine the significance of tinnitus & hearing impairment in earphones and other PLD users.RESULTS A total of 163 patients were included in the study. The patient’s age range was 12-25 years, with a mean age of 18.03 years and a standard deviation of ± 3.575. There were 117 males and 46 females. The male: female ratio was of 2.54:1.Tinnitus was present in 73% and Hearing impairment in 54.4% of the patients. The chi-square test and p-values determined showed that both tinnitus and hearing loss occurred in many patients using personal listening devices.CONCLUSION Tinnitus and hearing impairment occurs in a significant number of those who use personal listening devices. Their inappropriate use can lead to auditory system damage. It is recommended that PLD users undergo periodic audiological testing to detect early hearing loss and tinnitus to minimize damage to the ear.

Objective: To determine the; Frequency of types of fungi and identify the commonest fungus implicated in fungal rhinosinusitis in covid-19 positive patients. Frequency of clinical types of fungal rhinosinusitis in covid-19 positive patients. Commonest co-morbidity and type of fungal rhinosinusitis associated with it. Methods: This retrospective study was conducted at ENT Department Medical Teaching Institution, Hayatabad Medical complex, Peshawar during the period July 1, 2021 to Dec 31, 2022. Record of all the covisd-19 positive patients admitted to this department was examined. Those who have fungal rhinosinusitis were selected. The co morbidities in these patients such as diabetes, chronic renal failure and malignancies were recorded. Frequency of types of fungi, fungal rhinosinusitis and the commonest co-morbidity were determined.  Chi-square test performed and p-value determined to determine significance of observed relationship of fungal rhinosinusitis with diabetes mellitus, renal failure and malignancies. Results: A total of 86 patients, male: female ratio was 1.26:1. The ages ranged from 28-80 years with mean age of 56.13 ± 3.221 years. A total of 65(75.5%) patients were diabetic. Acute fulminant fungal rhinosinusitis was the commonest clinical type occurring in 40(46.5%) patients. Mucor was isolated from 56(65%). Chi square test and p value showed that the invasive fungal rhinosinusitis caused by mucor has significant association with diabetes in these patients (p=0.02). Conclusion: Acute fulminant fungal rhinosinusitis caused by mucor is the commonest fungal infection in the co-morbid diabetic covid-19 positive patients. As this is a life-threatening disease, timely recognition and prompt treatment is important.