This paper presents a systematic review on the impact of psychosocial factors on the surgical outcomes of low back pain (LBP). It aims to synthesize the existing evidence on the influence of psychological, social, and behavioral factors on surgical outcomes, including pain relief, functional improvement, patient satisfaction, and quality of life. The review explores the potential mechanisms through which psychosocial factors interact with surgical interventions and highlights the implications for preoperative assessment, patient selection, and postoperative care.

Objective: to determine the cases brought to the Otolaryngology Department with adenoidal hyperplasia. Study Design: Cross-sectional study. Place and Duration of Study: ENT Department, Combined Military Hospital, Multan Pakistan from Jan to May 2022. Methodology: The study was conducted on children of age more than 2.5 years having adenoid hypertrophy that was confirmed by an X-Ray lateral view of the nasopharynx for adenoids. Their tympanogram was obtained. Results: The study showed that 2(2%) cases had a Type-B curve in a single ear, and 14(14.3%) had a Type-B curve in both ears.PTA was normal in 32(32.7%) cases. Up to 25 decibels (dB) of hearing loss was seen in 6(6.1%) cases. In 8(8.2%) cases, hearing loss, was more than 25Db. Conclusion: The tympanometry test is an objective test which is very easy to carry out and can very easily detect patients having glued ears which can be managed, and possible complications of the disease can be avoided.

Objective: To train young doctors and paramedical staff on needle cricothyroidotomy and surgical cricothyroidotomy and provision of kits in trauma centers, main operation theatres and medical reception centers of the hospitals. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Peshawar and Pakistan Naval Ship Shifa, Karachi Pakistan, from Nov 2017 to Oct 2020. Methodology: Doctors and paramedical staff were selected on volunteer basis. Small groups were trained in 2-3hours. The participants were shown two videos of two procedures in Urdu language first and then were trained on mannequin. Results: A total of 345 participants including 205 males and 140 females were trained with mean age was 28.2667 ± 6.24 (SD) years. Out of 61 residents, 54 medical officers, 143 house officers, 35 nurses and 52 paramedical staff were participants. Conclusion: ENT surgeons must arrange mannequins and conduct training sessions of small groups after every 1 to 2 months.

Objective: To find out the outcome of the ear Reconstruction and its association with improvement in psychological wellbeing along with physical benefits. Study Design: A cross-sectional study. Place and Duration of Study: Department of Plastic Surgery and ENT, Combined Military Hospital Quetta and Multan in liaison with the department of Psychiatry, from Jan 2017 to Jan 2021. Methodology: A sample size of 108 was estimated while keeping level of significance 5%, confidence level 90%, estimated true proportion 63% based on the observation made in the study by Steffen, and 5% of absolute precision. Specific performas were filled by the patient pre and post operatively and data analysis was performed using SPSS-20. Results: The mean age was 20 ± 8.75 years with a range of 12-29 years. Thirteen (11.11%) were male and ninety-five (87.8%) were females, 14 (12.9%) were married, 94 (86%) were un-married and all (100%) had social support. Fifty-two (48.1%) had primary education. Ninety-four (94%) were un-employed. Fifty-five (50.9%) of participants had congenital ear defect. Ninetyeight (90.7%) of the participants showed confidence in surgical procedure and would go for the same procedure if required, 5 (4.6%) said no to the same procedure while 8 (7.4%) did not know whether to opt for same procedure. Conclusion: Ear Reconstruction is a very rewarding procedure for surgeon and patients. Apart from aesthetic and functional improvement it also enhances the self-esteem of the patients.