ObjectiveTo describe feasibility and results of systematic screening of tuberculosis (TB) patients for HIV.DesignCross-sectional study.SettingSix selected sentinel sites (public DOTS clinics) in the province of Sindh, Pakistan.ParticipantsAll TB patients aged 16–60 years registered for treatment from April 2008 to March 2012.MeasurementDemographic information of registered TB patients, screening for HIV through rapid testing and confirmation by referral lab of Sindh AIDS Control Program, according to national guidelines.ResultsOf a total of 18 461 registered TB patients, 12 882 fulfilled the inclusion criteria and were given education and counselling. Of those counselled 12 552 (97.4%) were screened for HIV using a rapid test. Men made up 48% of the sample and 76.5% of patients had pulmonary TB. Of the total patients tested, 42 (0.34%) were HIV-positive after confirmatory testing at the Sindh AIDS Control Program Laboratory. Prevalence of HIV among male patients was 0.67% whereas prevalence among female patients was 0.03% (p value <0.001). Prevalence of HIV among pulmonary TB patients was 0.29% and among extrapulmonary TB patients was 0.48% (p value=0.09).ConclusionIn public DOTS clinics in Pakistan it is feasible to test TB patients for HIV. Prevalence of HIV is three times higher among TB patients as compared with the general population in Pakistan. Although the results are not representative of Pakistan or Sindh province they cover a large catchment area and closely match WHO estimate for the country. Routinely screening all TB patients for HIV infection, especially targeting men and ensuring antiretroviral therapy, can significantly improve TB/HIV collaborative activities in Pakistan and identify many cases of HIV, improve health outcomes and save lives.

Objective: To Compare the difference on the inflow of patients before and during COVID-19 on the patients presented at oral & maxillofacial surgery at Advance Dental Care Centre, Liaquat University of Medical and Health Sciences Materials &Methods: Medical statistics have been collected for the patients who visited the Advance dental care centre, Liaquat university of medical and health sciences between 1 January 2019 and 31 December 2020. The data collected included age, gender, and extraction of teeth. SPSS version 20.0 was used for the statistical analysis. Results: Of all the patients who visited, 3715 were females and 2571 were males, with a female to male ratio of 1.2:1. The youngest patient was 15 years old, and the oldest was 60 years old. The most common cause among patients in 2019 and 2020 was periodontal problems. Conclusion: The COVID-19 epidemic affected the population, pattern of oral diseases, its services, and the frequency of visits to advance dental care centre the proportions of patients who were adolescents and elderly people increased, meanwhile the percentage of the conservative treatments increased during the outbreak of COVID-19. Keywords: COVID -19, Tooth extraction; Periodontal disease, Prophylactic antibiotics.

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Interscalene block is used for shoulder surgeries however it almost always results in phrenic nerve palsy1,2. Some anaesthesiologists have described careful ultrasound guided low volume (5mls only) of local anesthetic interscalene block which does not cause hemidiaphragmatic paresis3. However we present to you a case where we implied a recently described technique of phrenic sparing involving a combination of oblique infraclavicular brachial plexus block with subomohyoid suprascapular nerve block. Keywords: Shoulder block, phrenic nerve palsy,