Since time immemorial doctor’s service to mankind was considered as one of the noblest profession and doctors were treated as next to God with highest respect in the society. With the struggle of development, the modern society has become intolerant and impatient leading to change in this sacred relationship. This deterioration is not only affecting the social relationship but also the treatment of patients as there is a feeling of mistrust and concealment of facts. This article elaborates about the factors for such deterioration and also the ill effects both on patients and doctors. This article further suggest the measures to be taken on timely bases by all the stakeholders i.e. the doctors, the patients and society as well as by governments for improving this mandatory relationship.

NTRODUCTION Oral malignancies are debilitating disorders of the oral cavity. Etiopathogenesis of these disorders is multifactorial. The prognosis of these disorders depends upon early diagnosis and management. 1 Imbalances between the oxidant-antioxidant status have been implicated in the pathogenesis of premalignant and malignant lesions. The extent of oxidative damage caused by ROS directly depends on body antioxidant defense mechanism. 2 Superoxide dismutase (SOD), glutathione peroxidase (GPx), and catalase (CAT) are the three major enzymatic antioxidant defense systems responsible for scavenging free radicals and nascent oxygen. 3 Antioxidant enzymes catalyze decomposition of ROS. Redox modulation is seen by distinctive changes in the activities of these enzyme systems in oxidative stress. Thus, an overall balance between production Access this article online Quick Response Code

Objective A prospective randomised study was undertaken to compare the results of type 1 tympanoplasty with and without middle-ear packing with gelfoam. Method Eighty patients undergoing type 1 tympanoplasty were randomised into two groups according to packing in the middle ear: with gelfoam and without gelfoam. The data in terms of graft uptake rate, hearing gain and subjective improvement were analysed at one and three months. Results The graft uptake rate between both groups did not show a statistically significant difference. There was conductive hearing loss in the gelfoam group in the early post-operative period. Subjectively, patients were more comfortable with respect to heaviness and hearing gain than in the non-gelfoam group. Conclusion Gelfoam use in middle-ear packing is not an essential step and causes more discomfort in patients during the early post-operative period. It should be a surgeon's choice to use it when and where it is necessary.

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COVID-19 spreads through contact, minute droplets and aerosol from infected person which may be symptomatic or asymptomatic. Nose and throat had very high load of severe acute respiratory syndrome (SARS-CoV-2) virus. Otorhinolaryngologists by virtue of their work which requires close examination of these part are at very high risk of infection. Many studies are available for precautions to be taken in patient management related to COVID-19 in wards and surgical intervention in operation theaters but very little information is available regarding precautions in working in outpatient clinic setting. Our article highlights some changes we made in ear, nose and throat (ENT) outpatient clinics after going through various guidelines to make it safe in current scenario. These changes may inspire others to move toward safer work practices in their outpatient area to provide ENT consultations. The main changes were categorized into infrastructural changes, identification of frugal but effective personal protective equipment (PPE) for ENT, training for use of different level of PPE as per risk, new modus operandi, and new infection prevention measures. These changes had taken into account safety guidelines by Ministry of health and family welfare (MOHFW) government of India and various international associations specific to specialty. The modification and its advantages were presented.