The perforations of the tympanic membrane maybe of traumatic origin or due to chronic suppurative otitis media. If the perforations fail to heal conservatively, they require surgical closure. Autologous graft materials have stood the test of time in repairing tympanic membrane perforations. In our tertiary care institution we conducted a prospective randomized control trial on 50 subjects to evaluate the comparative efficacy of temporalis fascia and tragal perichondrium as grafting material in underlay tympanoplasty. In this study surgical success was evaluated in terms of intact drum membrane during the follow up period and closure of A-B gap within 10 dB. Temporalis fascia achieved a graft uptake of 84% and a satisfactory hearing improvement in 76% of the patients. Tragal perichondrium achieved a success rate of 80% graft uptake and 75% hearing gain. The rates are comparable with no statistical significance of the difference between them.

A variety of swellings located on or near the gums is clinically included under the heading of epulis. There are various types of epulis. In today's era of super specialization gum swellings more commonly present to the dental surgeon than to the practicing otolaryngologist. We present an interesting case of a fibrous epulis managed in our institute along with a brief review of literature.

The jaw bones may develop the same types of tumors as the other bones of the body but may also develop tumors arising from the alveolar processes (epulis) and the developing teeth (odontomes). They are usually benign in nature and can affect the functions of mastication, swallowing and cause facial deformity. They make about 3% of all bone tumors with a tendency for a local recurrence if a wide excision is not contemplated at the first attempt. Local destruction caused by the tumor can mimic a malignancy; however with imaging we can get a fair idea about the treatment planning. We present a series of 6 cases of such nature for their variety, diagnostic challenge they posed and different reconstruction methods used for better cosmesis.

Background: Morbidly adherent placenta with its variants is one of the most feared complication causing high morbidity and mortality in obstetrics. Aim of this study is to help in identifying high risk pregnancies, planning line of management of morbidly adherent placenta. The objective of the study wad to evaluate the risk factors, different modes of management, maternal outcome in case of morbidly adherent placenta.Methods: A prospective study for one year was done to describe the incidence, causes, treatment, complications, and maternal morbidity and mortality associated with morbidly adherent placenta.Results: A total of 20 cases of morbidly adherent placenta were studied over one-year span at our Institute. Most of the women with morbidly adherent placenta were in the age group of 26-30years (55%).The most common aetiology of morbidly adherent placenta was previous caesarean scar with placenta praevia (85%). In majority, placenta accreta found. Total abdominal hysterectomy done in 12 patient and subtotal hysterectomy in 6 cases. Trial haemostasis with uterine sparing in 2 cases out of which one case underwent total hysterectomy due to massive haemorrhage on same day. Associated Bladder repair in adherent placenta with invasion of bladder was needed in 10% cases. There was 1 maternal death noted in this study.Conclusions: Leading cause of morbidly adherent placenta is previous caesarean section with placenta praevia, high index of suspicion, early antenatal diagnosis, planned surgery at high care centre with multi-disciplinary expertise, anticipation of blood volume transfusion, Delivery of foetus without manipulating placenta are key steps to reduce morbidity and mortality in morbidly adherent placenta. The decision to perform hysterectomy and conservative management to be individualized. Timely decision is the key to get success in morbidly adherent placenta as in other obstetric emergencies.

Background: Recurrent idiopathic epistaxis is a common paediatric condition associated with anxiety in children and their parents. We retrospectively studied the safety and efficacy of silver nitrate cauterisation in children. Materials and Methods: A retrospective cohort study of 70 children was performed as a part of departmental Audit for the year 2018-2019. Results: The average age was 10.51 [SD = 2.42], after a single session of nasal cauterisation 78.57 % cases reported no further nosebleeds. Stinging and discomfort was reported by 70% of patients. Conclusions: Outpatient silver-nitrate cautery under topical anesthesia is a safe and effective method associated with mild stinging and discomfort.