Abstract Background: COVID-19 has effected General Surgical Elective list and most of the surgical procedures are postpone. Inguinal hernia surgery can be performed under local anesthesia on day care basis in selected group of patients taking all necessary precautions for COVID-19. Patients & Methods: This prospective study was conducted at department of General Surgery Federal Hospital, Islamabad for a period of three months from 15th March 2020 to 15th June 2020. All patients were included in the study through purposive sampling and preference was given to patients elder than 50 years of age. This study included 59 adult patients with inguinal hernia who under mesh repair under local anaesthesia on day care basis. Results: A total of 59 patients were included in the study. All patients were male. The age range was from 37 to 82 years (SD=± 10.23).  30 (50.84%) patient had inguinal hernia on left side while 26 (44.06%) had hernia on right side. Mean Operative time was 35 min. Pain was chief complaint postoperatively 30 (50.8%) patients had moderate pain while 6 (10.1%) patients had severe pain in first 24 hours after surgery. Fever was present in 15 (25.42%) patients in first 24 hours. All patients were negative for COVID -19 preoperatively and after 2 weeks none of the patients develop any symptoms of COVID-19. 3 (5.08%) patients needed readmission within 24 hours for pain and some haemorrhage. There was no mortality in our study Conclusions: Inguinal Hernia Surgery under local anaesthesia on day care basis in a very good practice at this time of global pandemic of COVID-19. This is a safe and reliable strategy. Key words: Inguinal Hernia, COVID-19, Local Anaesthesia

Objective: To determine the frequency of unsafe type of chronic otitis media (COM) in patients with chronic ear discharge. Materials and Methods: A cross sectional study was conducted in August 2019 to May 2020 at ENT department, Khyber Teaching Hospital, Peshawar. All patients with more than 3 months history of ear discharge were included in the study. Unsafe COM was defined as persistent foul-smelling ear discharge for at least 3 months with attic or marginal perforation of the pars tensa, suspicious of cholesteatoma and granulation tissues on otoscopy/ otoendoscopy and/ or hearing loss of more than 30 dB on pure tone audiometry. Spss Version 22 was usecd for analysis. Results: Out of total 312 participants, age distribution showed 224 (72%) participants between 18-30 years, while 88(28%) between 31-60 years. Among 312 patients most of the participants 194 (62%) participants were male as compare to female 118 (38%) participants were female. Duration of symptoms showed 46 (15%) with duration of symptoms ≤6 months, 266 (85%) patients had duration of symptoms > 6 months. Mean duration of symptoms was 6 months with SD ± 4.212. Unsafe type COM was found in 44 (14%) participants and 268 (86%) patients did not have unsafe type COM. Conclusion: The frequency of unsafe type of COM is 14% among patients presenting with chronic ear discharge.

For almost one and a half year the world is facing the pandemic called COVID-19, which is an acute respiratory distress syndrome caused by coronavirus 2 (SARS-CoV2). This disease has already engulfed many lives and has not been tamed so far. Physicians all over the world still, trying to get a hold of this global health issue, are faced with another life-threatening challenge associated with COVID-19, called black fungus-Mucormycosis.  Within a span of few weeks, we have encountered three cases of black fungus in our institute which has stirred a serious concern among physicians in Pakistan. Keywords: Mucormycosis, Black fungus, COVID-19, Pandemic.

Objective: This study aims to present the outcomes of the patients who underwent endoscopic dacryocystorhinostomy (DCR) without intubation at a tertiary care hospital. Study Design: Observational Study. Setting: Holy Family Hospital, Rawalpindi, Pakistan. Period: October 2018 to November 2019. Material & Methods: Endoscopic dacryocystorhinostomy operation was performed in a total of 52 patients presenting with chronic epiphora. Silastic tubes were not used to maintain the patency. Patients were prescribed antibiotic eye drops, oral painkillers, decongestant eye drops, and regular nasal douches. Results: Fifty patients (96.2%) presented with successful post-operative outcomes on the 12th week for follow-up. Post-operative canal patency was evaluated by endoscopic examination and syringing. Patients were also evaluated for the presence of epiphora. Conclusion: Our results of 52 patients who underwent endoscopic DCR without stenting are as promising as those with stenting. Hence, the procedure without intubation is recommended.