Objective: Aim of current study was to determine the causes of hearing impairment among patients visited to hospital. Study Design: Observational study Place and Duration: Frontier medical college, Abbottabad, May, 2021 to April, 2022. Methods: Total 122 patients of both genders had complained of hearing impairment were included. After obtaining informed written consent detailed demographics were recorded. An extensive history, thorough E.N.T. examination, and pertinent radiological and audiological tests were performed. Frequency of causes for hearing impairment was assessed. SPSS 20.0 was used to analyzed all data. Results: Among all cases, 68 (55.7%) patients were males and 54 (44.3%) were females. Mean age of the patients was 17.5±11.50 years. 72 (59.02%) cases were from rural areas and 75 (61.5%) cases had poor socio-economic status. We found that conductive hearing loss was the most common found in 63 (51.6%) cases, followed by mixed hearing loss in 35 (28.7%) cases and sensorineural hearing loss found in 24 (19.7%) cases. Chronic Suppurative Otits Media was the most common cause of hearing impairment found in 61 (50%) cases, followed by infection, physical trauma, prenatal causes, postnatal causes, drug related and other problem. Conclusion: We concluded in this study that COSM was the most common cause of hearing impairment among all cases. Most common hearing loss was conductive, mixed and sensorineural. It is possible to reduce the incidence of sensorineural hearing loss by preventing variables that occur both during and after pregnancy. Keywords: Hearing Loss, Hearing Impairment, COSM, SNHL

Objective: The purpose of the research was to determine the rate of sensorineural hearing loss that is associated with chronic otitis media. Study Design: A Descriptive Cross-sectional study Place and Duration: Frontier Medical College, Abbottabad, from June, 2021 to November, 2021. Methods: Total 87 patients of both genders had age 15-55 years were presented. All the included patients had chronic suppurative otitis media clinical symptoms. Patients were enrolled after getting informed written consent from the patients. Through the use of a pure tone audiogram, we were able to determine the mean threshold of voice frequencies for sick as well as normal contralateral ears. In sick ears, a mean of more than 25 dB was considered to represent a positive case of SNHL. SPSS 24.0 was used to analyze all data. Results: We found that 49 (56.9%) patients were males and 38 (43.1%) patients were females. 17 (19.5%) cases had age 15-25 years, 35 (40.2%) patients had age 26-35 years, 25 (28.7%) patients had age 36-45 years and 10 (11.5%) patients were aged between 46-55 years. Majority of the cases 51 (58.6%) were from urban areas. There were 50 (57.5%) cases had chronic otitis media duration <10 months and remaining had disease duration >10 months. Frequency of sensorineural hearing loss was found in 47 (54.02%) cases. Among 47 cases SNHL, 32 cases were aged between 31-55 years. Conclusion: We concluded in this study that patients with chronic otitis media had significantly higher number of sensorineural hearing loss, Among SBHL cases, patients were mostly aged between 31-55 years and disease duration was >10months. Keywords: Otitis Media, Sensorineural Hearing Loss,

Background: In adults, lymph nodes are not normally palpable. A number of patients with asymptomatic lymphadenopathy never visit physicians for the condition, and thus, this important sign is often missed by the medical practitioner if it is not the presenting complaint. The incidence of lymphadenopathy is suggested to be increasing. While lymphadenopathy is benign and self-limiting in most patients, the underlying disease may range from treatable infectious etiology to malignant neoplasms. In most cases clinical examination and history guide towards the cause of lymphadenopathy. In recent years, fine needle aspiration cytology (FNAC) has become an easy clinical tool (with or without the assistance of CT, MRI, and ultrasound) for the diagnosis of the underlying cause of lymphadenopathy.Aims and objectives: To find out the cytomorphological pattern in superficial lymphadenopathy with the help of FNAC.Materials and methods: This descriptive cross-sectional study was conducted at HBS General Hospital, Islamabad from January 2017 to June 2019. Patients presenting with superficial lymphadenopathy were included in the study. FNAC was performed by the pathologist, histopathological reports were examined and analyzed using Statistical Package for the Social Sciences (SPSS) version 22 (IBM Corp., Armonk, NY).Results: Six hundred and thirty-two patients underwent FNAC. Tuberculous lymphadenitis was the most common diagnosis (56.1%) followed by reactive hyperplasia (28.29%). The sample showed metastatic malignancy 3.36% and lymphoma 2.05%. Cervical lymphadenopathy was the most common site for TB (49.36%). Metastatic cancer observed in cervical lymph nodes was 3.16% and lymphoma was 1.74%. Conclusion:FNAC is recognized as a simple and safe diagnostic technique that can diagnose cases of superficial and deep lymphadenopathy easily. The most common cause of superficial lymphadenopathy in our study was tuberculosis with cervical lymph nodes.

Objective: The objective of this study was to compare transseptal suture and anterior nasal packing after septoplasty in terms of frequency of postoperative crusting. Design: It’s a randomized controlled trial. Study Settings: Research was conducted at Department of ENT and Head & Neck Surgery Abbas Institute of Medical Sciences (AIMS) Muzaffarabad, Azad Kashmir for a period of six months from 26/5/2020 to 25/11/2020. Patients and Methods: This study involved 132 patients of both the genders undergoing septoplasty for deviated nasal septum. These patients were randomly divided into two groups. Patients in Group-A were treated with transseptal suturing of mucoperichondrial flaps while patients in Group-B were treated with anterior nasal packing. A written informed consent was obtained from every patient. Results: The mean age of patients was 28.44±6.16 years in the range of 18 years to 40 years. The study group had 53 (40.2%) female and 79 (59.8%) male with a female to male ratio of 1:1.5. In terms of gender distribution and mean age both the groups were comparable (p-value=0.859 and 0.978 respectively). In patients treated with transseptal suturing, the frequency of post-operative nasal crusting was significantly lower (4.5% vs. 27.3%; p=0.000) as compared to anterior nasal packing. This difference was observed across all age and gender groups. Conclusion: This study has reported transseptal suturing to be better than anterior nasal packing in terms of significantly lower frequency of post-operative nasal crusting regardless of patient’s age and gender in patients undergoing septoplasty for deviated nasal septum. The results of this study thus advocate the use of transseptal suturing in future practice. Keywords: Deviated Nasal Septum, Septoplasty, Transseptal Suturing, Anterior Nasal Packing, Post-Operative Nasal Crusting

Objective: The goals of this research were to (1) assess the efficacy of free flap reconstruction in patients with early and recurrent head and neck cancers, and (2) investigate the variables associated with these surgeries that increase the risk of problems. Study Design: Retrospective Study Place and Duration: Frontier Medical College, Abbottabad, from March, 2022 to August, 2022. Methods: Total 200 patients of head and neck cancer were included in this study. Patients were both males and females with primary and recurrent cancer types were underwent for free flap reconstruction. After receiving informed written consent, in-depth demographic information about the cases that were enrolled was recorded. Patients were divided in two groups. Hundred patients of recurrent cancers were included in group I and 100 patients of primary cancers were included in group II. Surgical outcomes among both groups were assessed and compared. SPSS 24.0 was used to analyze all data. Results: We found that 87 (87%) patients in group I and 81 (81%) patients in group II were males. Mean age of the patients in group I was 49.8±11.37 years and in group II mean age was 51.4±7.42 years. Majority of the patients had tumor stage 5. Smoking, betel nut and alcohol were the most common causes found in all cases. Anterior lateral thigh (ALT) and anterior medial thigh (AMT) were the most common flap types among both groups. We found that free flap reconstruction had higher success rate in primary cancers found in 96 (96%) as compared to recurrent cancers group in 92 (92%). There was no any significant difference found among both groups in terms of post-surgery complications. Conclusion: This study's findings suggest a greater failure rate for free flap reconstruction in the recurrent group compared to the primary group, however this finding may be attributable to the varied patient characteristics between the two groups.