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This paper attempts to explore satisfying and dissatisfying determinants of online education in Pakistan. Participants were well abreast with the online mode of education due to the closure of physical classroom activities during the COVID-19 pandemic. Purposive sampling was research design.Students enrolled in communication skills course were drawn as study respondents. An open-ended questionnaire was a research instrument. Eighty (80) engineering students participated in this survey and provided feedback about satisfying and dissatisfying factors of online education in Pakistan. Data were analyzed using the content analysis approach. Results exhibited students were satisfied with ‘class feasibility, low financial cost and communication opportunities. On the other front, they were dissatisfied with ‘internet issue, load shedding of electricity, technical issue, home disturbance, expensive internet packages, and lack of communication. This research concluded that online education is never free from issues and challenges in Pakistan.

Many users of recreational drugs use cocaine and opioids together, often called “speedballing.” Hearing loss is a rarely reported adverse effect following recreational drug abuse. Only one case has been reported in history with hearing loss caused by speedballing. Here, we present the case of a 38-year-old female who presented with speedball abuse and new-onset bilateral hearing loss to the emergency department. A computed tomography scan of the head was unremarkable. She was treated with thiamine, folate, multivitamins, and intravenous fluids. The hearing loss improved without any acute intervention. The significance of sudden hearing loss due to recreational drug use is highlighted by this case. Apart from a few animal studies, there is no detailed research explaining the pathophysiology of speedball-induced hearing loss. Further studies and trials are needed to better understand the effects of combined and separate cocaine and opioid use on audiologic physiology.