Background: Quinsy (also known as Peritonsillar abscess) can be defined as pus collection in peritonsillar space (between superior constrictor muscle of pharynx and lateral surface of tonsil). It is a common complication of tonsillitis. Materials & Methods: This is a descriptive, prospective study.  It was carried out on 27 consecutive patients which were treated for Quinsy from September 2016 to August 2018. All of the patients were hospitalized. Peritonsillar abscess was treated with aspiration of pus by wide bore needle followed by Antibiotics and short dose of steroid. Results: 74 % of patients were found to have previous history of recurrent tonsillitis. 56 percent of patients were already receiving antibiotics at the time of presentation. Mean hospital stay was two days. None of the patients required incision drainage.  Recurrence was seen in only 3 patients. Conclusion: Needle-aspiration at the most prominent (bulging) part of the peritonsillar region followed by intravenous antibiotics and steroids is an effective treatment protocol. We also suggest further controlled studies on larger number of patients to establish its efficacy and safety.

Aim: to present our experience regarding the safety of bipolar diathermy in relation to recurrent laryngeal nerve (RLN) damage during thyroidectomy. BACKGROUND: Thyroidectomy is one of the most frequently performed surgical procedures all over the world with an encouragingly low morbidity rate. The advent of new biomedical equipment has increased the precision of this procedure and has further reduced the incidence of complications. Classically thyroidectomy, like other surgical procedures was performed by conventional knife and scissor dissection techniques with excessive use of sutures for control of bleeding.METHODS: This is an observational clinical study. In this study we share our experience regarding 52 patients with thyroid gland enlargement who underwent thyroidectomy with the help of bipolar cautery from February 2015 to February 2017 at Islam Teaching Hospital Sialkot.RESULTS: Our study shows that most of the patients (57.7%) belonged to the age group of 18 to 30 years. There was no patient above 50 years of age. Majority of the patients (84.6%) were female. 53.8% of patients underwent hemithyroidectomy, 38.5% of patients underwent a near total thyroidectomy whereas 7.7% of patients underwent a total thyroidectomy. 48.1% of patients took 30 to 45 minutes for their procedures, 46.2% of patients took 45 to 60 minutes, and 5.8 patients took up to 75 minutes. Of the 52 patients, none developed any vocal cord palsy or weakness immediately after the completion of surgery, seen after extubation at the operating table.CONCLUSION: Cautious use of bipolar cautery in the Beahrs triangle is perfectly safe regarding nerve injury as the current stays confined between the two prongs of the bipolar forceps and because it keeps the operating field clear of blood.

ABSTRACT: Background: Functional endoscopic sinus surgery (FESS) is the standard treatment for inflammatory nasal polypi and sinusitis as it targets the common drainage pathway or the osteomeatal complex in the middle meatus. New techniques tailored according to regional patient needs and available on ground situations are constantly being mentioned in research articles.Aim: to present our experience in practicing a hybrid technique of performing middle meatal antrostomies without endoscope.Materials and Methods: This is an observational clinical study. This study was performed on 50 patients who underwent middle meatal antrostomies without endoscope from April 2017 till Aril 2019 in the department of ENT at Islam Medical College Pasrur Road Sialkot.Results: In our study all the 50 patients were found to be having patent middle meatal antrostomies at 6 weeks times after surgery, assessed by flexible fiber optic nasal endoscopy.Conclusion: middle meatal antrostomy without endoscope is a safe and effective method in treating maxillary sinus disease and should be practiced instead of the traditional inferior meatal antrostomies, at centers where an environment conducive to FESS is not available. Studies with larger sample size will further establish the efficacy, cost effectiveness and time conservation with this technique.

Background: Cleft palate surgeries are one of the most common surgeries done by Plastic surgeons. Aim: To determine the role of postoperative antibiotics in terms of incidence of complications in cleft palate surgery. Study Design: Prospective randomized control trial. Place and duration of study: Department of Plastic Surgery, Bashir Hospital, Sialkot from May 2016 to January 2019 Methodology:. Patients were randomly divided into two groups. Both groups received a single dose of injection Ceftriaxone (50mg/kg) about 30 minutes before incision. Group A (n=25) received a 5-day regimen of oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) post operatively. Group B (n=25) received 5-day regimen of oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) plus oral Metronidazole (7.5mg/kg/dose in three divided doses) for 5 days postoperatively. Patients were followed up postoperatively at 2 weeks, 1month and 2 months for complication such as infection and wound dehiscence. Result. .Candidates belonging to Group A, (Amoxicillin + Clavulanic acid group) were reported to have Infection 6 (24%) (P 0.005) and delay oral intake. Candidates who were administered oral Amoxicillin + Clavulanic acid (15mg/kg/dose in three divided doses per day) plus oral Metronidazole (7.5mg/kg/dose in three divided doses) 2 patients (8%) had infection in group B which was settled with improvement in oral hygiene. Conclusion: whose candidates who were admitted or stayed for longer duration of time in hospital had insufficient and poor dietary intake. One of the candidates was again admitted due to being dehydrated along with rotavirus whereas group A 24% patients got infected on the other end group B only 8% patients got infected.In net shell, this study revealed that use of postoperative antibiotics (Amoxicillin + Clavulanic acid and metronidazole) can reduce the incidence of infection and results in better surgical outcome of cleft palate surgery Keywords: cleft palate repair, Amoxicillin, Clavulanic acid, Metronidazole, Prophylactic Antibiotics

Objective: To determine frequency of complication of modified radical neck dissection in patients at a tertiary care hospital Karachi, Pakistan Material and Methods: Study design: This is a cross sectional section study, conducted at Department of ENT, for Six months from January 1, 2019 to July 1, 2019. All the patients who fulfilled the inclusion criteria and visited to department of ENT, were included in the study after taking informed consent. Patients were discharged by 48-72 hours postoperatively. Patients were assessed daily till the time of discharge for occurrence of nerve complication, wound complications and vascular complications. Data was entered and analyzed by SPSS 21 software. Mean, Frequency and percentage were given for continuous and discreet data respectively. Chi squire test was applied to detect significance. P value of < o.o5 was taken as significant. Results: Mean ± SD of age was 40.31±9.54 with C.I (38.62.......41.99) years. Out of 126 patients 84 (67%) were male and 42 (33%) were female. Out of 126 cases complication 46(37%) developed nerve complication, 47 (37%) had wound complication and vascular complication was documented in 27(21%) cases. Conclusion: surgical complications after modified radical neck surgery are not uncommon. Wound complication was found to be most common followed by nerve and vascular complication. Therefore proper antiseptic measures before, during and after surgery, patient care and careful surgical steps have a role in preventing these dreadful complications. Keywords: Modified Radical Neck Dissection, Complications, Nerve Complication, Wound Complication, Vascular Complication