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.

Background: Occupational hazards and risks are a common public health issue, especially when healthcare workers safety is concerned; Noise induced hearing loss is a common preventable occupational hazard which affects millions of people globally1. It is the hearing loss that is caused by prolonged exposure of the ear to the noise2. Aim: To identify prevalence of Noise induced hearing loss in industrial workers from July 1, till December 31st, 2021 Study design: Descriptive, cross-sectional study Place and duration of study: The current study was conducted at Taxila at HITEC-Institute of Medical sciences from July 1, till December 31st, 2021. Methodology: A total number of 314 workers working in industrial area with noisy surroundings according to the selection criteria were included in the study. A questionnaire about past medical history of all participants in regard to ear and hearing disorders was obtained. Prevalence of NIHL was assessed in all workers with or without hearing loss. Results: The total numbers of workers included in the study were 314. The total number of patients having NIHL was 42. Prevalence of NIHL was 13. NIHL is a global health problem and is the second most important cause of hearing loss. It is a preventable disorder that affects a large proportion of workers. In our setup the NIHL was lower than expected due to better control of Noise and proper use of noise protective equipment. Keywords: NIHL = Noise-induced Hearing Loss, sensorineural hearing loss, Hearing loss.

Objectives: To evaluate the effect on post tonsillectomy pain control with IV and infiltrated dexamethasone and infiltrated bupivacaine. Methodology: This randomized controlled trial study was conducted in the department of ENT and neck surgery of Holy Family hospital, Rawalpindi, over a period of one year from May 2019 to May 2020. A total of 140 pediatric patients were selected and were divided into four equal groups randomly by lottery method. Patients in all four groups had endotracheal intubation with general anesthesia. As premedication, all the patients received intravenous midazolam (1mg). Intravenous fentanyl (1.5mg/kg) and propofol (2.5 mg/kg) followed by endotracheal intubation facilitated with atracurium (0.5 mg/kg) were used as general anesthesia in all patients. Results: There was no significant (p-value >0.05) difference in gender, age of children, postoperative heart rate, postoperative SPO2, and fentanyl consumption. The duration of surgery was significantly (p-value < 0.05) different in all four groups. According to the results, no significant (p-value >0.05) difference was found based on postoperative nausea and vomiting and the requirement of antiemetics. The requirement of analgesics was significantly (p-value <0.05) different among four groups. Minimum number (22.86%) of patients who required the analgesic were in IV dexamethasone group and highest requirement rate (60%) was found in local dexamethasone group followed by bupivacaine (48.57%) group. Conclusion: Intravenous dexamethasone was found to be more effective for early postoperative pain control and reduction in requirement of analgesics. The use of dexamethasone can be a preferred choice in patients undergoing tonsillectomy.