Objectives: It’s very common that patients with psychiatric illness visit other specialties and in a survey it was found to hold a percentile of 15% to 30% of all primary care consultations. This study is designed to assess psychiatric patients who present in Clinic with ENT symptoms but result in no disease. Study Design: Cross-sectional study. Setting: ENT OPD of People Medical College, Nawabshah. Period: 1ST Jan 2019 to 31ST Jan 2019. Material & Methods: We selected a total sample of 320 patients who presented with ENT diseases where we excluded patients with organic diseases and studied those who didn’t show any clinical sign of organic diseases. The registered patients were evaluated by psychiatrist. Results: It was observed that out of 320 patients 180 patients were having psychiatric problem and those patients were advised to visit psychiatrist and take follow up on month end. Out 0f 180 patients 140 patients visited ENT OPD twice and 110 patients got relief in one visit. Conclusions: We found that conducting a cross-sectional survey using GHQ-12 helped us in detecting psychiatric patients presenting with unexplained diseases in ENT Clinics however to reach more accuracy in results, further tools can be utilized .We also believe doctors at all specialty clinics need to give more attention to their diagnosis and assist patients to open up to them and not to feel embarrassed.

In the following report, we document a case of gastroesophageal reflux disease (GERD) emerging from a peculiar etiology. A 20-year-old male presented to the out-patient department (OPD) of ear, nose & throat (ENT) of Dow University Hospital in Karachi, Pakistan, by referral from remote hospitals with a complaint of stomach upset. Upon a detailed historical assessment of the patient, the picture of a convoluted path to diagnosis emerged. Considering the patient's short stature and a bony mass on the mandible, a full body bone scan was ordered, uncovering a brown tumor. An elevated serum parathyroid hormone (PTH) level was detected in the presence of elevated serum calcium and low vitamin D levels. Upon subsequent computed tomography (CT) and magnetic resonance imaging (MRI), a cystic tumor of the pancreas was discovered in addition to a parathyroid adenoma which was promptly operated upon through a right-sided parathyroidectomy. The procedure successfully controlled the serum calcium levels of this patient which are suspected to have produced his gastroesophageal reflux-related symptoms. This case highlights the importance of accessible medical infrastructure and one of the unique causes of GERD.