Background: Epistaxis is bleeding through nose. It is most common emergency situation in ENT that is disastrous to the patient and troublesome to treat for doctors. It is seen that 60% population experiences epistaxis in their life time and only 6% went to take consultation. The study  aims to evaluate incidence, etiology, provoking factors and cost effective management. Subjects and Methods: A 3 years retrospective study between September 2015 to August 2018 carried out in Anugarah Narayan Magadh Medical College & Hospital, Gaya on 98 admitted epistaxis patients. Results: Total 11,667 patients came in ENT department among them 2,723 patients with nasal complain. Incidence was0.84% among all cases and 3.6% among nasal problems. No obvious cause seen in 34 cases (34.23%) then cardiovascular cause in 32 cases (32.65%) then infection in19.32% and lastly by trauma in 5.68%. Maximum patients in 40-50 years age group 36% and minimum in 70-80 years 1%. Most patients belong to urban76 cases (77.27%) and middle age 36 cases (36.36%). Males are more prone 57 cases (57.95%) with ratio 1.39:1. Mostly in January-March months 45 cases (46.59%). Most patients came with unilateral epistaxis 86 cases (87.5%). About 26cases (26.14%)came with single episode whom urgent treatment required. Well managed with Nonsurgical method to 85 patients (86.73%) by anterior nasal packing (ANP) in 43 cases (43.87%) and chemical cauterization to 19 cases(19.30%) while surgical treatment given to 13 patients (13.26%).Some required electrocauterization 16 cases (16.32%) with bipolar. Mean hospital stay length 3.2 days. Blood transfusion required in 7cases (7.14%). Conclusion: Cost effectively anterior nasal packing is best conservative indirect method and electrocauterization is very effective direct method.

Introduction: I-gel and classic Laryngeal Mask Airway (cLMA) are two Supraglottic Airway Devices (SAD) used for management of airway in various situations, including for management of difficult airway. Despite widespread use of these devices, there are very few trials studying I-gel and classic LMA for management of patients with difficult airway. The outcome of present study determines which SAD is better for managing difficult airway. Aim: To compare I-gel and cLMA in managing anticipated difficult airway. Materials and Methods: This randomised and single blinded clinical trial study was conducted in King George’s Medical University, Lucknow, Uttar Pradesh, India, between February 2019 to January 2020. Adult patients with Mallampati class 3 or 4, thyromental distance <6 cm, sternomental distance <12 cm, restricted neck movement, micrognathia/retrognathia or short/thick neck undergoing elective short duration surgery under general anaesthesia were included in this study. Total 50 patients divided into group C received cLMA while group I patients received I-gel for airway management. Fifty patients were recruited in each group. Nominal variables were analysed using chi-squared test. A two-sided p<0.05 were considered significant for all the tests. Analysis was performed using Statistical Package for Social Sciences (SPSS) version 25.0 for windows. Results: Mean age in group C was 40.38±12.96 (years) and in group I was 37.94±11.77 (years) with p-value 0.327. Overall (n=44 in group C, 50 in group I, p-value=0.012) and first attempt (n=10 in group C, 40 in group I, p-value <0.001) success rate of device placement was higher for I-gel. Number of attempts, manipulations, time needed to insert and Leak Fraction was significantly lower for I-gel (p-value <0.001). Compared to cLMA, Oropharyngeal Leak Pressure (OLP) was higher with I-gel. Fibreoptic view on a four-point scale was better with I-gel. Desaturation, tachycardia, bradycardia, and postoperative sore throat was more frequent with cLMA. Conclusion: Compared to cLMA, I-gel has higher success rate of insertion in patients with difficult airway and has added advantage of more rapid insertion, higher OLP and need for fewer insertion attempts and manipulations with lower rates of complications.

Background: Type I tympanoplasty is a surgical technique used to restore the integrity of tympanic membrane as well as improve the hearing in inactive mucosal chronic otitis media. There are two main methods that are underlay and overlay in between both is interlay. The aim of the present study is to analyse and compare the results of the two most commonly used type I tympanoplasty techniques, underlay and the interlay technique in chronic otitis media with mucosal disease in large central perforation, in terms of graft uptake and hearing improvement. Subjects and Methods: This is a randomized prospective study of 100 cases of inactive mucosal chronic otitis media with total or large anterior central perforation between October2017 to September 2019 in Anugarah Narayan Magadh Medical College & Hospital, Gaya. Half had gone through Interlay and half by Underlay technique of Type I Tympanoplasy surgery. Results: The graft uptake rate in this study was 96% and 90% for Interlay and Underlay technique respectively. Postoperatively mean air bone gap maximally reduced in the Interlay technique. Conclusion: The present study showed that Interlay method had better graft uptake rate as well as hearing improvement in total and large anterior central perforation of inactive mucosal chronic otitis media than the Underlay technique.