Effect of military deployment in operational area on the trend of smoking among troops

To identify effect of military deployment in operational area on trend of smoking cigarettes among troops. Descriptive cross-sectional study. The study was carried out in an Army Brigade deployed in Operation Al-Mizan, Swat, from Jan to March 2014. Whole troops of an army brigade deployed in operation Al-Mizan, Swat were the part of present study. Total strength of brigade comprised of 1850 troops. Out of these 1850, officers constituted 53 [2.86%] and rest 1797 [97.14%] were Junior Commissioned officers [JCOs], noncommissioned officers [NCOs] and soldiers. All ranks other than officers were collectively termed as soldiers. All the individuals were given structured questionnaire to fill. The information was gathered on variables like age, rank, unit, education, duration of deployment in operational area, habit of smoking, intensity of smoking [number of cigarettes smoked daily] and change in the habit and intensity of smoking after being deployed in the operational area. Information was also gathered from the individuals about the reasons for change in the habit [starting or stopping smoking] and intensity of smoking after deployment in operational area. Forty nine individuals with less than 6 months duration in operational area were excluded. All the other officers and soldiers [1801] having served more than 6 months in the operational area were included in the study. There were total 1801 individuals included in the study. Officers constituted 52 [2.88%] of the total and rest 1749 [97.12%] were soldiers. The mean age of officers was 26.34 +/- 4.6 years and mean age of soldiers was 27.92 +/- 4.5 years. The overall frequency of smoking in officers and soldiers in the operational area came out to be 29.6%, however the overall frequency of smoking in these individuals before coming to operational area was 26.8%. There were 3 officers and 47 soldiers who started smoking in the operational area. There was an increased consumption of cigarettes among troops [p < 0.001]. The increased frequency of consumption of cigarettes in operational area was because of stress/increased combat activities, boredom, lack of recreational activities and monotony. It is concluded from the present study that operational activities increase the tendency of smoking in some troops and cause increased consumption of cigarettes by others mainly because of stress and peer pressure, which over the period of time can affect health, medical fitness and operational readiness of military personnel

To compare efficacy and discomfort in posterior nasal packing with Foley's catheters versus bipp gauze packing in cases of posterior epistaxis

To compare efficacy and discomfort in posterior nasal packing with Foley's catheters versus BIPP gauze packing in cases of posterior epistaxis. Randomized controlled trial. Combined Military Hospital [CMH] Kharian from October 2011 to October 2013. A total of 206 patients of posterior epistaxis were included in the study through nonprobability convenience sampling and randomly divided in two groups of 103 each. In group A patients were treated by posterior nasal packing with Foley's catheter and in group B patients were treated by posterior nasal packing with BIPP gauze and results in terms of control of epistaxis and discomfort during pack insertion, while the packs were in situ and pack removal, based on VAS [Visual Analogue Scale] were observed. Average age in group A was 52.64 years [SD=9.57] and in group B it was 50.27 years [SD +/- 10.13]. There were 71 [68.9%] males in group A while 67 [65%] males in group B. During posterior nasal pack insertion, the mean pain score in Group A was 6.21 [SD +/- I.13] and in Group B was 7.43 [SD +/- 1.19]. The mean pain score with the pack in situ was 4.27 [SD +/- 0.08] in Group A versus 4.76 [SD +/- 0.09] Group B. Similarly pack removal was also more painful in group B than group A [6.14 +/- 0.91 vs 6.89 +/- 1.09] [p =0.000]. In the group A, 31 [30.1%] patients had rebleeding after pack removal, out of which 9 [8.7%] had significant bleeding requiring repacking. In 22 [21.4%] cases there was mild bleeding which settled without repacking. In group B 22 [21.4%] patients had rebleeding after pack removal, out of which 5 [4.7%] had significant bleeding requiring repacking. It is concluded that posterior nasal packing with BIPP gauze pack is effective for controlling posterior epistaxis but causes more discomfort to the patients as compared to Foley's catheter packing

Management of suicidal cut throat-a case report

Suicide is one of the 10 leading causes of death in the world, accounting for more than 400,000 deaths annually1. Hanging, poisoning and fire arm are the most common methods of committing suicide in the world. Knives and razor blades are the common implements used in suicide2. Tentative marks were present in most fatalities3. Suicide by cutting one's own throat without hesitation cuts remains rare. Such life threatening injuries require emergency treatment3,4. Here we present a case of young individual presenting in ENT department Combined Military Hospital [CMH] Quetta with a suicidal cut throat injury, using a long bladed knife

Submandibular gland involvement in early stage oral cavity carcinomas: can the gland be left behind?

To determine the frequency of submandibular gland involvement in early oral cavity tumors. Observational study. ENT Department, CMH, Rawalpindi, from January 2008 to December 2011. Data of 110 oral cavity tumors operated over 2008 - 2011 was retrieved from ENT OPD, tumor registry in AFIP and from Head and Neck Oncology Forum Registry. Cases of oral cavity tumors that had undergone elective neck dissections were retrospectively studied for invasion of the submandibular gland, TNM Staging, perineural, perivascular, lymphovascular invasion, site specific frequency of oral cavity tumors and frequency of lymph node metastasis. Tumors of tongue were the most common constituting 42%, squamous cell carcinoma was the histological diagnosis in 90% cases. Sixty eight [61.8%] cases were node negative. Selective neck dissection was done in 55.5% of the cases. Submandibular gland was involved in 2 cases [1.8%]. Submandibular gland metastasis from early oral cavity tumors is rare; any neoplastic involvement of the gland usually occurs via direct spread