Impact of the Covid-19 pandemic on audiology service delivery: Observational study of the role of social media in patient communication.

The Covid-19 pandemic has highlighted an era in hearing health care that necessitates a comprehensive rethinking of audiology service delivery. There has been a significant increase in the number of individuals with hearing loss who seek information online. An estimated 430 million individuals worldwide suffer from hearing loss, including 11 million in the United Kingdom. The objective of this study was to identify National Health Service (NHS) audiology service social media posts and understand how they were used to communicate service changes within audiology departments at the onset of the Covid-19 pandemic. Facebook and Twitter posts relating to audiology were extracted over a six week period (March 23 to April 30 2020) from the United Kingdom. We manually filtered the posts to remove those not directly linked to NHS audiology service communication. The extracted data was then geospatially mapped, and themes of interest were identified via a manual review. We also calculated interactions (likes, shares, comments) per post to determine the posts' efficacy. A total of 981 Facebook and 291 Twitter posts were initially mined using our keywords, and following filtration, 174 posts related to NHS audiology change of service were included for analysis. The results were then analysed geographically, along with an assessment of the interactions and sentiment analysis within the included posts. NHS Trusts and Boards should consider incorporating and promoting social media to communicate service changes. Users would be notified of service modifications in real-time, and different modalities could be used (e.g. videos), resulting in a more efficient service.

Ameliorating effect of Malva Neglecta on hyperglycemia and hyperlipidemia in diabetic rats

The plant, Malva neglecta wallr., is widely consumed for medicinal and nutritional purposes. The current study was carried out to assess the hypoglycemic and antihyperlipidemic potential of aqueous methanolic extract of M. neglecta. Chemical evaluation of the extract was performed by high pressure liquid chromatography. Oral glucose tolerance test (OGTT) was done in diabetic rats pre-exposed to 250, 500 and 750 mg/kg plant extract via the oral route. For hypoglycemic and biochemical study, the same therapy was administered to alloxan induced diabetic rats for 14 days. The standard control group received Glibenclamide (5 mg/kg). Ferulic acid, p-coumaric acid and other phenolic acids were detected and estimated in the extract. Administration of the plant extract significantly reduced blood glucose level in diabetic rats subjected to OGTT. The plant extract lowered the fasting blood glucose and alpha amylase, and prevented the damage to pancreas. It also corrected dyslipidemia in diabetic animals following 14 days therapy. Hence, this experimental study establishes the fact that M. neglecta exhibited significant antidiabetic and antihyperlipidemic activities in alloxan induced diabetic rats.

Emergency Inguinal Hernia Repair: Comparison Of Desarda's Versus Darning Technique.

BACKGROUND: Emergency inguinal hernia repair remains the commonest operation performed by general surgeons all over the world. The aim of this study was to compare the mean operative time, post-operative pain, wound infection and early recurrence between Desarda's and Darning emergency inguinal hernia repair. METHODS: This is a randomized controlled trial conducted at Jinnah Postgraduate Medical Centre, Karachi. A total of 186 patients of male gender between ages 20-60 years with incarcerated, obstructed and strangulated inguinal hernia were enrolled in the study. Patients with primary and recurrent inguinal hernias were excluded. All patients were randomized to Desarda group (n=93) and Darning group (n=93). RESULTS: Mean operative time in Desarda group was 55.53±6.81 minutes and mean operative time in darning group was 53.06±5.51 minutes (p-value 0.007). Mild to moderate pain was found insignificantly higher in Desarda group 75 (80.6%) as compared to Darning group 66 (71%) (p-value 0.170). Wound infection was found higher in Desarda group 18 (19.4%) as compared to darning group 9 (9.7%) (p-value 0.061). Recurrence was found significantly higher 15 (55.5%) in Darning group as compared to Desarda group 2 (7.4%) (p-value <0.001). CONCLUSIONS: No significant difference was observed in the postoperative pain, wound infection however, significant differences were observed in the mean operative time and recurrence rates.

Zuckerkandl Tubercle: An Important Landmark in Thyroid Surgery.

OBJECTIVE: To find out the frequency of Zuckerkandl Tubercle (ZT) and the position of recurrent laryngeal nerve with reference to ZK. STUDY DESIGN: Cross-sectional observational study. PLACE AND DURATION OF STUDY: Surgical Ward-3, Jinnah Postgraduate Medical Centre (JPMC), Karachi, from June 2010 to August 2011. METHODOLOGY: Patients having goiter, aged between 12 - 60 years were admitted through OPD and operated after informed written consent. After admission, they underwent surgery. ZT and recurrent laryngeal nerve position i.e. whether medial, lateral or posterior to ZT was identified during surgery. Data was collected on pre-designed proforma and analysed on SPSS version 15 for descriptive statistics. RESULTS: Out of the 84 patients ZT was found in 52 (61.90%) patients. Nineteen patients had grade-I (less than 0.5 cm), 22 (42.3%) had grade-II (0.5 - 1 cm) and 11 (21.1%) had grade-III (more than 1 cm) ZT. During surgery, 33 (63.4%) patients had recurrent laryngeal nerve medial to ZT, 15 (28.8%) patients had lateral and in 4 (7.6%) patients recurrent laryngeal nerve was engraved posteriorly. CONCLUSION: Zuckerkandl tubercle was found in about 62% cases; recurrent laryngeal nerve was located pre-dominantly medial to ZT.

Screw fixation of the radial head: radiological assessment of the proximal radio-ulnar joint and average radial head diameter-an anatomic study.

INTRODUCTION: Anatomical study of 11 radii heads was done. METHOD: A screw which is 2 mm longer than radial head diameter was used. Five views (AP with the forearm in supination, neutral rotation, pronation and LAT view the arm in supination and neutral rotation) were taken. In all cases the screw penetration was detected in one or two of the anteroposterior views. The lateral views were not sensitive to detect the screw penetration. For intraoperative assessment of screw length, the anteroposterior views in different position of rotation is sensitive method to detect penetration of the open reduction of head radius. Anteroposterior and lateral view with the arm in same position can miss some case of screw penetration. The diameter of the radial head was assessed. RESULT: A difference in the radial head diameter between males and females was noticed. This can be reflected on the screw diameter.