Background: Various local anaesthetic agents are used for brachial plexus block.We compared effectiveness of addition of Dexamethasone versus Neostigmine to Lignocaine, adrenaline admixtures for Brachial plexus block in providing perioperative analgesia. Methods: Ninety patients were randomized in three groups and were received 24ml of study drugs. The groupA [Lignocaine with adrenaline (1.5%)], groupB [Lignocaine with adrenaline (1.5%)] +500μg Neostigmine, and group C (Lignocaine with adrenaline (1.5%) +4mg Dexamethasone) for brachial plexus block through supraclavicular approach. The observed parameters were onset of analgesia, completion of sensory and motor blockade, Duration of analgesia, Surgeon's score, side effects, number of supplemental analgesics doses and Visual analogue scale (VAS) score for pain in 12 hour of post-operative period. T he recent emergence of pain management as formal subspecialty and increasing importance of outpatient (Ambulatory) surgery in anaesthetic practice have further bolstered interest in peripheral nerve blocks. The peripheral nerve block may be used for surgical anaesthesia alone or, in conjunction with general anaesthesia and for the acute and chronic pain management. Many studies have been carried out for the search of better quality of analgesics in per-operative as well as in post operative period and it has been found that regional anaesthesia provides better result 1 . Brachial plexus block is an easy and relatively safe procedure for upper limb surgeries though there are different approaches to it, out of which supraclavicular approach is most consistent and widely used method for anaesthesia and peri-operative pain management in surgery below shoulder joint . So the provision of good quality of analgesia during and post -operative period is important not only to ease patients suffering and induce sense of well being but also improve the ability to ambulate early and thereby reducing post operative complication 2 .Various local anaesthetic agents are used for Brachial Plexus Block but most commonly used drugs are; Bupivacaine, and Lignocaine. Bupivacaine is long acting where as Lignocaine is short acting drug. Novel adjuncts studied to date include opioids, Clonidine, Neostigmine, Tramadol, Midazolam, Dexmeditomidine etc.Dexamethasone is very potent and highly selective glucocorticoid. Basically it is used as anti-inÀ ammatory and immunosuppressant. Its potency is about 40 times

Background: Tonsillectomy is one of the most commonly performed operations in otolaryngology. There are many proven methods of tonsillectomy, including cold dissection and bipolar electrocautery. Objective: To compare bipolar elecrocautery tonsillectomy with cold dissection method in pediatric age groups. Methods: Single blind controlled study to compare bipolar technique against the conventional dissection/snare technique. Results: The average amount of bleeding on electrocautery side was 4.07ml and on the cold dissection side was 14.58 ml. The mean time of operation for electrocautery and cold dissection was 12.04 and 16.57 minutes respectively. On the second post operative day, 35% of the patients complained of pain on the cauterized side, 30% complained of more pain on the dissection side while 35 % experienced equal pain on both sides. Post-operative complication such as hemorrhage was not seen in both the techniques employed. Conclusion: In the present study, bipolar diathermy tonsillectomy had advantages in having less post-operative time and blood loss intraoperatively but patients experience slightly more pain than cold dissection.

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Neurocysticercosis (NCC) is the most common parasitic infestation of the central nervous system and is one of the major public health problems in developing nations like Nepal. This study was conducted to find out total number of neurocysticercosis cases in BPKIHS from 2005 to 2013 AD and to know the duration for which cases were admitted and improvement seen in them. This is a hospital based retrospective study conducted from 31st March to 13th April 2014 to see the number of NCC in B P Koirala Institute of Health Sciences, Dharan of Nepal, a tertiary level referral hospital in the Eastern Nepal. It was study in which secondary data, consistent with the diagnosis of Neurocysticercosis was collected from the Medical Record Section of BPKIHS and reviewed. One hundred fourteen cases of neurocysticercosis were enrolled. The patients were predominantly males (nearly 63.2%) and it was more commonly seen in 2-20 years age group (42%). Most of the cases were from Sunsari District. Most of the patients (63.2%) were admitted in Medicine wards. Almost 90.4% of admitted Neurocysticercosis cases were improved in BPKIHS. The trend of Neurocysticercosis cases did not show any showed any consistent pattern in the past nine years. We conclude that the problem of Neurocysticercosis is common and has become a key public health concern for all.

Neuroendocrine neoplasms of the larynx are rare but are the second most common tumors of the region.  It is difficult disease to diagnose due to clinical and pathological heterogeneity of the condition. We report a 50 year old non-smoker lady with neuroendocrine tumor of supraglottic region of the larynx who was managed with endoscopic excision of the tumor and had no recurrence till 2 years of follow up.