Background In the past, group A beta-haemolytic streptococcus infection consequences were the main goal of empirical antibiotic therapy of sore throat. Antimicrobial stewardship is crucial due to the threats posed by multi-resistant pathogens. The aim of this study : was to investigate the possibility of limiting the role of antibiotic in children with adenotosilitis Methods: This hospitalbased, randomised, prospective research involved 120 child who visited OPD of both Pediatrics and Otorhinolaryngology departments, pesented with adenotonsillitis were enrolled . All cases met the eligibility requirements were randomly assigned to two groups: 60 cases in Group A got systemic antibiotics. Group B 60 cases received symptomatic treatment with immune modulator, vit D 2000-5000 IU orally once daily. The cases were selected through 2 months from 4118 February 2022 to April 2022. Age :2 years to 9 years. In younger children less than 3 years, dysphagia was expressed by the mothers as difficult swallowing and crying during feeding with drolling of saliva. Results: Regarding baseline symptoms and indicators and after three days, there was no discernible difference between groups A and B. However, after six days of therapy, group B considerably outperformed group A in terms of absent sore throat, dysphagia, and tonsillar hypertrophy. Comparing group B to group A, there was a noticeable improvement in clinical symptoms and indicators. Parents' clinical cure assessments of patients dramatically increased in group B, and group B also had a much shorter time to clinical cure.Conclusion: Vitamin D supplementation can reduce inflammation and modulate innate and adaptive immunity in children with adenotonsillitis, which can be utilised in place of antibiotics in these situations to restrict the usage of antibiotics.

Epistaxis has the potential to be lethal since it can impair a patient's airway, breathing, respiratory system, and circulation. To reduce morbidity, it is essential to recognise underlying bleeding diatheses that may be addressed medically as soon as feasible. Ten days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine, a 29-year-old man began to experience hematomas and epistaxis. This is the case study that we are providing. The experience serves as a cautionary tale that the SARS-CoV-2 virus can harm any organ, including the circulatory system, either directly through tissue tropism or inadvertently through inflammatory reactions in the form of innate immunity.According to the study that follows, vasculitis and vasculopathy associated with COVID-19 are a telltale symptom of a systemic virus-related disease.