Background: Blue Rubber Bleb Nevus syndrome (BRBNS) is a rare disorder, that results in congenital cutaneous hemangiomas of the skin and gastrointestinal tract. Although asymptomatic, the nevi present as soft, non-mobile, dark blue, compressible papules. Clinically it presents as iron deficiency anemia due to occult gastrointestinal bleeding. Case presentation: A 22-year-old female patient presented with complaints of shortness of breath, fatigue, and palpitation for 2 months. On examination, she had a pale effect and widespread hemangiomas on her lips, hands, and feet. Laboratory results revealed iron deficiency anemia with hemoglobin (Hb) of 2.1 gm/dl and histopathology results of the hemangioma specimen showed angiokeratomas. Based on clinical manifestations and laboratory results, the patient was diagnosed with a case of BRBNS. The patient was transfused with red cell concentrate her symptoms improved but on the first follow-up visit her Hb again dropped to 8.6 mg/dl. Conclusion: A high suspicion of BRBNS diagnosis should be considered if a patient presents with iron deficiency anemia and multiple cutaneous hemangiomas. Further screening should be done to explore internal bleeding and hemangiomas.

A retrospectively reviews of 11 patients treated for carcinoma of EAC at our department between January 2000 and December 2018 was conducted to evaluate outcomes in treating carcinoma of external auditory canal (EAC) and to analysis factors which effect the prognosis of this disease. All patients underwent surgical treatment and the diagnosis confirmed by pathological examination. Results: There were adenoid cystic carcinoma (ACC) in 6 patients, squamous cell carcinoma (SCC) in 3 patients, adenocarcinoma (AC) in one patient, and verrucous carcinoma (VC) in I patient. The tumors were classified as Stage I in 5 cases, Stage II in 2 cases, Stage III in 3 cases, and Stage IV in 1 cases. Four patients underwent extensive tumor resection (ETR), 2 patients underwent lateral temporal bone resection (LTBR), 2 patients underwent modified LTBR, one patient underwent subtotal temporal bone resection (STBR), and 2 patients underwent only open biopsy. Besides, adjunctive procedures, including neck dissection, parotidectomy and pinna resection were performed when indicated. Ten patients received postoperative radiotherapy. By the end of follow up, two patients had died of their disease, 2 lost to follow up, 2 survived with the disease, and the rest survived disease-free. The median follow-up period was 24 months. Complete tumor resection appears to be an effective treatment for carcinoma of the EAC. Patients with SCC seem to have worse prognosis than those with ACC. Radiation therapy seems less effective for the disease than surgical treatment.

Sudden Sensory Neural Hearing Loss (SSNHL) is a serious medical condition and requires prompt medical attention. The study was done to estimate the effect of different protocols of oral Prednisolone plus high dose vitamin B-complex and vitamin BI, 132. Be in patients with unilateral SSNHL who have failed to respond to treatment. A retrospective study was done from January 2015 to January 2018 at the outdoor patient department of Holy Family Red Crescent Medical College Hospital, Dhaka among 75 randomly selected patients with a mean age of 46.32 years (range 25-69 years). with the preselected criteria. Each of the patient received one of the four standard oral Prednisolone dosing protocols along with high dose of vitamin B-complex and BI, 132, Be orally 20mg four times for a total dose of 80mg daily for one week, Group A, n=18; orally 20 mg three times, for a total dose of 60mg daily for one week Group B, n=18; orally 20mg two times for a total dose of 40mg daily for one week Group C, n=18; orally 10mg three times for a total dose of 30mg daily for one week. Group a n=18. All the doses were then tapered for next 5 days. Patient characteristics and pharmacological effects were compared among the 4 groups. The mean age, average duration of symptoms from onset to treatment, and degree of hearing loss were analyzed by means oft-test Treatment effects were analyzed by means of Chi-square test. P<0.05 was considered significant. Improvement of hearing was assessed by pure tone audiogram. The total effective rate was 88.89% 83.33%, 77.78% 66.67% for each treatment protocol, respectively, with no significant statistical difference between them (p00.05). The results suggest that a total dose of 80 mg is the most appropriate protocol. Prednisolone significantly improves the prognosis of SSNHL. Further multicenter studies are needed to determine the more standard treatment protocol.

A prospective study of 169 children when compliments of possible hearing loss who attend to ENT OPD of Holy Family Red Crescent Medical College Hospital within the period of 2010 - June 2013 at the age between 2-5 years. Among the children 102 (60%) were diagnosed having hearing loss. Male and female ratio was 1.3:1. Large age group was between 2-3 yrs. Measles (18.37%) was the leading childhood infection, exposure to passive smoking (52.63%). Birth history evalution showed foctal deshur (33.13%), low apger score (24.26%), hyperbilirubinemia (52.66%). Physical examination revealed variety offending including small (7.10%) and long (5.33%) stature, persistent otorrhoea (11.24%), and cleft lip (5.32%), cleft platate (3.55%). Sensorineural (74.53%) and conductive (25.47%) type of deafness was found.

The cross sectional study was done too measure prevalence of hearing impairment (HI) in school children living in poverty area of Bangladesh and to identify risk factors for HI and assess its impact on academic performance. The study was conducted on 325 school children (aged 6-19 years) of Digpait D.K high school, Jamalpur, from January 2013 to July 2013. Audiological health was assessed with pure-tone audiometry, tympanometry, and otoscopy. The primary outcome was HI, defined as average threshold >25 dB HL for 0.5, 1, 2, and 4 kHz, in one or both ears (a s per World Health Organization/International Organization for Standardization). A questionnaire on health history was administered to parents. HI prevalence: 6.9 percent, risk factors for HI: neonatal jaundice (8.0) seizure (7. 31), hospitalization (15.3), recurrent otitis media (13), past otorrhea (13.7), tympanic membrane abnormality (14.8), cerumen impaction (6.3) and eustachian tube dysfunction (8.67). HI was an independent predictor of academic failure (3.36). impoverished Bangladesh school children were four to seven times more likely to experience HI than children living in higher-income countries. Untreated middle ear disease in the context of limited access to pediatric care was a major risk factor for HI. Furthermore, HI was associated with worse scholastic achievement.