Context: Chronic suppurative otitis media (CSOM) is a common cause of preventable hearing impairment worldwide, particularly in low and middle-income countries. Untreated CSOM may result in permanent hearing loss, which in turn, may result in speech and language delays or permanent learning disabilities, as well as behavioural problem. Of the treatment options, the efficacy of using only topical antibiotics and combination of systemic antibiotics and topical antibiotics are most disputable. The present study was undertaken to investigate the role of adjuvant systemic antibiotics in the treatment CSOM. Methods: A randomized clinical trial was carried out on children with chronic suppurative otitis media at the ENT outpatient department of Dhaka Shishu Hospital from January to December 2009. Any patient presenting with a stage of ear disease in which there is chronic infection of the middle ear cleft, a non-intact tympanic membrane and a history of discharge for at least two weeks was considered as a case. A total of 112 cases of chronic suppurative otitis media were consecutively enrolled in the study. Of them, 72 completed 3rd follow up visit and hence, considered evaluable. Results: The results of the study demonstrated that the study groups were almost identical in terms of age, sex, socioeconomic class and residence. The peak age incidence of chronic suppurative otitis media was found between 4-6 years (around 75%). In both the groups, the patients were predominantly male, belonged to poor and lower middle class families and slum dwellers. No significant difference was observed between the study groups in terms of primary and secondary outcome as well as the complications encountered by the patients. Patients of who received combined therapy, 70% of them showed resolution of otorrhoea by 2 weeks and 95% by 3 weeks, which in the patients of topical antibiotics alone was 50% and 87.5% respectively. The trial did not show any adverse event except tinnitus complained by a few patients in both groups. Conclusion: Topical quinolone antibiotics (ciprofloxacin) are equally effective as topical plus oral antibiotics (ciprofloxacin) for resolution of otorrhoea from uncomplicated CSOM. However, for faster resolution of otorrhoea, a short course systemic antibiotic can be added. Key words: Chronic suppurative otitis media (CSOM); topical antibiotics; topical plus systemic antibiotics; primary outcome; secondary outcome. DOI: 10.3329/jdmc.v19i2.7075J Dhaka Med Coll. 2010; 19(2) : 86-90

DOI: http://dx.doi.org/10.3329/jdmc.v21i1.13243 J. Dhaka Med. Coll. 2012; 21(1): 76-82

DOI: http://dx.doi.org/10.3329/jdmc.v20i2.10551 J. Dhaka Med. Coll. 2011; 20(2): 204-209

Juvenile angiofibroma is a rare hypervascular, locally aggressive benign tumour which is exclusively found in the nose and paranasal sinuses of male adolescents. The definitive treatment for this tumour is complete surgical excision. Different surgical approaches are used for complete excision. Most recent development is excision of the tumour using endoscopes. But in certain cases with large size and different extensions, open transfacial approaches are the choice for complete removal and for less operative bleeding, which are the main challenges for surgical excision of this tumour. DOI: http://dx.doi.org/10.3329/jdmc.v20i1.8587 J Dhaka Med Coll. 2011; 20(1) :78-81

Context: Cervical plexus block anaesthetizes the pain sensitive structures in the neck, shoulder and skin of upper chest up to sternal angle which is suitable for operations in the neck and shoulder, particularly on the thyroid gland. It may also be used as a modality of pain therapy in this region. The aim the study was to find out the advantages and disadvantages of thyroid surgery under regional anaesthesia i.e. cervical plexus block. Methods: Nine cases of thyroid disorders were operated in Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, over a period of 18 months from July 2008 to September 2010, where lobectomy was done in 2 cases, hemithyroidectomy in 4 cases, isthmusectomy in 1 case, subtotal thyroidectomy in 1 case and total thyroidectomy in 1 case. Results: The advantages that we observed were less bleeding, time saving procedure, avoidance of endotracheal intubation, physical ability of the patient to take food and drink immediately at post operative period and early mobility of the patient after the operation. The only disadvantage that we faced was temporary dysphagia in one case. Key words: Cervical plexus block; regional anaesthesia; thyroid surgery. DOI: 10.3329/jdmc.v19i2.7072J Dhaka Med Coll. 2010; 19(2) : 76-79