Patients with advanced age, abscess size > 5 cm, both lobes of the liver involvement and duration of symptoms > 7 d were likely to undergo aspiration of the liver abscess, regardless of etiology.

Objectives: To assess the pattern and degree of hearing loss in CSOM. Methods: A prospective study was carried out from January, 2007 to December, 2008 at the department of Otolaryngology-Head & Neck Surgery, BSMMU, Dhaka This study included 150 cases with 198 ears of CSOM including both tubo-tympanic and attico-antral variety excluding intracranial complications if any. Results: There were 81.31% cases of tubo-tympanic and 18.69% cases of attico-antral patients. Age of the patients was between 5-60 years, where male were 59.33% and female were 44.67%. Highest number of patients was in the age group of 21-30 years. Out of 198 ears, 102 had unilateral perforation and 96 had bilateral perforation. Most of the patients (53.33%) came from low income family and majority of them used to take their bath in the pond (29.34%) followed by tube-well (24.44%). Most of the patients had cleaning habit with clothes with sticks (53.5%).Majority of them resided in katcha house (52%) with poor hygienic condition. Central melleolar perforations were maximum (41.41%) and anterior central perforations were minimum (18.69%). According to sized of perforation, medium size central perforations were common (26.67%) It was shown that the site and sized of perforation affects the degree of hearing loss. Posterior central and attic perforations had greater hearing loss, 51.5 dB and 57.36 dB accordingly. On the basis of size, subtotal perforation had more hearing loss (54.54dB). It was also shown that posterior central perforation had greater hearing loss (51.5dB) than anterior- central (33.64dB) perforation. Hearing loss was more marked in patients with long duration of disease. In a history of 21-25years of disease, mean air conduction thresholds was 59 dB whereas of 0-5 years were 38.18 dB. Difference between them was statistically significant (t=5.88, p<0.001). Among the pattern of hearing loss, most of patients had conductive type (80.8%) hearing loss followed by mixed (17.17%) and sensorineural types (2.01%). Conclusion: Site of perforation, size of perforation and duration of disease affects the degree of hearing loss in CSOM . Key words: Hearing loss; CSOM; Tubo-tympanic; Attico-antral. DOI: 10.3329/bjo.v16i2.6844Bangladesh J Otorhinolaryngol 2010; 16(2): 96-105

Objectives: To find out the difference between tubotympanic and atticoantral type of chronic suppurative otitis media in their presentation, complications and hearing impairment they produce. Methods: This cross sectional study done in the department of Otolaryngology of Mymensingh Medical College Hospital and Bangabandhu Sheikh Mujib Medical University, during the period of January 2005 to February 2006. For this study 100 Patients who were diagnosed as a case of chronic suppurative otitis media by detailed history, clinical examination and related investigations were collected. Results: In this study majority of the patients were within 10-20 years of age & male female ratio 2.1:1. This condition was common in rural population with low socio economic status having poor nutrition and those who take bath in river or pond water in rural area. Common presentation of tubotympanic type of CSOM was aural discharge and deafness but presentation of atticdntral type of CSOM was aural discharge and deafness with other symptoms like earache, fever, headache tinnitus and vertigo, etc. Hearing loss was found more in atticoantral type of disease. Complication of CSOM was found only in atticoantral type of disease. Conclusion: Complications are more frequent and hearing impairment is morein severity in case of atticoantral type of chronic suppurative otitis media Key word: CSOM; Tubotympanic; Atticoantral.DOI: 10.3329/bjo.v16i2.6846Bangladesh J Otorhinolaryngol 2010; 16(2): 113-119

Abstract:Background: Systemic lupus erythematosus in children (Paediatric SLE / pSLE)

Objectives: To find out the frequency ,indications and effects of tracheostomy in head-neck malignancy.Methods: Total 100 cases of head-neck malignancy that needed tracheostomy were studied in the department of Otolaryngology and Head-Neck surgery of Dhaka Medical College Hospital and Begum Khaleda Zia Medical College and Shahid Sohrawardi Hospital, Dhaka.Results: The mean age of the subjects was 53.60 years. Out of 100 cases male were 86 and female were 14 with male to female ratio 6.14:1. The highest number of the subjects were related to cultivation and majority of the subjects came from poor socio-economic status. Malignancy in head-neck region is multifactorial disease. Regarding habits 71% were smoker, 21% were habituated with chewing betel nut and leaf. Only 2% were alcoholic. In 93% tracheostomy was done on an emergency basis and rest 7% was elective. Carcinoma of larynx was the most frequent indication (65%), which was followed by carcinoma pyriform fossa (28%), carcinoma base of the tongue (3%), carcinoma tonsil 2% and carcinoma thyroid gland 2%. The rate of complications was 41%. Surgical emphysema was the commonest complications (19%), which were followed by haemorrhage (7%), wound infection (4%), tube displacement (3%), tube blockage (3%), crusting (2%), stomal stenosis and subglottic stenosis (1%). No fatality was found in this study.Conclusion: The rate of complication of tracheostomy is high in patients of head-neck malignancy with respiratory distress. Key words: Tracheostomy; Head Neck Cancer. DOI: 10.3329/bjo.v16i2.6847Bangladesh J Otorhinolaryngol 2010; 16(2): 120-125