BackgroundAutism spectrum disorders (ASD) are a group of complex neurodevelopmental disorders. The prevalence of ASD in many South Asian countries is still unknown. The aim of this study was to systematically review available epidemiological studies of ASD in this region to identify gaps in our current knowledge.MethodsWe searched, collected and evaluated articles published between January 1962 and July 2016 which reported the prevalence of ASD in eight South Asian countries. The search was conducted in line with the PRISMA guidelines.ResultsWe identified six articles from Bangladesh, India, and Sri Lanka which met our predefined inclusion criteria. The reported prevalence of ASD in South Asia ranged from 0.09% in India to 1.07% in Sri Lanka that indicates up to one in 93 children have ASD in this region. Alarmingly high prevalence (3%) was reported in Dhaka city. Study sample sizes ranged from 374 in Sri Lanka to 18,480 in India. The age range varied between 1 and 30 years. No studies were found which reported the prevalence of ASD in Pakistan, Nepal, Bhutan, Maldives and Afghanistan. This review identifies methodological differences in case definition, screening instruments and diagnostic criteria among reported three countries which make it very difficult to compare the studies.ConclusionsOur study is an attempt at understanding the scale of the problem and scarcity of information regarding ASD in the South Asia. This study will contribute to the evidence base needed to design further research and make policy decisions on addressing this issue in this region. Knowing the prevalence of ASD in South Asia is vital to ensure the effective allocation of resources and services.

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

Deafness prevention should focus mainly on chronic suppurative otitis media, otitis media with effusion, and impacted ear wax prevention, integrated within the primary healthcare system and addressing the equity issue.

When we age, not only our aches and pains worsen, our skin wrinkles, teeth fall out, and our hair disappears, voices show sign of age as well. Few of us just think about how important it is until it stops functioning properly. In advanced age, we loose some of the fine coordination that we had in younger years, we loose muscle mass, our mucous membrane become thin and dry. Aging affect two main aspects of vocal fold anatomy and function. First, much like muscles elsewhere in the body, muscles of the vocal fold loses bulk (atrophy). Second, the flexible tissues which are responsible for vocal fold vibration during voicing (i.e. superficial lamina propria) become thinner, stiffer and less pliable. Together these changes sometimes results in voice which is percieved as sounding 'old'. The aging and upper aerodigestive tract:The phonatory organ is composed of the resonator (larynx), the articulator (supraglottic structures) and the compressor (lungs). Age related changes in any one or all of these structures can have a direct impact on voice quality and general comfort level (direct factors). 1

Tonsils are one of the important secondary lymphoid organ in immune system. It remains controversial whether tonsillectomy results in decreased serum immunoglobulin level. The purpose of this study was to observe the effect of tonsillectomy on humoral immunity parameters among the patients with tonsillar disease. Total group A 70 patients up to the age of 18 years, who were enrolled for tonsillectomy and 30 age matched children group B were included for comparative study. Serum IgG, IgM and IgA levels were measured in all 70 patients before tonsillectomy and in 56 patients who came for 1 st follow-up after one month and 30 patients who came for 2nd follow up after three months of tonsillectomy. Serum IgG, IgM and IgA levels were also measured in group B children. Serum IgG, IgM and IgA levels in patients of group A did not show any significant difference in comparison to group B. One month after tonsillectomy the level of IgG was slightly decreased and IgM and IgA were increased compared to preoperative value but not statistically significant. All IgG, IgM and IgA were also not significantly altered in comparison to group B. Three months after tonsillectomy serum IgG, IgM and IgA level were found decreased in comparison to pre operative value and group B, among which difference of only IgG was significant. After tonsillectomy humoral parameters were found reduced but overall impact on humoral immune status was not significantly altered.