Background Bell’s palsy is the most common cause of acute facial peripheral neuropathy commonly encountered in otolaryngology clinics. Studies regarding epidemiology, risk factors, treatment and prognosis of Bell’s palsy are sparse in our settings. Objective To analyze the prognostic factors of Bell’s palsy in tertiary care Centre of eastern Nepal. Method A retrospective chart review of patients diagnosed with Bell’s palsy from 1st January 2005 to 31st December 2018 was done. Records of the patients were obtained from medical record section of BP Koirala Institute of Health Sciences. Result A Total of 208 patients were included for analysis. After six months 72.6% patients had complete recovery. Patients who presented with lower House Brackmann (HB) grade had significantly better complete recovery than those with high grade (89.1% vs 45.6%). The complete recovery was 80.3%, 73.8%, 63.5% and 50% for the patients of more than 30 yrs, 31-45 years, 46-60 years and more than 60 years respectively and the difference was significant (p= 0.012). Alcohol significantly reduced the complete recovery (p= 0.043). Multivariate analysis showed high HB grade score at presentation to be significant predictor of poor prognosis. (p= 0.001 odds ratio 11.262). Conclusion Old age, use of alcohol and the severity of facial nerve palsy at the time of presentation were the bad prognostic factors, severity of the palsy was found to be most significant predictor.

In rare cases, foreign body aspiration may present with similar clinical features and CT findings to subglottic stenosis. A high index of suspicion and additional diagnostic techniques may be required to distinguish them.

Zygomycosis is an infrequently encountered locally invasive, aggressive fungal infection that frequently occurs in patients with an underlying immunodeficiency. It is usually diagnosed on histopathology and treated with systemic antifungals. We report a case of 16 years old female who presented with swelling on the dorsum of nose with overlying redness and tenderness. As she did not respond to antibiotics and conventional treatment, computed tomography (CT) scan and fine needle aspiration cytology (FNAC) were performed which revealed an inflammatory lesion. However, her histopathological examination was a surprise for all of us as it came out to be zygomycosis. She was started on oral antifungal, and responded well. Although a rare entity, primary cutaneous zygomycosis should always be kept in mind while evaluating any swelling if it doesn’t improve on conventional treatments and dealt accordingly.

e19014 Background: T-cell acute lymphoblastic leukemia/lymphoblastic lymphoma (T-ALL/TLBL) is an aggressive neoplasm of lymphoid tissue. It comprises 15-25% of all cases of ALL. Given the rarity of the disease, data regarding its optimal management remains limited. Hematopoietic stem cell transplant (HSCT) is usually recommended for patients with T-ALL in second or later complete remission (CR). The data on upfront use of HSCT in ethnic minority rich population is rare. Methods: We conducted a single-center retrospective observational study in patients diagnosed with T-ALL who were followed at our center from 2004-2022. We collected and analyzed data on demographics, race, treatment regimens including HSCT, and survival outcomes. Overall survival (OS) was compared using the Kaplan-Meier curve and log-rank test. P-values < 0.05 were considered as statistically significant. Cox proportional hazards regression model was used for the statistical analysis of prognostic factors and analyses were performed using R software. Results: We identified 59 unique records with this diagnosis (78% males, 22% females). The median age at diagnosis was 20 years (range 1-48 years). Sixty one percent were ethnic minority (32% African American, 29% Hispanic), 17% were white, and 14% were of other ethnicities. Patients were treated at diagnosis with conventional chemotherapy regimens. Our transplant cohort had 10 patients, eight of whom received an allogeneic graft (2 matched related donor, 4 matched unrelated, 1 haploidentical, and 1 cord blood transplant) and 2 an autologous graft. Eight out of 10 patients received HSCT in CR1, 1/10 patient in CR2 (remission data-not available 1/10 patient). The OS of patients transplanted in CR1 did not differ significantly from the patients not receiving HSCT in CR1 (p = 0.5) with OS rates at 12, 24, and 36 months of 87.5% vs 83%, 75% vs 77%, 60%vs 77% respectively. However in the patients who eventually relapsed (n = 13), OS was significantly higher in patients receiving upfront HSCT in CR1 (n = 8) vs patients receiving chemotherapy only (p = 0.013). Furthermore, the OS from the transplant date compared between patients of age (at the time of transplant) < / = 20 years vs > 20 years didn’t differ significantly with p values of 0.29. Conclusions: Our study in T-ALL patients from a mainly minority urban population in NYC showed OS was not significantly different when transplant patients were compared to patients receiving only chemotherapy. For patients who eventually relapsed, the OS for patients receiving upfront HSCT was significantly higher than patients receiving chemotherapy only. Hence, patients at high risk of relapse might benefit from upfront HSCT. However, due to small sample size, evaluation of the effects of confounders was limited in our study.