Background: Foreign body (FB) impaction in the esophagus is a common emergency in all age groups. In the children coins are the commonest foreign bodies while bones have been found as the commonest in adults. Methods: This is a retrospective study comparing FB in the esophagus in adult and pediatric population between June 2007 and May 2010 in Manipal Teaching Hospital, Pokhara, Nepal. Most of the patients underwent rigid esophagoscopy and FB removal; few were removed under anesthesia by the anesthesiologists. Comparison was done in terms of pattern of FB, their site of impaction and relative ease of removal. Data were collected from the case file available from the medical record department and analysed using SPSS 11.6. Results: A total of 63 cases were included in this study. Out of which 28 (44.4%) patients were children and 35 (55.5%) were adults. Coin was the most common foreign body in the pediatric population (82.1%) whereas bones were the commonest ones (91.4%) in adults. In the pediatric population the commonest site of impaction was upper esophagus (92.8%) whereas mid esophagus was the commonest site (65.7%) in adults. Conclusion:There are differences in various aspects of impacted foreign bodies in esophagus in adult and pediatric populations. Coins being the commonest foreign bodies in children are relatively easier to remove due to their higher location and less chances of trauma. Contrary in the adults, bones being the commonest foreign body are difficult to remove due to the lower location and chances of trauma. Keywords: Foreign body; esophagus; rigid bronchoscopy DOI: http://dx.doi.org/10.3126/njms.v1i1.5797   Nepal Journal of Medical Sciences. 2012; 1(1): 42-44

A 48-year-old man presented with proptosis of the left eye, which on excisional biopsy proved to be primary adenosquamous carcinoma of the lacrimal gland. The lesion was excised radically by a limited frontotemporo-orbitozygomatic approach and any further surgeries, such as exenteration, were avoided in view of the patient's wish to preserve the eye and vision. Long-term follow-up is planned to look for any metastasis or recurrence of the tumour. Primary adenosquamous carcinoma of the lacrimal gland is a very rare entity and, following a thorough literature review, only two cases of lacrimal gland adenosquamous carcinoma have been reported so far.

Objective: To study the role of nasal decongestants in spontaneous healing of traumatic tympanic membrane perforation.Material and Methods: A prospective single blinded, randomized controlled study was carried out in the department of ENT, Manipal College of Medical Sciences, Pokhara, Nepal. Patients with traumatic tympanic membrane perforation were divided into two groups; those receiving nasal decongestants along with conservative measures (Group1) and those receiving conservative measures only (Group2). Healing of tympanic membrane was compared in between these groups at 1 and 3 months. Statistical analysis was done using SPSS 20.Results: There were 30 patients in group 1 and 28 patients in group 2. The mean age of the study population was 26.98 (SD= 7.53). The M: F ratio in group 1 was 0.58:1 and that in group 2 was 0.56:1. Complete healing was seen in 25 (83%) patients in group 1 and 16 (57.1%) patients in group 2 at the end of 1 month (P=0.029). Similarly, healing was seen in in 29 (96.7%) patients in group 1 and 21 (75%) patients in group 2 at the end of 3 months (P=0.023).Conclusion: Routine use of nasal decongestants increases the chances of spontaneous healing of traumatic tympanic membrane perforations.

Introduction: Otorhinolaryngological injuries in head injury are something which are very common but yet are overlooked, missed and at times forgotten. In this study, we tried to see the epidemiological characteristics, clinical presentations and management of these associated injuries in cases of head injuries in a tertiary care center in western Nepal. Methods: An analytical study was done in all cases of head injury admitted to neurosurgical ward and ICU in between January 2019 to December 2019. Various clinical and epidemiological details were collected from the patient’s records obtained from Medical Records Department and charted in a preformed performa. All the continuous data were presented in terms of mean and standard deviation and categorical data in terms of percentage. Statistical analysis was done using SPSS 22.0 software. Results: Soft Tissue lacerations were the commonest findings in all head injuries; nose and face lacerations (29.5%), ear lacerations (23.5%) followed by facial bone fractures (19.2%). There were 41(52.6%) cases with mild head injury, 23 (29.5%) cases with moderate head Injury and 17 (17.9%) cases with severe head injury in patients those had associated ENT findings. There was no any statistically significant difference in outcome or hospital stay in between the head injuries with and without ENT manifestations (p=0.187) and (p=0.219) respectively. Conclusion: Skull base tumors are treated based on findings of diagnostic nasal endoscopy and imaging results. CT scans and MRIs are becoming more significant in the diagnosis of diseases. Endoscopic techniques to the skull base were beneficial in treating the malignancy. Chemotherapy can be used as a gold standard first-line treatment with radiation and surgery for significant types of head and neck tumors. immunotherapy-like checkpoint inhibitors targeting PD1 are the second-line treatments of advanced HNSCC. Prospective research and trials will be required in the future.

Background: The main goal of inferior turbinate surgery is to relieve obstruction while preserving the function of the turbinates as much as possible. Partial inferior turbinectomy (PIT) is an accepted and effective treatment in relieving the nasal obstruction while preserving the turbinate function. The use of endoscope provides complete visualization of the operating field and thus decreases the risk of excessive or inadequate resection. Methods: A prospective single blinded randomized controlled trial was carried out in Department of ENT, Manipal Teaching Hospital, Pokhara, Nepal from September 2008 to March 2010 with an objective to compare between the conventional and endoscopic method of PIT in terms of outcome and post-operative morbidity in chronic hypertrophic rhinitis. Hundred cases were taken and assigned randomly into two groups; i.e. endoscopic PIT and conventional PIT. The post-operative findings were compared between the two groups using Fischer Exact test for proportion and t test for mean. Results: There was 94% improvement in nasal obstruction in conventional group and 100% in endoscopic group at 1 month whereas improvement was 100% in both the groups at 3 months. Though no significant difference was seen statistically yet improvement was more in endoscopic group. There was significant difference in the SNOT 22 change score between endoscopic and conventional method at 1 month and 3 months. Significantly higher rates of post- operative morbidities were seen in case of conventional PIT at 1 month. Conclusion: Endoscopic PIT is better than conventional in terms of improvement in nasal obstruction and decreased postoperative morbidity. Nepal Journal of Medical Sciences | Volume 02 | Number 02 | July-December 2013 | Page 102-107 DOI: http://dx.doi.org/10.3126/njms.v2i2.8945