Background: It is acknowledged that size and site of tympanic membrane perforation is proportional to degree of hearing loss but there are many studies which suggests otherwise. Persistent ear discharge is also supposed to deteriorate hearing level with passage of time. This study is carried out to find out the relation between size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Objectives: The objective of this study is to study the effect of size and site of tympanic membrane perforation and duration of ear discharge on hearing loss. Materials and methods: This is a cross-sectional prospective study conducted at Kathmandu Medical College, department of ear nose and throat from January till July 2009. One hundred patients aged between 8 to 60 years with pars-tensa perforations were included in the study. Detail clinical examination and history was carried out followed by hearing evaluation by audiometry was done in all cases. All the data is collected, statistical analysis is done using SPSS program and documented for study. Results: One hundred patients with 119 perforated tympanic membrane, age ranged between 8 to 60 years, 44 males and 56 females were studied. Bilateral tympanic membrane perforation were seen in 19 patients, right sided perforation in 39 and left sided in 42 patients respectively. Large central perforation involving all four quadrants was the most common otologic findings seen in 72 ears (60.50%) whereas perforation in posterosuperior quadrant was the least common finding seen in 3 patients (2.52%). Significant relation is observed between site of perforation and degree of hearing loss; posterior placed perforations seem to have larger hearing loss. Ninety-five perforations (79.83%) showed more loss in low frequencies with larger air bone gap at low frequencies. The longer the duration of ear discharge, the more the hearing loss. Conclusion: The larger the perforation, the greater the decibel loss in sound perception. The location of perforation on the tympanic membrane and the duration of ear discharge have significant effect on the magnitude of hearing loss. Key words: chronic suppurative otitis media; tympanic membrane perforation; hearing loss DOI: 10.3126/kumj.v7i4.2761 Kathmandu University Medical Journal (2009) Vol.7, No.4 Issue 28, 397-401

Background: The tumors of the salivary glands are uncommon head and neck neoplasms. The aim of this study was to evaluate the relative frequencies, types, site distribution and the histopathological features of salivary gland tumors. Materials and Methods: This was a retrospective study of 176 cases of salivary gland tumors collected from medical record section and department of pathology at B.P.Koirala Memorial Cancer Hospital from Jan. 2005 to Dec. 2010. Tumors were analyzed based on demographics, anatomic location and histopathological type. Results: Out of 176 cases, 66 (37.5 %) were benign and 110 (62.5 %) were malignant with M:F ratio of 1.7:1. The mean age observed was 44.76 years with age range of 12 to 75 years. Pleomorphic adenoma was found to be the commonest benign tumor (72.7 %), followed by Warthin tumor (15.1%), monomorphic adenoma (3.0 %) and basal cell adenoma (3.0 %). The mucoepidermoid carcinoma was the most common malignant tumor (38.1 %), followed by adenoid cystic carcinoma (25.4%), acinic cell carcinoma (10.9%), adenocarcinoma NOS (6.3%), carcinoma ex pleomorphic adenoma (5.4%) and unclassified malignant tumor (4.5 %). Parotid was the most common site for the location of tumors (70.4%) followed by submandibular (19.3%) and minor salivary glands (10.2 %). Conclusion: Pleomorphic adenoma was the commonest salivary gland tumor observed in both sexes. Mucoepidermoid carcinoma was the most common malignant salivary gland tumor. The parotid gland was the most common site of origin in both benign and malignant tumors. DOI: http://dx.doi.org/10.3126/jpn.v4i7.10291 Journal of Pathology of Nepal (2014) Vol. 4, 520-524

Breast cancer is one of the common cancers. Hormonal therapy along with surgery, chemotherapy, radiotherapy and targeted therapy are vital modalities for the management of breast cancer. Tamoxifen has been the most widely used hormonal therapy for more than two decades. In this article we review the benefits, dose, duration and timing of Tamoxifen therapy in patients with breast cancer. Keywords: breast cancer, hormonal therapy, tamoxifen.

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Tomato (Lycopersicon esculentum L.) is an important winter vegetable crop in Central Tarai. As compared to India (25 t/ha), the productivity of this crop in this area is quite low (17 t/ha). One of the major contributing factors of low productivity of tomato is the lack of suitable high yielding varieties under rice based cropping system. Ten tomato cultivars, 3 released check cultivars (Pusa ruby and CL-1131 open pollinated and Srijana hybrid cultivar), 7 superior cultivars from Initial Evaluation Trial in the past were planted in November 2005November , 2006November , 2009November and 2010 at RARS Parwanipur in rice-based cropping system. The trial was laid out in a randomized complete block design with four replications. Seedlings were transplanted on beds at 60x60 cm spacing fertilized with 120:100:60 NPK + 15 t compost per hectare. Results showed that cv. HRDTOM-005XHRDTOM-010 (30.64 t/ha) followed by Makis (28.90 t/ha) and cv. Srijana (28.87 t/ha) gave higher yield among the tested cultivars. These cultivars had given 47.0%, 38.7%, and 38.5% more yield as compared to commercial hybrid variety Manisha (20.84t/ha) whereas Bari-4 and CL-1131 had superior performance among the tested open pollinated cultivars. On the basis of overall performance, cultivars, HRDTOM-005XHRDTOM-010, Makis and Srijana hybrid cultivars, and Bari-4 and CL1131from open pollinated cultivars were selected and recommended for cultivation in central Tarai.