Monoclonal gammopathy can accompany diverse conditions and is usually benign. It should be distinguished from monoclonal gammopathy of undetermined significance (MGUS) which can rarely turn malignant. Visceral leishmaniasis has only rarely been associated with monoclonal gammopathy. We describe the case of a 55-year-old male who had monoclonal gammopathy associated with visceral leishmanisais, which reversed with stibogluconate therapy.

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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

<p class="abstract">Tubercular otitis media is a rare presentation of tuberculosis. High index of suspicion is required for diagnosis. We present a rare case of tubercular otitis media presenting as post auricular swelling with no evidence of pulmonary or any other foci of tuberculosis. Diagnosis was made on the basis of acid fast bacilli seen in fine needle aspirate. Anti-tubercular drugs were initiated and patient responded well to treatment.</p><p class="abstract"> </p>

<p class="abstract"><strong>Background: </strong>Adenoid hypertrophy is a common disorder in the paediatric population, presenting with multiple signs and symptoms ranging from nasal obstruction to obstructive sleep apnoea. Most common symptom is usually nasal airway obstruction. This prospective, randomized study aims to evaluate the efficacy of mometasone furoate spray in reducing size and clinical symptoms in patients with adenoid hypertrophy compared to saline spray.</p><p class="abstract"><strong>Methods:</strong> 60 patients in the age group of 3-11 years were enrolled in the study. Five symptoms were included that were hypo nasal speech, snoring, night cough, open mouth breathing and nasal obstruction which were scored as never=0, mild (sometimes)=1, moderate (less than 50% of times)=2, and severe (constant)=3. Diagnosis of adenoid hypertrophy was made on basis of nasal endoscopy.</p><p class="abstract"><strong>Results:</strong> Significant improvement was seen in individual as well as overall symptom score in group A as compared to group B after 8 weeks of treatment (p&lt;0.001). There was significant improvement in mean adenoid grade as per nasal endoscopy at 8 weeks post therapy (p&lt;0.001) which was not seen after 4 weeks of therapy.</p><p class="abstract"><strong>Conclusion:</strong> Intranasal steroid sprays have good role in decreasing the symptoms of adenoid hypertrophy and has reduced number of adenoidectomies required. The long-term effects as well as optimal duration of therapy is still controversial and needs to be studied further.</p>