Introduction: Chronic rhinosinusitis (CRS) is a common and persistent illness that otorhinolaryngologists encounter commonly. It is an important cause of morbidity and accounts for major loss of income. Anatomical variations of the lateral wall of the nose have been reported which can predispose to CRS. The aim of the present study was to determine the percentage of concha bullosa in patients with CRS and to ascertain its relationship with chronic rhinosinusitis. Aim of the study: To determine the percentage of concha bullosa in patients with chronic rhinosinusitis and to determine the relationship between concha bullosa and chronic rhinosinusitis. Methods: This was a hospital based prospective one-year study done during the period from June 2019 to December 2020 was conducted at the outpatient department of ENT, Shaheed Monsur Ali Medical College and Hospital, Uttara, Dhaka, Bangladesh. Sample size in this study were selected 57 patients. Result: Of the 57 patients in our study, 21 were males and 36 were females (Figure-1). Of these 36.84% male patients 21 showed concha bullosa and of the 63.84 female patients 326 showed concha bullosa on CT nose and PNS and DNE. The most common age group showing concha bullosa was 21-30 years 23(40.35%) (Table 1). The most common symptom found in our study was headache in 57(100.00%). The next commonly occurring symptom was nasal block 51(89.47%) followed by nasal discharge or nasal purulence 48(84.21%). DNE and CT scan of nose and paranasal sinuses (coronal and axial) were studied for the evaluation of concha bullosa in our patients of CRS. Concha bullosa was noted in 33(57.89%) patients having unilateral and bilateral presentations. Conclusion: Concha bullosa is one of the most common anatomical variations of the lateral wall of the nose. The presence of concha bullosa plays a significant role in the development of chronic rhinosinusitis particularly in chronic maxillary sinusitis.

Hot volcanic massage is a treatment from the Far East that has been used for more than 1000 years, and today is an integral part of anti-stress programs in spas around the world. The aim of our research was to study the extent to which this alternative method of massage has proven health benefits through the analysis of already published papers. Material and method: We performed a retrospective analysis of published papers on the effect of heat and massage on pain, stress, depression, and muscle tension. Results: Hot massage has positive effects on musculoskeletal pain, fibromyalgia pain and degenerative rheumatism. Side effects can occur if the heat is too high and causes burns, drop in blood pressure and dehydration. Discussion: Research on the effect of treating volcanic rocks on health problems is scarce. This alternative method can be applied due to the known physiological effect of massage and warmth on a scientific basis along with indications and contraindications. Conclusion: The treatment with volcanic stones has the effects of heat treatment and massage with still insufficiently measurable parameters for the combined effect and concrete evidence.

This study investigated the impact of toxicological air on cardiovascular indices of non-pregnant women in Bayelsa state. The study subjects consist of two hundred apparently healthy non pregnant women in gas flaring communities selected randomly between the ages of 20 to 45 years. Parameters measured was systolic,diastolic,pulse rate, pulse pressure, mean arterial blood pressure, body mass index using auscultatory, weight and height methods and calculation of the prevalence rate of high blood pressure among non-pregnant women in Bayelsa state. Result from the study shows significant higher mean values of systolic (123mmHg),diastolic (78,75mmHg), mean arterial blood pressure (93,90mmHg) among resident of Obunagha/Polaku and Immiringi located in the epicentre of gas flares compared with Kolo/Otuagila (118mmHg), (72mmHg) and (87mmHg) a non-gas flaring communities. However the pulse rate and pulse pressure was higher (86bpm) (47mmHg) among resident subjects in Kolo and Otuagila compared with Polaku and Immiringi having a decrease percentage difference. Furthermore, the blood pressures of the participants increase significantly with advancing age while the pulse rate decreases. The systolic blood pressure increases among those that fall into the category of underweight compared with other body mass index. The prevalence of hypertension was 14%, prehypertension 42% and a normal blood pressure of 44% respectively. Subjects with prolong exposure to gas flares in their respective communities had higher blood pressure in comparison to short duration of exposure. This study has shown that exposure to the toxic components from gas flares have a detrimental effect on the cardiovascular tree of women residents with resultant increase in their blood pressures in Bayelsa state.

Background: Sometimes children are referred to the EEG lab without overt seizures but with wide array of features of delayed developmental domains like motor delay, cognitive delay, speech and communication delay, visual impairment, hearing impairment. A detailed history and physical examination are most important for the diagnosis. EEG is done to identify the background dysfunction and the cases of Epilepsy. Aim of the study: To see the background function and the cases of Epilepsy through EEGs children presenting with delayed developmental domains. Method: Retrospective analysis was done from the EEG records during a 1year period (ie, 2015). 537 cases were identified with developmental delay but not having overt seizure. Their EEG findings were compared with history and clinical presentation. Results: In this study, 41.7% presented with speech communication problems, 32.4% with cognitive delay, 10.6% with hearing impairment, 8.8% came with motor delay and 6.5% with visual impairment. EEG of 29.5% showed abnormal features. These included 15% with features of focal discharges, 7% with generalized epileptiform discharges, 0.5% with multifocal epileptic form discharges, 2% with features of epileptic encephalopathy, 3% with features of generalized encephalopathy, 2 children with diffuse encephalopathy, and 5 children with non-specific dysfunction, 4 children with generalized low amplitude activities. Conclusion: EEG abnormalities were found in over one-third of the referred children based upon which important decisions could be taken for appropriate diagnosis and management.

Background: Globally, very limited studies have explored the unique contributions of hygiene and sanitation practices on the odds for stunting and underweight in children. Hence, the study examined the relationship between environmental hygiene and sanitation practices and odds for stunting and underweight among children under-five years old in rural communities in Ghana. Methods: The study was a cross-sectional study, in which study participants were simple randomly selected. All data were gathered from face-to-face interviews and by the use of observational checklist. Data were analysed using statistical product and service solutions software version 21.0. Further, binary logistics regressions model was used to assessed for adjusted odds of stunting and underweight across hygiene and sanitation practice variables. Results: Upon adjustment for the effects of covariates, children from households with toilet facilities had lower odds for underweight compared with their counterparts recruited from households without toilet facility [0.2(0.0-0.8); p = 0.031]. Also, lower frequency (1-3 times a week) of cleaning toilet facility per week was associated with higher odds for underweight compared with the higher frequency of cleaning (4 times or more per week) of toilet facility [4.5(1.3-15.3); p = 0.018]. Conclusions: The study revealed that both stunting and underweight were prevalent among the children. Also, inappropriate sanitation and hygiene practices were associated with increased odds for child malnutrition. The district health administration and the district assembly ought to intensify education on the importance of kitchen hygiene and the need for households to own toilet facilities.

Background: Although breast abscess is a serious common complication of lactational mastitis with a high morbidity rate, there is a lack of high-quality trials to define the best treatment option. The traditional management of lactational breast abscesses involves incision and drainage of pus along with antibiotics, which is associated with prolonged healing time, regular painful dressings, difficulties in breastfeeding, and the possibility of milk fistula with unsatisfactory cosmetic outcomes. We reported a novel way of applying primary closure after incision and drainage. The new method is applicable on all sizes of lactational breast abscesses, has a shorter healing time, no need for frequent painful dressings, early return to breastfeeding, and a more acceptable scar. Aim of the study: The aim of this study was to compare the effectiveness of primary closure following incision and drainage in treating lactational breast abscesses with the traditional open method. Methods: This prospective, randomized controlled trial was conducted in Universal Medical College and Hospital Limited, Dhaka, Bangladesh, and MH Somorita Hospital and Medical College, Dhaka, Bangladesh during the period from January 2020 to March 2021. In total 50 lactating women with breast abscesses were selected as the study population who were divided into two groups. In group A, 25 patients were managed by primary closure following incision and drainage and in group B, other 25 patients were managed by incision and drainage. All data were processed, analyzed, and disseminated by MS Office and SPSS version 26.0. Results: In group A, the VAS scores were lower than those of group B. In every day’s comparative VAS scores, there were significant correlations between the groups where p values <0.0001. The mean (±SD) hospital staying periods were 1.2±0.3 and 3.1±0.5 days in group A and group B respectively. The mean (±SD) healing times were 18.7±3.4 and 26.4±5.8 days in group A and group B respectively. In both the durations, p values were less than 0.0001, So, those differences were considered extremely statistically significant. In this study, ‘recurrence’, ‘sinus formation’ and ‘ugly scar’ were found in 8%, another 8%, and 28% participants respectively in only group B patients as major complications. But in the group A, no such complication was observed. Conclusion: Primary closure of lactational breast abscess following incision and drainage is an effective modality in treating patients with lactational breast abscess and it should be the first line of treatment, especially for larger and multilocular breast abscesses with intact overlying skin.

Chronic suppurative otitis media is persistent and insidious disease that often lead to destructive changes and irreversible sequelae if not treated properly. The study aimed to find the pattern of antimicrobial drug susceptibility of the pathogenic microorganisms causing tubotympanic type of CSOM. The study was conducted in 65 patients with tubotympanic type of disease attending the (ENT) OPD clinic at Central Hospital-Tripoli, Libya. Drug susceptibility testing was carried out using a Kirby Bauer disc diffusion method. Pathogens were isolated from 96.9% patients with a total of 95, of the 95 isolates, (88.4%) were bacterial pathogen and (11.6%) were fungal. The most predominant isolates were Pseudomonas aeruginosa (31.6%), followed by Staphylococcus aureus (25.3%) and Proteus mirabilis (8.4%). The antimicrobial profile of the major isolates of Pseudomonas aeruginosa revealed maximum sensitivity to ciprofloxacin (93.3%), followed by polymyxin (90.0%), ceftazidime (83.3%) and amikacin (73.3%). Whereas the antimicrobial profile of the isolates Staphylococcus aureus was revealed maximum sensitivity to ciprofloxacin (95.8%), followed by amoxil/clavulanic acid (83.3%), cephalexin, gentamicin, chloramphenicol (79.2%) each, neomycin (75.0%) and erythromycin (70.8%). On the other hand Proteus mirabilis showed high level of sensitivity to ciprofloxacin, ceftazidime (100%) each, followed by amoxil/clavulanic acid, amikacin (87.5%) each, gentamicin, neomycin, trimethoprim sulphamethoxazole (75.0%) each. Our finding highlight the importance of a continuous and periodic evaluation of microbial pathogens causing tubothympanic CSOM and their susceptibility patterns to antimicrobial drugs, this will guide the clinician for choosing the appropriate treatment regimen and prevention of the emergence of resistant strain as well as can minimize complication that require surgery.