Background: ENT disorders specially hearing impairment nega vely impacts students' development of academic, language and social skills. If le undiagnosed, these condi ons may result in signifi cant irreversible damage such as varying degree of hearing loss that can aff ect the social or professional performance of the individuals in later stages of life. Students going to government school in our country generally come from under privileged society. We inves gated the occurrence of ENT diseases among various government school students in Kailali district. Methods: Nine government school of Kailai district were chosen at random. All students of those school present on the day of examina on went rou ne ENT examina ons. Brief history, if any, was recorded and fi ndings were noted. The study was done throughout the month of September, 2013. Results: There were a total of 2256 students enrolled in the study. There were 1126 male and 1130 female students. Mean age of the students was 9.88 years. Forty One percent of students had ENT problems. Ear wax was the most common (17%) fi ndings followed by suppura ve ear diseases, o s media with eff usion as so on in decreasing frequency. Conclusions: ENT diseases and specially ear diseases are important health problems among school children of Nepal. Regular school health services, screening program, public awareness, improvement of socioeconomic status, mely referral to a specialist doctor can help to reduce the diseaserelated burden.

Introduction: There is no consensus on the first line medical treatment of Meniere disease to produce symptomatic improvement and slow the disease progress. Dietary salt restriction, diuretics, and vasodilators like betahistine are among the first line drugs that have been used for long. There is lack of evidence due to paucity of quality studies to support their effectiveness and advocate their use. This study is done to evaluate the effectiveness of three first line treatment of Meniere disease i.e. salt restriction, oral diuretics, and betahistine.   Methods: Double blind randomized controlled trial was carried out in out-patient clinic of Ear Nose and Throat department of Lumbini Medical College Teaching Hospital. Cases were randomized into three groups; dietary salt restriction, diuretics as amiloride and furosemide, and vasodilator as betahistine. Pre and post treatment evaluation was done in terms of number and severity of vertigo, tinnitus, and hearing outcome.   Results: There were a total of 97 cases with F:M ratio of 1.1:1. Mean age of patients was 47.86 yr (SD=12.7). Twenty-nine (30%) were treated with dietary sodium restriction alone (Group A), 35 (36%) were treated with diuretics (Group B) and the rest 33 (34%) were treated with vasodilator (betahistine, Group C). There was no significant difference in hearing outcome in any group. Tinnitus was significantly improved in Group B. Number of vertigo attack was significantly decreased in Group B and Group C. Severity of vertigo was significantly decreased in Group B.   Conclusion: Dietary salt restriction alone was not effective in controlling any aspect of the disease whereas diuretics were effective in reducing tinnitus and number and severity of vertigo. Betahistine was effective in reducing the number of vertigo attacks but not effective on other aspects of the disease.

Introduction: Insomnia is a common problem among old age population. Almost half of all old age adults report difficulty in initiating and maintaining sleep. The objective of this study was to assess the prevalence of insomnia, its associated factors and effects in old age adults. Methods: This was an observational analytical study where adults above 60 years of age from a ward of a village development committee were included. Data were collected for a period of four months. Insomnia was measured by Athens Insomnia Scale and structured questionnaires were used to assess the effects of insomnia. Descriptive statistics were presented as frequency and percentages. Association between variables was assessed with Chi-square test or Fisher's Exact test as appropriate. Results: There were a total of 55 participants in the study. Insomnia was prevalent in 56.4% (n=31) of the study population. Among the studied socio-demographic variables, presence of medical illness was significantly associated with insomnia. Insomnia was significantly associated with morning headache, irritability, unhappiness, fatigue, lack of concentration, day time sleepiness, avoiding interaction with people, and need of sedative for sleep. Conclusion: Majority of the old age adults suffer from insomnia with night awakenings as the most common symptom. Insomnia significantly affects various aspects of life at an old age.

Introduction: Aerodigestive and Ear foreign bodies are common Ear Nose Throat (ENT) emergencies. They arecommonly encountered by otolaryngologists, paediatricians, and primary care physicians. Objective: The aim ofthis study is to analyze different types of foreign bodies and sociodemographic correlates of self-inflicted foreign body insertion in ear, nose and throat.   Method: Seventy-four patients with aerodigestive foreign body coming to our Hospital over a period of one year, starting from January 1, 2012, were enrolled in the study. Hospital based cross sectional descriptive study was done. Socio-demographic data was collected by history and clinical examination of all those patients. The data collected from 74 patients were entered and analyzed using descriptive and analytical statisticalmethods using SPSS version 17.0.   Result: There were total of 74 cases of ENT foreign body. Male predominance was noted (61%). Foreign body of ear was found to be most frequent (43%) followed by throat (37%) and nose (20%). Foreign body of nose was almost limited in paediatrics population (14 out of 15) whereas in the elderly group foreign body of throat was only found. Seeds, meat bolus or bone or both, insects and cotton bud were the most common foreign bodies. There was significant relation between the type of foreign body and age (p <0.05) and the living foreign body and ear.   Conclusion: Foreign bodies of nose, ear and throat are common in ENT department. They should be timely managed to prevent potential complications.

Introduction: Globus sensation is described as a constant feeling of a lump or foreign body in the throat in absence of pain and dysphagia. It is a common complaint in Ear Nose and Throat clinics. Etiology of this condition remains multifactorial and unclear. Psychiatric disorder has been described as one of the cause of globus. The objective of this study is to evaluate the occurrence of psychological distress in patients complaining of globus sensation in throat coming to our centre. Methods: A case-control study was done. Patients coming to Outpatient of Ear Nose and Throat Department of Lumbini Medical College Teaching Hospital with complain of globus and not having an organic explanation of the condition were included. Age, sex and socio-economic condition matched control group was selected from healthy visitors (patient parties). Validated Nepali version of GHQ-12 was used to assess the psychological distress. Results: Psychological distress was present in 72.69% of the cases and 39.91% in the control group. The difference was statistically significant. Conclusion: Psychological distress was significantly higher in the patients with globus pharyngeus compared to the control group. It was also present in a larger fraction of the controlgroup. The patient who present with Globus should undergo psychiatric evaluation after organic causes have been ruled out. We recommend a national policy to evaluate the population for their psychiatric health.