Background: The optimal conservative treatment protocol of parotid abscess in children is evaluated.Material and Methods: This is a randomized, prospective, cross-sectional study conducted between November 2013 and June 2017 in Nobel Medical College and Teaching Hospital. Thirty children (below 14 years age) suffering from parotid abscess diagnosed by ultrasonography were included in this study. Recurrent parotid abscess cases were excluded. The children were divided into 2 groups by computer assisted randomization into15 patients each. Group A were treated with intravenous Clindamycin while group B were given intravenous Ampicilin + Cloxacillin combination. Results: Five patients of group B did not respond to treatment and were then put on intravenous Clindamycin. Three of these patients responded to treatment but 2 developed multi-lobulated fluctuation and required incision + drainage. Remaining 10 patients in group B and all patients in Group A responded to medical treatment without recurrence. Five patients in group B developed severe diarrhea during antibiotic treatment but none of the patients in group A had this complaint. No patient developed any complications like parapharyngeal abscess or septicemia. Conclusion: Parotid abscess in children can be managed conservatively with intravenous Clindamycin without the need for incision and drainage. Journal of Nobel Medical College Volume 7, Number 1, Issue 12, January-June 2018, Page: 56-59
Background: Thyroid dysfunction is a major health problem in eastern Nepal with a high prevalence and the pattern of thyroid disorders. Previous studies have shown the tendency of hypothyroidism to increase with the age and being more common in women. Objective: this study was undertaken to study the various possible manifestations of thyroid disorders and their relation to age in female population in eastern Nepal. Methods: This was a hospital based study, conducted in the Department of ENT of Nobel Medical College and teaching hospital in eastern Nepal. A total of 153 female subjects, who attended the outpatients department (OPD) for thyroid screening were enrolled in the study. Blood samples were collected and thyroid assay was done (fT3, fT4, and TSH). Data was tabulated and analysed. Results: On analyzing the Thyroid profile of 153 subjects, 107 (69.93%) of them were found to be of euthyroid status. Rest of them had abnormal status. Subclinical hypothyroidism status was found in 31 (20.26%) subjects, while frank hypothyroidism was found in 9 (5.88%) cases. Subclinical hyperthyroidism and frank hyperthyroidism was found in 3 (1.96%) cases each. The fT3 level was of high normal level in the less than 40 years age group, while it was low normal in the above 40 years age group. On analysis, with ANOVA, there was significant difference in fT3 values among three age groups. But, no significant difference was found for fT4 level among age groups. The TSH level was shown to differ significantly among three different age groups. The normal range of TSH increased with increasing age. On analyzing the correlation of Thyroid function parameters, fT3 and fT4 values did not correlate with age, but, TSH was positively correlated with age. This signifies that TSH increases with increasing age, which is also similar to the ANOVA results. Conclusion: the prevalence of thyroid disorder in the studied sample of eastern Nepal is found to be 30.07% and hypothyroidism was the commonest disorder in this study. There is a tendency of fT3 to decrease and TSH to increase with increasing age. However no definite pattern was found for fT4.
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