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Background: Auditory differences among male and female is an underexplored topic. Sex-specific process of evolution has lead to differences in the physiology of male and female. For a long time, health equity has been confronted due to unawareness among health care providers that the findings are usually derived from research conducted among male. The objective of this study was to find differences in hearing threshold among healthy male and female. Materials and Methods:This was a hospital-based cross-sectional study conducted on age-matched male and female groups. Independent student's t-test was used to compare hearing thresholds at different frequencies between males and females. Result:There were 23 males, and 23 age-matched females recruited in the study. The mean age of male participants was 52.65±14.41 years, and that of female participants was 51.41±11.34 years. The differences in hearing threshold were not statistically significant at 250 Hertz, 500 Hertz, 1000 Hz, 2000 Hz, 3000 Hz, 4000 Hz and 8000 Hz of both ears. However, a higher threshold was observed in females at most frequencies. Conclusion: Although the hearing threshold was higher among females, observed differences in the hearing threshold between males and females were not significant.

Introduction: Thyroid nodules brought to a hospital are checked for cancer. A post-operative histological examination is a gold standard for diagnosing thyroid lesions. Treatment is aided by a prior understanding of the disease’s underlying pattern. Objective: A retrospective study was done to determine the prevalence and distribution of malignancy in suspicious thyroid nodules. Methods: The study was conducted at Ganesh Man Singh Memorial Academy of ENT- Head and Neck studies from August 2017 to March 2020. All the subjects (n=183) presenting with a thyroid nodule and who had post-operative histopathological evaluation available were recruited in the study. The proportion and percentage of findings of Fine Needle Aspiration Cytology (FNAC) and histopathological evaluation were done. The distribution of histopathological observation was also analyzed in terms of age group and gender. Results: The mean age of study participants was 40.23 ± 13.77 years (n=183). The predominance of women was notable. In about 98 (53.55%) of the patients who underwent thyroidectomy, a benign lesion was found, but the most common finding was papillary carcinoma (40.98%). In the age group below 50 years, papillary carcinoma was most common. Among people older than 50, colloid goiter was more common. Follicular and medullary carcinomas were only observed in female participants. Gender did not appear to be associated with malignancy (p=0.99). Follicular adenomas were noted to have the youngest mean age. Conclusions: We observed a high prevalence of malignancy, particularly papillary carcinoma in clinically suspected thyroid nodules of a tertiary hospital in Nepal. Keywords: Colloid Goiter; malignancy; papillary carcinoma; thyroid cancer; thyroid nodule.

Aflatoxin is a secondary fungal metabolite that contaminates foods, mostly staple diets like maize, peanuts, chillies, and even rice. These foods are also a major constituent of weaning food for infants in Asia and Sub-Saharan Africa. The fungal metabolite contaminates food during production, harvest, storage, and processing. The contamination is largely promoted by genotypes of crops, soil conditions, temperate regions, and insect activity. Once ingested into the body, aflatoxins get metabolized into different hydroxylated derivatives such as AFb1, AfM1, AFP1, aflatoxicol, and Aflatoxin B1. AFB1 is the most carcinogenic and potent of the known metabolites and they have been categorized as Group I carcinogenic agents by the International Agency for Research on Cancer. The toxic metabolites of aflatoxins have been found in blood samples, breast milk and also have been shown to traverse the placental route. Through various metabolic pathways aflatoxins are responsible for different types of pathological outcomes like gut enteropathy, anemia, stunting, and other immunological disorders. Moreover, socioeconomic determinants have indirectly shown to be strong predictors of aflatoxins exposure and thus its related pathological outcomes. Since we have a very limited number of researches about aflatoxins, this review altogether puts forward what is known about the toxin and its harmful metabolites. Keywords: Aflatoxins; aflatoxinB1; carcinogens; fungal toxins.

Laryngeal Schwannoma is rare comprising 0.1 – 1.5% of all benign laryngeal tumors. The most common site in larynx is aryepiglottic fold followed by arytenoids, ventricular folds, and vocal cord. Patients present with the symptoms of hoarseness, dysphagia or globus sensation. We present a 33-year-old male with supraglottic schwannoma who experienced hoarseness of voice for three months. The patient underwent micro laryngeal surgery and submucosal solid tumor of false vocal cord was removed. Postoperative recovery was uneventful and after one month of follow up the patient was improving with no hoarseness of voice.

Burkholderia Cepacia is an aerobic gram-negative bacillus, rarely affects immunocompetent indi­viduals, usually found in various aquatic environments. We present a case of a 45-year-old male with a known case of diabetes for five years. He presented with high-grade fever, dysuria, and abdominal pain. Routine tests, ultrasonography along together with high-resolution computed tomography was done. High Resolution Computed Tomography showed subtle ground-glass opacity of the superior segment of lingulae of the left lobe of the lungs. Real time polymerase chain reaction was advised to rule out Covid-19 infection, which was negative. Burkholderia Cepacia was identified in Cystine- Lactose-Electrolyte-Deficient Agar culture (CLED).

Background: Neoplastic lesions are one ofthe causes oflymphadenopathy, which harbors a wide spectrum of diseases.It is essential to conduct a lymph node biopsy and histopathological examination of the enlarged nodes. Histological processing beginswithnoticingdownthegrossfeatures.Itis possible torecognize thediseaseprocess bygrosslyexamininglymphnodes. Objectives: The objective of thisstudy isto characterize the neoplastic lymph node grossly on the premise of itssize,shape, cutsection appearance andpatternofinvolvementwhetherpresentingassingle,multipleormatted. Methods: The study used cross-sectional, quantitative methods, conducted in a hospital over a one-year period from 30thApril 2018 to 29thApril 2019 at Department of Pathology, TUTH. Ourstudy included participants with neoplastic lymph nodes who underwent excisional and lymph node biopsynodedissection, alongwithotherradicalprocedures.Wenotedthegrossfeatures of aneoplastic lymphnode. Results: The mean diameter of the largest lymph node with a neoplastic lesion was 2.02± 0.86 cm. The majority of neoplastic lymph nodes were round.Matted lesionswere found in seven cases, discretemultiple lymph nodesinvolved in 16 cases, and single lymph nodewasinvolved in 16 cases. Metastasisinvolving lymph nodes was most common in invasive carcinoma of the breast, NST.Among primary tumors of lymph nodes, most were Hodgkinlymphomas.Typically,lymphnodeswere irregular andshowedhomogenous brown and irregular grey white areas on cut sections. Conclusion: Neoplastic lymph nodes are characterized by different gross characteristics depending on theirshape, cutsection, and location. Pattern oflymph nodesinvolved is associatedwith origin of cancer(metastatic or primary tumor oflymph node).For amore complete understanding of gross features of lymph nodes, a rigorous study is recommended to identify whether the gross appearance of lymph nodes correlates with neoplastic pathologyandtodosimilarstudieswithlargersample sizes.

Low-grade appendiceal mucinous neoplasm (LAMN) is an uncommon malignancy with varied clinical features. The most alarming complication of this neoplasm is seeding of mucin into the adjacent peritoneum leading to pseudomyxoma peritonei (PMP). We report three cases of LAMN. Two cases were seen postappendicectomy in 23-year old and 36-year old females. The third case was seen in 53-year-old male post Whipple procedure and hemicolectomy. LAMNs are often diagnosed incidentally, as clinical presentation is barely specific and resembles acute appendicitis. Hence it is imperative to examine all appendicectomyspecimens not to miss cases of appendiceal mucinous neoplasm which can have implications on the further management of the patient.Keywords: Appendectomy, mucinous appendiceal neoplasm, pseudomyxoma peritonei

In order to meet today’s complex health and environmental challenges, multi-disciplinary research has never been more exigent. Nepal is in the early stages of adopting One Health (OH), but it is continuously expanding. Various initiatives have been taken by the Government of Nepal (GoN) to combat problems such as antimicrobial resistance, highly pathogenic avian influenza and rabies using an integrated health approach, but several challenges remain in their implementation. A few of the major obstacles to implementing OH in Nepal include weak organizational structure to support the initiative, no legal framework required to implement OH, insufficient technical expertise, lack of intersectoral data sharing mechanisms, a limited budget, and poor legislative understanding. To address these gaps and prioritize the health problems where OH will lead to the best outcome, we encourage GoN to address the gaps. To control the ongoing COVID-19 pandemic, the rational appli­cation of the One Health strategy should be our utmost priority. The One Health paradigm can help healthcare professionals and researchers improve the public’s health in response to the coming wave of COVID-19 pandemic and prepare for future pandemics.