ABSTRACT
Bilateral choanal atresia is uncommon in our environment. CA is caused by the failure of resorption of the bucco-nasal membrane during embryonic development.This occur in the posterior nasal cavity wereby they will be complete obtiration of the choanal. BCA presents with breathing problems immediately after birth this calls of emergence care.For our case have 18years old female presented in our department with complains of difficult in breathing, persistence nasal discharge, nasal obstruction, mouth breathing, and history of on and off visiting to the hospital with the same complains. Also reports to be taken to theter twice and got some improvement for few days but can not recall what was done.Surgical intervention is needed immediately to help such patient as soon as the diagnosis is lied down.

ABSTRACT
Background: Treatment of gall stones have evolved markedly since open cholecystectomy was first described by Langenbuch in 1881. Management has progressed through eras of nonsurgical management, laparotomy, minilaparotomy and now laparoscopic cholecystectomy which is the gold standard for the treatment of gall stone disease today. Methods: This comparative randomized study was conducted at Nimra Institute of Medical Sciences between November 2019 to October 2020. 100 consecutive patients who fit into the inclusion criteria were included in the study. 50 patients were included in the multiport cholecystectomy arm and 50 in the single port cholecystectomy arm. Random allocation of patients presenting with symptoms suggestive of gall bladder disease with confirmatory USG study was done to the two groups using the sealed envelope technique which was opened just before the skin incision. Results: Significant difference in the conversion rate was found in the two groups the conversion rate for single port cholecystectomy was 12%. No statistically significance rise in surgical complications occurred in the patients operated by single port technique as compared to multiport surgery. Median time required to complete cholecystectomy by single port technique was significantly higher than that required for multiport cholecystectomy. No difference was found in the duration of postoperative pain experienced in the two groups. Postoperative complaints of nausea and vomiting occurred in almost equal number of patients in the two groups. Patients operated by single port technique had a postoperative hospital stay of mean 2.12 days, almost same as for patients operated by multiport technique. Conclusion: Technical difficulty and inflammatory changes due to chronic cholecystitis are the leading causes of conversion from single port to multiport cholecystectomy. Time required for single port surgery is significantly higher than multiport cholecystectomy. Postoperative port site .......

ABSTRACT
Background: Gallstones, also widely recognized as cholelithiasis, cause histological changes including chronic inflammation, glandular hyperplasia, granulomatous inflammation, metaplasia dysplasia and anaplasia (Carcinoma). As more than just a result, the goal of this system was also to evaluate how gallstones mucosal changes limit the amount and number of stones in cholecystectomy patients. Methods: At Rajshahi Medical College Hospital and Private Hospital in, a multicenter non-randomized experimental prospective study comprising n=264 patients with symptomatic cholelithiasis who were scheduled to have laparoscopic cholecystectomy with written and informed consent between 2014 and 2020 was conducted. All of the patients underwent a preoperative biochemical profile, as well as a complete abdominal ultrasound, was performed by surgeons who were very trained and experienced. The morphologic profiles of gallstones were documented and examined. The mucosal tissues from the gallbladder were transported to a general pathology lab for analysis. All gallbladder mucosal specimens were histopathological typed, and the number and type of gallstones were correlated. Results: A total of n=264 gallbladder specimens were collected, with 192 (73%) from female patients and 72 (27%) from male patients (M: F ratio 2:6.4). Patients were on average 42.5 years old (range 22-70). In 57 patients (21.52%), the outer gallbladder surface was clogged, the wall thickness was raised in 86 (32.57%), and mucosal abnormalities were discovered in 121 individuals (45.91%). On microscopy, 155 specimens (58.36%) had epithelial hyperplasia, 44 (16.85%) had antral metaplasia, 41 (15.57%) had intestinal metaplasia, 22 (8.52%) had dysplasia, and one had cancer in situ 2 (0.7%). We have found the satisfactory (Excellent and good) result 96.24% and unsatisfactory (Post Cholecystectomy Syndrome) was 3.76%. When the amount and kind of stones were linked with the gallbladder mucosal response, .................