Background: Maxillary sinus mucocele is a rare form of mucocele and are usually under diagnosed due to its vague symptomatic presentation. It is caused by obstruction of the natural ostium and accumulation of secretions inside the sinus cavities. It is a locally expansile lesion and symptoms are due to pressure on surrounding structures. Case Presentation: A 45-year-old female patient presented with swelling on the left side of the face for 6 months with left infra orbital pain. On examination the swelling was diffuse in the left side of cheek. CT scan showed a homogenous opacity completely filling the maxillary sinus with expansion of the walls which helped in diagnosing the condition. Endoscopic marsupialisation was done and the patient is under follow-up for more than a year with no recurrence. Conclusion: Maxillary sinus mucocele is an epithelium lined sac filled with mucous secretions. They are expansile and can cause bony erosion of surrounding anatomical structures. It is mainly differentiated radiologically by the presence of air in the sinus cavity. CT scan shows homogenous opacity completely filling the antrum with no air shadow. The walls may be thickened or thinned out. Endoscopic marsupialisation of the mucocele gives excellent results with minimal recurrence. Maxillary mucocele being a rare benign cystic lesion is mostly under diagnosed. Hence, proper clinical examination and radiological evaluation help in early diagnosis. Appropriate surgical management gives a good success rate with nil recurrence.

Kawasaki disease is an acute febrile vasculitis of childhood first described by Dr. Tomisaku Kawasaki in Japan in 1967. The disorder occurs worldwide, with Asians at highest risk. Approximately 20% of untreated patients develop coronary artery abnormalities including aneurysms, with the potential for the development of coronary artery thrombosis or stenosis, myocardial infarction, aneurysm rupture, and sudden death. Kawasaki disease has replaced acute rheumatic fever as the leading cause of acquired heart disease in children. The disease is characterized by fever, bilateral nonexudative conjunctivitis, erythema of the lips and oral mucosa, changes in the extremities, rash, and cervical lymphadenopathy. The classic diagnosis of Kawasaki disease has been based on the presence of ≥5 days of fever and ≥4 of the 5 principle clinical features. During the past few years there have been several reports of patients with coronary aneurysms corresponding to changes in Kawasaki disease who did not exhibit the other required symptoms. The diagnosis of Atypical Kawasaki, in addition to coronary aneurysms, requires the presence of three to four of the major symptoms. Atypical Kawasaki is more common in infants than in older children, making accurate diagnosis and timely treatment especially important in these young patients who are at substantial risk of developing coronary abnormalities. Therefore, Kawasaki disease should be considered in an infant with prolonged, high fever in spite of atypical or incomplete presentation and echocardiography may help us to begin earlier treatment in these high risk patients.

Purpose: Visual loss associated with multiple traumas in the context of road traffic accident, especially when the maxillofacial and orbital areas are not directly injured, is an uncommon occurrence. The possibility of Purtscher's retinopathy, i.e. retinal manifestation of mechanical trauma elsewhere in the body, as the cause of visual disturbance in these situations can often be overlooked.Patients & Methods: We present three cases of Purtscher's retinopathy where the diagnosis was initially MISSED. All three patients presented to Accident and Emergency department with visual loss in the left eyes, having sustained compressive chest and/or abdominal injuries in road traffic accidents. None had direct trauma to the orbital region. Serial color fundus photographs, fluoresce in angiogram, Goldman visual fields, and electro diagnostic tests were performed on each patient, with a mean follow-up of 8.3 months (Range 6 to 10 months). The correct diagnosis of Purtscher's retinopathy was made retrospectively in all three cases. Two patients had persistent central scotoma despite complete resolution of the retinal signs.Conclusion: Purtscher's retinopathy should be considered as a differential diagnosis in all cases of unexplained visual loss associated with multiple traumas. The retinal manifestations of Purtscher's retinopathy can disappear in a short time interval. A retrospective diagnosis may be difficult in the absence of any fundal abnormalities if the diagnosis is initially MISSED on presentation.

Background & Aim: Historically, comfort has been an optimal outcome in caring of hospital patients though, the concept of comfort from patients' perspective is rarely assessed. The aim of this study was to explore hospitalized Medical-Surgical patients' experiences and perceptions regarding of comfort and discomfort.Material & Method: A qualitative approach using grounded theory was adopted in this study. The data collected by semi-structured interviews and participants' observation, from a purposive sample of 31 medical-surgical patients, with 11 patients' accompanied relatives who were subjected to questions and constant comparative analysis. This study was conducted in five large teaching and semi-private hospitals in Iran.Result: Date analysis covered a number of themes obviously included discomfort. In fact, experiencing discomfort was so persistent in the data, that it formed several categories including "physical, psychosocial and environmental discomfort". Self help and organizing of informal caring web, and seeking help from others, were the participants' main strategies to deal with discomfort.Conclusion: The finding indicated that hospitalization of patients is not always necessarily equivalent to effective deal with caring and therapeutic needs. Patients experience a lot of distress related to hospital's policies, regulations and priorities. Patients can have active role for discomfort management. In addition, it is highlighted the roles of patients' relative and care-givers in hospitals.Therefore, without cooperation of care-givers (patients' relatives), the quality of nursing care could be disturbed seriously.