Correlation of the Geriatric Assessment with Overall Survival in Older Patients with Cancer.

AIMS: Global guidelines recommend that all older patients with cancer receiving chemotherapy should undergo a geriatric assessment. However, utilisation of the geriatric assessment is often constrained by its time-intensive nature, which limits its adoption in settings with limited resources and high demand. There is a lack of evidence correlating the results of the geriatric assessment with survival from the Indian subcontinent. Therefore, the aims of the present study were to assess the impact of the geriatric assessment on survival in older Indian patients with cancer and to identify the factors associated with survival in these older patients. MATERIALS AND METHODS: This was an observational study, conducted in the geriatric oncology clinic of the Tata Memorial Hospital (Mumbai, India). Patients aged 60 years and older with cancer who underwent a geriatric assessment were enrolled. We assessed the non-oncological geriatric domains of function and falls, nutrition, comorbidities, cognition, psychology, social support and medications. Patients exhibiting impairment in two or more domains were classified as frail. RESULTS: Between June 2018 and January 2022, we enrolled 897 patients. The median age was 69 (interquartile range 65-73) years. The common malignancies were lung (40.5%), oesophagus (31.9%) and genitourinary (12.1%); 54.6% had metastatic disease. Based on the results of the geriatric assessment, 767 (85.4%) patients were frail. The estimated median overall survival in fit patients was 24.3 (95% confidence interval 18.2-not reached) months, compared with 11.2 (10.1-12.8) months in frail patients (hazard ratio 0.54; 95% confidence interval 0.41-0.72, P < 0.001). This difference in overall survival remained significant after adjusting for age, sex, primary tumour and metastatic status (hazard ratio 0.56; 95% confidence interval 0.41-0.74, P < 0.001). In the patients with a performance status of 0 or 1 (n = 454), 365 (80.4%) were frail; the median overall survival in the performance status 0-1 group was 33.0 months (95% confidence interval 24.31-not reached) in the fit group versus 14.4 months (95% confidence interval 12.25-18.73) in the frail patients (hazard ratio 0.50; 95% confidence interval 0.34-0.74, P = 0.001). In the multivariate analysis, the geriatric assessment domains that were predictive of survival were function (hazard ratio 0.68; 95% confidence interval 0.52-0.88; P = 0.003), nutrition (hazard ratio 0.64; 95% confidence interval 0.48-0.85, P = 0.002) and cognition (hazard ratio 0.67; 95% confidence interval 0.49-0.91, P = 0.011). DISCUSSION: The geriatric assessment is a powerful prognostic tool for survival among older Indian patients with cancer. The geriatric assessment is prognostic even in the cohort of patients thought to be the fittest, i.e. performance status 0 and 1. Our study re-emphasises the critical importance of the geriatric assessment in all older patients planned for cancer-directed therapy.

Enhancement in electrical conductivity of liquid crystals by graphene metal oxide composites.

Enhancing the electrical conductivity of liquid crystal (LC) circumvents challenges for application in advanced electronic components. Toward this, using additives made of different nanostructures that could result in functional LCs is suggested. In this paper, various concentrations of graphene (Gr)/metal-oxide (Fe3O4) nanocomposite (GMN) (0.0001-1 w%) were added to E7 nematic LC. We found that the role of anisotropic Gr flakes, their edges as well as surface-decorated-metal-oxide-additives have significant impact on electrical properties of E7. A range of appropriate additives of such a nanocomposite enhances the electrical conductivity of LCs. This effect can be traced through the decrease in the formation of GMN aggregates in the E7 and increase in the electrostatic field at the edges of the Gr sheets. Moreover, the presence of metal-oxide nanoclusters due to the presence of oxygen vacancies and defects facilitates the construction of conductive network for improving the charge transfer pathways and contributes to a stronger interaction of the Gr surface with charged species. These factors can provide Gr layers as dipole moments and lead to signal propagation in the dielectric medium. Our finding conveys a pathway toward significant enhancement of electrical conductivity in the LC family which can be useful for functional applications.

Analysis of human rabies deaths reported at two hospitals in Karachi, Pakistan: a call to save lives by reforming rabies prevention facilities.

BACKGROUND: Rabies is endemic in low- and middle-income countries. It is caused mainly by the bite of a rabid dog and is fatal if not treated effectively and in a timely manner with quality post-exposure prophylaxis. Despite a profusion of private and public healthcare centres in Sindh province, most are ill-equipped to treat dog bites. METHODS: We analysed 129 human deaths from rabies who presented at the emergency departments of two tertiary care hospitals in Karachi over 10 y. Demographic data, time, location of the bite and distance travelled to report symptoms of rabies were recorded. RESULTS: Most victims were male, and children were more often affected; almost none had received post-exposure prophylaxis. A total of 12% of bites were on the face, head or neck. The mean incubation period was 56 d. Most (60%) of the rabies victims travelled long distances, hoping to receive treatment. CONCLUSIONS: Rabies deaths were either due to a lack of awareness or the non-availability of rabies immunobiologicals within easy reach. Public health services must raise awareness, conduct surveillance and provide appropriately spaced centres for free treatment of dog bites. This lethal disease must be prevented at all costs.

Feasibility to Measure Tissue Oxygen Saturation Using Textile-Integrated Polymer Optical Fibers.

Tissue oxygen saturation (StO2) is a crucial factor in the aetiology of pressure injury (PI), since hypoxia leads to necrotization. Pressure on the tissue occludes blood circulation and reduces the StO2, resulting in hypoxia. PI causes severe suffering, heals slowly and is expensive to treat. Hence it is important to prevent PI by detecting hypoxia, e.g., by near-infrared spectroscopy (NIRS) monitoring of StO2. For this, the NIRS device has to be wearable for a long time and it is crucial that it provokes no pressure itself. An integration of optical fibres into a textile achieves this. The aim was to investigate the feasibility of such a textile NIRS device.Knots and loops were tested as textile light emitters (LEs) or detectors (LDs) on a phantom. The light coupling efficiency of the LEs and LDs was investigated.Results show that knots perform similarly to loops. More loops per fibre increase efficiency both in LEs and in LDs. The best trade-off is at 3 loops. LEs are slightly more efficient than LDs, with an average attenuation from baseline of about -2 dB for loops of 0.5 mm diameter. Adding fibres multiplies the signal by the number of fibres. Inclusions mimicking hypoxia in phantoms were successfully identified. In-vivo arm occlusion tests showed the expected decrease in StO2. This shows feasibility of optical fibres in a textile to prevent PI.

Numerical Optimisation of a NIRS Device for Monitoring Tissue Oxygen Saturation.

The present work aims to develop a wearable, textile-integrated NIRS-based tissue oxygen saturation (StO2) monitor for alerting mobility-restricted individuals - such as paraplegics - of critical tissue oxygen de-saturation in the regions such as the sacrum and the ischial tuberosity; these regions are proven to be extremely susceptible to the development of pressure injuries (PI).Using a combination of numerical methods including finite element analysis, image reconstruction, stochastic gradient descent with momentum (SGDm) and genetic algorithms, a methodology was developed to define the optimal combination of wavelengths and source-detector geometry needed for measuring the StO2 in tissue up to depths of 3 cm. The sensor design was optimised to account for physiologically relevant adipose tissue thicknesses (ATT) between 1 mm and 5 mm. The approach assumes only a priori knowledge of the optical properties of each of the three tissue layers used in the model (skin, fat, muscle) based on the absorption and scattering coefficients of four chromophores (O2Hb, HHb, H2O and lipid).The results show that the selected wavelengths as well as the source-detector geometries and number of sources and detectors depend on ATT and the degree and volume of the hypoxic regions. As a result of a genetic algorithm used to combine the various optimised designs into a single sensor layout, a group of four wavelengths was chosen, coinciding with the four chromophores and agreeing very well with literature. The optimised number of source points and detector points and their geometry resulted in good reconstruction of the StO2 across a wide range of layer geometries.

High and low density patches in simulated liquid water.

We present insights into the nature of structural heterogeneities in liquid water by characterizing the empty space within the hydrogen bond network. Using molecular dynamics simulations, we show that density fluctuations create regions of empty space characterized by a diverse morphology - from spherical to fractal-like voids. These voids allow for the identification of low and high density patches of the liquid, encompassing short (0.3-0.5 nm) as well as long (1-2 nm) length-scales. In addition, we show that the formation of these patches is coupled to collective fluctuations involving the topology of hydrogen-bonded rings of water molecules. In particular, water molecules in the high density patches tend to be slightly more tetrahedral - which is consistent with the predictions of the hydrophobic effect.

Comparative Study of Cytology and Histopathology of Cervical Lesion in VIA Positive Patients and Its Correlation with High Risk Human Papilloma Virus.

Cervical cancer is the second most frequent type of cancer and leading cause of mortality among women worldwide. The present study was undertaken to assess precancerous and cancerous cervical lesion by cytology as well as HPV DNA identification and their comparison with histopathology in VIA positive cases. This descriptive, cross-sectional type of observational study was carried out in the Department of Pathology, Mymensingh Medical College in collaboration with the Department of Gynecology and Obstetrics, Mymensingh Medical College Hospital and Department of Microbiology and Hygiene in Bangladesh Agriculture University for HPV DNA detection from July 2012 to June 2013. Study was carried out among 160 VIA positive patients and selected by non-random judgment sampling from the colposcopy clinic. Out of 160 cases, only 40(25.00%) were found HPV DNA positive, while the rest 120(75.00%) cases were negative. Among positive cases 77.50% were cancerous cases and 22.50% were precancerous cases. It was further revealed that in cancerous cases, 86.11% were HPV DNA positive. PCR showed low sensitivity, probably due to sampling error and inclusion of all cases (chronic cervicitis, precancerous and cancerous lesion). The statistical value of accuracy, sensitivity and specificity of Pap smear cytology, HPV DNA test and histopathology yielded some important directives. The sensitivity values of Pap smear cytology and HPV DNA were found 87.50% and 88.89% respectively. Thus Pap smear test showed almost equal sensitivity to DNA test. The accuracy of the Pap smears and HPV DNA in this study was 88.13% and 96.88% respectively. The accuracy of Pap smears is lower than HPV DNA tests. The present study show significant relationship between cytological with HPV DNA test and histopathological diagnosis. But cytology and HPV DNA testing are not suitable as a single test. In conclusion, it can be stated that combination cytology (Pap smear), histopathology and new technologies such as HPV DNA typing would ultimately be more useful.

A Retrospective Histopathological Study on Extra-pulmonary Tuberculosis in Mymensingh.

Tuberculosis is a very common disease in our country. This retrospective histopathological study was designed to assess the distribution of extra-pulmonary tuberculosis (EPTB) in various organs through examination of biopsy specimens. A total of 216 specimens were diagnosed as tubercular lesion by histopathological evaluation in the Department of pathology, Community Based Medical College and a private laboratory during the period from January 2014 to December 2014. Mean age of the case was 32 years. Majority of the cases were female (126 out of 216). Lymph nodes were the most common site of EPTB (62.96%) followed by skin and subcutaneous tissue (17.59%), intestine (11.11%), breast (2.77%), female genital tract (2.31%), male genital tract (1.38%), bone and joint (1.85%). Out of 136 cases of tubercular lymphadenitis, 96(70.58%) were cervical, 18(13.23%) were axillary, 12(3.82%) were mesenteric and 10(7.35%) were inguinal. This study reveals, in our locality, EPTB is very common in adulthood with female preponderance. Cervical lymph node is very common sites for EPTB.

Comparison of pro-inflammatory cytokines of non-healing and healing cutaneous leishmaniasis.

Cutaneous leishmaniasis (CL) heals spontaneously within several weeks or months, but, in rare cases, CL-active lesions last for many years. In this study, we assessed cell-mediated immunity in non-healing CL through the measurement of three pro-inflammatory cytokines: Interferon-γ (IFN-γ), IL-17a and CXCL-11. For this, 32 patients afflicted with healing or non-healing CL were recruited in this study. Peripheral blood mononuclear cells (PBMCs) of every patient were treated with three antigens: purified protein derivative (PPD), soluble Leishmania antigen (SLA) and phytohaemagglutinin (PHA). Cytokine quantification was performed using enzyme-linked immunosorbent assay (ELISA) method. Results of our study showed that neither cytokine produced in the presence of a PPD stimulator (as an irrelevant antigen) significantly differed between the healing and non-healing groups (P-value ≥0.05 for all of them). However, IFN-γ, CXCL-11 and IL-17a levels produced in the presence of PHA or SLA were significantly higher within the healing than in the non-healing group (P-value <0.01 for all of them). It seems that appropriate levels of IFN-γ, as well as IL-17a and CXCL-11, contribute to the control of Leishmania infection.

[Atypical and rare cardiac revelation about Sheehan's syndrome: A report of three cases]. / Révélations cardiaques atypiques rares du syndrome de Sheehan : à propos de trois cas.

Sheehan syndrome is a potentially serious complication in the postpartum period corresponding to ischemic necrosis of the anterior pituitary related to postpartum haemorrhage. We report three original observations showing an unusual mode of revelation of this syndrome. The first observation is that of a 46-year-old patient admitted initially to resuscitation for a recovered cardiorespiratory arrest, severe hypoglycemia and profound hyponatremia. The second is that of a 45-year-old patient, admitted for recurrent cardiac tamponade after pericardial and pleural puncture and pericardial drainage; clinical survey found signs of slight panhypopituitarism. The latest case is that of a patient of 44 years, admitted to pericardial effusion average abundance revealed by dyspnea and tachypnea with hypotension. The interrogation of all patients revealed the concept of an old hemorrhagic syndrome, absence of lactation and secondary amenorrhea thereafter. Laboratory tests showed insufficient thyroid-stimulating, low cortisol, a hypogonadism hypogonadism. The pituitary magnetic resonance imaging showed an empty sella in the three cases. Patients were placed under replacement therapy with L-thyroxine and hydrocortisone with good clinical, biological and echocardiographic evolution. The three cases illustrate a rare heart atypical presentation for Sheehan's syndrome and underline the importance of early diagnosis and suitable replacement therapy of this syndrome to avoid this complication that can be life threatening.

Unenhanced whole-body MRI versus PET-CT for the detection of prostate cancer metastases after primary treatment.

OBJECTIVE: The aim of this study was to evaluate the accuracy of unenhanced whole-body MRI, including whole-body Diffusion Weighted Imaging (DWI), used as a diagnostic modality to detect  pathologic lymph nodes and skeletal metastases in patients with prostate cancer (PCa) undergoing restaging after primary treatment. PATIENTS AND METHODS: 152 male patients with biochemical recurrence after radical prostatectomy (RP) or external beam radiation therapy (EBRT) underwent MRI at a 1.5 Tesla magnet with whole spinal sagittal T2-weighted, sagittal T1-weighted, sagittal STIR images, axial T1 and T2-weighted and STIR images of the pelvis and whole-body. 18Fcholine-PET/CT exam was used as the reference standard. RESULTS: MRI protocol including whole-body combined T1-weighted+T2-weighted+STIR+DWI showed a sensitivity (Se) of 99%, a specificity (Spe) of 98%, a positive predictive value (PPV) of 98%, a negative predictive value (NPV) of 96%, an accuracy of 98% and an area under the receiver operating characteristic curve (AUC) of 0.971 for identification of bone metastatic lesion. The same protocol, displayed a Se of 98%, a Spe of 99%, a PPV of 97%, a NPV of 98%, an accuracy of 98 % and an AUC of 0.960 in the detection of pathologic lymph nodes. CONCLUSIONS: Unenhanced whole-body MRI, including whole-body-DWI, is an accurate and cost-effective diagnostic tool which is able to detect lymph node involvement and bone metastases in patients with biochemically recurrent PCa after RP or EBRT. Thanks to its lack of ionizing radiation, excellent soft tissue contrast, high spatial resolution, no need of contrast agent, high Se and Spe, it could play a role in the restaging procedure of such patients.

Cytoreductive surgery and hyperthermic intraperitoneal chemotherapy in 1000 patients with perforated appendiceal epithelial tumours.

PURPOSE: To report early and long term outcomes following cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in 1000 patients with perforated appendiceal epithelial tumours, predominantly with pseudomyxoma peritonei (PMP). METHODS: Retrospective analysis of a prospective database of 1000 consecutive patients undergoing CRS and HIPEC for perforated appendiceal tumours between 1994 and 2014 in a UK National Peritoneal Malignancy unit. RESULTS: Overall 1000/1444 (69.2%) patients treated for peritoneal malignancy had appendiceal primary tumours. Of these 738/1000 (73.8%) underwent complete cytoreductive surgery (CCRS), 242 (24.2%) had maximal tumour debulking (MTD) and 20 (2%) had laparotomy and biopsies only. Treatment related 30-day mortality was 0.8% in CCRS and 1.7% in MTD group with major postoperative morbidity rates of 15.2% (CCRS) and 14.5% (MTD). Five- and 10-year overall survival was 87.4% and 70.3% in the 738 patients who had CCRS compared with 39.2% and 8.1% respectively in the MTD group. On multivariate analysis, significant predictors of reduced overall survival were male gender (p = 0.022), elevated CEA (p = 0.001), elevated CA125 (p = 0.001) and high tumour grade or adenocarcinoma (p = 0.001). CONCLUSIONS: Perforated epithelial appendiceal tumours are rare, though may be increasing in incidence and can present unexpectedly at elective or emergency abdominal surgery, often with PMP. CRS and HIPEC results in good long term outcomes in most patients.

Emergence of multidrug-resistant Acinetobacter baumannii producing OXA-23 Carbapenemase in Qatar.

The objective of our study was to describe the molecular support of carbapenem resistance from randomly selected clinical isolates of multidrug-resistant (MDR) Acinetobacter baumannii as a pilot study from the Hamad Medical Corporation (HMC), Qatar. Results of our report will be used to study carbapenemases using molecular techniques in all isolated MDR A. baumannii. Forty-eight MDR A. baumannii were randomly selected from isolates preserved at HMC. Identification of all isolates was confirmed by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. Antibiotic resistance was tested phenotypically by Phoenix and confirmed by Etest. The molecular support of carbapenemases (bla OXA-23, bla OXA-24, bla OXA-58, bla NDM) was investigated by real-time PCR. The epidemiologic relatedness of the isolates was verified by phylogenetic analysis based on partial sequences of CsuE and bla OXA-51 genes. All 48 isolates were identified as A. baumannii and were confirmed to be resistant to most antibiotics, especially meropenem, imipenems, ciprofloxacin, levofloxacin, amikacin, gentamicin and most of the ß-lactams; they were sensitive to colistin. All the isolates were positive for bla OXA-23 and negative for the other tested carbapenemase genes. Clonality analysis demonstrated that different lineages were actually circulating in Qatar; and we suggest that an outbreak occurred in the medical intensive care unit of HMC between 2011 and 2012. Here we report the emergence of MDR A. baumannii producing the carbapenemase OXA-23 in Qatar.

Integrative role of vitamin D related and Interleukin-28B genes polymorphism in predicting treatment outcomes of Chronic Hepatitis C.

BACKGROUND: Improving prediction of treatment outcomes in chronic hepatitis C (CHC) genotype 4 (G4) is necessary to increase sustained viral response (SVR) rates. Vitamin D related and interferon stimulated genes are good candidates as they are recently crosstalk altering interferon response. Thus single nucleotide polymorphisms (SNPs) within some of these genes and multiple stepwise regression analysis including other independent predictors (IL28B(rs12979860), serum 25OH-vitamin D, serum alfa-fetoprotein (AFP)) were performed on a cohort of 200 Egyptian CHC patients treated with Pegylated interferon-alpha (Peg-IFN) plus ribavirin. METHODS: SNPs in cytochrome P-450 (CYP2R1)(rs10741657AG), vitamin D receptor (VDR)(rs2228570AG, rs1544410CT), oligoadenylate synthetases-like (OASL)(rs1169279CT) and adenosine deaminases acting on RNA (ADAR)(rs1127309TC) genes were analyzed by real-time PCR. RESULTS: The carrier state of A allele in VDR rs2228570 and CYP2R1 rs10741657 genes were independently associated with SVR [OR 6.453 & 3.536, p < 0.01 respectively]. Combining carriers of A allele in CYP2R1 and VDR genes with IL28B C/C genotype increased the probability of SVR from 80 % to reach 87.8 %, 93 % and 100 %. No relation was found between VDR rs1544410CT, ADAR rs1127309TC, OASL rs1169279CT polymorphisms and treatment outcome. Combining VDR rs2228570 A/A genotype with IL28B C/C genotype increased the probability of SVR from 82 % to reach 100 % and from 29 % to reach 80 % in C/T+ T/T IL28B genotype in none F4 liver disease patients. CONCLUSION: Vitamin D related (VDR rs2228570 and CYP2R1 rs10741657) and IL28B rs12979860 genes polymorphisms accurately assure SVR in naïve CHC G4 patients treated with low cost standard therapy.

Robust and automated three-dimensional segmentation of densely packed cell nuclei in different biological specimens with Lines-of-Sight decomposition.

BACKGROUND: Due to the large amount of data produced by advanced microscopy, automated image analysis is crucial in modern biology. Most applications require reliable cell nuclei segmentation. However, in many biological specimens cell nuclei are densely packed and appear to touch one another in the images. Therefore, a major difficulty of three-dimensional cell nuclei segmentation is the decomposition of cell nuclei that apparently touch each other. Current methods are highly adapted to a certain biological specimen or a specific microscope. They do not ensure similarly accurate segmentation performance, i.e. their robustness for different datasets is not guaranteed. Hence, these methods require elaborate adjustments to each dataset. RESULTS: We present an advanced three-dimensional cell nuclei segmentation algorithm that is accurate and robust. Our approach combines local adaptive pre-processing with decomposition based on Lines-of-Sight (LoS) to separate apparently touching cell nuclei into approximately convex parts. We demonstrate the superior performance of our algorithm using data from different specimens recorded with different microscopes. The three-dimensional images were recorded with confocal and light sheet-based fluorescence microscopes. The specimens are an early mouse embryo and two different cellular spheroids. We compared the segmentation accuracy of our algorithm with ground truth data for the test images and results from state-of-the-art methods. The analysis shows that our method is accurate throughout all test datasets (mean F-measure: 91%) whereas the other methods each failed for at least one dataset (F-measure≤69%). Furthermore, nuclei volume measurements are improved for LoS decomposition. The state-of-the-art methods required laborious adjustments of parameter values to achieve these results. Our LoS algorithm did not require parameter value adjustments. The accurate performance was achieved with one fixed set of parameter values. CONCLUSION: We developed a novel and fully automated three-dimensional cell nuclei segmentation method incorporating LoS decomposition. LoS are easily accessible features that ensure correct splitting of apparently touching cell nuclei independent of their shape, size or intensity. Our method showed superior performance compared to state-of-the-art methods, performing accurately for a variety of test images. Hence, our LoS approach can be readily applied to quantitative evaluation in drug testing, developmental and cell biology.

Endometrial stromal nodule - a case report.

Among the endometrial tumour endometrial stromal nodule are very rare. It is one of the form of endometrial stromal tumour. There are no definite presurgical diagnosis and diagnosis in most instances by microscopy. Hysterectomy is the treatment of choice to evaluate the tumour margin to differentiate it from stromal sarcoma. We present a case of 40 years woman, ultrasonographically diagnosed as leiomyoma and ovarian cystadenoma, underwent a total abdominal hysterectomy with one sided salpingo-oophorectomy. Microscopic examination show an endometrial stromal nodule and serous cystadenoma of the ovary. Though it is a benign tumour margin should be carefully examined to differentiate from stromal sarcoma, whose treatment and prognosis is totally different.

The validity and reliability of the functional rating index for evaluating low back pain in athletes.

The purpose of the present study was to determine the reliability and validity of the Functional Rating Index (FRI) for athletes with low back pain (LBP). In this cross-sectional and prospective cohort study, the validated Persian FRI (PFRI) was tested in 100 athletes with LBP and 50 healthy athletes. From the athletes with LBP, data were recollected among 50 athletes with a 7-day interval to examine test-retest reliability. The content validity was excellent, and the athletes with LBP responded to all items with no floor or ceiling effects. The discriminative validity was supported by a statistically significant difference in PFRI total scores between the athletes with LBP and healthy athletes. The concurrent criterion validity was good (rho = 0.72). The construct, convergent validity was good (r = 0.83). The internal consistency reliability estimate was high (Cronbach's α = 0.90). Factor analysis demonstrated a single-factor structure with an explained variance of 52.22%. The test-retest reliability was excellent, indicated by an ICC(agreement) of 0.97, and the agreement observed in the Bland and Altman plot demonstrated no systematic bias. It is concluded that the PFRI has excellent psychometric properties for assessing athletes with LBP.

Nasal glioma in a six month old girl.

Congenital midline frontonasal swellings are rare condition and nasal glioma accounts for 5% of these abnormality. Nasal gliomas are benign tumours results from embryonic developmental error. Although it is a rare tumour but clinically it has some differential diagnoses. Most common are dermoid tumour, nasal glioma and nasal encephalocele. About 15-20% cases nasal glioma have a fibrous stalk that connecting to the central nervous system. Multidisciplinary approach is needed for proper diagnosis and to prevent life threatening intracranial complication. We present a case of nasal glioma in a 6 months old girl presented with a congenital swelling on the left lateral side of the nose with complaints of watering from the eye of same side.