https://www.selleckchem.com/products/Metformin-hydrochloride(Glucophage).html Conclusion Pediatric Otolaryngologists at our institution have lower degrees of moral distress compared to other pediatric subspecialists. Fellows had higher levels of distress compared to faculty. Further research is necessary to determine degrees of distress across institutions and to determine its impact on the wellness of pediatric otolaryngologists.Objective Infantile hemangiomas (IHs) are the most common benign tumor in infancy. Periorbital IHs may lead to visual dysplasia so prompt and effective treatment should be adopted. In this study, we retrospectively analyzed the diagnosis and treatment of periorbital IHs treated in our clinic and give the strategy for clinical practice. Methods From Jan. 2006 to Dec. 2018, 35 patients with periorbital IHs were enrolled into this study, including 13 males. The initial age of treatment ranged from 0.6 to 7 months. The clinical manifestations, imaging examination results, treatment measures and follow-up results were analyzed. Then diagnosis and treatment strategy were summarized. Results All patients were examined by ultrasound to confirm the depth of tumor, evaluate the effect of treatment and provide the evidence for drug withdrawal. For patients with deep hemangiomas, enhanced CT were added. Intralesional injection of glucocorticoids and oral propranolol were applied. All patients achieved good results. Ocular symptoms were avoided in most of the patients. Conclusion Periorbital IHs have special growth features and can be diagnosed by the appearance, ultrasound, CT scan, and propranolol experimental therapy if necessary. In consideration of potential complications, oral propranolol is the first treatment option for periorbital IHs.Otitis media with effusion has been the subject of a number of recent studies. It was first recognised during the second half of the 19th century, when Adam Politzer (1835-1920) of Vienna was one of the leading ot