scholarly journals Comprehensive Community Screening of Otological Patients by Trained Technicians Using a Telemedicine Device: An Efficient and Cost-Effective Way to Triage Patients With Ear Diseases

2020 ◽  
pp. 014556132095099
Author(s):  
Nishi Gupta ◽  
K. S. Baghotia ◽  
Manipadama Rabha ◽  
Sanchi Sachdeva ◽  
Garima Sahai ◽  
...  
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Intervention Group ◽  
Cost Effective ◽  
P Value ◽  
Suppurative Otitis Media ◽  
Community Screening ◽  
Ear Diseases ◽  
Rural And Urban ◽  
Underserved Community

Objective: To emphasize the benefits of tele-otology in community screening of patients with ear diseases. Methods: A retrospective study of all patients screened and treated under the Shruti tele-otology program between 2013 and 2019 was conducted. It involved screening, diagnosis, medical management, surgical intervention, and rehabilitation using hearing aid. The study focused on underprivileged and underserved community of rural and urban slums across 12 states of India. The study was conducted using a telemedicine device called ENTraview, that is, a camera-enabled android phone integrated with an otoscope and audiometry screening. Result: A total of 810 746 people were screened, and incidence of various ear diseases was recorded. Ear problems were found in 265 615 (33%) patients, of which 151 067 (57%) had impacted wax, 46 792(18%) had chronic suppurative otitis media, 27 875 (10%) had diminished hearing, 12 729 (5%) had acute otitis media and acute suppurative otitis media (ASOM), and 27 152 (10%) had problems of foreign body, otomycosis, and so on. Of the total 265 615 referred patients, 20 986 (8%) reported for treatment and received treatment at a significantly reduced cost through Shruti program partners. The conversion rate of nonsurgical and surgical procedure was also compared, and it was found that, while 9% of the patients opted for nonsurgical treatment, only 3% opted for surgery in the intervention group giving a significant P value of .00001. Conclusion: The potential for telemedicine to reduce inequalities in health care is immense but remains underutilized. Shruti has largely been able to bridge this gap as it is an innovative, fast, and effective programs that address the ear ailment in the community.

Evaluation of Antifungal Activity of CalvatiaCraniiformis and IverMectin as Novel Alternative Therapies for Aspergillus Niger Associated Acute Otitis Media with Special Refer to SocioDemographic Factors Among Rural Children of Diyala Province-Iraq

2017 ◽  
Vol 9 (08) ◽  
Author(s):  
Ghassan H. Jameel ◽  
Ali Ibrahim Ali Al-Ezzy
Keyword(s):  
Antifungal Activity ◽  
Aspergillus Niger ◽  
Otitis Media ◽  
Family Size ◽  
Acute Otitis Media ◽  
Sociodemographic Factors ◽  
P Value ◽  
Rural Children ◽  
Alcohol Extract ◽  
Family Economy

Objectives are to determine antifungal activity of Ivermectin and Calvatiacraniiformis as a novel alternative therapy for aspergillus niger associated acute otitis media (AOM) among rural children of Diyala province; correlation of sociodemographic factors with frequency of infection. Ear swabs taken from 58 infected children and cultured onSabouraud dextrose agar for 7-14 days .Macroscopic and microscopic criteria used for diagnosis of A.niger .High isolation rate for A.niger (27.59%) among children of (4-6) years with significant difference between age groups ( p value 0.039); genders ( p value 0.004);house status(p value=0.018);family size (p value =0.00006334) and month of infection (p value=0.000). A.niger infection negatively correlated with patients age (p value =0.039), family economy and house status (p value =0.000),family size (p value =0.000). Alcohol extract of C.craniiformis (100mg, 200mg, 400mg, 500mg, 600mg, 800mg and 1000 mg) and ivermectin (0.5%,1 % and 2%) restricted the growth of A. niger after 3 days .Significance difference reported between all concentrations except 100 mg and 200 mg ; 600 mg and 800 mg. Significance difference in inhibitory activity between concentration 1% and 2%,0.5% and 2% of Ivermectin respectively. Conclusions: A.niger infections positively correlated with family size and inversely with age and family economy. The growth of A nigersignificantly restricted by alcohol extract of C.craniiformis and Ivermectin in concentration dependent manner. The powerful concentration was 1000mg, for C.craniiformis and 2% for Ivermectin. Thus, C.craniiformis and Ivermectin consider a novel antifungal agents that can be used in clinical practice for treatment of A.niger associated otitis media that represents a clinical problem in children and need serious attention from clinicians.

scholarly journals Otitis media outcomes of a combined 10-valent pneumococcal Haemophilus influenzae protein D conjugate vaccine and 13-valent pneumococcal conjugate vaccine schedule at 1-2-4-6 months: PREVIX_COMBO, a 3-arm randomised controlled trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Amanda Jane Leach ◽  
Edward Kim Mulholland ◽  
Mathuram Santosham ◽  
Paul John Torzillo ◽  
Peter McIntyre ◽  
...  
Keyword(s):  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Conjugate Vaccine ◽  
Otitis Media With Effusion ◽  
Controlled Trial ◽  
Acute Otitis Media ◽  
Trial Registration ◽  
Open Label ◽  
Suppurative Otitis Media ◽  
Link Type

Abstract Background Aboriginal children living in Australian remote communities are at high risk of early and persistent otitis media, hearing loss, and social disadvantage. Streptococcus pneumoniae and non-typeable Haemophilus influenzae (NTHi) are the primary pathogens. We compared otitis media outcomes in infants randomised to either a combination of Synflorix™ (PHiD-CV10, with protein D of NTHi) and Prevenar13™ (PCV13, with 3, 6A, and 19A), with recommended schedules for each vaccine alone. We previously reported superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months. Methods In an open-label superiority trial, we randomised (1:1:1) Aboriginal infants at 28 to 38 days of age, to either Prevenar13™ (P) at 2–4-6 months (_PPP), Synflorix™ (S) at 2–4-6 months (_SSS), or Synflorix™ at 1–2-4 months plus Prevenar13™ at 6 months (SSSP). Ears were assessed using tympanometry at 1 and 2 months, combined with otoscopy at 4, 6, and 7 months. A worst ear diagnosis was made for each child visit according to a severity hierarchy of normal, otitis media with effusion (OME), acute otitis media without perforation (AOMwoP), AOM with perforation (AOMwiP), and chronic suppurative otitis media (CSOM). Results Between September 2011 and September 2017, 425 infants were allocated to _PPP(143), _SSS(141) or SSSP(141). Ear assessments were successful in 96% scheduled visits. At 7 months prevalence of any OM was 91, 86, and 90% in the _PPP, _SSS, and SSSP groups, respectively. There were no significant differences in prevalence of any form of otitis media between vaccine groups at any age. Combined group prevalence of any OM was 43, 57, 82, 87, and 89% at 1, 2, 4, 6, and 7 months of age, respectively. Of 388 infants with ear assessments at 4, 6 and 7 months, 277 (71.4%) had OM that met criteria for specialist referral; rAOM, pOME, or CSOM. Conclusions Despite superior broader overall immunogenicity of the combination schedule at 7 months, and early superiority of PHiD-CV10 compared to PCV13 at 4 months, there were no significant differences in prevalence of otitis media nor healthy ears throughout the first months of life. Trial registration ACTRN12610000544077 registered 06/07/2010 and ClinicalTrials.govNCT01174849 registered 04/08/2010.

Comparison of Cefpodoxime Proxetil and Cefixime in the Treatment of Acute Otitis Media in Infants and Children

PEDIATRICS ◽  
1994 ◽  
Vol 94 (6) ◽  
pp. 847-852
Author(s):  
Basim I. Asmar ◽  
Adnan S. Dajani ◽  
Mark A. Del Beccaro ◽  
Paul M. Mendelman ◽  
Keyword(s):  
Otitis Media ◽  
Acute Otitis Media ◽  
Drug Efficacy ◽  
Oral Suspension ◽  
Suppurative Otitis Media ◽  
Once Daily ◽  
Cefpodoxime Proxetil ◽  
Long Term Follow Up ◽  
Cure Rates

Objective. To compare the use of once-a-day cefpodoxime proxetil to once-a-day cefixime in the treatment of acute suppurative otitis media. Design. Randomized, multicenter, investigator-blinded. Setting. Outpatient. Patients. A total of 368 patients (age 2 months to 17 years) were randomized to receive either cefpodoxime or cefixime in a 2:1 ratio (245 cefpodoxime, 123 cefixime); 236 patients (155 cefpodoxime, 81 cefixime) were evaluable for drug efficacy. Interventions. Patients received either cefpodoxime proxetil oral suspension (10 mg/kg/day, once daily for 10 days) or cefixime oral suspension (8 mg/kg/day, once daily for 10 days). Main outcome measures. Clinical evaluations were performed before treatment (study day 1), at an interim visit (study day 3 through 6), at the end of therapy (study day 12 through 15), and at final follow-up (study day 25 through 38). Microbiologic evaluations were performed at enrollment and whenever appropriate thereafter. Results. End-of-therapy clinical cure rates in evaluable patients were 56% for the cefpodoxime group and 54% for the cefixime group. Clinical improvement rates were 27% for both groups. Clinical response rates were not significantly different between treatment groups (P = .541; 95% confidence interval = -8.1%, 15.2%). At long-term follow-up, 17% of patients in the cefpodoxime group and 20% in the cefixime group had a recurrence of infection. Drug-related adverse events (eg, diarrhea, diaper rash, vomiting, rash) occurred in 23.3% of cefpodoxime-treated patients and 17.9% of cefixime-treated patients (P = .282). Conclusions. These findings suggest that cefpo-doxime proxetil administered once daily is as effective and safe as cefixime given once daily in the treatment of acute suppurative otitis media in pediatric patients.

scholarly journals Relationship between Acute Suppurative Otitis Media and Chronic Secretory Otitis Media: Role of Antibiotics

1984 ◽  
Vol 77 (9) ◽  
pp. 754-757 ◽  
Author(s):  
Robert Mills ◽  
Ann Uttley ◽  
Michelle McIntyre
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Secretory Otitis Media ◽  
Sensitivity Testing ◽  
Suppurative Otitis Media ◽  
In Vitro Sensitivity ◽  
Resistance To Penicillin

A total of 204 chronic middle ear effusions from 122 children have been studied. Bacteria were isolated from 30 effusions. The commonest species found were Strep. pneumoniae and H. influenzae. These are also the commonest organisms causing acute otitis media (AOM). A similar pattern of serotypes was also demonstrated. In vitro sensitivity testing showed that most of the organisms isolated were sensitive to most commonly-used antibiotics. The main exception was resistance to penicillin amongst strains of H. influenzae and Staph. aureus. It is suggested that some cases of chronic secretory otitis media (SOM) may arise as a result of incomplete resolution of AOM and that the use of penicillin to treat AOM may be one factor in this process.

scholarly journals Effectiveness of Tympanic Thermometry for diagnosing Acute Otitis Media

2019 ◽  
Vol 8 (2) ◽  
pp. 74-78
Author(s):  
Muhammad Zubair ◽  
Ghulam Saqulain ◽  
Arfat Jawaid
Keyword(s):  
Tympanic Membrane ◽  
Otitis Media ◽  
Temperature Difference ◽  
Acute Otitis Media ◽  
P Value ◽  
Upper Respiratory Tract ◽  
Mean Temperature ◽  
Ear Wax ◽  
The Mean ◽  
Group B

Background: Acute Otitis Media (AOM) is a common upper respiratory tract infection (URTI) in children and usually presents with fever and otalgia. AOM is characterized by congested tympanic membrane and possible increase in temperature, which might be picked up by infrared tympanic thermometry. The objective of this study was to compare the temperature difference of tympanic membrane of affected ear with the unaffected ear and axilla in unilateral acute otitis media, and compare it with the control group.Material and Methods: This case control study comprised of 200 cases of both genders, aged up to 5 years. They were divided into two groups; Group A included 100 clinically diagnosed cases of acute otitis media (AOM), who reported in the ENT Outpatient Department (OPD) and Group B included 100 controls who presented in General Filter Clinic with no ear complaints. Cases with chronic ear disease, ear discharge, and use of local drugs including ear drops, impacted ear wax, tragal tenderness and congenital malformations of the ear were excluded by taking a detailed history. Clinical examination including otoscopy by an expert was done before subjecting patients to axillary and tympanic thermometry measurements and data recording. Data was collected and tabulated using Microsoft Excel Worksheet and analyzed by SPSS 16. Qualitative data like gender were presented as percentage and ratio, while means and standard deviation were calculated for the quantitative data. Difference between the means of experimental and control groups were analyzed by independent sample t-test and P value of less than or equal to 0.05 was taken as significant.Results: This study included 100 cases of unilateral AOM and 100 normal controls without AOM. In patients with AOM, the mean temperature difference between the affected ear and axilla was 1.41ºF as compared to 0.075ºF in controls (p=0.026). While the mean temperature difference between the affected ear and other ear was 0.65ºF as compared to 0.19ºF in controls (p=0.069).Conclusion: In acute otitis media, the temperature of affected ear is significantly higher than axilla but was not significantly higher than the other ear. The finding may help establish thermometry as a diagnostic tool in clinics manned by doctors not competent to do otoscopy.

scholarly journals EFFICACY OF LATERAL WEDGING IN FOOTWEAR IN MEDIAL COMPARTMENT OSTEOARTHRITIS KNEE

2019 ◽  
pp. 1-3
Author(s):  
Suman Badhal ◽  
U. Singh ◽  
S. L Yadav ◽  
Gita Handa
Keyword(s):  
Intervention Group ◽  
Cost Effective ◽  
Mean Difference ◽  
Medial Compartment ◽  
Treatment Modalities ◽  
Rank Test ◽  
P Value ◽  
Knee Oa ◽  
The Mean ◽  
Group B

INTRODUCTION: In Knee osteoarthritis (OA) Shoe modifications, such as lateral-wedge insoles or shock absorbing shoes with insoles, have been recommended for conservative therapy of mild knee OA but with little objective data on Indian patients. OBJECTIVE : this prospective study was done to study the effect of lateral heel sole wedging (insole) in the patients of OA of knee (medial compartment) and its relation to function,pain and stiffness parameters status on VAS and WOMAC scale and to see the requirement of the number of Aceclofenac tablets. METHODS: 60 patients fulfilling the inclusion criteria were enrolled and divided into intervention group A (30) and nonintervention Group B (30) with random allocation.Paired t-test,Wilcoxon sign rank test and Man Whitney U test were applied at significant p-value of <0.05%. RESULTS: the reduction of mean difference in pain on VAS and WOMAC scale, improvement in Mean difference in function parameters the mean reduction of pain in standing/ walking,bending and ascending/descending at WOMAC scale was significantly higher in intervention group. Also the mean reduction in the need for aceclofenac was significantly lower in intervention group evident from fourth week onward to fifth and sixth week.Conclusion:The lateral wedging in shoes in medial joint osteoarthritis is beneficial and it can be cost-effective conservative treatment modalities in early osteoarthritis patients, particularly in developing countries as it can reduces the requirement of NSAIDS and improve functional level of patients by reducing pain in various activities.

scholarly journals The management of acute otitis media

1984 ◽  
Vol 22 (14) ◽  
pp. 53-54
Keyword(s):  
Hearing Loss ◽  
Otitis Media ◽  
Clinical Examination ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Infectious Complications ◽  
Middle Ear Effusion ◽  
Suppurative Otitis Media ◽  
Painful Condition ◽  
Ear Effusion

Acute suppurative otitis media (AOM) is a common, painful condition affecting 20% of children under 4 years at least once a year,1 and perhaps more in infancy when clinical examination is most difficult. Infectious complications such as mastoiditis, meningitis and cerebral abscess are now rare, but chronic middle ear effusion and hearing loss remain common. Hearing loss may persist long after the infective episode,2 and may impair learning.

Acute Suppurative Otitis Media

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 285-294
Author(s):  
D. Stewart Rowe
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Pathogenic Bacteria ◽  
Acute Otitis Media ◽  
Polymorphonuclear Cells ◽  
Secretory Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Middle Ear Fluid ◽  
Purulent Fluid

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children. DEFINITION Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below. INCIDENCE In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.

scholarly journals Silencing Nrf2 attenuates chronic suppurative otitis media by inhibiting pro-inflammatory cytokine secretion through up-regulating TLR4

2020 ◽  
Vol 27 (1) ◽  
pp. 70-80
Author(s):  
Abulajiang Tuoheti ◽  
Xingzhi Gu ◽  
Xiuqin Cheng ◽  
Hua Zhang
Keyword(s):  
Chronic Inflammation ◽  
Otitis Media ◽  
Inflammatory Cytokines ◽  
Inflammatory Cytokine ◽  
Acute Otitis Media ◽  
Chronic Otitis Media ◽  
Chronic Suppurative Otitis Media ◽  
Related Factor ◽  
Suppurative Otitis Media ◽  
Knock Down

Compromised TLR-mediated chronic inflammation contributes to bacterial infection-caused chronic suppurative otitis media, but the mechanisms are unclear. The present study examined the expression status of nuclear erythroid 2-related factor 2 (Nrf2) and TLRs in human middle-ear mucosae tissues collected from patients with chronic suppurative otitis media, chronic otitis media and non-otitis media, and found that Nrf2 was high-expressed, whereas TLR4, instead of other TLRs, was low expressed in chronic suppurative otitis media compared to chronic otitis media and non-chronic otitis media groups. Consistently, inflammatory cytokines were significantly up-regulated in the chronic suppurative otitis media group, instead of the chronic otitis media and non-chronic otitis media groups. Next, LPS-induced acute otitis media and chronic suppurative otitis media models in mice were established, and high levels of inflammatory cytokines were sustained in the mucosae tissues of chronic suppurative otitis media mice compared to the non-otitis media and acute otitis media groups. Interestingly, continuous low-dose LPS stimulation promoted Nrf2 expression, but decreased TLR4 levels in chronic suppurative otitis media mice mucosae. In addition, knock-down of Nrf2 increased TLR4 expression levels in chronic suppurative otitis media mice, and both Nrf2 ablation and TLR4 overexpression inhibited the pro-inflammatory cytokine expression in chronic suppurative otitis media. Finally, we found that both Nrf2 overexpression and TLR4 deficiency promoted chronic inflammation in LPS-induced acute otitis media mice models. Taken together, knock-down of Nrf2 reversed chronic inflammation to attenuate chronic suppurative otitis media by up-regulating TLR4.

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