Audiological profile of pre-operative and post-operative results in mucosal diseases of the ear: a comparative study

Background: The Objectives of the study were to study pre-operative audiological results in mucosal diseases of ear; to study post-operative audiological results in mucosal diseases of ear and to compare pre-operative and post-operative audiological results in mucosal diseases of ear.Methods: A prospective study was done on 60 patients presenting to out-patient department of Otorhinolaryngology and Head and Neck Surgery, S.Nijalingappa Medical College and H.S.K Hospital and Research Centre, Bagalkot from May 2018 to April 2020 with CSOM-mucosal disease. Audiological evaluation was done and compared using pure tone audiometry (Amplaid311TypeIEC645) before and after tympanoplasty with cortical mastoidectomy and mean air conduction (AC) threshold improvement and mean air-bone gap (AB gap) closure was analyzed. Results: Out of 60 patients, 27(45%) patients had medium sized central perforation. Mean pre-operative AC threshold was 44.5958±10.64639 dB HL which improved to 30.100±10.41056 dB HL at 1month and 21.8125±8.6928 dB HL at 3months post-operatively which was statistically significant with p<0.001*. Mean AB gap closure at 1-month was 10.175±6.01098 dB HL and at 3-months was 11.0416±6.3458 dB HL.Conclusions: AC threshold gain and AB gap closure at 1month and 3 months post-tympanoplasty with cortical mastoidectomy for CSOM-mucosal disease are significant. Hence surgery is main basic tool which results in improvement of audiological results in mucosal diseases of ear.

Download Full-text

Clinical evaluation of total abdominal hysterectomy - a prospective study in a tertiary care hospital

Northern International Medical College Journal ◽

10.3329/nimcj.v6i2.23178 ◽

2015 ◽

Vol 6 (2) ◽

pp. 76-77

Author(s):

Shirin Akhter ◽

Rumana Nazneen

Keyword(s):

Tertiary Care Hospital ◽

Tertiary Care ◽

Total Abdominal Hysterectomy ◽

Abdominal Hysterectomy ◽

Care Hospital ◽

College Hospital ◽

Cross Sectional ◽

Medical College ◽

Before And After ◽

A Prospective Study

Total abdominal Hysterectomy are gradually rising in our country. This study has been designed to find out the common indications of abdominal hysterectomy in a tertiary care hospital,. to know the clinical characters of the patients and. o elucidate postoperative complication of abdominal hysterectomy.Methodology : Cross- sectional observational study was done during 1st October 2007 to 30th September 2008. Holy Family Red Crescent Medical College Hospital (HFRCMCH). Total 100 patients were selected following enclusion & exclusion criteria hyperposive sampling. Data were recorded before and after operation and analyzed by SPSS version 15.Result : In the present study patients with leiomyoma of uterus was found to be the major indication of hysterectomy followed by dys functional uterine bleeding (DUB) 18.0%, Pelvic inflammatory disease (PID) 14.0%, chronic cervicitis 10.0%, adenomyosis 10.0%, pelvic endometriosis 6.0%, cervical polyp 2.0%, ovarian cysts 1.0% and chriocarcinoma 1.0%. Mean duration of operation (hour) and hospital stay was 1.15 hours and 7.48 days respectively. Most common complication of present series was fever 20.0% followed by 13.0% had wound infection, 6.0% UTI and 2.0% wound dehiscence.Conclusion : Hysterectomy is now the most widely performed major operation in gynaecology. Indication and post operative complications of hysterectomy varies from region to region.Northern International Medical College Journal Vol.6(2) 2015: 76-77

Download Full-text

Visual estimation of blood loss versus quantification of blood loss after vaginal birth using an innovative drape: a prospective study

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20205780 ◽

2020 ◽

Vol 10 (1) ◽

pp. 268

Author(s):

Nalini Mishra ◽

Suman Dhruw ◽

Ishan Mishra ◽

Abha Daharwal

Keyword(s):

Blood Loss ◽

Correlation Coefficient ◽

Point Of Care ◽

Low Cost ◽

Vaginal Birth ◽

Strong Positive Correlation ◽

Visual Estimation ◽

Medical College ◽

Before And After ◽

A Prospective Study

Background: This study was done to compare the accuracy of visual estimation of blood loss (EBL) and quantitative assessment of blood loss (QBL, sum of volumetric and gravimetric assessment) against a reference standard i.e. calculated QBL (C-QBL) and also with each other after vaginal birth.Methods: Prospective observational cohort study conducted at Pt. JNM medical College Raipur, Chhattisgarh, India and involved 101 low risk women after vaginal birth. Women were allocated alternately to EBL or QBL group (volumetric component of measured blood loss was done with an innovative low cost drape prepared with a plastic apron at the point of care. Gravimetric component was measured by weight difference of the mops and pads before and after use). C-QBL was calculated for each case with a standard formula. Main outcome measure was comparing the correlation coefficient of EBL and QBL each with C-QBL.Results: The mean blood loss in 51 women of EBL group and 50 women of QBL group was 275.29 ml and 380 ml respectively. Pearson’s correlation coefficient (r) of EBL with C-QBL was 0.4984 (weak correlation) compared to that of QBL with C-QBL (r=0.9093, strong positive correlation). The error of underestimation by EBL compared to QBL was 28% (mean=104.71 ml p<0.0001). The relative risk (RR) of underestimating blood loss of >500 ml by EBL method was 5 (95% CI .605-41.3).Conclusions: Visual EBL should be replaced with QBL for measurement of postpartum blood loss. Using innovative under-buttock low cost drape greatly helps in routine QBL.

Download Full-text

A comparative study of preoperative and postoperative hearing after type I tympanoplasty using temporalis fascia graft at Dr. B. R. Ambedkar Medical College, Bengaluru

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20202777 ◽

2020 ◽

Vol 6 (7) ◽

pp. 1258

Author(s):

Muniraju M. ◽

Smita Hegde

Keyword(s):

Disease Duration ◽

Type I ◽

Temporalis Fascia ◽

Hearing Gain ◽

Medical College ◽

Type 1 Tympanoplasty ◽

Fascia Graft ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: The objective of the study was to identify the factors which significantly influence type 1 tympanoplasty success.Methods: A prospective study was performed on 30 patients who underwent type 1 tympanoplasty via underlay technique using temporalis fascia graft from December 2017 to September 2019 in a teaching hospital. Outcome measures were graft uptake rate and hearing gain. The factors assessed were the age and sex, preoperative condition of the ipsilateral and contralateral ears, perforation size, presence of tympanosclerosis, and whether simultaneous cortical mastoidectomy was performed. Results: None of the factors proved to have a significant influence on tympanic membrane closure or hearing gain.Conclusions: The success rate of a type 1 tympanoplasty is dependent on the skills of the surgeon and the type of graft used. Age, sex, laterality of the disease, duration of dry ear, size of the perforation, presence of tympanosclerosis and simultaneous cortical mastoidectomy have no bearing on hearing gain.

Download Full-text

Does hearing loss relate to gestational diabetes mellitus?

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20193863 ◽

2019 ◽

Vol 5 (5) ◽

pp. 1244

Author(s):

Devanshu Kwatra ◽

Sunil Kumar ◽

Gautam Bir Singh ◽

Ratna Biswas ◽

Prabhakar Upadhyay

Keyword(s):

Diabetes Mellitus ◽

Gestational Diabetes ◽

Gestational Diabetes Mellitus ◽

Pregnant Women ◽

Postpartum Period ◽

Pure Tone Audiometry ◽

Neck Surgery ◽

Hearing Sensitivity ◽

Significant Difference ◽

Air Conduction

Background: This study aims to check if gestational diabetes mellitus leads to changes in hearing.Methods: A prospective hospital based observational study was performed with total 60 subjects in age group of 18-40 years in the Department of Otolaryngology and Head and Neck Surgery and the Department of Obstetrics and Gynaecology, Lady Hardinge Medical College, New Delhi between November 2016 to March 2018. Subjects were divided in two groups. The first group included 30 pregnant women with diagnosed gestational diabetes mellitus and the second group had 30 pregnant women not having gestational diabetes mellitus. Pure-tone audiometry and impedance audiometry was performed twice in all the subjects, first during the antepartum period and second time during the postpartum period. Results: Significant difference was seen between the average of air conduction threshold values at speech frequencies between the two groups during both antepartum and postpartum period.Conclusions: The alterations in hearing sensitivity in air conduction between the two groups can be attributed to gestational diabetes mellitus.

Download Full-text

A clinical study of evaluation of tympanoplasty with mastoidectomy in mucosal chronic otitis media

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20195709 ◽

2019 ◽

Vol 6 (1) ◽

pp. 163

Author(s):

Ritesh Mahajan ◽

Nidhi Abraham ◽

Nagaraj T. M.

Keyword(s):

Otitis Media ◽

Disease Process ◽

Chronic Otitis Media ◽

Chronic Suppurative Otitis Media ◽

Suppurative Otitis Media ◽

Medical College ◽

Cortical Mastoidectomy ◽

A Prospective Study

Background: Chronic suppurative otitis media (CSOM) is one of the most common ear diseases in developing countries with a varying incidence of 3% to 57%. It the disease process is further divided into mucosal type and squamosal type depending on clinical presentation. The mainstay of therapy in CSOM remains surgery which aims at eradication of disease and restoring the hearing mechanism. The main objective of our study was to evaluate the changes and impact of tympanoplasty with mastoidectomy as a surgical treatment modality in mucosal type of CSOM.Methods: A prospective study was conducted in Rajarajeshwari Medical College and Hospital between November 2015 and June 2017, involving 50 patients with mucosal type of chronic otitis media. These patients, after complete clinical examination and hearing analysis, underwent tympanoplasty with cortical mastoidectomy. Follow-up of the patients was done at one month and three months after the surgery where the parameters recorded preoperatively were assessed. Results: The graft uptake three months after the surgery was 94%. Patients reported a subjective improvement in symptoms of ear discharge, decreased hearing, earache and tinnitus to 94%, 70%, 86% and 78% respectively. There was hearing improvement in ears that had discharge preoperatively and those ears that did not.Conclusions: Chronic suppurative otitis media is a very common problem and it can lead to recurrent ear discharge and hearing problems. Timely intervention is necessary as early diagnosis results in good surgical outcomes and can make an impact on patient’s quality of life.

Download Full-text

Endoscopic dacryocystorhinostomy: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20163476 ◽

2016 ◽

Vol 2 (4) ◽

pp. 254 ◽

Cited By ~ 2

Author(s):

Jyothi A.C. ◽

Ajay Kumar ◽

Prawahar Chiluveru

Keyword(s):

Neck Surgery ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Research Centre ◽

Surgical Removal ◽

Lacrimal Sac ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Medical College ◽

Frontal Process

Background: The purpose of the study was to determine the outcome and safety of endoscopic dacryocystorhinostomy (ENDO-DCR) with the use of silicon stents in nasolacrimal duct obstruction.Methods: This study was done in the department of otorhinolaryngology and head and neck surgery, Navodaya Medical College and Research Centre, Raichur, from January 2013 to June 2015, with a total of 82cases (10 cases with bilateral disease) underwent a standardized procedure, with an endonasal approach to the lacrimal sac, surgical removal of nasal mucosa, lacrimal bone, and a fragment of the frontal process of the maxilla. The medial wall of the lacrimal sac was removed completely and canalicular silicone intubation tube was placed for six weeks post operatively. Main outcome measures were resolution of epiphora, absence of discharge, and patency of the ostium confirmed by irrigation and endoscopic evaluation of neo osteum at 6 weeks.Results: The ENDO-DCR procedure with adjunctive canalicular silicon intubation tube was successful in 78 (95%) cases. No significant complications were encountered during or after operative periodConclusions: Endoscopic dacryocystorhinostomy with canalicular silicon intubation for shorter duration (6 weeks) is a safe and successful procedure for the treatment of nasolacrimal duct obstruction in adults as well as in children with a success rate of 95%.

Download Full-text

Evaluation of Post-Hemithyroidectomy hypothyroidism

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v26i2.50608 ◽

2020 ◽

Vol 26 (2) ◽

pp. 95-101

Author(s):

SM Abdul Awual ◽

Syeda Marufa Hasan ◽

Suhel Al Muzahid Reza ◽

Md Shahriar Islam ◽

Utpaul Kumar Sarkar ◽

...

Keyword(s):

Risk Factors ◽

Thyroid Function ◽

Neck Surgery ◽

Thyroid Stimulating Hormone ◽

Thyroid Antibodies ◽

Medical College ◽

The Mean ◽

A Prospective Study ◽

Head Neck Surgery ◽

Head Neck

Objective: To evaluate the incidence of post-hemithyroidectomy hypothyroidism and identify possible risk factors that indicates which patients require thyroid function monitoring after surgery. Methods: A prospective study of patients with benign, non-toxic thyroid disease undergoing hemithyroidectomy between January 2017 and July 2019 in the Department of Otolaryngology and Head-Neck Surgery, Sir Salimullah Medical College Mitford Hospital, Dhaka. All patients were in euthyroid state preoperatively.Thyroid specimens were examined for pathological diagnosis and thyroid function was evaluated again six weeks after surgery. Results: All had normal preoperative thyroid function. Six weeks after surgery, 10 (22.22%) of the cases developed hypothyroidism (6.66% overt or symptomatic hypothyroidism and 15.56% subclinical hypothyroidism). The mean preoperative TSH level was significantly higher in the hypothyroid group than in the euthyroid group (2.1±1.1 vs 1.3±0.7mIU/L, p<0.01).Seven of patients with preoperative thyroid stimulating hormone (TSH) level more than or equal to 2 mIU/L developed hypothyroidism in comparison to only 3 of those with preoperative TSH <2 mIU/L (odds ratio 11.3). Conclusion: Ten (22.22%) patients in the present study developed hypothyroidism after hemithyroidectomy. Preoperative TSH more than or equal 2 mIU/L, elevation of thyroid antibodies and thyroiditiswarrant post-operative close TSH monitoring. Awareness of such risk factors for post-operative hypothyroidism would improve patients care and reduce complications. Bangladesh J Otorhinolaryngol; October 2020; 26(2): 95-101

Download Full-text

A COMPARATIVE STUDY TO ASSESS THE EFFICACY OF HYDROXYPROPYLMETHYLCELLULOSE POWDER OVER STEROID SPRAY IN TREATMENT OF ALLERGIC RHINITIS IN THE DEPTT. OF ENT AND HEAD & NECK SURGERY, SILCHAR MEDICAL COLLEGE & HOSPITAL

10.36106/paripex/2403115 ◽

2021 ◽

pp. 79-81

Author(s):

Tinku Moni Borah ◽

Smrity Rupa Borah Dutta

Keyword(s):

Allergic Rhinitis ◽

Nasal Spray ◽

Neck Surgery ◽

Complete Relief ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B ◽

A Prospective Study ◽

Surgery Department

Objective: To assess the efficacy of Hydroxypropylmethylcellulose powder over steroid nasal spray in treatment of allergic rhinitis. Methods: A prospective study of 60 patients suffering from allergic rhinitis was conducted in the ENT and Head & Neck surgery Department, Silchar medical College and Hospital from April 2018 to August 2018.The study subjects were divided into two groups A and B. Group A was treated with oral antihistaminic and steroid nasal spray, while group B was treated with oral antihistaminics and HYDROXYPROPYLMETHYLCELLULOSE powder nasal spray for 4 weeks. The treatment outcomes were evaluated after 14 days and 28 days from the beginning of treatment, by assessing relief of symptom on a five point scale. Results: There was almost similar score in both the groups ranging between score 3 and 4(i.e., relief of nasal obstruction and sneezing) after 14 days of treatment (62% vs 64%). But after 28 days there was significantly better improvement score of group B study subjects over group A in score 5 (i.e., complete relief from symptoms (83.3% vs. 66.6% ).In both the groups, mild sedation at the beginning of the treatment was reported in some patients, which is a well known side effect of antihistaminics. Conclusion: The result obtained comparing both the groups indicated high efficacy of hydroxypropylmethylcellulose powder over steroid nasal spray in the treatment of allergic rhinitis.

Download Full-text

Prescription patterns of Antibiotics in Acute tonsillitis: Hospital-based study

Journal of Gandaki Medical College-Nepal ◽

10.3126/jgmcn.v13i1.27561 ◽

2020 ◽

Vol 13 (1) ◽

pp. 65-67

Author(s):

Brihaspati Sigdel ◽

Tulika Dubey ◽

Rajendra Nepali ◽

Neeraj KC

Keyword(s):

Drug Combination ◽

College Teaching ◽

Neck Surgery ◽

Research Centre ◽

Acute Tonsillitis ◽

Prescription Pattern ◽

Prescription Patterns ◽

Medical College ◽

Group A ◽

The Mean

Introduction: Acute tonsillitis is caused by either viruses or bacteria and is characterized by a sore throat and painful swallowing. About 49% of cases are thought to be caused by Group A beta-hemolytic streptococci. Penicillin should be given empirically after the diagnosis of acute tonsillitis. This study was carried out to find out the prescription pattern of antibiotics among the admitted cases of acute tonsillitis. Materials and Methods: This study was conducted in the Department of Otorhinolaryngology and Head and Neck Surgery, Gandaki Medical College Teaching Hospital and Research Centre (GMCTH), Pokhara. All the patients who were admitted for acute tonsillitis in the ENT ward were enrolled in this study. Age, gender, the average number of drugs per prescription, and the most commonly prescribed drug was recorded. Results: There were 320 patients with acute tonsillitis and the mean age was 27.44 ± 11.1 years. Most of the cases were in their twenties. The average number of drugs per prescription was four while the total number of antibiotics used was 520. The single antibiotic was used in 170 (53%) cases and a two-drug combination was used in 91(28.4%) cases. Ceftriaxone was the most commonly prescribed drug. There were 78 (24.3%) cases under monotherapy and 69 (21%) in multitherapy. Conclusion: Among the various effective antimicrobials, ceftriaxone was the most commonly prescribed antimicrobial. The injectable route of antibiotics administration was a widely used method in hospitalized patients in our setting.

Download Full-text

Surgical findings & audiological outcomes of Stapedotomy in patients with Otosclerosis

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v20i2.22024 ◽

2015 ◽

Vol 20 (2) ◽

pp. 87-92

Author(s):

Mohammod Delwar Hossain ◽

Md Rafiquzzaman ◽

Nasir Uddin Ahamed ◽

AKM Asaduzzaman ◽

Md Tauhidul Islam ◽

...

Keyword(s):

Facial Nerve ◽

Pure Tone ◽

Bone Conduction ◽

Pure Tone Audiometry ◽

Neck Surgery ◽

Military Hospital ◽

Prospective Clinical Study ◽

Chorda Tympani Nerve ◽

Stapedial Artery ◽

Air Conduction

Objective: This study was focused on the assessment of patients improvement in hearing, as measured by pure tone audiometry after stapedotomy for primary otosclerosis. Materials and Methods: This prospective clinical study was performed in a total of 50 patients diagnosed with Primary Otosclerosis, who underwent Stapedotomy at the Department of ENT & Head-Neck Surgery, Combined Military Hospital, Dhaka between June 2012 to January 2014. All patients were evaluated as per the candidacy criteria for stapedotomy and selected patients underwent surgery during the study period and were followed up for a period of 12 months in the Otology clinic. Pre-operative and Post-operative audiometric evaluation was done using conventional pure tone audiometry with standard calibrations. Post-operative audiometry was performed at 03 month, 06 months and 12 months. The bone-conduction & air conduction thresholds and the Air- Bone gap (ABG), were documented and analysed at 0.5 KHz, 1 KHz, 2 KHz and 4 KHz frequencies respectively. The subjective outcomes in hearing were also recorded with a patient satisfaction questionnaire to assess improvement in quality of hearing after stapedotomy. Results: Overall, the frequency specific pre-operative mean averaged Air Conduction thresholds were 63.3dB at 500Hz, 57.5dB at 1 KHz, 55.1dB at 2 KHz and 45.7dB at 4 KHz. The frequency specific post-operative mean averaged Air conduction thresolds were 34.6 dB at 500Hz, 28.9 dB at 1Kz, 30.5dB at 2Kz and 33.3dB at 4Kz.The frequency specific mean average post operative Air Bone Gap (ABG) closure was achieved by 28.7dB at 500Hz, 27.6 dB at 1KHz, 24.6 dB at 2KHz and 12.4 dB at 4KHz by the time of completion of the study at 01 year. A successful closure of AB gap to less than 10dB was achieved in the speech frequencies of 2 KHz and 4 KHz in 84% of cases. Overall, the frequency specific bone-conduction thresholds were unchanged postoperatively in all cases except one, showing that no significant sensori-neural impairment had occured due to the stapedotomy procedure. 1 patient developed post-op severe vertigo which was self-limiting after six weeks. A few interesting cases with anomalous intra-operative findings were also documented and reported herewith. These included monopodal stapes (n=1), anomolous facial nerve (n=1), laterally placed chorda tympani nerve (n=1), high jugular bulb, Malleus ankylosis (n=1) and persistent stapedial artery (n=1). All patients included in our study had significant subjective audiological improvement and responded satisfactorily to the questionnaire formulated to assess their hearing quality after stapedotomy. Conclusions: Our case study confirms that stapedotomy is a safe and successful procedure providing long-term hearing improvement in primary otosclerosis. Obliterative otosclerosis, biscuit or floating footplate, monopodal stapes, anomalous facial nerve and persistent stapedial artery may be special scenarios encountered during stapedotomy and they need judicious management by an experienced surgeon. Our study shows that meticulous selection of cases for stapedotomy will result in highly successful audiological outcomes. DOI: http://dx.doi.org/10.3329/bjo.v20i2.22024 Bangladesh J Otorhinolaryngol; October 2014; 20(2): 87-92

Download Full-text