MYRINGOTOMY FOR THE TREATMENT OF OTITIS MEDIA WITH EFFUSION; A COMPARISON IN THE OUTCOME WITH AND WITHOUT GROMMET INSERTION

Objective: To compare the outcome of myringotomy with and without grommet insertion in the patients of otitis media with effusion in terms of improvement of hearing in a one-month follow-up. Study Design: Quasi experimental study. Place and Duration of Study: Pakistan Airforce Hospital Jacobabad and Combined Military Hospital Lahore Pakistan, from Jan to Dec 2020. Methodology: A total of 28 patients aged 4-12 years diagnosed to have conductive hearing loss due to otitis media with effusion not responding to medical treatment were included. Non probability convenience sampling was done. Children aged less than 4 years and above 12 years were not included in the study. They were randomly divided into two groups of 14 patients each using lottery method. Group A underwent myringotomy alone whereas group B underwent myringotomy with grommet insertion. Patients in both groups also underwent adenoidectomy on case-to-case basis. Both groups were compared in terms of improvement in hearing post operatively in a one-month follow-up. Results: There was statistically significant reduction in air bone gap at the end of follow up period as compared to preoperative air bone gap in group B (p=0.007). In group A there was statistically significant reduction in air bone gap at one week (p=0.002) however this improvement was not maintained at 4 weeks (p=0.386). Conclusion: Myringotomy with grommet insertion had significantly more patients with improved hearing as compared to myringotomy alone after one month.

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COMPARISON OF THE EFFICACY OF ANTIBIOTIC-STEROID AND ICHTHAMMOL GLYCERINE WICK IN TREATMENT OF ACUTE OTITIS EXTERNA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4556 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S612-16

Author(s):

Maryam Khan ◽

Kamran Ashfaq Ahmed Butt ◽

Naeem Riaz ◽

Zaheer Ul Hassan ◽

Attique Ahmed ◽

...

Keyword(s):

Experimental Study ◽

Otitis Externa ◽

The Other ◽

Military Hospital ◽

P Value ◽

Similar Response ◽

Quasi Experimental ◽

Group A ◽

Group B

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.

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Prevalence and Management of Otitis Media with Effusion Amongst the School Going Children of a Rural Area in Puducherry

Bengal Journal of Otolaryngology and Head Neck Surgery ◽

10.47210/bjohns.2016.v24i1.68 ◽

2016 ◽

Vol 24 (1) ◽

pp. 21-28 ◽

Cited By ~ 1

Author(s):

Sharath Babu K ◽

Jayagar Prabakaran ◽

Shankar Radhakrishnan

Keyword(s):

Otitis Media ◽

Otitis Media With Effusion ◽

Pure Tone Audiometry ◽

Developed Countries ◽

Wide Field ◽

Age Group ◽

College Hospital ◽

Medical College ◽

Group A ◽

Group B

Background : Otitis Media with Effusion(OME) also known as Secretory Otitis Media, has been identified as the commonest middle ear condition causing deafness in children in developed countries. Neither the indication for surgical treatment nor the types and number of procedures used are uniform. Possible treatment includes myringotomy with or without insertion of ventilation tube either alone or with adenoidectomy and occasionally tonsillectomy. Aims and Objectives : To assess the prevalence and the different modes of presentation of Otitis Media with Effusion among the rural school children of Puducherry and to assess the improvement in hearing after 6 months of surgical intervention done on patients with Otitis Media with Effusion. Materials and Methods: A school screening camp was conducted on 600 children in the age group of 5-12 years in a government middle school near our medical college hospital for identifying children with Otitis Media with Effusion. Students with Otitis Media with Effusion were further classified into 4 groups for various interventional procedures namely adenotonsillectomy with bilateral grommet insertion (Group A), adenoidectomy with bilateral grommet insertion (Group B), bilateral grommet insertion (Group C), bilateral myringotomy with wide field incision in the antero-inferior quadrant (Group D). Result : The prevalence was almost in equal proportions in the age group between 5-12 years and the overall prevalence of Otitis Media with Effusion among the study population was 13.3%. The adenotonsillectomy with bilateral grommet insertion procedure had shown a significant improvement in hearing, which was measured by using pure tone audiometry by assessing the mean air-bone gap, which was 9.81, 8.27 and 6.73 at the end of 6 weeks, 3 months and 6 months respectively, when compared to the other procedures. Conclusion : Adenotonsillectomy with bilateral grommet insertion should be considered in a child with Otitis Media with Effusion who is at risk for speech/language/hearing loss.

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COMPARISON OF MICRODEBRIDER - ASSISTED TURBINOPLASTY VERSUS ENDOSCOPIC PARTIAL TURBINECTOMY IN CASES OF INFERIOR TURBINATE HYPERTROPHY IN ALLERGIC RHINITIS PATIENTS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-3.4121 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S598-602

Author(s):

Muhammad Ahmed Khan ◽

Faiz Ul Hassan Nawaz ◽

Muhammad Tahir ◽

Hina Mazhar ◽

Muhammad Dawood ◽

...

Keyword(s):

Allergic Rhinitis ◽

Nasal Obstruction ◽

Inferior Turbinate ◽

Military Hospital ◽

Turbinate Hypertrophy ◽

Quasi Experimental ◽

Group A ◽

Group B ◽

Inferior Turbinate Hypertrophy ◽

Age Range

Objective: To compare microdebrider-assisted turbinoplasty versus endoscopic partial turbinectomy in cases of inferior turbinate hypertrophy in allergic rhinitis patients in terms of relief/improvement of nasal obstruction, post operative bleeding, crusting and synechie formation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Mardan and Combined Military Hospital Malir, from Jan 2019 to Jan 2020. Methodology: A total of 90 patients of allergic rhinitis with severe nasal obstruction due to bilateral inferior turbinate hypertrophy fulfilling the inclusion exclusion criteria were selected. Cases were randomly divided into two groups of 45 each. Group A cases underwent microdebrider assisted turbinoplasty and Group B cases underwent partial turbinectomy via endoscpic approach. They were comparedin terms of post op bleeding, relief of nasal obstruction, post op crusting & synechie/adhesions. All the data was entered on SPSS-17 and analyzed. Results: Out of 90 cases, there were 43 (47.8%) females and 47 (52.2%) males with age range from 15-65, mean age 37.68 ± 11.56 Years. There was only 1 case of post op bleeding after microdebrider assisted turbinoplasty requiring nasal packing in contrast to 6 cases of post op bleeding after endoscopic partial turbinectomy. On one month post op visit, there was no case of nasal crusting in turbinoplasty group in contrast to 7 of mild and 1 of moderate crusting & 3 synechie/adhesions in endoscopic partial turbinectomy group. Conclusion: Microdebrider-assisted turbinoplasty is associated with less post operative bleeding and synechie formation as compared to endoscopic turbinectomy.

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Comparison of 4% Topical Hydroquinone versus Combination of Oral Tranexamic Acid and 4% Topical Hydroquinone in the Treatment of Epidermal Melasma

10.53350/pjmhs2115103406 ◽

2021 ◽

Vol 15 (10) ◽

pp. 3406-3409

Author(s):

Sarah Riaz ◽

Najia Ahmed ◽

Ayesha Anwar ◽

Moizza Tahir ◽

Farrah Yousaf ◽

...

Keyword(s):

Tranexamic Acid ◽

Topical Therapy ◽

Military Hospital ◽

Ethical Review ◽

P Value ◽

Treatment Groups ◽

Quasi Experimental ◽

Group A ◽

Group B ◽

Better Than

Objective: comparison of efficacy of topical 4% hydroquinone monotherapy with combination of oral tranexamic acid and topical 4% hydroquinone in the treatment of epidermal melasma Study design: Quasi experimental study Study period and place: Dermatology OPD, Pak Emirates Military Hospital Rawalpindi from July 2018 to January 2019. Methodology: Total 80 patients presenting with epidermal melasma were selected from outdoor patient department after applying the inclusion criteria and consent was taken from selected patients. Study was started after getting permission from hospital ethical review board. Two treatment groups were made after dividing patients by using alternate method. Treatment with topical 4% hydroquinone alone was started for group A patients and combination of capsule tranexamic acid (250 mg two times a day) along with topical 4% hydroquinone were started for group B patients for the next 6 months. Evaluation of patients through detailed history, clinical and wood’s light examination before starting therapy and after of 24 weeks of treatment was done for both groups. Efficacy of treatment was assessed via Modified MASI score. Results: Hydroquinone monotherapy was effective in 21 (52.5%) patients among group A while in group B patients, combination treatment i.e. oral tranexamic acid and topical hydroquinone, was effective in 31 (77.5%) patients (p value= 0.01). Conclusion: Effectiveness of Hydroquinone 4% topical therapy combined with oral tranexamic acid for epidermal melasma is better than topical 4% hydroquinone alone. Key words: Epidermal melasma, oral tranexamic acid, topical 4% hydroquinone.

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COMPARISON OF EFFICACY OF EPLEY MANOEUVRE AND VESTIBULAR SEDDATIVE IN POSITIONAL VERTIGO

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v1i1.7927 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S437-39

Author(s):

Muhammad Sohail Babar Niazi ◽

Khawar Kamal ◽

Zaheer Ul Hassan ◽

Aisha Qaiser ◽

Shahid Farooq Khattak ◽

...

Keyword(s):

Benign Paroxysmal Positional Vertigo ◽

Military Hospital ◽

Chi Square ◽

Total Recovery ◽

Positional Vertigo ◽

Quasi Experimental ◽

Chi Square Test ◽

Group A ◽

Group B ◽

Paroxysmal Positional Vertigo

Objective: To carry out the comparison of the effectiveness of Epleys manoeuvre and Vestibular Sedative in the management of benign paroxysmal positional vertigo. Study Design: Quasi experimental study. Place and Duration of Study: Department of ENT, Combined Military Hospital Peshawar, from Jul 2019 to Dec 2020. Methodology: The study was conducted on 60 patients who were diagnosed Benign Paroxysmal Positional Vertigo by Dix Hallpike test. The patients were divided into 2 groups of 30 each. Group A was treated with vestibular sedative and group B was treated with Epleys manoeuvre. The examination of all patients was done on day 3, day 7 and day 14 and the results were documented. Results: The study revealed that the 30 cases which were managed by Epleys manoeuvre, 27 cases were completely symptom free after 14 days. Meanwhile from the 30 patients who were treated by oral vestibular sedation, only 5 patients had total recovery on 14th day. Chi square test was used to compare the results. The results showed that Epleys manoeuvre has greater efficacy in the treatment of Epleys man oeuvre than vestibular sedative. Conclusion: Epleys manoeuvre is more effective for the management of benign paroxysmal positional vertigo than vestibular sedative.

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COMPARISON OF ISOCONAZOLE NITRATE VERSUS NYSTATIN FOR TREATMENT OF OTOMYCOSIS

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v1i1.7949 ◽

2021 ◽

Vol 71 (Suppl-3) ◽

pp. S581-84

Author(s):

Muhammad Ahmed Khan ◽

Bushra Anwar ◽

Sumera Akram ◽

Attique Ahmed ◽

Sunarays Akhtar ◽

...

Keyword(s):

Marked Improvement ◽

External Auditory Meatus ◽

Military Hospital ◽

Moderate Improvement ◽

Quasi Experimental ◽

Group A ◽

Group B ◽

Age Range ◽

Minor Improvement ◽

Better Than

Objective: To compare isoconazole nitrate versus nystatin for treatment of otomycosis. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital Bahawalpur and Combined Military Hospital Mardan, from Jan to Dec 2018. Methodology: Total 204 cases fulfilling the inclusion criteria were selected from outpatient department of Combined Military Hospital Bahawalpur and Mardan. They were divided into 2 groups of 102 each using random number tables. Group A cases were given Isocona-zole nitrate for application in external auditory meatus and group B cases were given Nystatin. All the cases were examined two weeks later and outcome was compared in terms of clinical improvement and symptoms resolution. Results: Out of 204, 125 patients were females and rest 79 were males. Age range was from 12-87 years with mean age 31 ± 2.4. Both groups were identical in terms of gender. In group A patients, 74 (72.5%) showed marked improvement after two week, 15 (14.7%) showed moderate improvement and 13 (12.7%) showed minor improvement. However, in group B, 55 (53.9%) showed marked improvement after two week, 23 (22.5%) showed moderate improvement and 24 (23.5%) showed minor improvement. Group A treatment was found significantly better than group B treatment (p=0.021). Conclusion: Isoconazole nitrate ointment was found significantly more effective for treating otomycosis than nystatin.

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Oral steroids alone or followed by intranasal steroids versus watchful waiting in the management of otitis media with effusion

The Journal of Laryngology & Otology ◽

10.1017/s0022215117001700 ◽

2017 ◽

Vol 131 (10) ◽

pp. 907-913 ◽

Cited By ~ 8

Author(s):

A Hussein ◽

H Fathy ◽

S M Amin ◽

N Elsisy

Keyword(s):

Otitis Media ◽

Complete Resolution ◽

Watchful Waiting ◽

Otitis Media With Effusion ◽

Intranasal Steroids ◽

Oral Steroids ◽

Group A ◽

Group B

AbstractObjective:To evaluate the effects of oral steroids alone or followed by intranasal steroids versus watchful waiting on the resolution of otitis media with effusion in children aged 2–11 years.Methods:A total of 290 children with bilateral otitis media with effusion were assigned to 3 groups: group A was treated with oral steroids followed by intranasal steroids, group B was treated with oral steroids alone and group C was managed with watchful waiting. Patients were evaluated with audiometry and tympanometry.Results:The complete resolution rates of otitis media with effusion were higher in groups A and B than in group C at six weeks. There were no significant differences in otitis media with effusion resolution rates between the groups at three, six and nine months.Conclusion:Oral steroids lead only to a quick resolution of otitis media with effusion, with no long-term benefits. There was no benefit of using intranasal steroids in the management of otitis media with effusion.

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Effectiveness of Ponseti Versus Kite Method for the Management of Club Foot- A Quasi Experimental Trial

10.53350/pjmhs211561871 ◽

2021 ◽

Vol 15 (6) ◽

pp. 1871-1873

Author(s):

Shabana Sharif ◽

Rehan Ramzan Khan ◽

Saima Riaz ◽

Sajid Rashid ◽

Zaigham Rasool Athar ◽

...

Keyword(s):

Club Foot ◽

Rapid Improvement ◽

Treatment Groups ◽

Experimental Trial ◽

Score Difference ◽

Pirani Score ◽

Quasi Experimental ◽

Group A ◽

Group B

Objective: To determine the effectiveness of ponseti versus kite method for the management of club foot among children. Methods: A quasi experimental trial was conducted to determine the most effective conservative method for managing idiopathic club foot. This study was carried out in District Head Quarter Hospital, Layyah. A total of 46 children (60 Feet) aged less than six months of both genders were included in this study using convenience sampling technique. The study sample was divided into Group A (Ponseti) and Group B (Kite). Each treatment group comprises of 30 feet. Patients were called for weekly follow up till ten weeks consecutively. At every follow-up visit, patients were assessed to check the improvement of deformity with the help of the Pirani scoring system for the foot. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. Pirani score difference was measured in both treatment groups from the baseline until the last follow-up interval until the 10th Week. A greater negative value signified better correction. SPSS 23 was used for data entry and analysis. Results: Children's mean age in both treatment groups (A and B) was 10.83±4.59 and 10.20±4.75 weeks. At presentation mean Pirani score in both treatment groups (A and B) was 5.85±0.67 and 5.86±0.45, respectively, while at 10th follow up it was 1.42±0.39 and 2.35±0.54 for group A and group B, respectively. Conclusion: This study demonstrates that the Ponseti technique significantly improved the management of club foot as that of the Kites method. Ponseti's method is more effective in terms of rapid improvement in the involved group. Key words: Non operative Management, Idiopathic Club foot, Kites method, Ponseti method.

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COMPARISON OF LOCAL METHYLCOBALAMINE INJECTION VERSUS LOCAL BUPIVACAINE INJECTION FOR THE TREATMENT OF ACUTE HERPETIC NEURALGIA

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i6.6464 ◽

2022 ◽

Vol 71 (6) ◽

pp. 2228-2231

Author(s):

Ghazala Yasmin ◽

Naeem Raza ◽

Arfan -Ul- Bari ◽

Farah Yousaf ◽

Summaya Saleem ◽

...

Keyword(s):

Pain Score ◽

Subcutaneous Injection ◽

Visual Analogue Score ◽

Military Hospital ◽

Visual Analogue Pain ◽

Significant Difference ◽

Quasi Experimental ◽

Group A ◽

The Mean ◽

Group B

Objective: To compare the reduction in mean pain score with local Methylcobalamin injection versus local Bupivacaine injection in patients with acute herpetic neuralgia. Study Design: Quasi experimental study. Place and Duration of Study: Dermatology Outpatient Department, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2019. Methodology: Total 100 patients, having pain score more than 3, fulfilling the selection criteria were divided into two groups. Group A was treated with daily subcutaneous injection Bupivacaine, whereas Group B was treated with daily subcutaneous injection Methycobalamin at the site of neuralgia. Patients were followed up for 4 weeks. The pain score was noted. All the data was entered and analyzed on SPSS version 21. Results: In this study mean age of patients in group A was 43.82 ± 15.76 years and in group B was 44.76 ± 16.92 years. The mean visual analogue pain score at 4th week in the group A patients was 1.14 ± 0.32 and in group B was 1.90 ± 0.97. Statistically significant difference was found in group A (local Bupivacaine) with visual analogue score (VAS) at 4th week (pvalue=0.002). Conclusion: The local Bupivacaine injection showed significant reduction in mean pain score than local Methylcobalamin injection in patients with acute herpetic neuralgia.

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COMPARATIVE STUDY OF SEROMA FORMATION IN HARMONIC SCALPEL VERSUS ELECTROCAUTERY IN POST MODIFIED RADICAL MASTECTOMY

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71i2.2721 ◽

2021 ◽

Vol 71 (2) ◽

pp. 451-53

Author(s):

Muhammad Farooq Shahid ◽

Taseer Ibrahim ◽

Muhammad Ali Muazzam ◽

Hummaira Chaudhry ◽

Usman Shah Bukhari ◽

...

Keyword(s):

Harmonic Scalpel ◽

Radical Mastectomy ◽

Seroma Formation ◽

Military Hospital ◽

Modified Radical Mastectomy ◽

Quasi Experimental ◽

Group A ◽

Group B ◽

Surgery Department ◽

Mean Time

Objective: To compare the frequency of seroma formation in harmonic scalpel vsunipolar electrocautery in post modified radical mastectomy (MRM). Study Design: Quasi experimental study. Place and Duration of Study: General Surgery Department, Pak Emirates Military Hospital Rawalpindi, from Jul to Dec 2017. Methodology: Eighty women with breast carcinoma planned for modified radical mastectomy were included in the study with inclusion and exclusion criteria and divided in equal group A (Harmonic) and group B (Unipolar cautery). Randomization was performed by lottery method for both groups. A standard level III clearance was performed. All patients were followed up on weekly basis and seroma formation was evaluated in both groups. Results: Mean age in group A and B was 51.36 ± 11.04 years vs 52 ± 11.19 years (p>0.05). Mean duration of complain in group A and B was 1.675 ± 0.47 months vs 1.775 ± 0.42 (p>0.05). Mean time of procedure in group A and B was 110.00 ± 4.71 mins vs 100.875 ± 5.14 (p>0.05). Mean body mass index in group A and B was 30.217 ± 4.99 kg/m2 vs 30.210 ± 5.31 kg/m2 (p>0.05). Seroma formation in group A and group B patients were found to be 5 (12.5%) vs 10 (25%) with (p>0.05). Conclusion: Frequency of seroma formation in harmonic scalpel is lower than electrocautery in post modified radical mastectomy, so it can be safely performed along with harmonic scalpel with reduced duration of drainage and seroma formation.

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