scholarly journals Adenoidectomy Before Or After Myringotomy In A Single Stage Procedure: Does The Sequence Matter?

2019 ◽  
Vol 09 (02) ◽  
pp. 94-97
Author(s):  
Amer Sabih Hydri ◽  
Iqbal Hussain Udaipurwala ◽  
Iftikhar Aslam
Keyword(s):  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Single Stage ◽  
Military Hospital ◽  
Middle Ear Fluid ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range ◽  
Ear Effusion

Objective: To evaluate the sequence of performing adenoidectomy or myringotomy first in a single stage procedure has any bearing on the per- operative outcome on middle ear effusion and subsequent grommet insertion in a patient of otitis media with effusion (OME). The hypothesis was that initially performed adenoidectomy allowed the middle ear fluid to drain passively and precluded grommet insertion. Study Design and Setting: Comparative study conducted at Department of ENT, Combined Military Hospital Sialkot and PNS Shifa Hospital Karachi, from Jun 2016 to Jun 2017. Methodology: One hundred and twenty patients (218 ears) with OME and adenoid hypertrophy, meeting the inclusion criteria, were inducted in this study and divided into 2 groups. Group A (60 patients with 110 ears) had adenoidectomy first followed by myringotomy and or grommet insertion, while Group B (60 patients with 108 ears) had myringotomy with or without grommet insertion first and followed by adenoidectomy. Result: There were 76 males and 44 female patients with a ratio of 1.7:1 and the age range was 3 to 14 years with a mean age of 4.81 ± 0.77 years. There was a significant difference between the two groups. Out of a total of 110 ears in group A, 74 ears (67.2%) had no mucoid fluid or dry tap on myringotomy in contrast with group B where out of total 108 ears, only 26 ears (24.1%) had dry tap or no mucoid fluid (p = 0.001). Conclusion: Adenoidectomy performed before myringotomy significantly reduced the need for grommet insertion. Larger studies however are needed to corroborate these findings.

Measurement of the sound intensity during suction of middle-ear fluid following myringotomy

2014 ◽  
Vol 128 (7) ◽  
pp. 604-611 ◽  
Author(s):  
J C Wang ◽  
S J Allen ◽  
A I Rodriguez ◽  
C Zahner ◽  
S Dissanaike ◽  
...  
Keyword(s):  
Middle Ear ◽  
Sound Pressure ◽  
Prospective Observational Study ◽  
Sound Intensity ◽  
Frequency Domain Analysis ◽  
Serous Effusion ◽  
Noise Levels ◽  
Middle Ear Fluid ◽  
Significant Difference ◽  
Ear Effusion

AbstractObjective:To determine noise intensity during middle-ear aspiration in order to evaluate whether levels can be potentially harmful.Methods:In this prospective, observational study, middle-ear effusion was aspirated following myringotomy using a suction instrument with a probe tube microphone. Sound pressure levels and duration were measured, and frequency domain analysis was performed.Results:Forty-four ears were analysed, consisting of 20 with mucoid effusion, 11 with serous effusion and 13 with no effusion. Maximum peak sound intensity ranged from 84 to 157 dB. Half of the ears (50 per cent) were exposed to greater than 140 dB; of these, 82 per cent were exposed for longer than 0.2 ms (range, 0.05–14 ms). There was no significant difference in sound pressure level between ears with mucoid and serous effusion; however, ears with mucoid effusion required longer suction times (p < 0.0030). In addition, peak intensity was greater for ears with mucoid effusion versus those with serous or no effusion (p < 0.0001).Conclusion:Middle-ear aspiration during myringotomy caused noise levels within a potentially harmful range.

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

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S521-25
Author(s):  
Sunarays Akhtar ◽  
Uzma Gul ◽  
Arfat Jawaid ◽  
Khalid Azam ◽  
Muhammad Sohail Babur Niazi ◽  
...  
Keyword(s):  
Otitis Media ◽  
Otitis Media With Effusion ◽  
Military Hospital ◽  
Quasi Experimental ◽  
Group A ◽  
Group B ◽  
Conductive Hearing ◽  
Case Basis ◽  
Method Group

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.

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

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.

scholarly journals Comparison of Intralesional Meglumine Antimonite along withoral Itraconazole to Intralesional Meglumine Antimonitein the treatment of Cutaneous Leishmaniasis

2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Uzma Bashir ◽  
Moizza Tahir ◽  
Muhammad Irfan Anwar ◽  
Faisal Manzoor
Keyword(s):  
Cutaneous Leishmaniasis ◽  
Clinical Cure ◽  
Statistical Significance ◽  
Military Hospital ◽  
P Values ◽  
Meglumine Antimoniate ◽  
Significant Difference ◽  
Group A ◽  
Oral Itraconazole ◽  
Group B

Background & Objective: Cutaneous leishmaniasis (CL) is endemic in developing countries like Pakistan. Pentavalent antimonials are still drug of choice, despite being toxic and intolerable for patients. Second line treatments have been extensively studied but the results of their efficacy are conflicting. This, to our knowledge, will be the first study in this regard. Our objective was to  determine if combination of oral itraconazole with intralesional (IL) meglumine antimoniate (MA) reduces the duration of treatment for cutaneous leishmaniasis, as compared to intralesional MA alone. Methods: A randomized controlled trial (single blinded) was carried out from August 2017 till December 2017 on 69 patients who fulfilled inclusion criteria. They were assigned to Group-A or B by lottery method. Group-A patients received IL MA once a week while Group-B received oral itraconazole 200mg, once daily, for six weeks along with similar regimen of IL MA as Group-A. The patients were assessed every three weeks by the blinded assessor till clinical cure was achieved. A follow up visit, two months after clinical cure was done to look for relapse of the disease. Results: Thirty patients in Group-A and 35 patients in Group-B completed the study. At 3, 6, 9 and 12 weeks the patients were assessed for: no, partial or complete response and results of the two groups were compared for statistical significance. The p-values of 0.20, 0.57 and 0.11 at 3, 6 and 9 weeks, respectively, depict that there was no significant difference at any step of assessment between the two groups in terms of healing. The p values of each t test was >0.05 refuting the hypothesis. Conclusion: Combination of oral itraconazole with intralesional MA offered no benefit over intralesional MA alone in the management of cutaneous leishmaniasis in terms of duration of therapy.  Abbreviations Used: IL = Intralesional,  MA = Meglumine Antimoniate, LD = Leishmania Donovan, CL = Cutaneous leishmaniasis, CMH = Combined Military Hospital. doi: https://doi.org/10.12669/pjms.35.6.363 How to cite this:Bashir U, Tahir M, Anwar MI, Manzoor F. Comparison of Intralesional Meglumine Antimonite along with oral Itraconazole to Intralesional Meglumine Antimonite in the treatment of Cutaneous Leishmaniasis. Pak J Med Sci. 2019;35(6):1669-1673.   doi: https://doi.org/10.12669/pjms.35.6.363 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals COMPARISON OF ISOCONAZOLE NITRATE VERSUS NYSTATIN FOR TREATMENT OF OTOMYCOSIS

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.

scholarly journals Comparison of the anatomical and functional success of fascia and perichondrium grafts in transcanal endoscopic type 1 tympanoplasty

2019 ◽  
Vol 48 (1) ◽  
Author(s):  
Kadir Özdamar ◽  
Alper Sen
Keyword(s):  
Retention Rates ◽  
Success Rates ◽  
Temporal Muscle ◽  
Type 1 Tympanoplasty ◽  
Significant Difference ◽  
The Status ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Background There are no studies in the literature, comparing the functional and anatomical successes of the use of fascial and perichondrial grafts in endoscopic type 1 tympanoplasties. Objectives To compare the anatomical and functional outcomes of grafting with the fascia of the temporalis muscle and with the perichondrium of the tragal cartilage in patients undergoing primary transcanal type 1 tympanoplasty with endoscopy. Methods We enrolled a total of 151 patients (80 females and 71 males with a mean age of 26.0 ± 9.3 years in the age range between 18-57) with MERI scores ranging from 1 to 3 and who underwent a transcanal endoscopic type 1 tympanoplasty without tympanomeatal flap elevation. The patients were assigned to two groups according to the type of the graft used. The patients were assigned to either the tragal cartilage perichondrium group (Group A) or the fascia of the temporal muscle (Group B). The groups were compared according to the pre- and postoperative air-bone gaps and to the status of the tympanic membrane. Results There were no statistically significant differences in the distribution of the age, gender, localization, MERI scores, the duration of the operation, and the size of the perforation (all p values> 0.05). The pre-operative air-bone gap values of Group A and B did not show a statistically significant difference (p = 0.073). The postoperative improvement in the air-bone gap value did not demonstrate a significant difference between Group A and B (p = 0.202). The graft retention rates were 94.9 and 97.2% in Group A and in Group B respectively. There were no statistically significant differences between the two groups in terms of the graft retention success rates (p = 0.743). Conclusion Perichondrium and fascia were suitable for use in endoscopic tympanoplasties.

Therapeutic Superiority and Safety of Combined Hydroxyurea with Recombinant Human Erythropoietin Over Hydroxyurea in B-Thalassemia Intermedia Patients

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 252-252
Author(s):  
Mohsen Saleh Elalfy ◽  
Amira Adly ◽  
Yassmine Elhanawy
Keyword(s):  
Adverse Events ◽  
Short Form ◽  
Single Agent ◽  
Random Allocation ◽  
Thalassemia Intermedia ◽  
Transfusion Requirements ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range

Abstract Abstract 252 Background: Both Hydroxyurea (HU) as a single agent or in combination with Erythropoietin (rHuEPO) became a therapeutic option for β-Thalassemia intermedia(TI) over last 2 decades. However superiority and safety of combination therapy over HU alone needs further evaluation. Aim: to assess the increase of hemoglobin levels in TI patients by at least 1g/dl above baseline during therapy using combined HUO and rHuEPO compared to single HUO therapy, also to report decline in transfusion requirements, quality of life (QoL), and any drug related adverse events. Patients and methods: An interventional prospective randomized open-labeled study; was approved from the local ethical committee and was registered in the Clinical Trials. Goverment (NCT01624038 ). Eighty Patients 18 years or less will be assigned into one of 2 groups using a random allocation method. Group A: Forty TI patients (age range: 5–18 years) considered as interventional arm 1 and received combined daily HUO (25 mg/kg/day orally) and rHuEPO (1000 IU/kg/week subcutaneously divided in three times/week). Group B: Forty TI patients (age range: 4–18 years) considered as arm 2 (control arm) and received daily single HUO therapy of 25 mg/kg/day. Both groups were followed up both clinically and laboratory for a mean period of one year with assessment of transfusion requirements, blood pressure weekly, liver and renal functions, Hemoglobin (Hb), HbF monthly, basal serum erythropiotin levels and QoL was assessed at study entry and end using the Medical Outcomes Study 36-Item Short Form Health Survey (SF-36). Diagnosis of TI was based on both genetic mutations and absence of transfusion during the 1st 2 years of life. Exclusion criteria were: evidence of active hepatitis (ALT>5 times) or renal impairment. Results: There were a significant improvement in the QoL in 80% and 60% of patients on combined compared to single therapy(p<0.05). There was a significant increase in both Hb and HbF (p <0.001), and the increments were strongly correlated (r =0.84; p <0.001) in both groups more in group A patients. The median Hb level in groups A and B during the study was 9.1 and 7.9 g/dL, respectively (p=0.03). In 68% (n=27) of TI patients group (A) were responded by a 0.5–3 g/dl increase in Hb level. There was significant difference between the 2 groups as only 20% (n=8) of patients in group B show intended improvement in their hemoglobin levels (p<0.01). In studied thalassemics 40%(n=16) of group A compared to 15%(n=6) of group B (p=0.01) became transfusion independent with 20% in group A showed decrease in their transfusion requirements with significant decrease in transfusion index compared to group B thalassemics (p<0.001). There was no significant change in absolute Hb-F, and serum ferritin levels during treatment. splenectomized patients and those with serum EPO less than 500 mU/mL, and intial HbF% > 40% had best response to combined therapy. Side effects from rHuEPO included bone pain in 2 patients, headache in 4 patients, however no uncontrolled hypertension was reported. Gastrointestinal irritation was observed in 3 patients and resolved when the dose was given at bedtime. No renal or hepatic toxicity were reported. A single case of mild neutropenia was reported and recovered within one week of temporary discontinuation Conclusions: Hu was effective in management of TI however combination with erythropiotin had an additive therapeutic effect and was well tolerated with no further serious adverse events. Disclosures: No relevant conflicts of interest to declare.

Detection of Helicobacter Pylori in the Middle Ear Fluid of Patients with Otitis Media with Effusion

2005 ◽  
Vol 133 (5) ◽  
pp. 791-794 ◽  
Author(s):  
Setsuko Morinaka ◽  
Masayuki Tominaga ◽  
Hiroyuki Nakamura
Keyword(s):  
Helicobacter Pylori ◽  
Otitis Media ◽  
Middle Ear ◽  
Otitis Media With Effusion ◽  
Rapid Urease Test ◽  
Middle Ear Effusion ◽  
Gram Staining ◽  
Middle Ear Fluid ◽  
Urease Test ◽  
Ear Effusion

OBJECTIVES: In patients with otitis media with effusion (OME), colonization of the middle ear effusion (MEE) by Helicobacter pylori (HP) was investigated. STUDY DESIGN: A prospective nonrandomized study with nonpaired, nonmatched controls. Smear preparations were immunostained with anti-HP antibody and were subjected to Gram staining and Giemsa staining. The rapid urease test (CLO) was done. RESULTS: Twelve of 15 smears for MEE were positive for HP by immunohistochemistry and 14 by Giemsa that were Gram-negative. In 3 with positive immunohistochemistry, the CLO was positive. CONCLUSION: The results suggest that HP may exist in the MEE of some patients with OME.

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

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.

scholarly journals Correlation Between the Prostate-Specific Antigen Level and Bone Metastasis in Prostate Cancer. (Retrospective Study)

2020 ◽  
Vol 2 (2) ◽  
pp. 1-6
Author(s):  
Adel Hassan Mohamed Hassan ◽  
◽  
Tarek Huissen kamel ◽  
Nesreen Ahmed Mosalam ◽  
◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Bone Metastasis ◽  
Prostate Specific Antigen ◽  
Specific Antigen ◽  
P Value ◽  
Asymptomatic Patients ◽  
Significant Difference ◽  
Group A ◽  
Group B ◽  
Age Range

Background: The most common non-cutaneous malignancy for men is Prostate cancer (PCa). PCa diagnosed by biopsy and PSA detection. Bone metastasis (BM) causes a lot of complications, such as bone pain and pathological fracture that cause overall compromised quality of life. Bone scintigraphy (BS) is commonly used for monitoring and detection of (BM). Objective: To correlate between serum PSA level and BM in PCa patients on series of 250 patients through detecting PSA levels and BSs. Patients and Methods: In the present study Patients were stratified (group A) & (group B) according to BM. Out of the 250 patients, 180 patients (Group A localized PCa) were with age range from 57 -92 years, the remaining 70 patients (Group B metastasis PCa) the age range was 53-88 years. Prostate specific antigen (PSA) level for both groups were detected. Results: By comparing group A and group B there was a highly significant difference in PSA value in favor of positive BS group (p-value < 0.001). The present study recommends BS in asymptomatic patients with PSA above 60 Ng/ml. Conclusion: PCa is the most common malignant non-cutaneous tumor for men. The most common spread for PCa is bone spread. Age doesn’t correlate with BM in PCa patients. PSA total show highly significance with BM in PCa patients. PSA cut-off value for BM in PCa patients was 60 Ng/ml so it was recommended to perform BS for asymptomatic patients with PSA total above 60 Ng/ml.

Sign in / Sign up

Export Citation Format

Share Document