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Microbiological profile and their antibiotic sensitivity pattern in patients of chronic suppurative otitis media at eastern tertiary care center of Nepal 尼泊尔东部三级保健中心慢性化脓性中耳炎患者的微生物谱及其抗生素敏感性模式
Pub Date : 2020-10-15 DOI: 10.18231/j.ijoas.2020.019
B. P. Sah, S. Chettri, N. Bhattarai, Shankar P. Shah, D. Paudel
Chronic suppurative otitis media (CSOM) is one of the most common and an important global public health problem leading to hearing impairment and is particularly prevalent in developing countries. Even in this era of powerful antibiotics, due to increased irrational use of wide spectrum antibiotics, the resistance in the bacterial isolates is common. The objective of the study was to determine the aerobic bacterial etiology of patients with CSOM and the antimicrobial susceptibility of the bacteria isolated. A descriptive cross sectional study was carried out in 112 patients suffering from chronic discharging ear. Pus samples were cultured aerobically. Antibiotic sensitivity testing was performed with standard antibiotic discs using modified Kirby-Bauer disk diffusion method. Out of 112 patients, 70 (62.5%) were females. Among 112 swab cultures, 98 (87.5%) were positive for the growth of organism and 14 (12.5%) were sterile cultures. Among them Staphylococcus aureus (42.24%), Pseudomonas aeruginosa (28.44%), Klebsiella pneumoniae (10.34%), Acinetobacter anitratus (6.9%), Proteus mirabilis (5.17%) and E. coli (4.31%) were the common microbial isolates. Among the antibiotics commonly available as topical eardrops, Ofloxacin (91.83%)) had the highest susceptibility rate, followed by Ciprofloxacin (81.63%), Tobramycin (73.46%) and Gentamicin (63.26%). Staphylococcus aureus was the most common organism isolated followed by Pseudomonas aeruginosa. Ofloxacin had the highest susceptibility rate against the isolated organisms.
慢性化脓性中耳炎(CSOM)是导致听力损害的最常见和重要的全球公共卫生问题之一,在发展中国家尤为普遍。即使在这个强效抗生素的时代,由于广谱抗生素的不合理使用增加,细菌分离物的耐药是常见的。该研究的目的是确定CSOM患者的需氧细菌病因学和分离的细菌的抗菌敏感性。对112例慢性泄耳患者进行了描述性横断面研究。脓液样本需氧培养。采用改良Kirby-Bauer盘片扩散法,用标准抗生素盘进行抗生素敏感性试验。112例患者中,70例(62.5%)为女性。112个拭子培养物中,98个(87.5%)培养物阳性,14个(12.5%)无菌培养物。其中,金黄色葡萄球菌(42.24%)、铜绿假单胞菌(28.44%)、肺炎克雷伯菌(10.34%)、无硝不动杆菌(6.9%)、奇异变形杆菌(5.17%)和大肠杆菌(4.31%)是常见的分离菌。在常用外用滴耳剂中,易感率最高的是氧氟沙星(91.83%),其次是环丙沙星(81.63%)、妥布霉素(73.46%)和庆大霉素(63.26%)。金黄色葡萄球菌是最常见的分离菌,其次是铜绿假单胞菌。氧氟沙星对分离菌的敏感性最高。
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引用次数: 2
The efficacy and safety of Short course therapy with Cefixime in URTI in Indian Scenario 头孢克肟短期治疗印度尿路感染的疗效和安全性
Pub Date : 2020-10-15 DOI: 10.18231/j.ijoas.2020.018
K. Pakhale, G. Tandon, Tanmay Bansal, V. Jain, D. Dhoot, Saiprasad Patil, H. Barkate
Upper respiratory tract infections (URTI) are one of the commonest cause for a patient’s visit to outpatient department (OPD). Short course therapies with penicillin and cephalosporin class of antibiotics are commonly prescribed in URTI cases. This study was a retrospective, multicentre, observational cohort analysis, planned to evaluate the effectiveness and safety of Cefixime 400 mg per day in patients of URTI, using WURSS 21 score. We analysed the data of 200 patients who were prescribed Cefixime for URTI. Most of the patients (55%) were male. The baseline mean WURSS score of 41.09 ± 33.45 decreased to 25.74 ± 22.29 [(-37.3%), p value<0.05] at visit 2; moreover, it further decreased to 5.75 ± 6.75 [(-86.0%), p value<0.05] at visit 3. Similar trend was noted for WURSS symptom score and WURSS Quality of life score. At baseline, mean WURSS Symptom score was 25.34 ± 15.97 which was reduced to 16.32 ± 11.50 at visit 2 and 4.15 ± 4.50 at visit 3. Similarly, mean WURSS Quality of life score at baseline was 15.74 ± 18.41 which was reduced to 9.42 ± 11.66 and 1.59 ± 2.75 at visit 2 and visit 3 respectively. None of the patients reported adverse effects. The findings of the present survey confirm the effectiveness and safety of short course of Cefixime therapy in URTI.
上呼吸道感染(URTI)是患者访问门诊(OPD)的最常见原因之一。在尿路感染病例中,通常使用青霉素和头孢类抗生素进行短期治疗。本研究是一项回顾性、多中心、观察性队列分析,计划评估头孢克肟400mg /天对尿路感染患者的有效性和安全性,使用wwss 21评分。我们分析了200例使用头孢克肟治疗尿路感染的患者的数据。大多数患者(55%)为男性。基线平均WURSS评分从41.09±33.45降至25.74±22.29 [(-37.3%),p值<0.05];在第3次就诊时进一步下降至5.75±6.75 (-86.0%,p值<0.05)。WURSS症状评分和WURSS生活质量评分也有类似的趋势。基线时,wwss症状平均评分为25.34±15.97,第2次就诊时降至16.32±11.50,第3次就诊时降至4.15±4.50。同样,基线时的平均WURSS生活质量评分为15.74±18.41,在第二次和第三次就诊时分别降至9.42±11.66和1.59±2.75。没有患者报告有不良反应。本调查结果证实了短期头孢克肟治疗尿路感染的有效性和安全性。
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引用次数: 0
Sinonasal haemangiopericytoma- An unusual swelling in the nasal cavity 鼻窦血管外皮细胞瘤-鼻腔内的一种不寻常的肿胀
Pub Date : 2020-08-15 DOI: 10.18231/j.ijoas.2020.015
K. Akhtar, Aftab Ahmed, M. Talha, S. Warsi, Otorhinolaryngology
Sinonasal hemangiopericytoma, also known as glomangiopericytoma (GPC) is a benign perivascular tumor of low malignant potential, with an incidence rate of 0.5-1% of all sinonasal tumors. It often shows local recurrences with invasion to the surrounding bony tissues. It usually arises from the perivascular cells surrounding the capillaries. Etiology of the tumour is uncertain, with few postulated hypothesis like pregnancy, trauma, hypertension and corticosteroid drugs. They have an indolent course and tend to occur most commonly in the adults of seventh decade of life. We present a case report of 55 years old male presenting to the ENT OPD, with complaints of right sided nasal obstruction and repeated episodes of epistaxis since the last 9 months. History and general examination was unremarkable except for anti-hypertensive intake since the last few years. Laboratory investigations showed microcytic hypochromic anaemia, raised absolute eosinophil count of 1500 cells per microliter and positive Hepatitis B surface antigen (HBsAg) in the blood. Rhinoscopic examination showed a reddish brown nodular swelling in the right nasal cavity beneath the middle turbinate and hypertrophy of left nasal mucosa. CT imaging suggested an 18x15 mms, well defined soft tissue mass in the right nasal cavity. Complete resection of the mass with endoscopic surgery was performed. Histopathological examination coupled with immunohistochemistry confirmed the diagnosis of Sinonasal Hemangiopericytoma. This case report stresses upon various differential diagnosis of sinonasal swellings and the importance of considering long term follow up of Sinonasal Hemagiopericytoma.
鼻窦血管外皮细胞瘤,又称血管外皮细胞瘤(glomangiopericytoma, GPC),是一种低恶性潜能的良性血管周围肿瘤,发病率为鼻窦肿瘤的0.5-1%。它经常表现为局部复发并侵犯周围骨组织。它通常起源于毛细血管周围的血管周围细胞。肿瘤的病因不确定,很少有假设,如妊娠、创伤、高血压和皮质类固醇药物。他们有一个不痛的过程,往往发生在最常见的成年人的第七个十年的生活。我们提出一个病例报告55岁的男性呈现到耳鼻喉科,与投诉右侧鼻塞和反复发作鼻出血自过去9个月。除近几年服用抗高血压药物外,病史和一般检查无显著差异。实验室检查显示小细胞低色贫血,嗜酸性粒细胞绝对计数每微升升高1500个细胞,血液中乙型肝炎表面抗原(HBsAg)阳性。鼻镜检查显示右鼻腔中鼻甲下方有红棕色结节性肿胀,左鼻黏膜肥大。CT显示右鼻腔内有一18x15mm,清晰的软组织肿块。经内镜手术完全切除肿物。组织病理学检查结合免疫组织化学证实了鼻窦血管外皮细胞瘤的诊断。本病例报告强调鼻窦肿胀的各种鉴别诊断,以及考虑鼻窦血包皮细胞瘤长期随访的重要性。
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引用次数: 1
Tension Pneumothorax -Challenge of foreign body removal during Rigid Bronchoscopy in children 张力性气胸-儿童刚性支气管镜检查时异物清除的挑战
Pub Date : 2020-08-15 DOI: 10.18231/j.ijoas.2020.014
Deepa Shivnani, E. V. Raman, S. Gaur
Rigid bronchoscopy for foreign body removal from lungs can cause life threatening complications like tension pneumothorax. A timely diagnosis and active management can prevent devastating events. A two years old child who developed tension pneumothorax after rigid bronchoscopy for foreign body removal was survived successfully because of multidisciplinary active management.
硬支气管镜从肺部取出异物会导致危及生命的并发症,如紧张性气胸。及时的诊断和积极的管理可以防止破坏性事件的发生。一名两岁儿童在硬支气管镜下异物取出后出现紧张性气胸,由于多学科的积极治疗而成功存活。
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引用次数: 1
Significance of audio-vestibular evaluation in diabetes mellitus patients- A study 糖尿病患者听庭功能评估的意义研究
Pub Date : 2020-04-15 DOI: 10.18231/j.ijoas.2020.004
S. Rathnakara, Orl, Mohamed Ashraf Kuniyil, Prakruthi Jaladhar, N. Sequeira, V. Subramaniam
Introduction: Diabetes mellitus (DM) has a projected rise in its affected population to almost double by the year 2035 in India. Ongoing research regarding its microvascular complications has led to a disparity of opinion about involvement of the audio-vestibular system. Hence to evaluate the audio-vestibular functions in patients with diabetes mellitus and determine their correlation with duration and control of the disease, this study was conducted. Materials & Methods: 97 DM patients were included in this prospective, cross-sectional study and all of them underwent clinical examination, Dix-Hallpike maneuver and investigations like Pure tone audiometry (PTA) and Videonystagmography (VNG). Results: 64 of 97 patients, had varying degrees of sensorineural hearing loss on PTA and 16 patients had vestibular hypofunction noted on caloric test of VNG. It was identified that the occurrence of bilateral hearing loss and vestibular hypo-functioning were statistically significant with chi square test (p value 0.028 and <0.001 respectively), when 5years duration of DM was taken for cut off. Analysis of symptoms with PTA and VNG, found significant correlation of tinnitus and hearing loss (p value 0.03 and <0.001 respectively) with abnormal findings in both the investigations, revealing a subclinical nature of the vestibular dysfunction. However, there were no significant correlations found with the glycaemic control of DM. Conclusions: It is advisable to consider audio-vestibular evaluation with PTA and VNG, as screening tests for long term DM patients with or without symptoms of giddiness and hearing loss as a step for early identification of microvascular complications of the inner ear, though larger studies in other populations needs to be done for further confirmation of the correlation.
导读:到2035年,印度糖尿病(DM)患者预计将增加近一倍。关于其微血管并发症的持续研究导致了对听庭系统受累的意见分歧。因此,为了评估糖尿病患者的听前庭功能,并确定其与病程和疾病控制的关系,本研究进行了。材料与方法:本前瞻性横断面研究纳入97例DM患者,所有患者均接受临床检查、Dix-Hallpike手法及纯音听力学(PTA)、视频震图(VNG)等调查。结果:97例患者中64例PTA有不同程度的感音神经性听力损失,16例VNG热测有前庭功能减退。经卡方检验发现,以DM病程5年为截短时,双侧听力损失和前庭功能障碍的发生率有统计学意义(p值分别为0.028和<0.001)。对PTA和VNG的症状进行分析,发现耳鸣和听力损失与两项检查的异常结果有显著相关性(p值分别为0.03和<0.001),表明前庭功能障碍具有亚临床性质。结论:对于有或无头晕和听力损失症状的长期糖尿病患者,建议考虑使用PTA和VNG进行听庭评估,作为早期识别内耳微血管并发症的一个步骤,但需要在其他人群中进行更大规模的研究以进一步证实相关性。
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引用次数: 1
Hearing Impairment in children with history of kernicterus and crebral palsy 有核心症和脑瘫病史的儿童的听力损害
Pub Date : 2020-04-15 DOI: 10.18231/j.ijoas.2020.002
M. Ohal
Introduction: Critical period of development of speech and language is early 3 yrs of life. Even a mild hearing impairment can interfere with speech and language development. Hearing impairment has the highest incidence rate for any pediatric disability, since several risk factors in infants with cerebral palsy(CP) are the same risk factors to develop hearing impairment. Thus, it should come as no surprise that hearing impairment occurs more frequently among children with cerebral palsy than in the general population. Recent studies have shown that up to 13% of children with cerebral palsy suffer from a hearing loss and important cause of auditory neuropathy. the study: To assess and analyze the audiological profile in children with cerebral palsy Materials and Methods: A prospective study was done on 67 children of 1 to 16 years of age of both genders who were diagnosed with cerebral palsy. Tympanometry, otoacoustic emission, and auditory brain stem response hearing tests were employed to categorize the hearing impairment. Results: Hearing impairment was observed in right ear 67.2 % and left ear 64.2% in children with cerebral palsy. Profound sensorineural hearing loss in 25.4% in bilateral ear was observed. History of kernicterus was found in 17.9% children with cerebral palsy. Conclusions: Prevalence of hearing impairment in children with cerebral palsy is alarming. This warrants early identification and diagnosis of hearing impairment. This early identification may facilitate better development of speech and language as well as positive outcomes. Therefore audiological assessment should be incorporated into the diagnostic and therapeutic plan of all children with cerebral palsy
语音和语言发展的关键时期是生命的最初3岁。即使是轻微的听力障碍也会影响说话和语言的发展。听力障碍在所有儿科残疾中发病率最高,因为脑瘫婴儿的几个危险因素与听力障碍的危险因素相同。因此,听力障碍在脑瘫儿童中比在一般人群中更常见,这不足为奇。最近的研究表明,高达13%的脑瘫儿童患有听力损失,这是听神经病变的重要原因。研究:评估和分析脑瘫儿童的听力学特征材料和方法:对67名1至16岁的诊断为脑瘫的男女儿童进行了一项前瞻性研究。采用鼓室测量、耳声发射和听觉脑干反应听力测试对听力障碍进行分类。结果:脑瘫患儿右耳听力障碍占67.2%,左耳听力障碍占64.2%。重度感音神经性听力损失占25.4%。17.9%的脑瘫患儿有核黄疸病史。结论:脑瘫患儿听力损害发生率高。这就保证了听力损伤的早期识别和诊断。这种早期识别可能有助于更好地发展言语和语言以及积极的结果。因此,听力学评估应纳入所有脑瘫儿童的诊断和治疗计划
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引用次数: 0
Extramedullary plasmacytoma of Paranasal sinus: A rare case report 副鼻窦髓外浆细胞瘤1例
Pub Date : 2020-04-15 DOI: 10.18231/j.ijoas.2020.007
H. Gautam, S. Tripathi
We report an extremely aggressive case of extramedullary plasmacytoma of the right maxillary sinus without any known metastasis. A 45 year old male presented to ENT Department with chief complaints of recurrent Right sided nasal mass and nasal obstruction with recurrent episodes of cold for 3 years. Patient also had decreased sense of smell. Before presenting to us, he underwent two previous surgeries for the same complaint elsewhere in the year 2015 and 2017. Patient was a known case of Hypertension for 3 years and took treatment, was immunocompetent. Subsequent investigations including CT scan of Paranasal sinuses and peri-operative findings revealed a sinonasal mass involving right maxillary antrum with erosion of all the walls of maxillary antrum. Soft tissue mass lesion also extending into retro-zygomatic space, nasal cavity and buccal space. The nasal cavity mass lesion extending posteriorly to occupy whole of nasopharynx and overhanging into oropharynx. The patient was treated surgically by Cald well Luc’s approach and mass removed. HPE reports suggestive of tumour comprising of plasma cells with varying degree of maturation and atypia, nucleus- characteristic “clock face chromatin”pattern seen. Abundant basophilic cytoplasm. On IHC- CD 138 weak positive. Suggestive of Extramedullary plasmacytoma. Patient underwent 20 cycles of radiotherapy. Patient is on follow up since then and is asymptomatic.
我们报告一个极具侵略性的病例髓外浆细胞瘤的右上颌窦没有任何已知的转移。男,45岁,以复发性右侧鼻肿块及鼻塞伴反复发寒3年就诊于耳鼻喉科。病人的嗅觉也下降了。在就诊之前,他曾于2015年和2017年在其他地方因同样的疾病接受过两次手术。患者为高血压已知病例,已治疗3年,免疫功能正常。随后的检查包括鼻窦CT扫描和围手术期的检查结果显示,右上颌上颌窦有一个鼻窦肿块,上颌上颌窦的所有壁都被侵蚀。软组织肿块病变也可扩展至颧后间隙、鼻腔和颊间隙。鼻腔肿块向后延伸,占据整个鼻咽部并伸入口咽部。患者经calwell - Luc入路手术治疗并切除肿块。HPE报告提示肿瘤由不同程度成熟和异型性的浆细胞组成,可见核特征的“钟面染色质”模式。丰富的嗜碱性细胞质。IHC- cd138弱阳性。提示髓外浆细胞瘤。患者接受了20个放疗周期。患者此后一直在随访,无症状。
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引用次数: 0
Our experience with kite string injuries during makarsankranti festival 我们在makarsankranti节期间风筝线受伤的经验
Pub Date : 2020-04-15 DOI: 10.18231/j.ijoas.2020.001
R. R. Gupta, Darshil A. Vaishnav, R. Aiyer
Kite-flying is a popular activity during the Makar Sankranti festival in Gujarat which spans over 14 th and 15 th January of every year. Kite strings are an important cause of penetrating neck trauma in two-wheeler drivers. In this study a total of 63 patients of kite string injuries over face and neck were studied between 2018 and 2020 at Shri Sayajirao General Hospital, Vadodara. These patients were divided into 3 groups according to the site of injury. Males were most commonly affected. Most patients were in the 19-40 years age group. Neck was the most frequently involved in most of the patients. Majority of the patients did not use personal protective gears. An indigenous metal wire frame used over two-wheelers also appeared to be reducing the number of injuries. We conclude that awareness can prevent these injuries to a large extent.
在古吉拉特邦的Makar Sankranti节期间,放风筝是一项很受欢迎的活动,每年的1月14日和15日。风筝线是造成两轮车司机穿透性颈部创伤的重要原因。在这项研究中,共有63名面部和颈部风筝线受伤的患者在2018年至2020年期间在Vadodara的Shri Sayajirao综合医院接受了研究。根据损伤部位分为3组。男性最常受影响。大多数患者年龄在19-40岁之间。颈部是大多数患者最常受累的部位。大多数患者没有使用个人防护装备。在两轮车上使用的本土金属丝框架似乎也减少了受伤人数。我们得出结论,意识可以在很大程度上预防这些伤害。
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引用次数: 2
Goldnanoparticles in cancer detection and treatment - Review 金纳米颗粒在癌症检测和治疗中的应用综述
Pub Date : 2019-12-15 DOI: 10.18231/j.ijoas.2019.001
S. Hassan, Dental, S. Bhateja
The high death rate in cancer, for example, oral squamous cell carcinoma is usually ascribed to the troubles in distinguishing the illness at an early treatable stage and war with cancer is still on. Extraordinary research has prompted a progressively complete understanding of cancer at the hereditary, sub-atomic, and cell levels giving a road to strategies for expanding early analysis and treatment of oral cancer. Nanotechnology is the study of the little the exceptionally little. It is the utilization and control of issue at a small scale. At this size, particles and atoms work in an unexpected way, and give an assortment of astounding and intriguing employments. These nanoparticles can be utilized to distinguish or screen cancer. In this article we will show how the gold nanoparticles detect the cancer and help in treating the cancer.
癌症的高死亡率,例如口腔鳞状细胞癌,通常归因于在早期可治疗阶段识别疾病的困难,以及与癌症的战争仍在进行中。非凡的研究促进了对遗传、亚原子和细胞水平癌症的逐步全面了解,为扩大口腔癌的早期分析和治疗策略提供了道路。纳米技术研究的是极小极小的东西。它是在小范围内对问题的利用和控制。在这种尺寸下,粒子和原子以一种意想不到的方式工作,并给出了各种令人震惊和有趣的工作。这些纳米颗粒可用于区分或筛查癌症。在这篇文章中,我们将展示金纳米颗粒如何检测癌症并帮助治疗癌症。
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引用次数: 0
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IP Journal of Otorhinolaryngology and Allied Science
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