The Effect of Comfort Nursing on the Compliance and Efficacy of Treatment for Children with Acute Otitis Media Caused by Upper Respiratory Tract Infection

Objective:To explore and analyze the clinical effect of comfort nursing on children with acute otitis media.Methods:62 children with acute otitis media caused by upper respiratory tract infection who visited the outpatient clinic of our hospital from June 2022 to June 2023 were selected for this study.They were divided into a study group(n=31)and a control group(n=31).Children in the control group received basic care,while children in the study group received comfort nursing along with basic care.The hearing thresholds,body temperature,treatment compliance,and nursing satisfaction of the two groups of children were compared.Results:After the nursing intervention,the hearing threshold and average body temperature of the children in the study group were lower than those in the control group(P<0.05);the treatment compliance of the children in the study group was higher than that in the control group(P<0.05);the nursing satisfaction of the study group was higher than that of the control group(P<0.05).Conclusion:Comfort nursing can improve the treatment effect,treatment compliance,and nursing satisfaction of children with children with acute otitis media caused by upper respiratory tract infection.

Acute Otitis Media in Children Aged 0-5 Years, Epidemiological Aspects and Management in the Paediatrics Department of the Hospital National Ignace Deen (Conakry)

Introduction: Acute otitis media is an acute inflammation of the mucosa of the middle ear cavities. It is often secondary to nasopharyngitis, which favors the passage of infection through the Eustachian tube to the middle ear. The aim of our study was to improve the management of AOM in the Paediatric Department of the Hospital National Ignace Deen (Conakry). Patients and Methods: This was a prospective descriptive study lasting 6 months from 01 July to 31 December 2011;the study covered 525 cases out of a total of 6276 children, i.e. a frequency of 8.36%. Results: The most affected age group was 6 to 11 months. Males predominated (69.71%). 82.29% had a history of recurrent rhinopharyngitis. The most frequent reason for consultation was incessant crying (66.29%). Rhinopharyngitis and malaria were the most commonly associated pathologies (87.62% and 39.62% respectively). 72.19% of our patients were admitted with congestive AOM and received medical treatment. We recorded one case of otomastoiditis which was treated surgically. Conclusion: AOM is more common in children aged between 6 and 24 months. Good collaboration between paediatricians and ENT specialists is essential to reduce the morbidity of AOM.

Nasopharyngeal colonization of otopathogens in South Indian children with acuteotitis media -- A case control pilot study

Background: Acute otitis media (AOM) is an inflammatory disease of the middle ear causing significantmorbidity in early childhood. A pilot study was undertaken to identify the role of various risk factorsSouth Indian children with AOM, especially the role of nasopharyngeal otopathogens.Methodology: A prospective case control pilot study was conducted in children aged below six years,presenting to a single tertiary care from 2018 to 2019. Fifty cases with AOM and 45 age and gendermatched controls were recruited. Two nasopharyngeal swabs were collected, one was processed forbacterial culture. The other swab was processed according to the CDC recommended broth enrichmentmethod to identify carriage of S. pneumoniae. Subsequent serotyping was done by Quellung method andconventional sequential multiplex PCR.Result: Otalgia was the major presentation seen in 92% of the children with AOM. None of the clinical anddemographic characteristics were found to be statistically significant between the cases and controls. Themost common otopathogen was S. pneumoniae (55%) followed by H. influenza (29%). The commonS. pneumoniae serotypes encountered were 11A and 19F.Nasopharyngeal colonization with S. pneumoniae[OR 6.57, p < 0.003] and H. influenzae [OR14.18, p < 0.003] were significant risk factors for AOM inchildren. The risk increased with co-colonization (OR 13.89,p < 0.003).Conclusion: This study strengthens the significant association between nasopharyngeal colonization ofotopathogens and AOM as a risk factor that is enhanced by co-colonization.S. pneumoniae was the mainotopathogen in this population, serotypes 11A and 19F being the most common.

Multi-Drug Resistant Acute Otitis Media amongst Children Attending Out-Patient Clinic in Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka, South-East Nigeria

Objective: The study assessed microbial etiology and multi-drug resistant profile of the pathogens isolated from children diagnosed of acute otitis media (AOM) at Chukwuemeka Odumegwu Ojukwu University Teaching Hospital, Awka. Method: Ear swab samples were collected aseptically from 40 children that visited the children out-patient clinic of the hospital. The samples were cultured within 20 minutes of collection and the isolates identified microbiologically. Antimicrobial susceptibility testing was done by Kirby-Bauer’s disc diffusion method. Results: A total of 2025 children visited the hospital during the study period and 40 (1.98%) had clinical diagnosis of acute otitis media. Ten (25%) of the 40 samples did not yield any microbial growth. Children aged ≤one year had the highest prevalence of AOM (55%). Staphylococcus aureus (34.9%) was the predominant bacteria isolate followed by Pseudomonas aeruginosa (30.2%) while Candida krusei (14%) was the predominant fungi isolate. All the bacterial isolates were resistant to ampicillin and coamoxiclav. Staphylococcus aureus isolates were marginally susceptible to gentamicin (60%) and sparfloxacin (73.3%). Pseudomonas aeruginosa, Escherichia coli and Staphylococcus aureus were resistant to ceftriaxone, ciprofloxacin, streptomycin, cefuroxime, erythromycin and azithromycin. Nystatin and voriconazole had comparable effect (60%) against the fungal isolates and fluconazole was ineffective. Conclusion: The incidence of multiple antibiotic resistant bacteria associated with acute otitis media in the pediatric patient was very high. Empiric treatment of the infection in the community should be discouraged. AOM preventive strategies should be targeted on the very young children to reduce the risk of recurrence.

Cefprozil versus Amoxicillin/Clavulanate for the Treatment of Acute Otitis Media in Children: Meta-Analysis of Efficacy and Safety

Introduction: The efficacy of amoxicillin combined with clavulanic acid in Acute Otitis Media (AOM) is not debatable, but studies report a high frequency of gastrointestinal adverse effects related to this intervention. In this scenario, several studies about the antibiotic cefprozil report that it has the same efficacy as amoxicillin/clavulanate for the treatment of AOM with significantly fewer side effects. The aim of our study was to compare the efficacy and safety of both treatments in AOM. Methodology: We searched for clinical trials and systematic reviews with or without meta-analyses in the Cochrane Group Register and the MEDLINE database up to November 2013, comparing the two interventions mentioned. Results were expressed as a rate of treatment failures or favorable response rates (clinical and microbiological in both cases), and as the rate of adverse events. The analysis was carried out considering the fixed and random effects models. The significance level used in the test for heterogeneity was 0.05. Funnel plot was used to search for publication bias. Results: 7 clinical trials were included in the analysis and no significant difference was found for both interventions regarding clinical and bacteriological response (RR = 1.02, 95% CI, 0.97-1.06, p = 0.780 and RR = 1.02, 95% CI, 0.99-1.07, p = 0.228, respectively). However, a significant difference was found in the comparison of adverse effects, showing that amoxicillin/clavulanate has a significantly higher risk of developing side effects than cefprozil (RR = 0.52, 95% CI, 0.45-0.59, p = 0.000). Conclusion: Both treatments demonstrated equal clinical and microbiological efficacy. However, the use of cefprozil is significantly associated with a lower risk of adverse effects.

Study on the correlation between ambient environment-meteorological factors and the number of visits of acute otitis media,Lanzhou,China

To investigate the correlation between environmental-meteorological factors and daily visits for acute otitis media(AOM)in Lanzhou,China.Methods:Data were collected in 2014e2016 by the Departments of Otolaryngology-Head and Neck Surgery at two hospitals in Lanzhou.Relevant information,including age,sex and visiting time,was collected.Environmental data included air quality index,PM10,PM2.5,O3,CO,NO2 and SO2,and meteorological data included daily average temperature(T,C),daily mean atmospheric pressure(AP,hPa),daily average relative humidity(RH,%)and daily mean wind speed(W,m/s).The SPSS22.0 software was used to generate Spearman correlation coefficients in descriptive statistical analysis,and the R3.5.0 software was used to calculate relative risk(RR)and to obtain exposure-response curves.The relationship between meteorological-environmental parameters and daily AOM visits was summarized.Results:Correlations were identified between daily AOM visits and CO,O3,SO2,CO,NO2,PM2.5 and PM10 levels.NO2,SO2,CO,AP,RH and T levels significantly correlated with daily AOM visits with a lag exposure-response pattern.The effects of CO,NO2,SO2 and AP on daily AOM visits were significantly stronger compared to other factors(P<0.01).O3,W,T and RH were negatively correlated with daily AOM visits.The highest RR lagged by 3e4 days.Conclusions:The number of daily AOM visits appeared to be correlated with short-term exposure to mixed air pollutants and meteorological factors from 2014 through 2016 in Lanzhou.

Risk Factors for Acute Otitis Media in Children Aged 0 to 5 Years in Parakou

Introduction: Acute otitis media (AOM) is one of the most common ENT childhood diseases. Objective: To identify risk factors for AOM in children aged 0 to 5 years. Methods: This research work was a cross-sectional, descriptive and analytical study. It focused on 2040 children aged 0 to 5 years from both sexes, who were healthy or sick, and living in the Local government of Parakou for at least one year. Those children were randomly selected in all three districts of Parakou. Results: Frequency of AOM was 2.8% and their prevalence was estimated at 16.3%. The identified risk factors were persistent or chronic cases of rhinitis, exposure to charcoal and wood smoke, low socioeconomic status, personal history of AOM, AOM history among the siblings, and children’s poor nutritional status. No relationship could be established between AOM occurrence and factors like sex, passive smoking, attendance of a day-care centre or stay in nursery, prematurity, exclusive breastfeeding and large number of siblings. Conclusion: The identification of those risk factors will help put in place appropriate measures to reduce AOM prevalence in Parakou.

Parental acceptability of the watchful waiting approach in pediatric acute otitis media

AIM: To determine parental knowledge about acute otitis media(AOM) and its antibiotic therapy, antibiotic resistance and the willingness to comply with the watchful waiting(WW) approach in primary care settings in southern Israel.METHODS: The study was conducted in 3 primary care clinics and the pediatric emergency room of Soroka University Medical Center. Questionnaires(20 questions on education background, previous AOM experience, knowledge on antimicrobial resistance and attitude vs the WW approach) were filled by 600 parents(150 at each centers) of children < 6 years of age.RESULTS: Mothers represented 69% of parents; 2% had an education of < 10 school years, 46% had high-school education and 17% had an academic degree. 69% parents reported previous experience with AOM and 56% thought that antibiotics represent the only treatment for AOM. Knowledge on bacterial resistance to antibiotics was reported by 57% of the parents; 86% parents were willing to accept/probably accept the WW approach for their children. Logistic regression analysis revealed a significant association between parental education and knowledge about bacterial resistance to antibiotics and that previous experience with AOM was significantly associated with reluctance to accept the WW approach. More parents with knowledge on bacterial resistance were willing to accept the WW approach compared with parents without such knowledge. No correlation was found between the education level and willingness to accept the WW approach. CONCLUSION: A significant correlation was found between previous parental education and experience with AOM and the knowledge about antibiotic use, bacterial resistance and acceptance of the WW approach.

Aural Toileting and Dressing—Important Intervention Measures in the Management of Acute Suppurative Otitis Media

Background: Otitis media is one of the most common childhood infections, the leading cause of doctor’s visit by children in ENT clinic. The acute form if not recognized early is commonly characterized by suppuration from the middle ear following perforation of the tympanic membrane otherwise referred to as acute suppurative otitis media (ASOM). If not adequately treated, it progresses to chronic suppurative otitis media with attendant challenges in management. Ceasation of ear discharge is an indication of resolution of disease. The objective of this study is to appraise the value of local ear suction toileting and dressing in the ceasation of ear discharge in acute suppurative otitis media. Materials and Method: Consecutive new cases of acute suppurative otitis media seen at the Ear, Nose and Throat clinic of a tertiary health centre in north western Nigeria were assessed for efficacy of aural toileting and dressing with antibioctic impregnated guaze in the treatment of acute suppurative otitis media and compared with patients with similar disease without aural toileting and dressing or dressing with normal saline soaked guaze in addition to systemic antibiotic and antihistamine medications. Ear toileting was done by suctioning the discharge with suction machine, and cleaning the external auditory canal with hydrogen peroxide and methylated spirit. They were then dressed with gauze impregnated with antibiotic ear drops daily until there was no more ear discharge. The period of ceasation of ear discharge in each group was assessed. Results: There were 39 patients with acute suppurative otitis media (ASOM). Eighteen were females (46.2%) while 21 were males (53.8%), giving M:F ratio 1:2.1. Their ages ranged between 1 month and 45 years. About 36 (92.3%) were children and out of this, 28 (77.8%) were less than 5 years old. The average period of ceasation of discharge was 24 - 48 hours with those undergoing ear toileting and dressing but varied between 7 and 10 days with those without ear dressing or dressing with normal saline soaked guaze. This finding compelled us to stop the study on ethical grounds when this was carried out in the first 5 patients on each side of the study groups necessitating reversals of other groups to aural toileting and dressing with antibiotic impregnated guaze. Conclusion: Local ear toileting and dressing appear to show significant contribution to the early ceasation of ear discharge and are highly recommended not only for acute suppurative otitis media but also for all suppurative ear diseases.

Co-infection with Neisseria mucosa in a patient with tuberculous otitis media

Tuberculous otitis media(TOM) is a rare manifestation caused by Mycobacterium tuberculosis with low incidence rates among extrapulmonary tuberculosis cases. Diagnosis is often delayed because of the presence of several clinical manifestations and the high prevalence of secondary bacterial infections. Few reports have attributed secondary bacterial infections in patients with TOM to commensal Neisseria. Thus, understanding the pathogenic mechanisms and clinical features of commensal Neisseria is important, considering its recent presentation as an infection-causing pathogen. Neisseria mucosa is a commensal inhabitant in humans and is generally considered non-pathogenic but can cause infection in rare cases. Here, we report an atypical secondary infection caused by Neisseria mucosa in an 81-year-old woman with TOM being treated for pulmonary tuberculosis. Direct purulent otorrhea smear microscopy revealed no acid-fast bacilli using Ziehl-Neelsen staining, whereas the phagocytosis of gram-negative cocci by white blood cells was confirmed using Gram staining. Otorrhea culture revealed the growth of N. mucosa. Subsequently, M. tuberculosis infection in the otorrhea was identified using a culture-based method. Vigilance is critical for the early detection of TOM to prevent further complications. This report raises awareness regarding TOM and provides insight into the pathogenicity of N. mucosa in otitis media.

The Role of Toll-Like Receptors and Nuclear Factor κB p65 Protein in the Pathogenesis of Otitis Media

The role of Toll-like receptor 4 (TLR4) and nuclear factor κB p65 (NF-κB p65) proteins in the pathogenesis of otitis media is explored. In recent years, the incidence of otitis media has been rising globally, becoming a significant threat to human health. More and more studies have found that Toll-like receptor 4 (TLR4), as a member of the Toll-like receptor family, can promote the generation of inflammatory factors and is closely related to the body’s immune response and inflammatory response. Nuclear factor-κB p65 (NF-κB p65) is a nuclear transcription factor that can interact with various cytokines, growth factors, and apoptotic factors, participating in processes such as oxidative stress, apoptosis, and inflammation in the body [1]. This article elaborates on the structure, function, and signaling pathways of TLR4 and NF-κB p65 proteins in the pathogenesis of otitis media, aiming to provide more precise targets and better therapeutic efficacy for the diagnosis and treatment of otitis media. The role of inflammation in disease.

Expression and Clinical Significance of Various Cytokines in Otitis Media

The expression and clinical significance of relevant cytokines in otitis media (OM) are discussed, and the alterations to the pathological state of the otitis media mucosa are further understood through the study of cytokine transduction pathways. More and more studies have shown that relevant cell proliferation and inflammation progression pathways play a role in the development of otitis media, such as the Jun amino-terminal protein kinase (JNK) mitogen-activated protein kinase (MAPK) signaling pathway, the NF-κB signaling pathway, and the PI3K/AKT/PTEN pathway, which are involved in the proliferation of the middle ear mucosa during otitis media, which affects the mucosal cilia, motor function, Eustachian tube function, and the mucosal ciliary function. These studies provide new ideas for the treatment of otitis media and further explore the feasibility of immunotherapy in the future treatment of otitis media. In this paper, we present a review of the latest research progress on the expression of various cytokines in otitis media.

Audiological characteristics and exploratory treatment of a rare condition of acute-otitis-media-associated sudden sensorineural hearing loss

BACKGROUND Acute otitis media(AOM)is a common disease that is more prevalent in children.Most studies concerning AOM-associated sudden sensorineural hearing loss are case reports and retrospective in nature,hence the etiology of AOM-associated sudden hearing loss has not been fully established.AIM To analyze audiological characteristics of AOM-associated sudden hearing loss and evaluate efficacy of combined tympanostomy tube placement(TTP)and intratympanic methylprednisolone.METHODS Eight adult patients who were diagnosed with AOM-associated sudden hearing loss and ineffectively treated by conventional medical therapy were enrolled in this study.Basic data were collected,and pure tone audiometry was performed to assess the audiological characteristics.Combination therapy with TTP and intratympanic methylprednisolone injection was given to the patients.RESULTS Mixed or sensorineural hearing loss was observed at high frequencies(2–4 kHz).All the cases in this study were cured after TTP and intratympanic methylprednisolone.After treatment,the average hearing threshold at affected frequencies was significantly lower than those in the pretreatment group(P<0.05)and was similar to that in the healthy ears(P>0.05).CONCLUSION AOM rarely induces sudden sensorineural hearing loss.Combination therapy with TTP and intratympanic methylprednisolone injection may be effective after failure of conventional medical treatment.

Antibiotic Susceptibility Patterns of Isolated Bacteria from Otitis Media in Children at Mohamed Aden Sheikh Children Teaching Hospital in Hargeisa, Somaliland

Background: Otitis media (OM) is a group of inflammatory diseases of the middle ear. OM is a prevailing problem among children in Hargeisa. The antibiotic susceptibility of etiologic bacteria is not investigated in Somaliland which hinders the effective treatment of OM cases in children. Objective: This study aimed at determining the etiologic bacteria and its antibiotic susceptibilities in children presenting with OM to a pediatric referral hospital in Hargeisa for the period March 2013-May 2017. Methods: A cross-sectional retrospective study was conducted on a random sample of 270 children with OM. The laboratory used standard microbiological techniques for bacterial isolation and Kirby Bauer disk diffusion method for antibiotic susceptibility testing. Data were entered and analyzed using Epi Info 7 and any associations among the study variables tested with Chi2 test with confidence level of 95% and p value of Results: The rate of bacterial isolation was 96.3%. The predominant bacterial isolate was S. aureus (31.48%) followed by P. aeruginosa (24.81%) and P. mirabilis (15.93%) respectively while the least prevalent isolates were coagulase negative Staphylococcus (1.48%), S. pyogenes (0.74%) and Enterobacter spp. (0.37%) in descending order. Age group 0 - 3, χ2 (143,270 = 223.245, p = 0.000) showed highest bacterial isolation. There was no significant relationship between bacterial isolate and gender, χ2 (11,270 = 9.2283, p = 0.6008). S. aureus showed highest sensitivity towards ciprofloxacin (85.7%), amikacin (76.5%), and gentamicin (73.8%). All isolates showed mixed resistance pattern. Conclusion: S. aureus, P. aeruginosa and P. mirabilis were the leading causative pathogens of otitis media. No association was established between isolate distribution and gender. Both the isolated gram-positive and gram-negative bacteria showed greatest sensitivity towards ciprofloxacin while the highest resistance was observed to penicillins, tetracyclines and sulfonamides. The Otitis Media among children in Hargeisa could be possibly treated, based on the antibiogram of the major associated bacteria, with topical and systemic formulations of the following antibiotic groups: fluoroquinolones, aminoglycosides and 3rd gen. cephalosporins.

Chronic otitis media and middle ear variants:Is there relation?

BACKGROUND Chronic otitis media(COM)is an inflammatory disease that lasts for a long time.It is common in developing countries.Hearing loss can result from COM.The relationship between variations in middle ear anatomy and COM was investigated in our study.AIM To compare the prevalence of middle ear anatomic variations between the cases with COM and healthy individuals.METHODS This retrospective study included 500 patients with COM and 500 healthy controls.The presence of those variants was determined:Koerner’s septum,facial canal dehiscence,high jugular bulb,jugular bulb dehiscence,jugular bulb diverticulum,sigmoid sinus anterior location and deep tympanic recesses.RESULTS A total of 1000 temporal bones were examined.The incidences of these variants were respectively(15.4%-18.6%),(38.6%-41.2%),(18.2%-4.6%),(2.6%-1.2%),(1.2%-0%),(8.6%-0%),(0%-0%).It was observed that only high jugular bulb(P<0.001)and anteriorly located sigmoid sinus frequencies(P=0.002)in the case group were statistically significantly higher than the control groups.CONCLUSION COM is a multifactorial disease and variants of middle ear have always been important in terms of potential risk for complication during surgery but rarely associated with COM as an etiology or as a consequence of the disease.We didn't find a positive correlation between COM and Koerner’s septum and facial canal defect.We ended up with a significant conclusion with the variants of dural venous sinuses-high jugular bulb,dehiscence of jugular bulb,diverticulum of jugular bulb and anteriorly located sigmoid sinus-that have been studied less and frequently associated with inner ear illnesses.

SARS-CoV-2 Infection Caused COVID-19 Related Otitis Media Is Commonly Existed with Good Prognosis

Otitis media with effusion is a common disease in otolaryngology. Bacteria are the most common pathogen of otitis media with effusion, and other factors such as viruses have also been reported. The present study is aimed to investigate whether the increasing otitis media cases recently is correlated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection and the COVID-19-related otitis media is commonly existed. Thirty-two patients with otitis media were enrolled Blood cell analysis, C-reactive protein, interleukin-6 test bacterial and fungal cultures were tested. Nine patients were identified with positive SARS-CoV-2 RNA in middle ear discharge. All the subjects had the common symptoms of stuffy ear, hearing loss, and echoacousia. No positive results were found in cultures for bacterial and fungus of middle ear discharge. The levels of C-reactive protein (CRP) were significantly up-regulated in positive cases (P = 0.0335). The levels of proinflammatory cytokine interleukin-6 (IL-6) were higher in positive cases. There were no significant differences of age, gender and prothrombin time (PT) between positive and negative cases. Nasal sprays, ciliary stimulants, and prophylactic antibiotics or low-dose steroid treatments were sequentially used in the otitis media patients caused by SARS-CoV-2 infection. All the patients had improvements of typical symptoms within two to four weeks during the following-up. Thus, SARS-CoV-2 infection caused COVID-19 related otitis media is commonly existed, and the prognosis is good after treatments.

Navigating nephrotoxic waters:A comprehensive overview of contrast-induced acute kidney injury prevention

Contrast-induced acute kidney injury(CI-AKI)is the third leading cause of acute kidney injury deriving from the intravascular administration of contrast media in diagnostic and therapeutic procedures and leading to longer in-hospital stay and increased short and long-term mortality.Its pathophysiology,although not well-established,revolves around medullary hypoxia paired with the direct toxicity of the substance to the kidney.Critically ill patients,as well as those with pre-existing renal disease and cardiovascular comorbidities,are more susceptible to CI-AKI.Despite the continuous research in the field of CI-AKI prevention,clinical practice is based mostly on periprocedural hydration.In this review,all the investigated methods of prevention are presented,with an emphasis on the latest evidence regarding the potential of RenalGuard and contrast removal systems for CI-AKI prevention in high-risk individuals.

The Prevalence and Risk Factors Associated with Otitis Media in Children under Five Years of Age in Mogadishu, Somalia: A Hospital-Based Cross-Sectional Study

Background: Otitis media (OM) is highly prevalent and is one of the most important causes of preventable hearing loss in developing countries and it may have long-term impacts on the children. Several hospital-based cross-sectional studies have been conducted in East African countries to assess the prevalence of OM;however, no similar studies have been conducted in Somalia. Therefore, we conducted a hospital-based cross-sectional study to identify the prevalence and the underlying risk factors of OM among children under the age of five in Mogadishu, Somalia. Methodology: A hospital-based cross-sectional study was conducted from July 2022 to November 2022 at three main hospitals in Mogadishu, Somalia. A total of 384 children aged less than 5 years were included. Parents of these children were interviewed with a questionnaire and a clinical examination was performed for each child. The Statistical Package for Social Sciences, SPSS (Version 22, IBM, Inc.), was used for the statistical analysis. Result: The prevalence of otitis media among the 384 children recruited was 31.25% (120/384). Otitis media was significantly associated with age less than one year (P = 0.006), malnutrition (P Conclusion: In summary, the present study found that otitis media was highly prevalent (31.25%) in Mogadishu, Somalia. The majority of the affected children were younger than one year. Age of the child, malnutrition, upper respiratory tract infections, feeding in lying position, and dripping something into a child’s ear were found to significantly increase the risk of developing otitis media in children. In contrast, breastfeeding for more than one year has been found to reduce the risk of developing otitis media in children.

Acute otitis media with facial nerve palsy: our experiences at a tertiary care teaching hospital of eastern India

Objective:To assess acute otitis media with facial nerve paralysis,its prognosis,and treatment.Methods:It is a retrospective study.Thriteen patients of acute otitis media associated with facial nerve paralysis attended the outpatient department of otorhinolaryngology between May 2017 and April 2019.All patients were clinically assessed with appropriate investigations,prognosis,and treatment.Results:Out of 13 patients,2 were identified with complete facial paralysis and the remaining 11 patients presented with incomplete paralysis.Medical treatment including antibiotics and corticosteroids failed,while myringotomy and facial nerve decompression were done with a favorable outcome.Eleven patients recovered to grade-Ⅰ (House-Brackmann) and 2 cases to grade-Ⅱ (House-Brackmann).Conclusion:Peripheral facial nerve paralysis in acute otitis media is rare.Antibiotics and steroids yield good outcome as conservative management.In case of failure by conservative treatment,facial nerve decompression yields a favorable outcome.

The Role of Fibrinolysis in Adhesive Otitis Media(AOM)

Objective To study the effects of Batroxobin on otitis media with effusion(OME), an early stage of Adhesive Otitis Media(AOM), for the purpose of expanding our understanding of the role of fibrinolysis in the pathogenesis of AOM. Method Forty cases of OME(45 ears) were randomly selected to receive intratympanic administration of Dexamethasone at 5 mg/ml(Group 1 or G1), Batroxobin at 1 BU/ml(Group 2 or G2) or Batroxobin at 2 BU/ml (Group 3 or G3). Pre-and post-treatment changes in clinical symptoms, the Air conduction Hearing Threshold (AHT) in pure tone audiometry and average AHT over 0.25 to 2 kHz were compared. Results Data from 31 cases(33 ears) were available for analysis. AHTs among three groups were similar prior to treatment(P > 0.05). The rate of normal hearing following treatment in G3 was 70% or 7 / 10, higher than in G1(41.7% or 5 / 12) and G2 (54.5% or 6 / 11)(P < 0.05). The rate of improvement following treatment was 81.8% or 9/11 and 80.0% or 8 / 10 in G2 and G3, respectively, higher than that in G1(50.0% or 6 / 12)(P < 0.05). Conclusions Therapeutic effects of intratympanic injection of Batroxobin on OME is superior to traditionally used Dexamethasone. In addition, higher concentration of Batroxobin appears to be superior to lower concentrations. These findings confirm that fibrinolysis plays a pivotal role in the pathogenesis of middle ear adhesion and that fibrinolytic medicine can prevent or reduce adhesion development in the middle ear.