Dilemmas in Current Management of Complicated Chronic Otitis Media

AbstractTo evaluate the distribution of complications of chronic otitis media, dilemma of how soon to operate a seriously ill patient with CSOM and treatment outcomes. A retrospective study was done in a tertiary care centre. Clinical data from 2013 to 2015 was compiled, surgical management with outcome was analysed. A total of 425 patients with chronic otitis media were evaluated. Single/multiple complications were seen in 147 (34.5%) patients. Majority of the complications were seen in active squamosal type of chronic otitis media i.e. 137 (59.5%) cases out of the 147. Meningitis (3.3%) was the most common intracranial complication. Patients with intracranial complications were referred from other departments and did not primarily present to ENT, indicating a major fact that treatment was sort for the complication and not for chronic otitis media. Headache with or without ear discharge was the most common presenting complaint. Fever and pain were not prominent indicators of complications, posing a diagnostic dilemma as patients were already receiving antibiotics and analgesics before reaching tertiary care centre. The patients with severe intracranial complications were promptly taken up (within 3 –5 days) for canal wall down mastoidectomy with intravenous broad spectrum antibiotic (vancomycin) and mannitol with high risk consent. However ill the patients were, especially children with very poor general conditions, there was dramatic recovery as soon as the masto...
Source: Indian Journal of Otolaryngology and Head and Neck Surgery - Category: ENT & OMF Source Type: research

Related Links:

Conclusion: Current evidence precludes drawing a firm conclusion on the efficacy or superiority of LidoIV over traditional therapies for ED patients with renal colic. Evidence suggests LidoIV may be an effective non-opiate analgesic alliterative; however, it's efficacy may not exceed that of NSAIDs or opiates. Further study is needed to validate the potential improved efficacy of LidoIV plus metoclopramide. PMID: 32259122 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
Abstract Anaphylaxis is a life-threatening systemic allergic hypersensitivity reaction that may potentially be triggered after the administration of any drug. Our case was a 51-year-old man with the history of mild pain in his flanks since the night before he was admitted to our hospital. The patient was diagnosed with urolithiasis and admitted to the emergency department. He developed anaphylaxis after intravenous injection of 30 mg ketorolac. Allergic reactions to non-steroidal anti-inflammatory drugs (NSAIDs) such as ketorolac are rare; nonetheless, they can be life-threatening and should be carefully monitored...
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
Conclusion: It seems that naloxone is not a completely safe medication even in opioid-naïve patients, and administrating adjusted doses of naloxone even in opioid-naïve methadone intoxicated patients may be logical. PMID: 32259115 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
Conclusion: Based on the findings, 98% of TIS cases had respiratory acidosis. Higher doses of ingested drug and longer time interval between ingestion and admission were associated with severity of ABG disturbances. PMID: 32259113 [PubMed - as supplied by publisher]
Source: Accident and Emergency Nursing - Category: Emergency Medicine Authors: Tags: Arch Acad Emerg Med Source Type: research
This study aimed to determine mothers' level of satisfaction and the predicting factors of dissatisfaction towards spinal anesthesia during caesarean section. Methods: Cross-sectional study design was utilized in Orotta Maternity Hospital (OMH) and Sembel Hospital from December 2017 to February 2018, in Asmara, Eritrea. Satisfaction of the mothers was measured using a pretested questionnaire. Bivariate and multivariate logistic regression were utilized to identify predictors of dissatisfaction using SPSS (Version 22.0). Results: Involvement of mothers in the choice of anesthesia (3.3%) and explanation about the sta...
Source: Anesthesiology Research and Practice - Category: Anesthesiology Tags: Anesthesiol Res Pract Source Type: research
PMID: 32256911 [PubMed - as supplied by publisher]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
Conclusion and Recommendation. This study revealed that nurses working at University of Gondar hospital had good knowledge and a lower level of attitude towards pain management than those reported in previous studies. Thus, the situation demands various educational and quality improvement initiatives that could enhance the nurse's knowledge and attitude in the area of pain management. PMID: 32256910 [PubMed - as supplied by publisher]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
In conclusion, the evidence suggests that acupuncture may be an effective intervention for patients with CP/CPPS. However, due to the heterogeneity of the methods and high risk of bias, we cannot draw definitive conclusions about the entity of the acupuncture's effect on alleviating the symptoms of CP/CPPS. The adverse events of acupuncture are mild and rare. PMID: 32256909 [PubMed - as supplied by publisher]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
Conclusions: Lower back pain is a serious health problem, and this review article will help educate physicians and physiotherapists dealing with LBP in the options of evidence-based treatment. Ultimately, the article introduces and postulates the need to systematize therapeutic procedures in LBP therapy, with a long-term perspective. PMID: 32256908 [PubMed - as supplied by publisher]
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
Abstract Methods: Eighty-eight patients undergoing THA were randomized to receive 0.33% ropivacaine (Group QLB, n = 44) or saline (Group Con, n = 44) for QL3 block. Spinal anesthesia was then performed. Pain intensity was assessed using the visual analog scale (0: no pain to 10: worst possible pain). The primary outcome was pain scores recorded at rest at 3, 6, 12, 24, 36, and 48 h and on standing and walking at 24, 36, and 48 h postoperatively. Secondary outcomes were analgesic consumption, side effects, the 10-meter walking speed on day 6, and patient satisfaction after ...
Source: Pain Research and Management - Category: Anesthesiology Authors: Tags: Pain Res Manag Source Type: research
More News: Anesthesia | Anesthesiology | Children | Chronic Pain | ENT & OMF | Headache | India Health | Men | Meningitis | Migraine | Otitis | Otitis Media | Pain | Pain Management | Study