Assessment of nasal airflow and pain, safety and cost of an improvised nasal airway (nasogastric) tube after endoscopic sinus surgery

@#Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods: Design: Quasi - Experimental Prospective Cohort Study Setting: Tertiary Government Training Hospital Participants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

A preliminary study on the efficacy of plumeria acuminata (kalachuchi) bark extract ointment versus clotrimazole cream in the treatment of otomycosis

Objective:To compare the therapeutic efficacy of kalachuchi (Plumeria acuminata Ait.) bark extract ointment (KO) and clotrimazole cream 1% (CC) in the treatment of otomycosis. Methods Design: Randomized double blind controlled trial Setting: Outpatient otorhinolaryngology clinic of a tertiary government hospital Subjects: Patients aged 18-years-old and above diagnosed clinically to have otomycosis with a positive potassium hydroxide (KOH) smear were randomly assigned to kalachuchi (Plumeria acuminata Ait.) bark extract ointment or clotrimazole cream 1% in unlabeled containers. Selfapplication thrice daily for two weeks followed initial detailed instructions and demonstration. Symptoms, physical findings and repeat KOH smears were recorded after the first and second weeks of treatment. Results: Eighteen patients with otomycosis were enrolled in the study. There was one dropout per treatment group with no intention to treat. There were no statistically significant differences between KO and CC, with 75% (n=8) and 87.5% (n=8) cure rates, respectively. One subject in the KO arm reported severe ear pain. Conclusion: Kalachuchi extract ointment may be a promising topical antifungal agent. Multicenter clinical trials to establish its efficacy and safety as an effective alternative in the management of otomycosis should be conducted.