Chronic Suppurative Otitis Media in urban private school children of Nepal / Otite Média Crônica Supurativa em crianças de uma escola particular urbana do Nepal

Chronic suppurative otitis media is one of the common ear diseases of the ear, particularly in childhood. It is the commonest cause of persistent mild to moderate hearing impairment in children and young adults. AIM: To find out the prevalence of chronic suppurative otitis media among school children studying in urban private schools of Nepal. MATERIAL AND METHODS: This study was carried out among 500 school children aged between 5 -15 years. Students were selected from urban private schools of four districts of Nepal. In all students, history was taken and otoscopic examination done from May 2006 to October 2006. Data were described using frequency and percentage. Study design: Prospective cross sectional study. RESULTS: Results showed that the prevalence of chronic suppurative otitis media in children studying in urban private schools of Nepal is 5.0 percent. Unilateral disease was seen in 72.0 percent, 76.0 percent had a tubotympanic disease and 24.0 percent had atticoantral disease. CONCLUSION: The prevalence of chronic suppurative otitis media in urban private school children in Nepal is higher than other studies done in private school children. Health education, improvement of socioeconomic status and health facilities will be helpful in reducing the prevalence of chronic suppurative otitis media.

Otite média crônica supurativa é uma das mais comuns doenças do ouvido, principalmente em crianças. É a causa mais comum de perda auditiva persistente leve a moderada em crianças e adultos. OBJETIVO: encontrar a prevalência de otite média crônica supurativa em crianças de escolas particulares urbanas do Nepal. MATERIAIS E MÉTODOS: este estudo envolveu 500 crianças escolares com idades entre 5 e 15 anos. Os estudantes foram selecionados de escolas particulares urbanas de quatro distritos do Nepal. Todas as crianças passaram por anamnese e exame otoscópico entre Maio e Outubro de 2006. Os dados foram descritos por meio de freqüência e porcentagem. Formato do estudo: transversal e prospectivo. RESULTADOS: os resultados mostraram que a otite média crônica supurativa em crianças de escolas particulares do Nepal é de 5,0 por cento. Doença unilateral esteve presente em 72,0 por cento; 76,0 por cento tiveram doença tubo-timpânica e 24,0 por cento tiveram doença ático-coanal. CONCLUSÃO: a prevalência de otite média crônica supurativa em crianças de escolas particulares urbanas do Nepal é maior do que aquele encontrado em outros estudos envolvendo crianças de escolas particulares. Educação em saúde, estado sócio-econômico e instalações de atenção à saúde serão úteis na redução da prevalência de otite média crônica supurativa.

Correlação entre timpanograma e fluído de miringotomia em crianças portadoras de otite média com efusão / Correlation between tympanogram and myringotomy fluid in pediatric patients with otitis media with effusion

A Otite Média com Efusão é uma das causas da impotência auditiva que pode ser tratada simplesmente com a miringotomia ou sem a inserção do tubo de ventilação. Objetivo: Este estudo tem o objetivo de avaliar os diferentes tipos de fluidos após a miringotomia em Otite Média com Efusão; avaliar o exame de timpanograma de pacientes que são submetidos à miringotomia; correlacionar o fluído de miringotomia e o timpanograma pré-operatório em crianças portadoras de Otite Média com Efusão. Método: Um estudo retrospectivo em crianças menores de 12 anos portadoras de Otite Média com Efusão foi realizado na seção de otorrinolaringologia na escola da T.U. em Katmandu entre outubro de 2005 e setembro de 2007. Todos os pacientes que foram submetidos à miringotomia foram avaliados pelo exame timpanométrico e este foi comparado com os tipos de fluidos durante a cirurgia. O resultado foi estatisticamente analisado através do teste Qui-Quadrado. Resultados: A faixa etária dos pacientes era entre cinco e oito anos. Cerca de 56,8% das crianças apresentavam fluido de miringotomia espesso com aspiração seca em 27,5%. O timpanograma evidenciou curva tipo B em 90,2% das crianças. Curva tipo B e fluido espesso foram encontrados em 63%, e 21% das crianças apresentavam aspiração seca. Entretanto, todos os pacientes com fluido expesso apresentaram curva tipo B no timpanograma. A sensibilidade da curva B para prever a presença de fluido foi de 97,3%, enquanto a especificidade para foi de 28,6%. Conclusão: A Curva tipo B é a curva comum no timpanograma em pacientes portadores de Otitie Média com Efusão, porém, nem sempre ela indica a presença de fluido na orelha média. O timpanograma é bastante útil para prever a origem do fluído de miringotomia

Otitis Media with Effusion is a common cause of hearing disability that can be treated simply with myringotomy with or without ventilation tube insertion. Aim: The aims of this study are 1) to assess different types of fluid after myringotomy in Otitis Media with Effusion, 2) to assess the Pre Operative Tympanogram in Patients undergoing myringotomy 3)to correlate between myringotomy fluid and pre operative tympanogram in pediatric patients with Otitis Media with Effusion Method: A retrospective study in children (< 12 years) with Otitis media with effusion was carried out in ENT Department, T.U. Teaching Hospital, Kathmandu between October 2005 to September 2007. All patients undergoing myringotomy were assessed by tympanometry and compared with the types of fluid during surgery. Result was analyzed statistically using Chi -Square Test. Results: Most of the patients were in age group 5-8 years. Around 56.8 % of children had thick myringotomy fluid with dry tap in 27.5 %. Tympanogram showed B type curve in 90.2 % children. In patients with B type curve, thick fluid was found in 63.0%, while 21.0 % children had dry tap. But all patients with thick fluid had B type curve in Tympanogram. Sensitivity of B curve to predict fluid was 97.3% while Specificity was 28.6%. Conclusion: Common type of tympanogram curve in patients with Otitis Media with Effusion is B type, but it doesn?t always indicate to have fluid in middle ear. Tympanogram is useful in predicting the nature of the myringotomy fluid.

Foreign body pyriform sinus: an unusual presentation.

This is a case report of a foreign body (chicken bone) on the left pyriform sinus impacted in its lateral wall. Although it could be seen on x-ray soft tissue neck lateral view and on CT scan of the neck, the foreign body could not be found by rigid oesophagoscopy which was done twice. It was detected and removed by lateral pharyngotomy under GA. A brief review of literature is also included.

Trend of blood group distribution among the different ethnic groups of Kathmandu Valley.

This study was undertaken to find out the trend of blood group distribution (ABO and Rh) among the 1310 Nepalese attended in Tribhuvan University Teaching Hospital and Nepal Medical College Teaching Hospital Kathmandu. The frequency of distribution of A, B, AB and O was 28.5%, 27.3%, 8.7% and 35.5% respectively. Only 0.8% of them were found to be Rh (-) ve. In this population of study, O (+) ve blood group was found to be predominant among the Brahmins, Magars and Gurungs. A (+) ve blood group was predominant among the Chhetris, and B (+) ve among the Sherpas and the Lamas.

Oncocytoma of maxillary sinus--a rare presentation.

A case of Oncocytoma of maxillary sinus in a 73 years old female is reported along with a brief review of literature. To the best of our knowledge this extremely rare tumor is the first of its kind reported in Nepal. Literature review has revealed only four such cases originating from maxillary sinus.

Knowledge attitude and practice (KAP) study regarding facts for life.

This knowledge attitude and practice (KAP) study was done in the married women of age 18-38 years in Jorpati and Gokarna village development committees of Katmandu district to evaluate the knowledge of "Facts for Life". There were 510 married women involved in this study. Altogether 28 questions were asked to each of them regarding the "Facts for Life". It includes the following five subjects: Safe motherhood, Childhood Immunization, Childhood diarrhea, Acute Respiratory Infection (ARI) in childhood and hygiene. There was a significant increase in knowledge about hygiene and knowledge regarding childhood immunization than diarrhea, ARI and Safe motherhood. Results showed that the overall knowledge was at 62.8%. This shows that still more attention is needed to Nepalese women.

Resistance VS aerobic exercise--is the later a better choice?

Pulse pressures of two groups of young (18-35 yrs) normotensive non smoker men were compared. One group used to do regular resistance exercise in gymnasium & anther group used to practice aerobic exercise (playing football basketball etc.) regularly. Duration of exercise for both the group was same. Higher pulse pressure was noted in the group taking strength training than that of the persons taking aerobic exercise. Higher pulse pressure is an indication of endothelial dysfunction and arterial stiffness. It promotes vascular damage and atherosclerosis. It seems that, practice of regular aerobic exercise is preferable for maintaining physical fitness, normal blood pressure and endothelial health.

Awareness of sudden infant death syndrome needed in Nepal.

The author during his visit to different private and public hospitals of different parts Nepal found that doctors are not so much aware of Sudden Infant Death Syndrome (SIDS). In most of the hospitals, if an infant comes to the emergency department or baby dies in the post natal care/neonatal room then they are asked to take the baby without doing proper investigations. The practice should be in a broader concept in the sense that if such type of case comes then a full clinical history, examination of death scene and a complete autopsy should be done. This article reflects the importance of SIDS and makes aware the doctors and other paramedics about it.