Factors associated with time of diagnosis and habilitation of congenital hearing loss in Indonesia: A multicenter study.

OBJECTIVES: To investigate factors associated with time of diagnosis and habilitation of congenital hearing loss in Indonesia. METHOD: A retrospective cohort study was conducted from January to December 2020 by collecting data on patients with congenital hearing loss using validated questionnaires. RESULT: Among 535 children with congenital hearing loss, 2.7% had a family history of congenital hearing loss, 11.2% and 37.4% had a maternal history of ototoxic drugs and herbal medicine use during pregnancy, respectively, and 17.8% had prenatal exposure to TORCH infection. Lower maternal education level was shown to be associated with older age at diagnosis (p = 0.045), while older maternal age (p < 0.001), non-housewife mothers (p = 0.029), and out-of-pocket payment scheme (p = 0.027) were associated with a higher rate of habilitation. CONCLUSION: The present study showed that the presence of family history, the use of certain medications during pregnancy, and prenatal TORCH infection are prevalent in children with congenital hearing loss in Indonesia. Several factors such as maternal education level, age, occupation, and habilitation payment scheme may be associated with time of diagnosis and habilitation of congenital hearing loss.

The effect of plastic tape seal to reduce face seal leak in respirator N-95 type 1860.

The risk of face seal leak while using N-95 respirators is experienced by health workers and thus failing fit test are quite common. Finding solutions to overcome face seal leaks is crucial; one of which is by sealing the N-95 respirator. The seal used in this research was Tegaderm® a transparent film dressing or a plastic tape which is known to have the advantages of strong adhesion, high level of pore density and standardized medical grade. This study tries to determine the effectiveness of plastic tape adhesive on the N-95 type 1860 respirator in overcoming face seal leak qualitative fit test using Bitrex immediately after being worn and after 4 h of using it. The study used a quantitative approach with an incidence study design conducted pre and post experimental without comparison to see the effectiveness of plastic tape sealing. The subjects for the research were 81 health workers in the CMH environment who were at risk of being exposed to COVID-19. The study found a significant difference in the Bitrex fit test immediately after sealing the N-95 type 1860 respirator with plastic tape; 100% passed the fit test immediately after sealing, and 64.2% passed the fit test after 4 h of working. The effectiveness of sealing using plastic tape is considered to be quite good to overcome face seal leak on the N-95 type 1860 respirator. Health care workers need to be more vigilance to ensure better face seal.

Clinical and intraoperative findings for dangerous chronic suppurative otitis media in paediatric cases.

The number of complications in dangerous Chronic Suppurative Otitis Media (CSOM) remain high, especially in late presentation. Extensive disease with intratemporal and intracranial complications, especially in children, was commonly found in Cipto Mangunkusumo General Hospital (CMGH), a tertiary referral hospital. This was a retrospective study that used secondary data from 2017 to 2019 in CMGH. All paediatric patients with diagnoses of dangerous CSOM and who underwent surgery from January 2017 to June 2019 were included. Clinical and intraoperative findings were described in this study. Twenty paediatric patients underwent surgery in CMGH from 2017 to 2019; of that number, 17 had unilateral dangerous CSOM, and three had bilateral dangerous CSOM. All patients aged 2 to 18 years old underwent canal wall down technique surgery. Profound hearing loss was found in nine ears; severe loss, in four ears; moderately severe loss, in four ears; and moderate loss, in seven ears. The most common intraoperative finding was total ossicular destruction in 17/23 ears. Erosion of sigmoid sinus plate was found in 5/23 ears, with perisinus abscess occurring in one case. Tegmen erosion was found in 4/23 ears. Facial nerve dehiscence was found in seven ears (5 vertical segments, 2 horizontal segments) and two patients had facial nerve paralysis before surgery. Lateral semicircular canal (SCC) fistula was found in 6/23 ears. Late presentation in dangerous CSOM can lead to extensive disease and complication, especially in paediatric patients.