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Article
Prevalence of otitis media with effusion among preschool-age children in Erbil governorate
انتشار التهاب الأذن الوسطى لدى الأطفال في سن ما قبل المدرسة في محافظة أربيل

Authors: Arsalan Awlla Mustafa Shem --- Zhwan Maghdid Aziz Koye
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2018 Volume: 22 Issue: 3 Pages: 282-291
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objective: Otitis media with effusion is one of the common diseases in children at preschool age. This study aimed to determine the prevalence of otitis media with effusion in Erbil governorate and compare this prevalence by urban and sub-urban areas and by different seasons.Methods: This descriptive cross-sectional study was carried out in the Department of Otolaryngology, Rizgary Teaching Hospital from April 2015 to May 2016 through enrolling1077 children from randomly selected kindergartens.Results: Of 1077 children, 124 were diagnosed as otitis media with effusion and the prevalence was 11.5% in Erbil governorate. The highest rate of otitis media with effusion was seen in spring (17.3%), followed by winter, autumn and summer (15.3%, 10.8%, and 4.3%, respectively). The prevalence of otitis media with effusion was higher in the sub-urban areas (13.8 %) compared with urban areas (10.7 %).The prevalence of otitis media with effusion was higher among male children (13.4%) than female children (9.4%). The highest proportion of diagnosed otitis media with effusion was among four years old children (13.6%), followed by five and six years old (10.5% and 7.7%, respectively). History of repeated upper respiratory tract infection and snoring were the most common risk factors seen in the child with otitis media with effusionin the rate of 70.2% and 69.4%, respectively.Conclusion: The prevalence of otitis media with effusion among preschool-age children in Erbil governorate was 11.5% with a maximum prevalence of 17.4% in the spring season.


Article
TREATMENT OF ACUTE OTITIS MEDIA IN CHILDREN (SYSTEMIC ANTIBIOTIC AND TOPICAL NASAL DECONGESTANT VERSUS SYSTEMIC ANTIBIOTIC ALONE)
علاج التهاب الاذن الوسطى الحاد في الاطفال ( استعمال المضادات الحيوية و مضادات الاحتقان الانفية مقابل المضادات الحيوية فقط)

Authors: MOYASER A. YASEEN ميسر ياسين --- EDREES M. HUSSAIN أدريس حسين
Journal: Duhok Medical Journal مجلة دهوك الطبية ISSN: ISSN: 20717334 (online)/ ISSN: 20717326 (Print) Year: 2018 Volume: 12 Issue: 1 Pages: 96-105
Publisher: University of Dohuk جامعة دهوك

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Abstract

ABSTRACTBackground: decongestants whether systemic or topical nasal are widely used in thetreatment of acute otitis media but there is still controversy about their effectiveness. The aimof this study is to evaluate the effectiveness of topical nasal decongestants in the treatment ofacute otitis media and their role in the resolution of middle ear effusion after acute otitismedia attack.Subject and Methods: The current study involved 100 children ranging from 4-12 years ofboth sexes with acute otitis media that need antibiotics in treatment and the study done inRizgary teaching hospital in Erbil during the period of 2015-2017. Patients subsequentlydivided into two groups for treatment. Group A treated with oral co-amoxiclav, oralparacetamol, and topical nasal xylometazoline drop. Group B treated with the same antibioticbut without topical nasal xylometazoline drop. The children are followed up three months by5 visits; in the first and second follow up visits the children are examined clinically for theimprovement in the signs and symptoms of acute infection. In the last three visits the childrenare followed up for the resolution of middle ear effusion by otoscopic examination andtympanometry test. Pure Tone Audiometry (PTA) test done for children in the first and fifthvisits, to know the hearing gain between the two visits and the difference between group Aand group B.Results: The mean age + SD of the children were 7.26 + 2.4 years, ranging from 4 to 12years. The median was 7 years. 58% of the patients were boys and 42% were girls.In the first visit, we found better results in group A that was near significant for pain relief(p=0.067). During subsequent visits we found good resolution in both groups with nonsignificant better results in group A.Conclusions: there is no significant benefit from the use of topical nasal decongestant in thetreatment of AOM.

الخلفية والأهداف: مضادات الاحتقان سواء" عن طريق الفم والانف تستعمل بشكل واسع في علاج الالتهاب اللأذن الوسطى لكن هناك جدال حول تأثيرها .لتقيم تأثيرمضادات الاحتقان الانفية في علاج الالتهاب اللأذن الوسطى الحاد ودورها في ازالة تدفق الاذن الوسطى بعد الالتهاب.طرق البحث: هذه الدراسة تضمنت اخذ 100 طفل ممن اعمارهم تتراوح بين (4-12)سنةومن كلتا الجنسينو يعانون من الالتهاب اللأذن الوسطى الحاد ويحتاجون للمضادات الحيوية لغرض العلاج.تمت هذه الدراسة في مستشفى الرزكاري في اربيل بين (2015-2017), ثم تم تقسيم هؤلاء المرضى الى مجموعتين لغرض العلاج , المجموعة (أ) تم معالجتهم بمضادات الحيوية عن طريق الفم و مضادات الاحتقان الانفية.المجموعة (ب) تم معالجتهم بنفس المضاد الحيوي باستثناء مضاد الاحتقان الانفي.ثم تابعنا المرضى في خمس زيارات لمدة ثلاثة أشهر، وخلال المتابعات فحصنا المرضى سريريا لمراقبة التحسن في اعراض وعلامات الالتهاب وكذلك لمراقبة تحسن في تدفق الاذن الوسطى باستخدام جهاز الاوتوسكوب وتخطيط السمع.النتائج: معدل العمر كان ( ٧.٢٦± ٢.٤ )سنة ،متوسط العمر كان سبع سنوات، ٥٨٪ ذكور و ٤٢٪ اناث. تبين في الزيارة الاولى من المجموعة(أ) تحسن كبير في الالم ولكن لم يكن مهما احصائي (٠.٠٦٧p = ). خلال الزيارات اللاحقة لم يكن هناك اختلاف ملحوض في التحسن بين المجموعتين.الاستنتاجات: لم نلاحظ دور مهم لمضادات الاحتقان الانفية في علاج الالتهاب اللأذن الوسطى الحاد.


Article
Microbiological study and antimicrobial susceptibility pattern of ear infections in patients with Chronic Suppurative Otitis Media (CSOM) in Basrah Province

Author: Reham M. Al-Mosawi
Journal: JOURNAL OF THI-QAR SCIENCE مجلة علوم ذي قار ISSN: 19918690 Year: 2018 Volume: 6 Issue: 4 Pages: 109-117
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

The ear infections are highly popular disease in the world. Chronic suppurative otitis media (CSOM) is one of the prevalent hearing problems, this infection of the middle ear may extend to cranium that can cause many serious complications if not treated duly. It is famed for its return enduring infection. The causative agents of bacteria or fungi may be cause the CSOM infection. Therefore, our study is mainly aimed to identify the bacterial isolates which causing of CSOM and detect some isolates of fungi which implicated in this ear infection with performed of the antimicrobial susceptibility test.The study was executed on people whose attending the outpatients clinic of ENT in AL-Mwanee General Hospital during the period from November, 2016 to May, 2017 in Basrah governorate. Ear swab samples were collected and processed from eighty five (85) patients of CSOM by the following of standard bacteriological procedures mainly, for isolation and identification the bacterial pathogens, in addition, common diagnosis methods was used to detect of some fungal isolates.The positive microbial growth cultures were seen in 59 cases with frequent of (69.41 %) and 26 cases were negative in frequent of (30.58%). Their ages ranged from 1-60 years with high incidence of CSOM in age groups ≤ 10 and 31-50 years old in percent's of (38.82 % and 24.70 %) respectively. Polymicrobial samples from the total isolates (89) which identified in this study were (82) aerobic bacterial isolates in frequent (92.13 %) and 7 fungal isolates in frequent of (7.86 %).The most predominant bacterial isolated which causing CSOM was Pseudomonas aeruginosa in ratio (34.83 %) followed by Staphylococcus aureus, Streptococcus spp., Klebsiella pneumonia, Escherichia coli, Proteus mirabilis and P.vulgaris in proportions: 29.21% , 10.11% , 8.98% , 6.74% , 1.12% and 1.12% . While, the most common fungal detection which causing of CSOM was Aspergillus spp. and Candida spp. with frequently: 71.42% and 28.57%. Susceptibility test was done for known the best antibiotic agents which can be used as a proper treatment to CSOM infection. In the present study the most effective antibiotics agents for most of bacterial isolates were Ciprofloxacin, Vancomycin, Amikacin, Augmentin, Amox-Clav and Gentamycin.


Article
Risk factors of acute otitis media among children in Mosul
عوامل الخطورة لإلتهاب الأذن الوسطى عند الأطفال في الموصل

Authors: Asma O. Abed Alsalam اسماء اسماء عبد السلام --- Zaid M. Yassen زيد مؤيد شندالة --- Marwan F. Buraa مروان فيصل برع
Journal: Annals of the College of Medicine Mosul مجلة طب الموصل ISSN: 00271446 23096217 Year: 2018 Volume: 40 Issue: 1 Pages: 7-14
Publisher: Mosul University جامعة الموصل

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Abstract

ABSTRACTContext: Acute otitis media (AOM) is the most frequent diagnosis in the children visiting offices. The prolonged and recurrent episodes of AOM may lead to hearing impairment and delayed speech development, which will influence the child's performance at school.Aim: The aim of this study is to identify the risk factors of acute otitis media in preschool children attending ENT clinics at Al-jamhory Teaching Hospital in Mosul. Methods: To achieve this aim, a case control study design was adopted. The sample of the present study included 150 children (cases) who have been diagnosed by the responsible ENT specialist according to the otoscopic examination with another 150 children (controls) who were diagnosed not to have AOM. Period of data collection was from 1st of October 2011 to the 1st of April 2012. Results: The present study showed that the highest frequency of acute otitis media occurred in the age group 1-2 years 39 patients (26%), and more frequent AOM attacks occurred in males. Clinical presentation among the cases were fever, otalgia, otorrhea, irritability, loss of appetite, vomiting, diminished hearing, and few patients presented with tinnitus and vertigo. The significant risk factors for AOM were day care attendance, bottle feeding for the 1st 6 months of life, supine bottle feeding, pacifier use in the second 6 months of life, parental tobacco smoking, preterm baby, and allergy. No association was found between craniofacial anomaly and occurrence of AOM in the present study. Conclusion: Day care attendance, bottle feeding during the 1st 6 months of life, supine bottle feeding, pacifier use in the second 6 months of life, parental tobacco smoking, preterm baby, and allergy were found to be a significant risk factors for AOM among study population.Recommendation: Additional studies on potential measures to prevent AOM through the reduction of risk factors are needed.

الخلاصة المقدمة: إلتهاب الأذن الوسطى الحاد هو التشخيص الأكثر شيوعا في الأطفال المراجعين للعيادات الطبية. إطالة أمد وتكرر النوبات لإلتهاب الأذن الوسطى الحاد قد تؤدي إلى ضعف السمع وتأخر تطوير النطق، والتي سوف تؤثر على أداء الطفل في وقت لاحق في المدرسة، ونظرا للزيادة الأخيرة في عدد الأطفال الصغار المصابين بهذه الإلتهابات فقد توجب إجراء مراجعة للأعراض، والسببية المرضية، بالإضافة إلى العوامل الخطيرة ذات العلاقة.الهدف: الهدف من هذه الدراسة هو التعرف على عوامل الخطورة لإلتهاب الأذن الوسطى الحاد في الأطفال قبل سن المدرسة الذين يراجعون عيادات الأنف والحنجرة في مستشفى الجمهوري التعليمي في الموصل. طرق البحث: إعتمدت دراسة العينة والشاهد على 150 طفلا (حالة) شخصوا من قبل أخصائي الأنف والحنجرة وفقا للفحص بمنظار الأذن مع 150 طفلا (شاهد) شخصوا بعدم إصابتهم بإلتهاب الأذن الوسطى الحاد. إمتــدت فترة جمــع الحـالات والشـواهد من الأول من أكتوبر 2011 حتى الأول من أبريل 2012، ولقـد أستخدمت إســتمارة إسـتبيان خاصـة وقـد ملئت هـذه الإسـتمارة عـن طـريق مقابلــة أوليـاء الأمـور لكـل من الحالات والشواهد. النتائج: أظهرت الدراسة أن أعلى معدل إصابة بإلتهاب الأذن الوسطى الحاد وقعت في الفئة العمرية 1-2ســنة (26٪)، وفي الذكور أكثر بقليل من الإناث. الأعراض والعلامات لإلتهاب الإذن الوسـطى الحــاد بين الحالات كانت الحمى، ألم ألاذن، خروج القيح من الأذن، التهيج، فقدان الشهية، القيء، تضاؤل السمع، أما الطنين والدوار فقد ظهر في القليل من الحالات.الاستنتاج: عوامل الخطورة الهـــامة لإلتهـاب الأذن الوسـطى الحــاد كــانت دور الحضانة، الرضـاعة الصـناعية بواسطة الزجاجة للستة أشهر الأولى من الحياة، رضاعة الزجاجة بوضع منبطح، إستخدام المصاصة في الستة أشهر الثـانية مـن العمر، تدخـين الوالدين، الطفـل الخديج، والحساسـية.

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