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Article
The Effect of Amoxicillin-Clavulanate and Actifed Versus Actived Only in treatment of Otitis Media with Effusion

Authors: Ahmed Muhei Rasheed*,FIBMS(Otolaryngology) --- Yusra Hayder Taha**, FICMS(Otolaryngology احمد محي رشيد
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 3 Pages: 327-331
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Otitis media with effusion(OME)is a common cause of deafness in childrenwith subsequent impairment of speech development and scholastic difficulties.Treatmentremains controversial.Aim: To study the effect of amoxicillin-clavulanate in treatment of OMEPatients and methods: A prospective study of a target sample consisting of sixty childrenunder the age of 12 years presented with chief complaints duration for at least 6 weeks andon examination there were bilateral red and retracted tympanic membranes withoutoversized adenoids and no underlying causes require surgical correction e.g cleft palate.Thepatients were divided into two groups;group A which received Actifed for 4 weeks andgroup B which received Actifed +Amoxicillin-clavulanate for 4 weeks treatmentcourse.After complete history and otolaryngological examination,all the patients were sent tox-ray of postnasal space( to exclude oversized adenoids),audiometry andtympanometry.Assessment was repeated at the end of 2 and 4 weeks of treatment courseincluding audiometry and tympanometry.The response to treatment in group B wascompared to that in group A at the end of 4 weeks treatment course.In this study,we referedto improvement in otoscopic findings and tympanometry results to show the response to 4weeks treatment course.Results: Eight patients(25.81%)in group A have shown response to treatment at the end of 4weeks treatment course,while the response in group B was seen in 15 patients( 51.72%).Conclusion: Amoxicillin-clavulanate has statistically significant effect in treatment of otitismedia with effusion(OME)in short term follow-up and the clearance of middle ear efussionin response to amoxicillin-clavulanate indicates that bacterial infection may play a role in theaetiology of OME.Keywords: Otitis media with effusion,Amoxicillin-clavulanate,Tympanometry.


Article
PREVALENCE AND RISK FACTORS OF OTITIS MEDIA WITH EFFUSION IN SCHOOL AGE CHILDREN

Author: Hayder S Atwan*, Ahmed A Alansary**, Abdulwahab B Abdulwahab@& Abdul-Razzaq H Alrubaiee#
Journal: Basrah Journal of Surgery مجلة البصرة الجراحية ISSN: 16833589 / ONLINE 2409501X Year: 2016 Volume: 22 Issue: 1 Pages: 25-32
Publisher: Basrah University جامعة البصرة

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Abstract Otitis media with effusion, which refers to the accumulation of fluid in the middle ear cavity without any signs of infection, is a common health problem both in pre-school and school age children. The etiology of otitis media with effusion is multifactorial and many risk factors may increase its incidence. The aim of this study is to determine the frequency and risk factors of otitis media with effusion in school age children in Basrah. In this descriptive prospective study; sixty patients aged between 6-12 years were included; they were 34 males and 26 females diagnosed as having otitis media with effusion in the period between July 2013 to April 2014; at Basrah General Hospital, Iraq. Pure tone audiometry, tympanometry, and lateral x-ray film of post nasal space were done for each patient after a full ENT history and examination . A questionnaire form was constructed to apply for each patient including the possible risk factors for developing otitis media with effusion such as age group, gender, parental smoking, allergy, history of acute infection, maternal education, family income, school type. Otitis media with effusion was found to be higher (66.7%) in children aged between 6-8 years, males more than females with male to female ratio 1.3:1. (61.6%) were from rural area, parental smoking present in (65%), (58.3%) had history of allergy, (66.6%) with history of upper respiratory tract infection, low maternal educational level, low financial income (66.6%), attendance to public school, and the presence of adenoid hypertrophy (71%) were found to be associated with otitis media with effusion. Conclusion and Recommendation: Environmental, epidemiologic and familial factors play an important role in etiology of otitis media with effusion. The parents must be informed about these modifiable risk factors, by this way the development or delayed diagnosis of the disease that may cause serious consequences can be prevented.


Article
Middle Ear Effusion in Intensive Care Unit Patients at Al-Sadder Teaching Hospital in Al-Najaf City-Iraq (A Prospective Randomized Comparative Clinical Study)

Author: Yasir Lafta Hassoun ياسر لفتة حسون
Journal: KUFA MEDICAL JOURNAL مجلة الكوفة الطبية ISSN: 1993517X Year: 2017 Volume: 17 Issue: 1 Pages: 1-12
Publisher: University of Kufa جامعة الكوفة

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Background: Middle ear effusion (MEE) is one of the commonest chronic otological conditions in childhood but has a lower incidence in normal adult. By definition it is an accumulation of non-purulent fluid in the middle ear. It is an inflammatory effusion behind an intact tympanic membrane that is not associated with acute otological symptoms or systemic signs.Aim: To explore factors related to the occurrence of MEE in the intensive care unit (ICU) patients with prolonged oral endotracheal intubation in Al-Najaf city/Iraq.Methods: Forty patients (80 ears) with a prolonged endotracheal intubation (> 5 days) in the ICU were studied. Information of the age, gender, level of consciousness, duration of endotracheal intubation and placement of nasogastric tube were retrospectively collected from history and patient`s data. All patients were subjected to otoscopic examination, tympanometry studies and acoustic reflectometry for evidences of MEE. Results: Out of the 80 earsexamined, 46 ears had MEE (57.5%), 22 ears were normal (27.5%), and 12 ears (15%) had negative pressure in the middle ear by tympanometry. Patients who were intubated for more than 11 days and those with conscious disturbance had a significantly high incidence of MEE. No episodes of acute otitis media or systemic infection were encountered.Conclusion: Prolonged endotracheal intubation (more than 11 days), age advancing and conscious disturbance contribute significantly to the occurrence of MEE in adult ICU patients.Recommendation: Middle ear pathology like MEE in the ICU patients with prolonged intubation should not be underestimated


Article
Frequency of Otitis Media with Effusion in Children with Adenoid Hypertrophy
مدى الاصابة بالتهاب الاذن الوسطى مع انثقاب الطبله عند متضخمي العقد اللمفاويه للتجاويف

Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2017 Volume: 30 Issue: 2 Pages: 95-100
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Abstract:Background: Otitis Media with Effusion (OME) is a chronic accumulation of mucous within the middle ear , and sometimes the mastoid air cell system .Objective: To study the frequency of otitis media with effusion in relation to the effect and size of adenoid hypertrophy as an aetiological factor , in addition to others like presenting symptoms, risk factors and the changes of tympanometry in otitis media with effusion.Patients and methods: A cross sectional study for 12 months (January 2011-january 2012) in Al-Yarmouk Teaching Hospital, ENT department. One hundred children with adenoid hypertrophy aged (3-12years) were included. All of them were evaluated by clinical ENT examination, tympanometry and lateral plane x-ray of nasopharynx to assess the size of hypertrophied adenoid and classified into 3 grades (I, II and III) and asses the frequency of otitis media with effusion in each grade.Results: Only 38 children out of one hundred (38%) were diagnosed as having otitis media with effusion; with 26 patients were bilaterally involved (68.5%) and 12 patients were unilaterally involved (31.5%). According to adenoid grade, the incidence of otitis media with effusion was as follow: grade I: 19 patients (38ears) only 7 ear with effusion (18%) , grade II : 47 patients (94ears)only 26 ear with effusion (27%) and grade III : 34 patients (68 ears) only31 ears with effusion (45%). Type B tympanometry was more in grade III adenoid hypertrophy 47%.Conclusion and Recommendation: The frequency of otitis media with effusion is directly proportional to the size of adenoid. It is recommend that early diagnosis and proper management of adenoid hypertrophy to reduce the incidence of otitis media with effusion and its sequels of hearing loss and poor speech development in children .


Article
Incidence of otitis media with effusion in children with adenoid hypertrophy
نسبة حدوث التهاب الأذن الوسطى مع الانصباب عند الأطفال الذين يعانون من تضخم غداني

Authors: Lana Sh. Dabbagh --- Farhad J. Khayat
Journal: Zanco Journal of Medical Sciences مجلة زانكو للعلوم الطبية ISSN: 19955588/19955596 Year: 2011 Volume: 15 Issue: 2 Pages: 57-63
Publisher: Hawler Medical Univeristy جامعة هولير الطبية

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Abstract

Background and objectives: Otitis media with effusion is collection of fluid behind intact tympanic membrane. Otitis media with effusion usually coexists with the adenoid hypertrophy. The adenoid is a part of Waldeyer's ring; its basic function is thought to be antibody production. The aim is to identify the incidence of otitis media with effusion in children with adenoid hypertrophy.Methods: A prospective descriptive cohort study had been employed at Rizgari Teaching Hospital/ Erbil from January 2008 to July 2008. Summation of total 120 Child aged 3-12 years old were being conducted in the survey. All patients subjected for history, local physical examination, Information's recorded on a specially designed Questionnaire and proper investigations were done including lateral X ray of post nasal space, and audiological examination.Results: Among 120 patients age (3-12) years old with adenoid hypertrophy, 44 patients (36.7%) had OME, mean age was 6.5 years. Most common age group was (5-6) years (21) (47%).Conclusion: Adenoid Hypertrophy (AH) can be relevant in the pathogenesis of otitis media with effusion (OME) due to its anatomic position.


Article
2.THE VITRO STUDY EFFECT OF GINGER EXTRACTS ON FUNGAL ISOLATED FROM A SUPPURATIVE OTITIS MEDIA AND EXTERNA

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Background: Otitis media is a group of complex inflammatory disorders affecting the middle ear, which can be acute or chronic. Otitis externa is an inflammation on the skin of the external auditory canal usually associated with secondary bacterial and/or fungal infection of macerated skin and subcutaneous cellular tissue.Objective: To investigate the effect of ginger extracts on fungal isolates from patients suffering from otitis.Methods:Two hundred patients suffering from suppurative otitis media and externa who attended to ENT Department, Al-Imamein Al-Kadhimein Medical City enrolled in this study from November 2016 to the end of April 2017, included patients all age groups with discharging ear. All specimens were transported to the laboratory for processing and investigations at the same day. The powder of ginger rhizomes soaked with the solvent and left in a shaking water bath at 40 °C for 24 hours, and then filtered using Whatmann's filter paper No.1 for clear extract. Each extract was concentrated using a rotary evaporator with vacuum to get the final crude extract; after the procedure of ginger extract was done, this extract was taken and tested for bacterial and fungal isolates from patients with otitis.Results:Results revealed that acute otitis media consisted of about 96 (48%), while chronic suppurative otitis media about 75 (37.5%). Otitis externa was less common infection among the other types of otitis 29(14.50%). The most fungal isolates were Candida parapsilosis. In addition, there is a significant effect of (chloroform, methanol, and aqueous) extract of ginger on pathogenic fungi. Conclusion:Ginger extracts have been showed evident zones of inhibition effect on pathogenic fungi by chloroform more than ethanol, with less effect by aqueous extract.Keywords: Otitis externa, otitis media, ginger extractCitation: Al-Attraqchi AAF, Sahib HB, Al-Hasseni JMK, Mohammed MM. The vitro study effect of ginger extracts on fungal isolated from a suppurative otitis media and externa. Iraqi JMS. 2019; 17(1): 4-11. doi: 10.22578/IJMS.17.1.2


Article
THE PREVALENCE AND ANTIMICROBIAL RESISTANCE OF PSEUDOMONAS SPECIES IN PATIENTS WITH CHRONIC SUPPURATIVE OTITIS MEDIA

Author: Dr. Zaid Ihsan Al-Attar M.B.Ch.B ,M.Sc. (Pharmacology)
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2014 Volume: 10 Issue: 1 Pages: 114-117
Publisher: Baghdad University جامعة بغداد

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Background: Chronic suppurative otitis media (CSOM) is the result of aninitial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Methods. 1. To get an overview on the bacterial ear infection profile in general 2. To assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance... A cross sectional study was done which included 405 patient of CSOM patients196 (48%) case were males ,209 (52%)case were females. Swabs for aural discharge was taken from those patients. Discharge is cultured by inoculating it into blood , MacConkey agar , chocolate agars and Sabouraud agar (for fungi).If the isolate shows to be Pseudomonas isolate growth then another culture of the isolate is performed on Muller Hinton Agar. Then the antibiotic susceptibility and resistance of Pseudomonas isolate is assessed by (Kirby-Bauer Method)Results:196 (48%) case were males.209 (52%) case were females with a male to female ratio 1:1.1150 (73%) cases were infected with Pseudomonas species (PS) The sensitivity of the Pseudomonas isolates to the following antibiotics is shown below:Amikacin 91.7%Imipenem 89.7%Ceftazidime 81.8%Ciprofloxacin 73.7%Garamycin 72.9%Tobramycin 67.7%Ticarcillin 66.7%Cefoperazone 42.9%Conclusions: Pseudomonas species is the commonest microorganism in cases of CSOM.Microbiological identifications and antibiotic resistance determination of pathogens isolated from the middle ear in patients with CSOM not responding to empirical antibiotic treatment gives possibility of the choice of an effective antibiotic and its proper dosage. Cefoperazone ,a relatively new antibiotic that is used in Iraq to combat pseudomonal infections has proven to be poorly effective compared with other previously used antibiotics.


Article
The prevalence and antimicrobial resistance of Pseudomonas species in patients with chronic suppurative otitis media

Author: Zaid I. AL-Ataar M.B.Ch.B, M.Sc*
Journal: Al-Kindy College Medical Journal مجلة كلية الطب الكندي ISSN: 18109543 Year: 2015 Volume: 11 Issue: 1 Pages: 49-52
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Chronic suppurative otitis media (CSOM) is the result of an initial episode of acute otitis media and is characterized by a persistent discharge from the middle ear through a tympanic perforation for at least 2 weeks duration. It is an important cause of preventable hearing loss, particularly in the developing world.Objective: To get an overview on the bacterial ear infection profile in general and to assess the antibiotic resistance of Pseudomonal infection (PS) particularly since it is usually the commonest infection to cause otitis media and the most difficult to treat due to the problem of multi drug resistance..Methods: A cross sectional study was done which included 405 patients of CSOM patients, 196 (48%) case were males, 209 (52%) case were females. Swabs for aural discharge were taken from those patients. Discharge is cultured by inoculating it into blood, Mac Conkey agar, chocolate agars and Sabouraud agar (for fungi).If the isolate shows to be Pseudomonas isolate growth then another culture of the isolate is performed on Muller Hinton Agar. Then the antibiotic susceptibility and resistance of Pseudomonas isolate is assessed by (Kirby-Bauer Method)Results: 196 (48%) case were males, 209 (52%) case were females with a male to female ratio 1:1. One hundred fifteen(73%) cases were infected with Pseudomonas species (PS).The sensitivity of the Pseudomonas isolates to the followingantibiotics was Amikacin 91.7%, Imipenem 89.7%, Ceftazidime 81.8%, Ciprofloxacin 73.7%, Garamycin 72.9%, Tobramycin 67.7%, Ticarcillin 66.7%,Cefoperazone 42.9%Conclusion: Pseudomonas species is the commonest microorganism in cases of CSOM. Microbiological identifications and antibiotic resistance determination of pathogens isolated from the middle ear in patients with CSOM not responding to empirical antibiotic treatment gives possibility of the choice of an effective antibiotic and its proper dosage. Cefoperazone , a relatively new antibiotic that is used in Iraq to combat pseudomonal infections has proven to be poorly effective compared with other previously used antibiotics.


Article
Bacteriology And Antibacterial Susceptibility Of Tonsillopharyngitis And Chronic Suppurative Otitis Media Cross Sectional Study In Al.Habobi Hospital-Thi-Qar
دراسة مقطعية حول البكتريا المسببة لالتهاب اللوزتين و البلعوم والتهاب الاذن الوسطى المزمن في مستشفى الحبوبي-ذي قار

Author: Dr.mushtaq N.almalki د. مشتاق نعمة
Journal: Thi-Qar Medical Journal مجلة ذي قار الطبية ISSN: 19929218 Year: 2011 Volume: 5 Issue: 1 Pages: 118-125
Publisher: Thi-Qar University جامعة ذي قار

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Abstract

ABSTRACT:Antibacterial resistance is a great problem on proper management of tonsillopharyngitis and chronic otitis media.To determine the antibacterial susceptibility of the common causative bacteria throat and ear swabs were sent for culture and antibiotic sensitivity testing from out patients attending AL.Habobi hospital over aperiod from September 2009 to September 2010.Of 102 patients with tonsillopharyngitis , Beta haemolytic streptococcus type A ,was the commonest cause accounting for 59.8% of all isolated bacteria, followed by 29.4% was staphylococcus.On other hand pseudomonas represent the top of the list of bacterial causes of chronic suppurative otitis media(46%) ,followed by staphylococcus aureus (27.6%).Amikacin has the greater chance of action among most isolated bacteria in this study.Sensitivity to commonly used antibacterial agent like amoxicillin, cephalosporin, pencillin, erythromycin and co-trimazole were less.

الخلاصة:من اجل تحديد حساسية البكتريا المسببة لعدوى اللوزتين والبلعوم والتهاب الأذن الوسطى المزمن للمرض المراجعين للعيادة الاستشارية في مستشفى الحبوبي العام للفترة من ايلول 2009 ولغاية ايلول 2010. من بين 102 عينة لمرضى التهاب اللوزتين والبلعوم أظهرت النتائج ان 59.8% كانت بسبب العدوى بالبكتريا العنقودية المتكورة نوعِِِ (أ),تليها بكتريا الستافيلوكوكس 29.4% .على الجهة الأخرى كانت بكتريا السودومونس هي الأكثر تسببا" لمرض التهاب الأذن الوسطى (46%),تليها الستافيلوكوكس(27.6%).كما أظهرت النتائج ان الاميكاسين هو الأكثر حساسية لمعالجة أغلب البكتريا المسببة لألتهاب الأذن الوسطى وكان ثالثا" لمعالجة التهاب اللوزتين والبلعوم(12%) بعد السيتافكسيم والسيبروفلوكساسين(13%) ,في حين كانت حساسية المضادات الأكثر شيوعا" في المجتمع مثل الأموكسيسيلين ,البنسيلين ,السلفا, الكفلكس,والأرثرومايسين هي الأقل في هذه الدراسة للحالتين المرضيتين يوعز ذلك الى سوء الأستعمال الشخصي للادوية .


Article
Microbiological Assessment of Chronic SuppurativeOtitis Media
دراسة الأحياء المجهرية المسببة لالتهابالأذن الوسطى القيحي المزمن

Author: Imadfarhan al-zubaidy
Journal: kufa Journal for Nursing sciences مجلة الكوفة لعلوم التمريض ISSN: 22234055 Year: 2014 Volume: 4 Issue: 3 Pages: 101-105
Publisher: University of Kufa جامعة الكوفة

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Abstract

Background : Chronic SuppurativeOtitis Media is a common infectious disease . the microorganisms commonly associated with and their antibiotic sensitivity patterns is important for its treatment .Objectives : to study the microorganisms associated with chronic suppurativeotits media and their antibiotic sensitivity patterns among our patients . Material and Methods : this descriptive study was carried out from January 2012 to December 2012 at ENT Department and microbiology department . of AL-Hakeem general hospital in Najaf city . A total of 100 patients with unilateral and bilateral active chronic suppurativeotits media attending the out patients clinic were included in the study , pus sample were collected from the discharging ears and sent to microbiological department.Results :- from 100 specimens there were 90 (90%) bacterial isolates and 10 (10%) fungi .Pseudomonas aerugenosa 40 (40%) was the dominant isolate followed by Staphylocooccusaureus 19 (19%) and Proteus spp. 15 (15%) . Antibiotic sensitivity pattern of Pseudomonas aerugenosa showed that imipenem was active in 100% and Vancomycin was active in 100% of Staphylococcus aureus isolate .Conclusion :- Pseudomonas aerugenosa is the most common isolates followed by Staph . aureus from the cutluer specimens of chronicsuppurativeotits media . Pseudomonas aerugenosa is increasingly becoming more resistant to the commonly used antibioltic like cephalosporine Amoxicillin & Ampicillin .Recommendation:We advise to do culture and sensitivity test for every patient with chronic suppurativeotits media (CSOM)and to describe systemic antibiotics according to the result of this test .

خلفية البحث:يعد التهاب الأذنالوسطى القيحي المزمن من الأمراض الخمجية الشائعة كما ان دراسة الأحياء المجهرية المسببة للالتهاب وحساسيتها للمضادات الحيوية لها دور أساسي في علا ج هذا النوع من الأمراض.الهدف: هو دراسة الأحياء المجهرية المسببة لالتهاب الاذن الوسطى المزمن القيحي وحساسيتها للمضادات الحيوية بين المرضى المشمولين بهذه الدراسة . المنهجية: اجريت هذه الدراسة للفترة من كانون الثاني 2012 لغاية كانون الاول 2012 في شعبة الانف والاذن والحنجرة وشعبة الاحياء المحهرية في مستشفى الحكيم العام في النجف . شملت الدراسة مائة مريض مصابين بالتهاب الاذن الوسطى المزمن القيحي تم تشخيصهم سريريا في العيادة الاستشارية , وتم جمع العينات Ear swabs من المصابين ارسلت لدراستها بكتريولوجيا في شعبة الاحياء المجهرية في مختبر المستشفى وتم تحليل النتائج بإعتماد النسب المئوية . النتائج: ظهر من خلال هه الدراسة ان 40% من البكتريا التي تم عزلها كانت من صنف ال Pseudomonas aerugenosa تليها الStaph aureusبنسبة (19%) . اظهر نموج فحص الحساسية للمضادات الحيوية ان الPseudomonas aerugenosa كانت حساسة للمضاد الحيوي ( Imipenem) بنسبة 100% وال Staph aureusكانت حساسة بسنة 100% للمضاد الحيوي (Vancomycin) .الاستنتاجات: تعد الـPseudomonas aerugenosa البكتريا المسببة الأكثرشيوعا في حالات الإصابة بالتهابالأذن الوسطى المزمن القيحي تتبعها الـ Staph aureus . اصبحت البكتريا Pseudomonas aerugenosa مقاومة وبشكل متزايد للمضادات الحيوية شائعة الاستخدام مثل السفالوسبورينات والأوموكسيل والامبسلين . التوصيات: يوصى باجراء فحص الزرع والحساسيه للمضادات الحيويه لكل مريض مصاب بالتهاب الاذن الوسطى المزمن ثم وصف المضاد الحيوي المناسب طبقا لنتائج هذا الفحص .

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