Otitis is one of the most frequent diseases in early childhood and one of the reasons for first prescription of antibiotics.
Most frequently reported pediatric bacterial infection, with up to 85% of children experiencing an episode by the age of 3 years and many of them have to treat with medicine and surgical management is restricted
a detailed description of pain and therpaeutic options available and clinical assessment of pain, approach to the patient with pain, assessment of intensity of pain, nsaids and opioids, tca. WHO pain ladder, chronic opioid therapy
a detailed description of pain and therpaeutic options available and clinical assessment of pain, approach to the patient with pain, assessment of intensity of pain, nsaids and opioids, tca. WHO pain ladder, chronic opioid therapy
One can conduct an otoscopic examination at home with the help of an otoscope. Depending on the quality of the product, the otoscope price ranges between Rs. 10,000 and Rs. 20,000.
One can conduct an otoscopic examination at home with the help of an otoscope. Depending on the quality of the product, the otoscope price ranges between Rs. 10,000 and Rs. 20,000.
Acute Otits Media in Infant by\ Eman Salman
It was used for student presentation in ENT course rotation
I Hope you find what is helpful for your knowledge ♥
Otitis media with effusion in children Augustine raj
Otitis media with effusion, also called glue ear, serous otitis media is a very common problem encounterd in children . most of the times it is missed leading to deafness , social adjustment disorders, poor scholastic performance of kids. this slideshare is to create an awareness amonf general physicians and ENT specialists
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
MANAGEMENT OF ATRIOVENTRICULAR CONDUCTION BLOCK.pdfJim Jacob Roy
Cardiac conduction defects can occur due to various causes.
Atrioventricular conduction blocks ( AV blocks ) are classified into 3 types.
This document describes the acute management of AV block.
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
HOT NEW PRODUCT! BIG SALES FAST SHIPPING NOW FROM CHINA!! EU KU DB BK substit...GL Anaacs
Contact us if you are interested:
Email / Skype : kefaya1771@gmail.com
Threema: PXHY5PDH
New BATCH Ku !!! MUCH IN DEMAND FAST SALE EVERY BATCH HAPPY GOOD EFFECT BIG BATCH !
Contact me on Threema or skype to start big business!!
Hot-sale products:
NEW HOT EUTYLONE WHITE CRYSTAL!!
5cl-adba precursor (semi finished )
5cl-adba raw materials
ADBB precursor (semi finished )
ADBB raw materials
APVP powder
5fadb/4f-adb
Jwh018 / Jwh210
Eutylone crystal
Protonitazene (hydrochloride) CAS: 119276-01-6
Flubrotizolam CAS: 57801-95-3
Metonitazene CAS: 14680-51-4
Payment terms: Western Union,MoneyGram,Bitcoin or USDT.
Deliver Time: Usually 7-15days
Shipping method: FedEx, TNT, DHL,UPS etc.Our deliveries are 100% safe, fast, reliable and discreet.
Samples will be sent for your evaluation!If you are interested in, please contact me, let's talk details.
We specializes in exporting high quality Research chemical, medical intermediate, Pharmaceutical chemicals and so on. Products are exported to USA, Canada, France, Korea, Japan,Russia, Southeast Asia and other countries.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
2. ACUTE OTITIS MEDIA
According to “Scott-Brown's Otorhinolaryngology: Head
and Neck Surgery”-
The term ‘acute otitis media’ implies a viral or bacterial
infection of the mucosal lining of the middle ear and mastoid
air-cell system.
It is characterized by an otoscopically abnormal tympanic
membrane.
The clinical presentation is usually with otalgia and systemic
illness.
3. OTITIS MEDIA
According to “Ballenger's Otorhinolaryngology Head and Neck Surgery 17th
Edition”-
“Otitis media represents an inflammatory condition of the middle ear space
without reference to cause or pathogenesis.”
The process may be
acute (0 to3 weeks in duration),
subacute (3 to 12 weeks in duration), or
chronic (greater than 12 weeks in duration)
An effusion may be either serous (thin, watery), mucoid (viscid, thick), or
purulent (pus)
4. ACUTE OTITIS MEDIA
Most frequently reported pediatric bacterial infection, with up to 85% of children
experiencing an episode by the age of 3 years .
It is defined by rapid onset of signs/symptoms of inflammation in the middle ear such
as pain, discharge, fever or irritability and bulging tympanic membrane (TM)due to an
effusion or collection of fluid in the middle ear space.
Ref: Expert Opin. Pharmacother. (2014) 15(8):1069-1083 Otitis media: an update on
current pharmacotherapy and future perspectives
5. ACUTE OTITIS MEDIA
It is classified according to its onset, response to therapy, duration and
complications, each of which calls for a specific management plan.
Generally AOM is defined as uncomplicated (no otorrhea), nonsevere (mild
otalgia and temperature < 39C) or severe (moderate-to-severe pain, pain > 48 h,
with temperature > 39C/102.2F)
Otitis media with effusion (OME), a different stage in the otitis media continuum,
indicates asymptomatic inflammation with fluid collection in the middle ear. It may
be a result of Eustachian tube dysfunction (ETD) and precede the onset of AOM,
or it may be a result of inflammatory response following AOM
6. AOM
Uncomplicated AOM
Otitis media without the
presence of Otorrhea
Nonsevere AOM
Mild pain, Fever < 39C
Intense erythema or mild
bulging of the TM
7. AOM
Severe AOM
Moderate-to-severe pain
Duration of pain > 48 h, Fever ‡ 39 C
Moderate-to-severe bulging of the TM
OME
Asymptomatic
Fluid collection in middle ear
8. Chronic OM
Chronic OM with effusion
Persistent effusion > 6 weeks
Chronic suppurative OM
Chronic otorrhea
Leads to damage of structures and
potential
hearing loss
11. Factors Affecting Risk of Acute Otitis Media
Age Maximal incidence between six and 24 months of age;
eustachian tube shorter and less angled at this age. Underdeveloped
physiologic and immunologic responses to infection in children
Breastfeeding Breastfeeding for at least three months is protective;
this effect may be associated with position maintained during
breastfeeding, suckling movements, and protective factors in breast
milk
Daycare attendance* Contact with multiple children and daycare
providers facilitates spread of bacterial and viral pathogens
12. Factors Affecting Risk of Acute Otitis Media
Exposure to cigarette smoke Increased incidence with
cigarette smoke and air pollution, especially if parents smoke
Male sex Slightly increased incidence
Previous antibiotic use* Increased risk of antibiotic treatment
failure
Previous otitis media* Increased risk of antibiotic treatment
failure
Season* Increased incidence in fall and winter
Underlying pathology* Increased incidence in children with
allergic rhinitis, cleft palate, Down syndrome
13. Pathophysiology
An allergy or URTI causes obstruction of the ET which results in accumulation
of middle ear secretions (effusion).
Secondary bacterial or viral infection of the effusion causes suppuration and
features of AOM.
The effusion may persist for wks or months after the infection resolves.
Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella
catarrhalis are the most common bacterial isolates from the middle ear fluid of
children with AOM.
Penicillin-resistant S. pneumoniae is the most common cause of recurrent and
persistent AOM.
14. Diagnostic criteria for OM (AOM)
Rapid onset of symptoms
Middle ear effusion (bulging TM, limited or absent mobility of
membrane and air-fluid level behind membrane)
Signs and symptoms of middle ear inflammation (erythema of TM
and otalgia affecting sleep or normal activity)
19. Chronic supportive otitis media
Chronic suppurative otitis media presents with persistent or recurrent
otorrhea through a perforated TM.
20. Treatment of AOM
Treatment goals in AOM include symptom resolution and
reduction of recurrence.
Most children with AOM have spontaneous resolution within
seven to 14 days
Nasal Decongestant
Antihistamine
Antibiotics
21. Treatment AOM (Symptomatic)
Pain management is important in the first two days after
diagnosis.
Acetaminophen (15 mg/kg every four to six hrs) and ibuprofen
(10 mg/kg every six hrs)
.
22. Treatment AOM (antibiotics)
Antibiotics are recommended for all children younger than six
months, for those six months to two years of age when the
diagnosis is certain.
All children older than two years with severe infection (defined as
moderate to severe otalgia or temperature greater than 39° C.
23. Treatment AOM (antibiotics)
High-dosage amoxicillin (80 to 90 mg/kg/day BD for 10 days) is
recommended as first-line antibiotic therapy in children with AOM.
In children older than six years with mild to moderate disease, a
five- to seven day course is adequate.
First-line treatment with amoxicillin is not recommended in
children with penicillin allergy.
24. Treatment AOM (antibiotics)
Cephalosporins may be used in children allergic to penicillin if there is no
history of urticaria or anaphylaxis to penicillin.
A single dose of parenteral ceftriaxone (50 mg per kg) may be useful in
children with vomiting or in whom compliance is a concern.
If there is no clinical improvement within 48 to 72 hours, initiate
antibiotic therapy in those on symptomatic treatment alone. Patients
who are already taking antibiotics should be changed to second-line
therapy.
25. Treatment of persistent AOM
Second-line therapy include cephalosporins (Cefdinir), and macrolides.
Parenteral ceftriaxone administered daily over three days is useful in
children with emesis or resistance to amoxicillin/ clavulanate.
For children who do not respond to second-line antibiotics, clindamycin and
tympanocentesis are appropriate options.
CT is useful if bony extension is suspected. MRI is superior to CT in
evaluating potential intracranial complications.
26. Treatment of recurrent AOM
Most children with recurrent AOM improve with watchful waiting.
Although antibiotic prophylaxis may reduce recurrence, there are no
widely accepted recommendations for antibiotic choice or
prophylaxis duration.
27. Treatment of OM with effusion
Persistent middle ear effusion after resolution of AOM requires only monitoring
and reassurance.
Children older than two years who have otitis media with effusion must be seen
at 3-6 month intervals until effusion resolves.
Children with hearing loss of 40 dB or more should be referred for surgery.
Tympanostomy with ventilation tube insertion is the preferred initial procedure.
Adenoidectomy may be considered in children who have recurrent otitis media
with effusion after tympanostomy if chronic adenoiditis is present or if adenoidal
hypertrophy causes nasal obstruction.
28. Treatment of chronic suppurative OM
Topical antibiotics (e.g., quinolones, aminoglycosides, polymyxins) are more effective
than systemic antibiotics in clearing the infection in patients with chronic suppurative
otitis media.
Oral or parenteral antibiotics are useful in patients with systemic sepsis or inadequate
response to topical antibiotics. They should be selected on the basis of culture and
sensitivity results.
Tympanoplasty is an option in patients with chronic perforation and hearing loss.
Mastoidectomy is often recommended for patients with chronic mastoiditis.
29. Recommended Therapy
(American Family Physician)
Antimicrobials Dosage Comments
Amoxicillin 80 to 90 mg per kg per day, given orally in
two divided doses
First-line drug
Amoxicillin/
clavulanate
90 mg of amoxicillin per kg per day; 6.4 mg
of clavulanate per kg per day, given orally
in two divided doses
Second-line drug
Cefdinir 14 mg per kg per day, given orally in one or
two doses
As 1st line (in penicillin
allergy)
Cefpodoxime 30 mg per kg once daily, given orally
Ceftriaxone 50 mg per kg once daily, given
intramuscularly or intravenously
30. Topical agents Dosage Comments
Ciprofloxacin/hydrocortisone 3 drops twice daily
Hydrocortisone/neomycin/
polymyxin B
4 drops three to four times
daily
Ofloxacin 5 drops twice daily (10
drops in patients older than
12 years)
Recommended Therapy
(American Family Physician)
32. Clinical Practice Guideline: Otitis
Media with Effusion (Update) 2016
This guideline, however, does not apply to patients <2 months
or >12 years old.
Action Statements
(1) should document the presence of middle ear effusion with pneumatic
otoscopy when diagnosing OME in a child;
(2) should perform pneumatic otoscopy to assess for OME in a child with
otalgia, hearing loss, or both;
(3) should obtain tympanometry in children with suspected OME for
whom the diagnosis is uncertain after performing (or attempting)
pneumatic otoscopy;
33. Clinical Practice Guideline: Otitis
Media with Effusion (Update) 2016
This guideline, however, does not apply to patients <2 months
or >12 years old.
Action Statements
(4) should manage the child with OME who is not at risk with watchful waiting
for 3 months from the date of effusion onset
(5) should recommend against using intranasal or systemic steroids for
treating OME;
(6) should recommend against using systemic antibiotics for treating OME;
(7) should recommend against using antihistamines, decongestants, or both
for treating OME.