The Role Of Antibiotics As Treatment For Australian...

The Role Of Antibiotics As Treatment For Australian...
Otitis media (OM) remains to be a major health concern in Australia, with an inexcusably
substantial disparity in the severity and incidence of otitis media, of all its forms, between
Indigenous and non–Indigenous child populations. Specifically, children in Indigenous communities
suffer from chronic suppurative otitis media at rates that far surpasses the 4% threshold that defines
a massive public health concern (WHO, 1996). Currently, the first line of treatment for OM is the
use of antibiotics, which is characteristically used to treat cases of acute otitis media (AOM), with or
without perforation, and chronic suppurative otitis media (CSOM) (Morris & Leach, 2009).
However, with rates of OM in high–risk Indigenous communities failing to decline, the
effectiveness of antibiotic treatment has fallen under questioning. Many studies which have aimed to
investigate the role of antibiotics as treatment in Australian Indigenous children with OM have
yielded diverse conclusions regarding its efficacy. Therefore, the objective of this literature review is
to determine the effectiveness of antibiotics as treatment in Australian Indigenous children with
otitis media.
Literature Review
In Leach, Wood, Gadil, Stubbs and Morris' (2008) study, an investigation was made concerning the
effectiveness of topical ciprofloxin (CIP) drops in comparison to ototopical framycetin–gramicidin–
dexamethasone (FGD) drops in Aboriginal children with CSOM which was recently treated. The
participants
... Get more on HelpWriting.net ...

Otitis Media with Effusion Essay
Otitis Media with Effusion (OME) can be defined as, "The presence of fluid in the middle ear
without signs or symptoms of acute ear infection" (Pediatrics, 2004). It can be said that OME is an
invisible disorder, as there are no immediate signs or symptoms of an acute ear infection such as ear
pain, fever, or displeasure (Williamson, 2007). However, OME can have very significant
consequences in the life of a child. Early identification and monitoring of OME can combat against
possible speech and language delays, as well as protecting against further structural damage to the
middle ear. From a diagnostic standpoint, OME must be differentiated from Acute Otitis Media
(AOM), as the appropriate treatment will depend on if a child is suffering ... Show more content on
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OME can also occur following an upper respiratory tract infection, as the anatomy of a child's
middle ear and eustachian tube are more horizontal, hindering the drainage of fluid and placing them
at higher risk for OME (Williamson, 2007). Other risk factors that make a child more prone to OME
are attending day care, bottle feeding in the supine position, secondhand smoke in the home, a lower
socioeconomic status, and having a large number of siblings (Williamson, 2007).
Given that Otitis Media with Effusion is mostly an invisible disorder without visible symptoms, it
can be difficult to identify in early stages. However, it is imperative that professionals and parents
know the signs and symptoms of such a prevalent ailment in children. The first sign that parents
may notice is that many children with OME fail to respond appropriately to voices or react to
environmental sounds as expected. Middle ear effusion can sometimes results in a conductive
hearing loss of up to 50 dB (Boudewyns, et al. 2011), however hearing loss is not always suspected
at first. Parents and/or teachers may also notice that the child has poor attention problems and
struggles academically. Children with OME may also request that the television be turned up to very
high levels, and also have other audio equipment's volume much louder than necessary.
Furthermore, children with OME may suffer from balance problems and have

Antibiotics For Acute Respiratory Infections
Antibiotics are over–prescribed, and this has contributed to community bacterial resistance to
antibiotics. The use of antibiotics for acute respiratory infections (ARIs) is controversial. The
delayed antibiotic strategy has been advocated as a safety net for uncomplicated ARIs, in an effort to
reduce antibiotic use. The authors conducted the study to evaluate the antibiotic usage, clinical
outcomes, and patient satisfactions for acute respiratory infections (ARIs) of the delayed strategy
compared to immediate and no antibiotic strategies.
1. Are the results of the review valid?
a. Are the studies contained in the review RCTs?
Yes, this review included ten studies, involving randomized controlled trials (RCTs) with a total of
3157 participants. These RCTs met quality inclusion criteria. The delayed antibiotic strategy was
compared to antibiotic used immediately or no antibiotics in the participants of all ages with ARIs.
The authors evaluated clinical outcomes antibiotic use, patient satisfaction, and re–consultation rates
in the three methods.
b. Does the review include a detailed description of the search strategy to find all relevant studies?
Yes, a detailed description of search strategy is included in the review. A large number of database
were searched, such as Cochrane Central Register of Controlled Trials and Ovid MEDLINE,
EMBASE, Science Citation Index – Web of Science, and BSCO CINAHL. The month/year ranges
they conducted the search were provided.

Common Ear Disorders: Case Study
Common Ear Disorders: Case Study
Case 1
1. What organism(s) is most likely causing the patient's chronic infection?
Some of the most common organisms present in chronic suppurative otitis media are, Klebsiella
pneumonia, Staphylococcus aureus, and Pseudomonas aeruginosa (Wright & Safranek, 2009).
Furthermore, many anaerobes and fungi may grow concurrently with the above mentioned species.
However, P aeruginosa is the most typically found organism in an estimated 48–98% of patients
with chronic suppurative otitis media (Aarhus, Tambs, Kvestad, & Engdahl, 2015)
2. What is your immediate treatment plan for this patient?
My treatment plan for this patient would consist in selecting an antibiotic with adequate spectrum of
coverage, performing regular ... Show more content on Helpwriting.net ...
If you did an audiogram, what would you expect to find?
In the case of the Ryan's infection, I would expect to find certain degree of conductive hearing loss.
Case 2
1. What is your most likely diagnosis?
Given the patient's long history of recurrent ear infections, three pressure equalization tubes
placement, described right ear deformity, non–tender lymphadenopathy, and hearing loss, the
diagnosis is probably chronic otitis media with right secondary acquired cholesteatoma.
Nonetheless, it is important to note that the patient does not present other manifestations of
cholesteatoma including, painless otorrhea, dizziness, or central nervous system complications
(Lazard, Roger, Denoyelle, Chauvin, & Garabédian, 2007).
2. What is the most likely treatment plan?
The mainstay management for cholesteatomas is surgical excision (Chary, 2015). Mastoidectomy is
the surgical procedure of choice for cholesteatomas. Routine evaluations every 6–12 months are
required for proper monitoring after surgery.
3. What is Shelby's prognosis?
Shelby's prognosis is very favorable if the cholesteatoma is promptly removed. Nevertheless, Shelby
may experience permanent, moderate conductive hearing loss. On the other hand, the mortality rate
for cholesteatomas is low, and according to Lazard et al. (2007), reoperation for this medical
condition occurs in 5% of patients or

Ear Infection: A Case Study
One of my very close relatives is suffering from an ear infection in the duration of three months. She
has previously suffered from an ear infection earlier in the year, which left her with minimal ear
scaring. During her honeymoon, she caught another ear infection, which resulted in fungus growing
inside of her ear. As the onset pain began to worsen along with hearing deterioration, she went to
San Juan Mercy General emergency room multiple times. The emergency staff simply stated that
they do not have needed equipment to treat her and sent her home with multiple prescriptions for
eardrops and strong painkillers. After multiple and unsuccessful emergency visits, she went to the
UC Davis medical center, where the doctor was able to clean hear ear ... Show more content on
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Since she is a medi–cal recipient her choice of available ENT's was narrowed to a handful.
Another caveat in seeing ENT is that the referral was needed from family doctor. Upon her visit to
the family doctor, the doctor issued a referral that was never sent over to the ENT clinic. After
multiple weeks of severe pain and frustration with the clinic staff, the ENT office staff got the
doctor's referral but as it turns out, her health insurance does not allow her to see ENT without
specialized approval. After she obtained the needed approval, the ENT clinic once again asked for a
doctor's referral. After multiple phones call back and forth over duration of a week, the ENT clinic
got the needed referral, however, the family doctor's clinic referred her to ENT that did not accept
her insurance. After the same error happened twice, the family doctor office finally found ENT that
accepted her insurance. However, to see ENT she had to wait a period of two weeks. The following
week, she woke up in the middle of the night with blood and yellow mucus coming out of her ear
along

Essay On Childhood Otitis Media
Childhood Infections Acute Otitis Media 1. What are the symptoms and causes of this condition?
How does it differ from external otitis? Why are children more susceptible to this condition than are
adults? What are some of the potential complications? Acute Otitis Media is the term used to
describe many inflammatory and infectious conditions in the middle ear that can be caused by either
bacterial or viral infection that is often caused by another illness such as cold or flu. There are many
signs and symptoms of this condition and may include ear pain, which may be worse when laying
down, insomnia, excessive crying, irritability, loss of balance, fluid drainage from the ear, fever and
loss of appetite. Children are more susceptible to this condition due to having ... Show more content
on Helpwriting.net ...
Reye's syndrome was first discovered in 1963, however the connection to aspirin was not discovered
until the 1980's (Scogna 2016). Several methods of testing are used in the diagnosis of Reye's
syndrome such as blood and/or urine testing, spinal tap, MRI, and liver or skin biopsies (Slightham
2016). 8. How common is Reye's syndrome? What are some of the risk factors that are linked to this
condition? Reye's syndrome is less common now because aspirin is no longer recommended for
children. However, according to the New England Journal of Medicine, it likely becomes more
common and prevalent during influenza outbreaks (Balay et al. 1999). Risk factors include taking
aspirin to treat a viral infection, such as an upper respiratory issue, chicken pox or flu and also
having a disorder in which the body's enzymes do not break down fat. This is called fatty acid
disorder. 9. How serious is this syndrome? What can be done to prevent it from occurring? What is
the standard treatment for this

Ear Infections In Longview
Ear infections in Longview, TX are extremely painful and are the cause of many hours of sleepless
nights and crying for a great many infants and toddlers. Since the majority of children pass out of
the chronic ear infection phase when they're very young, few of them have memories of the pain that
can be caused by an ear infection. As adults, when an ear infection occurs, we become acutely aware
of just how bad they can be and how important it is to seek medical help for pain relief as quickly as
possible.
Types of Ear Infections in Adults ▸ Otitis Externa is an infection of the outer ear that's also called
'swimmer's ear' because is it fairly common among swimmers. It is the result of contaminated water
entering the outer ear where ... Show more content on Helpwriting.net ...
▸ Otitis Media is an infection of the middle ear and is most common in children because of the
shape and size of their Eustachian tubes – the tubes that run from the ear canal to the back of the
throat. However, adults whose Eustachian tubes are blocked can develop middle ear infections.
Blockages can result from swelling in the nose and throat caused by allergies, colds or sinus
infections. Infections can also be caused by sticking foreign objects, like Q–tips or car keys, into the
ear.
Symptoms of Ear Infections ▸ Symptoms of Otitis Externa include ear redness, itchiness inside the
ear, flaking of the skin on the ear, pus–like drainage from the ear, pain when the ear is touched and
fever. ▸ Symptoms of Otitis Media include ear pain, fever, drainage from the ear, a feeling of
pressure inside the ear, hearing loss and balance problems.
Treatment of Ear Infections ▸ Swimmer's ear infections in Longview, TX are usually treated with
antibiotic drops. Depending on the severity of the infection, your physician may clean pus and
debris from the

Chronic Suppurative Otitis Media
Introduction: Otitis media is an inflammation of the middle ear cleft without reference to etiology or
pathogenesis. Chronic suppurative otitis media (CSOM) is a destructive disease with irreversible
sequelae and can proceed to serious intra and or extra cranial complications. For the management of
CSOM and for the ENT surgeon to make the discharging ear dry for better results of surgical
procedures like myringoplasty and ossiculoplasty study of bacteriology and antibiotic sensitivity is
necessary.
Materials and Methods: This was a retrospective study conducted in a tertiary care hospital in South
India. Data was obtained from the microbiology records from March 2012 to March 2014. Ear
discharge were collected from them under strict aseptic precautions using two sterile cotton swabs
with the assist of aural speculum and processed immediately in the microbiology laboratory.
Antimicrobial susceptibility testing was done by Kirby–Bauer's disc diffusion method, according to
the guidelines of Clinical and Laboratory Standards Institute.
Results: A total of 176 cases of CSOM were included in the study. Microbial growth was seen in
156 (88.6%) while 20 (12.4%) were sterile. Among 156 ... Show more content on Helpwriting.net ...
Otitis media is divided into acute, sub–acute and chronic [2]. Chronic suppurative otitis media
(CSOM) is a destructive disease with irreversible sequelae and can proceed to serious intra and or
extra cranial complications [3]. The microbiological profile of otitis media depends on the type of
otitis media. Acute otitis media is caused by the most common organisms like Hemophilus
influenzae, Streptococcus pneumoniae, Pseudomonas aeruginosa (P. aeruginosa) and anaerobic
bacteria. A wide range of microorganisms like aerobic (eg: Pseudomonas aeruginosa, Escherichia
coli etc) anaerobic (eg: Bacteroids, Peptostreptococcus etc) and fungi (eg: Candida) are responsible
for CSOM.

Otitis Externa Paper
When a patient presents with otitis media it is important to distinguish if the diagnosis is acute otitis
media or otitis media with effusion (Woo & Wynne, 2012). According to Woo & Wynne (2012)
acute otitis media also known as AOM can be recognized as a fluid that becomes present in the
middle ear that is commonly associated with fever, otalgia, otorrhea, or an immobile tympanic
membrane. Otitis media with effusion presents with the fluid in the middle ear but is absent of other
symptoms of illness as described above. Due to the fact that otitis media only assumes a viral role
about 35 percent of the time and it can clear up within 7 to 14 days without treatment, it is important
to assess the patient's true risks and benefits with antibiotic ... Show more content on
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The prescription would read: Gentamycin otic drops, apply four drops in affected ear three times
daily and at bedtime for 7 days. Allow generics, no refills. Since this is more common in children,
and if the tympanic membrane is punctured or perforated than Ofloxacin drops will be prescribed.
This prescription would read: Ofloxacin otic drops, apply five drops to affected side once a day for a
total of 10 days. Allow generics, no refill. The patient should be advised to avoid any swimming
until healed or approved by a healthcare provider. Education should be provided to instill the drops
and allow a side lying position for several minutes following to ensure that the medication has been
readily absorbed into the area and prevent drainage. If a wick is placed in the ear then reassessment
should be completed within 48 hours. Chronic development of this condition would require more
frequent assessment every couple of weeks to ensure the topical treatment is working and
modifications to the treatment plan can be made (Woo & Wynne,

Surgical Repair Or Reconstruct The Tympanic Membrane With...
Myringoplasty is surgery performed to repair or reconstruct the tympanic membrane with a suitable
graft material. (1)
Tympanic membrane (TM) perforation is commonly a result of middle ear infection, trauma, or a
sequelae of tympanostomy tube insertion and the remainders of traumatic perforations become
chronic and require surgical repair. (2) Without reconstruction the tympanic membrane perforation
result in hearing loss, chronic otorrhea and cholesteatoma formation. (3) These tympanic membrane
perforations can be repaired surgically use Temporalis fascia, perichondrium and cartilage are the
most common grafts which requires a general anesthesia which is often protracted and/or
hypotensive, and which can represent an unacceptable risk in older patients. (4)
Day–stay surgery has become an integral part of modern otolaryngology. Myringoplasty with fat
graft under local anesthesia is a short, simple, cost–effective and minimally invasive technique
compared with traditional myringoplasty. (5)

Acute Suppurative Otitis Media
Acute suppurative otitis media is inflammation of the mucous membrane lining of the middle ear
cleft (consisting of the eustachian tube, tympanic cavity, mastoid antrum and mastoid air cells)
produced by pus–forming organism [1]. It is a disease of multiple etiologies and is well known for
its recurrence. ASOM often starts in infancy, and is among the top common childhood illnesses. It
mainly affects children [2]. Infections usually results from bacterial and fungal causes, and in some
cases secondary to other viral infections like upper respiratory tract infections (URTI) [3]. It may
result in serious complications as mastoiditis, meningitis or intracranial abscess [4]. In the pre–
antibiotic era of the early 1900s, β–haemolytic group A Streptococcus

Aboriginal Health Issues
As early childhood is the critical time for lay down the foundation of life, children's health and
wellness should be given enough attention. If there is any issue appear during this period, the early
intervention is able to change the situation and reap a lifetime of rewards. For many Aboriginal and
Torres Strait Islander children, they are suffering from different health and wellness issues but they
are not given adequate support. Therefore, in order to have a deeper understanding of the Indigenous
children's health and wellness situation, this report will identify Aboriginal and Torres Strait Islander
children's health and wellness issues including three physical issues (obesity, ear disease and
asthma) and factors that pose a threat to ... Show more content on Helpwriting.net ...
The National Quality Standard Quality Area 2 relates to children's health and safety is one of the
most supportive advocacy for Indigenous children when they are in the services. Furthermore, The
Aboriginal and Torres Strait Islander Child Placement Principle has been approved in legislation or
policy in Australia (AIFS, 2014). The principle states the preferred order of placement for an
Indigenous child who has been removed from their birth family (Lock, 1997). The preferred order is
the child's extended family, the second one is the child's Indigenous community and the last one is
other Aboriginal and Torres Strait Islander people (Lock, 1997). The principle acknowledged that
past policies caused suffering to Aboriginal and Torres Strait Islander families and it also cleared the
right of Indigenous parents or families to raise their children in their communities (Lock, 1997).
Furthermore, Indigenous children are protected by other laws and regulations that protect all the
Australian children across the country. In New South Wales, these laws are Child Protection
(Offenders Registration) Act 2000 (NSW), Crimes Act 1900 (NSW), Family Law Act 1975 (Cth),
Children and Young Persons (Care and Protection) Amendment Bill 2009 and other laws and
regulations (AIFS, 2014). The National Framework for Protecting Australia's Children 2009–2020 is
a

Genetic Disorders: Otitis Media
According to Smeltzer, Bare, Hinkle and Cheever (2010), "the ear is a sensory organ with dual
functions – hearing and balance. The delicate structure and function of the ear make early detection
and accurate diagnosis of disorders necessary for preservation of normal hearing and balance." (p.
1802). For infants and children, during regular check–ups, the inner and outer ear are examined and
hearing tests are incorporated to identify any abnormalities, for example, watery or bloody
discharge. Otitis media (OM) is commonly identified in children.
To begin, Tortora and Derrickson (2009) stated that, OM is "an acute infection of the middle ear
caused mainly by bacteria and associated with infections of the nose and throat and bacteria passing
into the auditory tube from the nasopharynx are the primary cause of middle ear infections" (p. 637).
In his article titled, Genetics of ... Show more content on Helpwriting.net ...
408). Similarly, Pilliterri (2010) stated that, "the fluid becomes so thick and tenacious that it is
described as "gluelike". Some children notice a felling of fullness or the sound of popping or ringing
in their ears" (see Appendix One, Figure Two) (p. 1506).
Furthermore, infants and children at risk of OM according to Hirst and Neill (2013) included,
"bottle–feeding, flat, supine feeding and use of dummies (pacifiers)" (p. 407). Not to mention,
Hockenberry and Wilson (2011) stated that, "the eustachian tubes is shorter, wider, straighter and
more horizontal in a child than in an adult, out –of–home daycare is a significant risk factor and
children living in households with many members (especially smokers) are more likely to have OM
than those living with fewer persons." (pp.

Causes And Consequences Of Streptococcus Pneumoniae
BIOL 2164 Pathogen Poster SafeAssign Template
Name: Eyerusalem Gebeyhu
Section:307
ABSTRACT
Streptococcus pneumoniae was discovered by Louis Pasteur in pneumonia patients in 1881. It is a
gram positive coccus that forms short chains or more commonly, pairs and classified in its own
genus, called "Diplococcus". Streptococcus pneumonie is a pneumococcal pneumonia consists about
85 % of all cases of pneumonia. Around ninety two different strains of S. Pneumoniae, collectively
called pneumococci, are known to cause harm on humans. Streptococcus pneumonia is a member of
pharyngeal microbiota that can colonize the lungs, sinuses, and middle ear. They are round shaped,
unpigmented grown for 24 hours. The Individual cells of streptococcus are between 0.5 and 1.25
mm in diameter. They are a fastidious bacterium.
PATHOGEN CHARACTERISTICS
Streptococcus pneumoniae cells are elongated cocci. (Lancet–shaped cocci). When cultured on
blood agar, it become alpha hemolytic which makes it different S. pneumoniae from the beta
hemolytic streptococcus. Colonies of Streptococcus pneumonaie grown for 24 hours are 1–3 mm in
diameter, round mucoid, un–pigmented, and dimpled in the middle because of the death of older
cells. Colonies are alpha hemolytic on blood agar when grown aerobically and beta hemolytic when
grown anaerobically. This bacterium lacks Lancefield antigens but does incorporate a species–
specific teichoic acid into its cell wall. Most of the time, they are

Corbin Ness Research Paper
Two–year old Corbin Ness was born just a few hours before Halloween, so the holiday holds a
special place for his parents Kelly and Justin. His first Halloween costume was a newborn baby's
blanket. A year later, Corbin's parents dressed him up for the holiday as a happy, bug–eyed minion,
from the computer–animated comedy Despicable Me. But after New Year's, Corbin started acting
less than happy due to an ongoing series of ear infections. Each lasting about a week and recurring
every month. This despite several courses of antibiotics from his pediatrician.
"It's very common among young children because the Eustachian tubes in their ears haven't come
into their proper position yet," says Dr. Joseph Scianna of Northern Illinois ENT Specialists in
Sycamore. He's the specialist Corbin's pediatrician ... Show more content on Helpwriting.net ...
He (Dr. Scianna) was rubbing his back and talking to him," Kelly remembers.
After what seemed like an eternity (but was only about 5 minutes) Dr. Scianna came out to the
waiting room to tell Justin and Kelly that the operation a success, and within 10 minutes Corbin was
back in their arms. Dr. Scianna told Kelly and Justin that they might see some bleeding in Corbin's
ears the first day or two or a slight fever, but that was normal and to be expected. By lunchtime on
the day of surgery, to his parent's great relief, he was already playing and acting normally.
Within a few days, something unexpected did happen. Corbin, became much more verbal, even
starting to sing for the first time.
"Justin and I were in the kitchen when all of a sudden, we heard Corbin trying to sing his ABC's for
the very first time.'"
"We were amazed," Kelly recalls still excited. "He had never done anything like that before."
"Corbin has had a couple of minor colds since the surgery and fluid has drained out of his ears...just
the way it's supposed to and for the first time in as long as we can remember, a cold did not turn into
a horrible ear infection," explains

Otitis Media Essay
Otitis Media is a condition that involves the middle ear that presents with inflammation. Otitis
Media with effusion can result with transudation from the middle ear vessels that can lead to chronic
effusion if symptoms are not present (Dunphy, Winland–Brown, Porter, & Thomas, 2015). Acute
otitis media often presents with purulent drainage in the middle ear, fever, otorrhea, and otalgia.
Chronic OM is present when the inflammation occurs over 3 months. Approximately 75% of
children by their third birthday will experience otitis media (Dunphy et al., 2015). By the school age
years approximately 80–90% of children will have otitis media with effusion (Harmes, Blackwood,
Burrows, Cooke, Harrison, & Passamani, 2013). Risks factors for this condition include: age,
allergies, viral infections, exposure to environmental factors such as smoke or other irritants, day
care, family history of ... Show more content on Helpwriting.net ...
Parents can be educated that keeping their infants upright during feedings and breastfeeding, if able
to for at least 6 months can help to reduce the risks (UMM, 2015). Patients families should be
educated on proper vaccination and time sequence and the vaccine Prevnar can help to reduce the
risk of ear infections. Swimming should be avoided until the infection has cleared to reduce
complicating the middle ear (Dunphy et al., 2015). Education should be provided to avoid the use of
cotton swabs or sharp objects to clean the ears to prevent perforation. Blowing of the nose should be
avoided, especially if the tympanic membrane is ruptured. If it must be blown it should be blown as
gently as possible. Folk remedies should not be used in the treatment of this condition and if
symptoms persist after 48 hours patients need to follow up within 48 hours. Patients should be
educated to keep the ear dry during the course of infection and complete the full course of antibiotic

Advantages And Disadvantages Of Baby Dubies
Many moms normally choose to give their babies dummies as they help to soothe them. Baby
dummy is also known as a baby pacifier. It is an effective nipple that is made from rubber, plastic or
silicone. Some of the features of a baby dummy include: a teat, handle and a shield. The shield is
large enough so that the child does not place the whole thing in his or her mouth. This goes a long
way in ensuring that the child does not swallow the dummy or get chocked by the dummy. Most
babies are soothed by the action of sucking. You will realize that your baby needs to suck on
something for comfort when he or she is not feeding. Some babies like sucking dummies when they
wake up. Once he or she gets older, he or she will discover other ways to soothe himself or herself.
What sort of dummy is the best for my baby? Many parents are normally in a dilemma when it
comes to choosing the best dummy for their babies. It is normally a question of trial and error before
you come across a dummy that can please ... Show more content on Helpwriting.net ...
Dummies have both advantages and disadvantages. Some of the disadvantages of using a dummy
include: 1. It can result in repeated middle ear infection. Sucking may actually channel bacteria from
your baby's mouth into the narrow tubes between his ears and throat. If your baby uses a dummy a
lot, it might affect the structure of his mouth. This means that mucus does not drain well as well
along his or her Eustachian tubes. This is the reason why you should limit the amount of time your
baby uses his dummy. Do not let him or her overuse it. It is advisable that your baby uses a dummy
moderately. 2. It affects the way his or her teeth grows. If your baby uses a dummy for a long period
of time, he or she can develop an overbite or crossbite.This is where the top and bottom teeth do not
meet properly. The worst effects are usually seen in children who use a dummy for four years and
above. 3. It makes your baby to take long before learning how to

Essay about Ebt1 Task 2 Wgu
Research Integration
EBT1 Task 2
Types of Sources of Evidence/Appropriateness/Classifications The article from the American
Academy of Pediatrics (AAP) and American Academy of Family Physicians (AAFP) that addresses
acute otitis media (AOM) is a filtered resource. This article is appropriate for use in nursing practice
as it establishes diagnosis and management guidelines for the treatment of AOM. In addition the
article recommends treatment options for the symptoms of AOM and addresses the concept of
watchful waiting. The is an evidence based guideline as it provides recommendations for practice
and was created a systematic review and best clinical research in clinical literature. The Block
article, Causative Pathogens, ... Show more content on Helpwriting.net ...
The prescribing of antibiotics for AOM can have an impact on the health of the treated children and
increases the cost of providing care. Watchful waiting is the recommendation from the AAFP &
AAP in cases of uncomplicated AOM that are a result of other illnesses such as an upper respiratory
virus. In the past doctors would immediately prescribe antibiotics for the signs and symptoms of an
ear infection, however new evidence shows that over time bacteria have become resistant to certain
antibiotics and so other means of treatment must be explored. If a child presents with symptoms of
AOM and has no other underlying illness or condition, then watchful waiting is an appropriate
avenue of treatment for the child. The research showed placebo trials had favorable outcomes and
children responded without antibiotic interventions. If watchful waiting is used the child is not
exposed to unneeded antibiotics and this reduces the chances of antibiotic resistance in the future. In
addition, it also reduces the amount of money spent on health care needs in the form of purchasing
medications. It should be noted that watchful waiting should only be considered in cases of
uncomplicated AOM and that education should be given to care givers on when to follow up if
symptoms do not improve within 48–72 hours. In the even that symptoms do not resolve then
antibiotics may become necessary.
Application

Streptococcus Pneumoniae ( S. Pneumoniae Essay
1. INTRODUCTION
Streptococcus pneumoniae (S. pneumoniae) also known as pneumococcus is an important
commensal bacterium of global significance that represents a leading cause of morbidity and
mortality worldwide. The bacteria initially establish an asymptomatic infection in the nasopharynx
of infected persons, a fundamental precursor for development of pneumococcal disease [1] and
horizontal dissemination of the pathogen to other individuals within the community (2].
Transmigration of the bacteria across the mucosal epithelium of the nasopharynx results in spread of
the bacteria and establishment of diseases. Infections caused by S. pneumoniae ranges from
superficial and non–invasive infections of mucosal tissues of the upper respiratory tract (sinusitis
and acute otitis media) to severe and life threatening, invasive pneumococcal diseases (IPDs) such
as sepsis, meningitis and bacteremic pneumococcal pneumonia. Bacteremia is the most common
form of IPD and therefore bacteremic pneumococcal pneumonia is responsible for the majority of
deaths due to pneumococcal infection [3, 4]. On a global scale pneumococcal infections are
responsible for the death of 1.6 million people annually [4]. Young children, particularly in low–
income countries, the elderly, the economically deprived as well as those with HIV/AIDS bear a
disproportionate share of the disease burden. Children under the age of 5 years account for the
majority of deaths with an estimate of 0.7 to 1 million deaths each

Evidence Based Practice For Pediatric Patients
Abstract: Evidence–based practice plays a critical role in the care of pediatric patients. Evidence–
based practice requires health care professionals to research and implement new evidence into their
nursing practice. New evidence can be used in all fields including pediatrics. It requires health care
professions to invest time outside of work to be able to access new research. Many barriers stand in
the way of implementing new protocols and procedures. Implementation can be supported with the
help of advocates to help further the process of adding new protocols and procedures. Standards of
practice are an essential to caring for patients in any field. Evidence–based practice has brought
about new protocols in assessing pain in pediatric patients in the emergency department, ways to
reduce antibiotic resistance in children, and even helps nurses to determine the normal vital signs in
pediatric patients.
The medical field is an ever–changing place. New medications, techniques, and products are coming
out every day. With all these new items, there needs to be current clinical evidence that proves the
effectiveness of such techniques and products and whether they can benefit a patient. In many
settings, nurses tend to use practice traditions that they use on a daily basis as part of a habit. With
new evidence, practice tradition interventions no longer support the actions. This is where evidence–
based practice comes into play. Evidence–based practice can be broken down into

Management of Acute Otitis Media Essay
Acute Otitis Media (AOM), inflammation or infection of the middle ear, is an illness most parents
have had experience with. Countless hours of lost sleep and worry secondary to their child's pain
and distress can keep even the most seasoned parents awake at night. Before the age of 36 months,
83% of children will experience 1 or more ear infections and AOM is the most common reason for
office visits of preschoolers in the United States (Zhou, Shefer, Kong & Nuorti, 2008). The graphic
below serves as a review of evidence and explores the usefulness of the information in relation to
the option of watchful waiting in the management of AOM.
Review of Evidence
Evidence to Evaluate Type of Source
General information, filtered, or ... Show more content on Helpwriting.net ...
Evidence Summary (Kelley, Friedman & Johnson, 2007)
Current Pediatric Diagnosis and Treatment
Ear, Nose and Throat General Information Yes: Useful, general referenced information from a
pediatric medical book that discusses diagnosis and management of AOM. Reference to studies and
data within the text.
Specific, useful discussion of watchful waiting as a treatment option. None of these. General
information with references to data and studies within the book. (McCracken, 1998)
Treatment of Acute Otitis Media in an Era of Increasing Microbial Resistance
Pediatric Infectious Disease Journal Unfiltered Yes: Discussion and summary of evidence about
studies on bacterial agents, antimicrobial resistance and considerations in selection of an antibiotic
regimen.
While not specifically focused on watchful waiting, this article discusses studies and gives data on
rates of spontaneous resolution of AOM without use of antibiotics. This is useful evidence in
support of watchful waiting as an option. Evidence Summary
Results from interviews with parents who have brought their children into the clinic for acute otitis

media. General Information Yes: Review of this information is useful because it gives insight into
parental point of view, parental reported history and symptoms and the degree of parental

Diseases: Otitis Media with Effusion Essay
Otitis media with Effusion (OME)
The Ear
The ear is made up of an outer (external), middle and inner ear. The outer and middle ear is mainly
involved in transmitting sounds to the inner ear where that sound is processed. The first step in this
process involves sound waves entering the external auditory canal and passing the tympanic
membrane (otherwise known as the eardrum– this separates the outer ear from the middle ear)(
Vander A, Sherman J, Luciano D, 2001). As small air molecules (sound) passes through the
tympanic membrane they cause it to vibrate and these vibrations are then passed onto the middle ear
(Moore KL, Agur MRA, 2002). The middle ear formed from 3 tiny bones (malleus, incus and
stapes)– known as auditory ossicles then ... Show more content on Helpwriting.net ...
In certain people the infection may present again from time to time and they may need similar
treatment again. Most of the time this will be due to a viral illness (cold) however sometimes it may
be due to a bacterial infection– particularly if the patient has a high temperature, pain does not settle
after a few days or the patient feels sick and is not able to eat and drink much (Collier J, Longmore
M, Brinsden M, 2006). If it is due to a bacterial illness than more often than not it will need
antibiotics to settle it down. According to NICE guidelines (NICE is a body which advises clinicians
how to treat certain conditions) antibiotics are needed in
1. children under the age of 2 with otitis media affecting both ears
2. or when there is discharge with otitis media affecting one or both ears,
3. or if the child has any condition that may weaken his immune system
4. or if they have any medical conditions affecting their lungs or heart
5. or if it goes on for longer than 4 days
6. if the child is unwell with sickness, vomiting, temperature etc.( National Institute for Health and
Care Excellence clinical guideline 69, 2008)
Otitis media with effusion
Otitis media with effusion also sometimes known as secretory otitis media or glue ear is chronic
(over long time) accumulation and build–up of fluid behind the ear drum (tympanic membrane) in
the middle ear (National Institute for Health and Care Excellence clinical

Medication Synthesis Research Paper
Medication Synthesis Week One The patient is an eight–year old girl who is taking hydrocortisone,
neomycin, and polymyxin eardrops for the diagnosis of a bacterial ear infection. The dose is 10mg
(1%)/3.5mg (0.35%)/10000 units/10ml and was instructed to take this medication every six to eight
hours with three drops in the affected ear. The medication has multiple classes since this medication
contains multiple drugs. Hydrocortisone is a corticosteroid medication that works to decrease
inflammation within the ear. Neomycin and polymyxin are within the antibacterial class and work to
combat infection. The combination of the drug helps to eliminate the bacteria within the ear;
decrease pain, redness, and itching that were accompanying her bacterial

Otitis Social Media
the world keeps growing and changing, people have more opportunity to find information about
almost anything. Technology such as social media, internet research websites like Google, and apps
available in their phones, are making it more accessible at every hour or place. This has shape the
health industry in many positive and negative ways, positive because it provides with knowledge to
the patients about signs and symptoms, treatment, and preventions, and negative because it could be
an inappropriate knowledge causing it to be more difficult for the health care provider to diagnose
and implement the right treatment and even could cause the patient to follow the treatment regimen
wrong. In this research paper I will talk about Otitis Media ... Show more content on
Helpwriting.net ...
This information could confuse the parents of the child in not thinking about an infection, therefore,
not providing sufficient importance in the antibiotic regimen, causing the infection to reoccur or the
organism to become resistance to the antibiotic. This website also said that the first line of treatment
is Broad–spectrum antibiotic. This information is inappropriate because the first approach should be
to monitor the infection to resolve without the use of antibiotic, helping the body to build immunity
and also prevent too much used of antibiotic putting the child at risk of opportunist infections.
(WebMD, LLC,

How Myringotomy Is A Surgical Procedure
Myringotomy is a surgical procedure in which a small incision is made in the eardrum (the tympanic
membrane), usually in both ears. The English word is derived from myringa, modern Latin for drum
membrane, and tome, Greek for cutting. It is also called myringocentesis, tympanotomy,
tympanostomy of the tympanic membrane. Fluid in the middle ear can be drawn out through the
incision. Ear tubes, or tympanostomy tubes, are small tubes open at both ends that are inserted into
the incisions in the eardrums during myringotomy. They come in various shapes and sizes and are
made of plastic, metal, or both. Eustachian tube is a 35mm long auditory tube, functions to connect
the middle ear to the upper pharynx. They are left in place until they fall out by themselves or until
they are removed by a doctor. Fluid collection that lasts longer than three months and does not
respond to drug treatment. This condition is also called glue ear. Myringotomy is the recommended
treatment if the condition lasts four to six months. Effusion refers to the collection of fluid that
escapes from blood vessels or the lymphatic system. In this case, the effusion collects in the middle
ear. Acute inflammation of the middle ear with effusion is treated with one or two courses of
antibiotics . Antihistamines and decongestants have been used, but they have not been proven
effective unless there is also hay fever or some other allergic inflammation that contributes to the
problem. Myringotomy with or

Otitis Media Case Study
bathing in unhygienic water was known to increase the risk of chronic suppurative otitis media
(Sabella, 2000). It seems that well–serviced swimming pool may help in clearing discharges from
the middle ear space(Pringle, 1993). However, some studies suggested this may not be the case
(Lee, Youk, & Goldstein, 1999). And a more recent international investigation suggested swimming
pools with improved hygienic facilities have no obvious benefit to other otitis media subtypes such
as acute otitis media(Bernard, Carbonnelle, Dumont, & Nickmilder, 2007).
Nevertheless, studies done in Australian Indigenous communities revealed a lower rate of chronic
otitis media in rural Indigenous communities with swimming pools or natural swimming
waters(Hudson ... Show more content on Helpwriting.net ...
Simply the status of Indigenous is a significant risk factor for all types of otitis media. The
prevalence of acute otitis media among Indigenous children can go up to 30%(HPE, 2009), which is
far beyond the percentage (4%) specified by WHO as a massive public health issue.
Some studies have been conducted to investigate the possibility of the involvement of a genetic
predisposition to the high prevalence of otitis media among Indigenous populations (Klein, 1994).
However, poverty and social disparities as major health risks should not be overlooked.
Otitis media in Australian Indigenous population is both under–recognized and under–
reported(Jervis–Bardy et al., 2014). The studies reviewed here showed that otitis media in
Indigenous populations starts earlier, lasts longer with a more severe manifestation compared to the
general population. Poor living conditions and household infrastructures, exposure to environmental
smoke contribute to a higher risk of otitis media in Indigenous children. However, recent studies on
the impact of swimming pools and breastfeeding negates the findings of previous researches.
Nevertheless, the unacceptably high prevalence of otitis media among Indigenous population is the
result of multiple factors including medical, socio–cultural, environmental and political elements.
All

The Effects Of Otitis Media On Children
Numerous therapeutic conditions, for example, those recorded beneath, can influence your listening
to wellbeing. Treatment of these and other listening to misfortunes can frequently prompt enhanced
or reestablished hearing. In the event that left undiscovered and untreated, a few conditions can
prompt irreversible listening to disability or deafness. On the off chance that you think that you or
your adored one has an issue with their listening ability, guarantee ideal listening to medicinal
services by looking for a restorative finding from a doctor.
OTITIS MEDIA
The most widely recognized reason for listening to misfortune in kids is otitis media, the restorative
term for a center ear disease or aggravation of the center ear. This condition can happen in one or
both ears and basically influences kids because of the state of the youthful Eustachian tube (and is
the most incessant finding for kids going to a doctor). At the point when left undiscovered and
untreated, otitis media can prompt contamination of the mastoid bone behind the ear, a burst ear
drum, and listening to misfortune. In the event that treated suitably, listening to misfortune identified
with otitis media can be reduced.
TINNITUS
Tinnitus is the restorative name showing “ringing in the ears,” which incorporates commotions
going from noisy thundering to clicking, murmuring, or humming. Most tinnitus originates from
harm to the infinitesimal endings of the listening to nerve in the internal ear. The

Otitis Media Essay
Otitis media, otherwise known as an ear infection, is a very common occurrence in children seven
months up to fifteen years of age. Specifically, this type of ear infection is categorized as an
inflammation of the middle ear, and subcategorized into either acute otitis or chronic otitis media. It
begins with a bacterial or viral infection from the throat that spreads into the ear, causing a fluid
backup in the middle part of the ear. "It is estimated that, by the time they reach two years of age, all
the children in the United States currently under that age will have had a total of 9.3 million
episodes of acute otitis media, and that approximately 17 percent of children have three or more
episodes during a six–month period (Berman 1995). ... Show more content on Helpwriting.net ...
Predisposing agents that can lead to higher risk are colds, upper respiratory infections, exposure to
air irritants (such as tobacco smoke), and children who have down syndrome or cleft palate.
Bacterial pathogens that are common be the eight–five percent of the causation to otitis media can
range from streptococcus pneumoniae (pneumococcus), nontypable hemophilus influenzae,
pseudomonas, and moraxella. However, it is much easier to contract an ear infection than spread it,
and although it is the child is suffering from the pathology the most, it also causes parents to have
greater anxiety and stress as well as disrupt average work and school cycles in daily living.
Symptoms and signs of otitis media can range from a combination of earaches, fever, and fussiness
in small children. Fluid buildup known as middle–ear effusion due to otitis media can cause
temporary hearing loss, and the fluid buildup in the ear can leak into the ear canal. Acute infections
of otitis media differ from chronic because they typically are short–lasting with a rapid onset.
Symptoms exhibited can range from vomiting, fever, pain, loss of hearing, inflammation of the
tympanic membrane, and often are a result from viral upper respiratory infections. Although over
diagnosed, there are certain methods to distinguish Acute Otitis Media (AOM); "the

The Medical Field Is An Ever Changing Place
The medical field is an ever changing place. New medications, techniques, and products are coming
out every day. With all these new items, there needs to be current clinical evidence that proves the
effectiveness of such techniques and products and if they can benefit a patient. In many settings,
nurses tend to use practice traditions that they use on a daily basis as part of a habit. With new
evidence, practice tradition interventions no longer support the actions. This is where evidence
based practice comes into play. Evidence based practice has five phases, ask the clinical question,
search for the evidence, critically appraise the evidence, apply the evidence to practice, and evaluate
the effectiveness of the evidence. Community nurses come face to face with many barriers that
impact their ability to incorporate evidence–based practice into nursing. Attitudes, beliefs,
experiences, autonomy, design considerations, access to training, time and resources, support and
implementation are just a few of those barriers. Although nurses can gain access to research through
items such as medical journals, they have such limited amount of time to actually absorb such
information due to their hectic work schedules. Typically research is not an inclusive role for many
nurses therefore it is considered a job that is done after working hours. Nurses perceive the job of
nursing to be based more on routine than on evidence. Nurses are used to doing a certain procedure
one way and when a

Acute Otitis Media Research Paper
Acute otitis media: Is the blockage of the eustachian tube that connects middle ear to the nose by
fluid, mucus, and pus; causing pressure, pain, and fever accompanied by irritability (CDC, 2017).
Acute Otitis Media often resulting from bacterial or viral infection of the fluid in middle ear. The
most common bacterial pathogen that cause Acute otitis media is Streptococcus pneumoniae. But
other bacteria like Haemophilus influenzae and Moraxella Catarrhalis are also causing acute otitis
media. The most common virus that cause acute otitis media are: Rhino virus, Influenza virus, adeno
virus, and respiratory syncytial virus. (CDC,2017). According to carman, children are more
susceptible for acute otitis media because the shortness and horizontal positioning of their
Eustachian tube, limited response to antigens, and lack of previous exposure to common pathogens
or the immaturity of their immune system (Carman, 2016). ... Show more content on
Helpwriting.net ...
Children older than 3 years of age may have rhinorrhea or a runny nose, vomiting, and diarrhea. In
contrast, younger children often have nonspecific signs and symptoms that manifest as ear tugging,
irritability, nighttime awakening, and poor feeding. Key diagnostic criteria include ear pain that
interferes with activity or sleep, tympanic membrane erythema (redness), and middle ear effusion.
Perforation of the tympanic membrane may occur acutely, allowing purulent material from the
middle ear to drain into the external auditory canal. This may prevent spread of the infection into the
temporal bone or intracranial cavity. Healing of the tympanic membrane usually follows resolution
of the

Ear Infection Symptoms : True Explanation, Diagnosis And...
Ear Infection Symptoms – True Explanation, Diagnosis And Treatment
By Cody Wilkerson | Submitted On March 26, 2011
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Otitis, the medical term for ear infection, does not sound threatening to a lot of people. However,
when the ear gets infected, ear infection symptoms can cause enough discomfort that can compel a
person to seek immediate medical attention.
The human ear anatomy has three basic parts, each with unique functions: the outer ear, the middle
ear and the inner ear. Categorizing each ear infection and their corresponding clinical manifestations
are dependent on the affected part.
Otitis Externa
Outer ear infection, also known as otitis externa, has a high prevalence among children and
swimmers. It is often caused by swimming in polluted water, hence, the term "swimmer 's ear".
Children tend to scratch their ears often with their fingers or use contaminated objects like cotton
buds and this can lead to injury and microscopic tears in ear skin integrity. Children also at times
place foreign objects in the ear that can get lodged within the ear canal.
The pinna (the visible part of the ear) and the external auditory canal are

Symptoms And Treatment Of Kartagener 's Syndrome
Kartagener's syndrome is an autosomal recessive disorder affecting the cilia within the body.
Autosomal recessive means that one or more of both the parent's genes responsible for encoding the
cilia's structure are mutated. This essay will focus on the etiology, clinical manifestations and
anatomic alterations while also exploring diagnostic and treatment modalities. Cilia are the tiny
hair–like structures found in many organ systems including the respiratory and reproductive
systems. It was diagnosed by a Swedish physician Manes Kartagener in 1933 (). Since Kartegner's
syndrome is a autosomal recessive disorder each child of the affected parents have a twenty five
percent chance of developing the syndrome. According to Zariwala,"it is estimated that in the
United States, there are 12,000 to 17,000 people who have the condition" (Zariwala). Kartagener's
syndrome often presents as a newborn suffering from mild to moderate respiratory distress. As the
neonate transitions into extrauterine life, tachypnea and the need for supplemental oxygen is often
apparent. Many babies affected by the disease also have persistent crackles or rhonchi when
auscultating their chest. Some patients may also have an wheezes similar to patient's with
asthma(Bergström, Sten–Erik). This is caused by the inability for the neonate to clear the secretions
from their airway. When performing a physical assessment of the chest you will often find that there
is a hyper resonant percussion note, as well

Retropharyngeal Abscess Research Paper
Introduction A retropharyngeal abscess is a collection of pus in the back of the throat usually caused
by a bacterial infection. This infection can make it difficult to swallow and breathe normally. This
can be a serious condition that requires immediate medical attention. What are the causes? This
condition is usually caused by a bacterial infection. In adults, a retropharyngeal abscess is often
caused by a spine infection. In children, a retropharyngeal abscess is often caused by an upper
respiratory illness. When a lymph node in the retropharyngeal area gets infected, it can become
filled with pus and cause swelling. What are the signs or symptoms? Symptoms of this condition
include: Swelling, pain, and tenderness on one or both sides of

midterm 554 Essay
Grading Summary These are the automatically computed results of your exam. Grades for essay
questions, and comments from your instructor, are in the "Details" section below. Date and Time
Started: 9/30/2014 4:52:19 PM Time Spent: 1 h , 28 min , 07 secs Points Received: 42 / 100 (42%)
Question Type: # Of Questions: # Correct: Multiple Choice 50 21 Grade Details – Missed Questions
Question 1. Question : A 32 Y/O female present to the clinic with 2 week H/O stabbing jaw pain
8/10 with lightening–like sensation along the eye and over the forehead. No meds taken for relief,
afebrile at home, no facial trauma or head injuries in past. Upon examination, you palpate crepitus
in the TMJ area with opening and closing of mouth. The most ... Show more content on
Helpwriting.net ...
Question : You are performing a skin assessment on a 75 year old female, based on your knowledge
of structural and functional changes of the skin, all of the following statements are true except:
Student Answer: Decrease in the thickness of the dermis Decreased vascularity and increased
fragility of existing capillaries Increase in the number of sweat glands Decreased inflammatory
response Points Received: 0 of 2 Comments: Question 14. Question : Which of the following should
be considered for hypertensive therapy in a 66 Y/O woman with CHF? Student Answer: Verapimil
HCTZ Cardura Fosinopril Points Received: 0 of 2 Comments: Question 20. Question : You have
diagnosed a 55 Y/O CM with COPD. What are effective first line therapy? Student Answer:
Bronchodilators Anticholingergics B2 adrenergic agonist Theophylline Points Received: 0 of 2
Comments: Question 23. Question : A 25 Y/O male present with acute sinusitis. Based on your
knowledge, the most likely causative organisms include all of the following except: Student Answer:
Streptococcue pneumonia Legionarraire Haemophilus influenza Moraxella catarrhalis Points
Received: 0 of 2 Comments: Question 24. Question : Secondary prevention strategy for a 76 year
old female with COPD include: Student Answer: Administering influenza vaccine Checking

Ear Pain Research Paper
Ear pain can be in or near the inner ear or distant such as referred pain from a distant site. Ear pain is
referred to as Otalgia. Inner ear pain known as otitis media occurs when infected fluid is present in
the middle ear of the affected ear. This is frequently related to symptoms form a virus or by a
bacterial infection. In contrast, the outer ear pain is outside or externa to the tympanic membrane.
This is otitis externa. It may be caused by a foreign object, earwax, and even mastoiditis. Acute
otitis media however is the most common cause of adult and pediatric ear pain (Sullivan, 2016).
The first assessment is thorough history and physical exam. A thorough history should include the
symptoms or events leading to the pain. A complete

Symptoms And Treatment Of Laryngopharyngeal Reflux ( Lpr )
Introduction
Laryngopharyngeal reflux (LPR) disease is defined as the backward flow of stomach content up to
the throat. It has a wide variety of symptoms in the paedi–atric population, and is usually associated
with many otolaryngological problems such as laryngitis, pharyn–gitis, rhinosinusitis, eustachian
tube dysfunction, recur–
rent otitis media, and otitis media with effusion (OME).1–6
Tasker et al. demonstrated that pepsinogen and pepsin could be found in the middle–ear fluid of
OME patients, indicating that LPR disease could be a significant aetiological factor in the
development of OME.7 Helicobacter pylori, a Gram–negative, micro–aerophilic bacterium that can
cause infection of the stomach, is likewise strongly linked to LPR ... Show more content on
Helpwriting.net ...
The local ethics committee had approved the study.
Procedure
A pilot study was conducted, in which 10 children with OME, with positive H pylori stool antigen
results, were subjected to ventilation tube insertion under general anaesthesia. Middle–ear fluid was
aspirated with a micro–aspiration cannula (blood contamination was entirely avoided; effusion
samples were collected under completely sterile conditions). Gastric lavage was performed with an
orogastric Nelaton catheter. This was inserted into the stomach, and 10 cc of saline solution was
injected and subsequently aspirated back into the injector. All ear and gastric lavage samples were
processed within 4 hours of collection. They showed positive reactions for catalase, oxidase and
urease. In addition, polymerase chain reaction ana–lysis revealed that all were positive for H pylori
infection.
For the main study, all stool samples of the 258 chil–dren diagnosed with bilateral OME were
examined for H pylori using the H pylori stool antigen test.12 In total, 124 children were negative
for H pylori stool antigen and received standard OME therapy of amoxicillin–clavulanate (90
mg/kg/day)13 for 4 weeks. A total of 134 children were positive for H pylori stool antigen. The H
pylori positive children were equally and ran–domly allocated either to a control group or a study
group, each with 67 children. The control group

Ear Infection Essay
When I was a few months old I began to get ear infections. Overtime these ear infections began to
get worse. Then my parents realized that water was the cause of my infections. Whenever water
went into my ear, the next day I would get an ear infection. Due to this, I couldn't go on school field
trips to the local pool, I couldn't go in a pool when I went to a family party, I had to cover up my
ears whenever I showered, and I always had to sit in the front of the class because I was slowly
losing my hearing. I had over 5 surgeries to fix the problem and the last 2 were the ones that
worked. The first doctor I went to for years told my parents that everything was fine but it turned out
he was incorrectly diagnosing me and things were getting

Rotten: The Garlic Industry In The United States
Over the past decades, the popularity of garlic has increased, and its uses have become more
common. This has caused the consumer's demand for garlic to increase therefore causing more
sellers to enter this market to take advantage of the profits that could be made. The documentary
"Rotten: Garlic Breath," shows the relationship between American and Chinese producers of garlic
over the timespan of this boom in garlic demand. China, being one of the largest garlic producers in
the world, also has one of the lowest costs of production due to economies to scale. The cheaper the
garlic is to produce, the more profit could be made, so naturally China began importing to America,
where demand for garlic was high. China's extremely low prices result in "dumping," the act of
selling a foreign product in the United States for an unfairly low price, causing a ... Show more
content on Helpwriting.net ...
China's highly elastic supply of garlic relied on avoiding the tax in order to keep production cost low
and profits high. American producers not being able to generate enough profit would lead to their
eventual exit of the market, causing American jobs to be lost to the cheap labor of China, some of
which is forced prison labor. Farmers in the United States face many negatives effects because of the
garlic industry in America being taken over by Chinese firms. The FGPA, or the Fresh Garlic
Producers Association, is against dumping and is supposed to helping fight against the growing
imports from China and stand up in the interests of American farmers. The largest member of the
FGPA is Christopher Ranch, who has actually been working with the FGPA and using a loophole to
keep Harmoni for having to pay the anti–dumping tax. For American farmers, this means that their
business will continue to suffer in comparison the Chinese companies because they are not able to
offer the same lower prices without giving up making a

Personal Narrative: My Ear Infection
I was staying home from school, because my ears hurt. So my mom took me to the urgent care up
the street because, it wasn't like me to stay home from school. The diagnosis was an ear infection
and a bronchial infection. They gave me this medicine called amoxicillin for my ear infection.
Then we left for Christmas break to Colorado we lived in AZ at the time. I was on medicine the
whole time while on vacation. I finished my last dose the last day we were in CO. On our plane ride
back is when all the real trouble began. We are the plane and my ears popped and I started crying.
¨It's probably justs the air pressure let's get off the plane and they will feel better hopefully,¨my mom
said from the row next to us. So later that week I didn't get any better so my mom assumed I still
had my ear infection. We went to the doctor sure enough I had a double ear infection so they
prescribed me prednisone to dry me out with a Z pack.
I still was not feeling great. So yet again another Drś appointment. This time they told my mom I
was faking and there was nothing wrong with me. My mom got mad and we left we tried a pediatric
doctor and they said we couldn't find anything there is no damage to the ear drum so they said give
this number a call and they will be able to help you. ¨He is my buddy that ... Show more content on
Helpwriting.net ...
I was on medicine the whole time while on vacation. I finished my last dose the last day we were in
CO. On our plane ride back is when all the real trouble began. We are the plane and my ears popped
and I started crying. ¨It's probably justs the air pressure let's get off the plane and they will feel better
hopefully,¨my mom said from the row next to us. So later that week I didn't get any better so my
mom assumed I still had my ear infection. We went to the doctor sure enough I had a double ear
infection so they prescribed me prednisone to dry me out with a Z

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