Objective Clinical symptoms of otitis media with effusion are rarely brought forward to the guardians of young children who the disease is most prevalent in. This often leads to poor scholastic performances and difficult social interactions. The objective of this study was to identify asymptomatic cases of otitis media with effusion present in individuals with adenoid hypertrophy. Material and Methods In a cross sectional study advocated in Justice K.S.Hegde Hospital, Karnataka India we evaluated one hundred patients above the age of three from August 2016 to December 2017. Candidates who presented with an adenoid nasopharyngeal ratio of more than 0.5 were selected for the study. Individuals who complained of otological symptoms were not considered for the study. Patients cleared of other pathological otological conditions were underwent audiological evaluation with pure tone audiometry and tympanometry for evaluating the middle ear status and hearing loss. Results The study showed a total of 36% of patients evaluated presented with asymptomatic otitis media with effusion. In candidates who presented with a bilateral B tympanogram, 40% had significant conductive hearing loss of more than 25dB. Conclusion An objective test such as impedance audiometry in all patients with adenoid hypertrophy would aid in the diagnosis of fluid in the middle ear, so that timely intervention can be done and possible complications be averted.
Meilodosis is an infection caused by a gram negative bacterium, Burkholderia pseudomallei associated with high fatality rates. This organism is a widely distributed environmental saprophyte found in soil and stagnant water in the endemic regions of south East Asia and 1 Australia. It was first diagnosed in Burma by Captain Alfred Whitmore, and his assistant, C.S. 2 Krishnaswami in 1911. Meilodosis is an emerging pathogen in South India predominantly due to negligent management and a delayed diagnosis.The majority of the cases of B. pseudomallei infections are subclinicalwith the primary modality of transmission being through broken skin. The disease predominantly manifests in individuals 3 with diabetes mellitus, chronic renal disease and alcoholism. The majority of patients present 4 with pyrexia and localized skin ulcerations or abscesses. There is a high incidence of 5 pneumonia and septic shock following contamination. Transmission from a patient by droplet 6 spread is rare even with the presence of pulmonary melioidosis. Meliodosis of the head and neck region is not common, however it accounts for 40% of the cases of supportive parotitis in 7 children in Thailand and Cambodia. Diagnosis can be challenging due to its close symptomatic resemblance to tuberculosis. Isolation of the organism is difficult; this leads to poor identification of the causative agent and mismanagement.
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