To assess the effectiveness of parental entries regarding functional hearing in the Child Health and Development Record(CHDR), in patients with severe to profound hearing loss, and detection of the hearing issues by the public health midwife(PHM)
Material and MethodA descriptive cross sectional study was carried out among parents/caregivers of children with severe to profound hearing loss who underwent cochlear implantation before the age of 5 years from 01.01.2017 to 31.12. 2018 at Lady Ridgeway hospital for children, Sri Lanka. An interviewer administered questionnaire was used based on the hearing assessment in CHDR
ResultsThe age of the mother at the birth of the index child spans from 17years to 50 years. Majority( 64.1% ) had another child older to the index child. The majority were diagnosed between 18-24 months. The age of cochlear implantation spans from 9 months upto 5 years. Average waiting period was 2 years. The correct entries were observed as follows: 20.8% at birth, 22.7% at 1 month and 22.6% at 4 months, 7 months, 9 months and 12 months respectively. Among those who have not marked or marked incorrectly, 45.9% stated that they couldn't recognise the hearing impairment and 23.4% stated they were reluctant to accept it. Only 4% of these children were referred for further assessment by the PHM
ConclusionParental and the PHM's assessment of a child's hearing is not a reliable indicator to detect early sensorineural deafness
IntroductionA large percentage of the population has some degree of deviated nasal septum causing symptoms of nasal obstruction. Nasal septoplasty is the surgery of choice for symptomatic nasal septal deviations. ObjectiveTo describe the patient profile, indications, complications and evaluation of septoplasty outcome using Nasal Obstruction Symptom Evaluation scale. (NOSE) Method:Interviewer administered questionnaire and data collection sheet were the study instruments used for prospective (30 subjects) and retrospective (35 subjects) components respectively. ResultsTwo thirds of the patients were in the 16-30 age group, 42% females and 48% males. 35% had a history of nasal trauma. 53% presented with allergic rhinitis and 20% with turbinate hypertrophy. More than 2/3rd presented with deviations in the Cephalic septum and S Shaped septum. 84% had dislocation from the maxillary crest. More than 90% of the subjects underwent, quadrangular cartilage trimming, vomer removal, perpendicular plate of ethmoid removal and maxillary Crest gouge. Plastic splints were used in 73% of the subjects and antibiotic was used in 26%. No septal perforations, infections or bleeding was reported from any of the 65 subjects. Pre and Post-operative (at 3 months), NOSE score was Mean 9.46; SD 4.36 and Mean 0.53; SD 0.97 respectively. When t-Test: Paired Two Sample for Means was calculated t stat was 11.7153, while t critical two tail value was 2.0452 indicating that there is a statistically significant difference between the two means (p=0.05). ConclusionSeptoplasty gave good results with minimum complications, resulting in significant improvement in disease specific quality of life.
Powered inferior turbinoplasty in children is described in detail in this "How I do it" article. This procedure is not commonly done in either children or in adults in the local setup. The procedure is simple, rarely gives complications and relatively easy. Equipment and instruments needed for this procedure are available in most of our ENT theatres.
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