Background: Chronic rhinosinusitis (CRS) is a prevalent disorder affecting up to 2% of the world population with a significant impact on the quality of life. Not only is it common, it is also the type of nasal disease with greater propensity for morbidity. The study was done to identify bacteria causing CRS and to obtain information regarding the antibiotic sensitivity of the organism. Materials and methods:A prospective study was done on 109 patients with CRS, undergoing endoscopic sinus surgery. Swabs were obtained from the maxillary sinuses and sent for bacterial cultures and sensitivity tests.Results: Hundred patients (91.7%) were positive for pathogenic organisms. Among them, Gram-positive cocci were seen in 77%, methicillin-sensitive Staphylococcus aureus was found in 49 patients and was the most common organism isolated. This was followed by methicillin-resistant S. aureus (MRSA) in 15 patients and coagulase-negative Staphylococcus (CoNS) in 13 patients. These organisms were most sensitive to Linezolid (96.1%) and least sensitive to Ampicillin and Clindamycin (54.4%). Gram-negative bacilli included Pseudomonas in 11 patients, Klebsiella in 5 patients, and Proteus, Enterobacter, and Fusobacterium one in each patient (3 patients). All the Gramnegative organisms were sensitive to Piperacillin-Tazobactam (100%) and showed 86.9% sensitivity to Amikacin, Imipenem, and Ceftazidime. Conclusion:Our study showed there is rise in the number of methicillin-sensitive S. aureus (MSSA) cases compared to other studies. All organisms isolated in our study showed resistance to majority of the oral and parenteral antibiotics. We also observed an increase in the number of Gram-negative rods, mainly Pseudomonas aeruginosa, and Klebsiella spp., and hence, antibiotic prescription should be streamlined to minimize the chances of rising trend in antibiotic resistance.
BACKGROUND Deflected nasal septum (DNS) is the commonest septal problem in ENT practice. The most painful and unpleasant part of this procedure is during removal of nasal pack. AIM Our study aims to compare the results of septoplasty with and without post-operative nasal packing and thereby assess the necessity of nasal packing after septoplasty in terms of patient's comfort, effectiveness at controlling the haemorrhage. METHODOLOGY In our study, 80 patients who underwent septoplasty in our institution during the period July 2014 till April 2015 were simply randomised into two groups, 1 group received post-operative packing and for the other group of 40 patients, nasal packing was not done and their symptoms assessed and compared on post-operative day 1, after 1 week and 1 month and results were analysed. The following symptoms nasal obstruction, headache, bleeding, irritation of eyes, mouth breathing, running nose, ear ache, fullness, disturbed sleep, loss of smell or taste and crusting were assessed. Patients who underwent septoplasty with turbinectomy or MMA or FESS were excluded from the study. RESULTS Among the 80 patients who participated in the study, predominant were males (67.5%) and the predominant age group was 11-20 years. On comparing the nasal symptoms on post-operative day 1, there was significant difference between the study and control groups in the symptoms, headache, nasal obstruction, irritation/watering of eyes, mouth breathing, earache, ear fullness, disturbed sleep, loss of smell/taste, crusting, showed statistically significant difference among both the groups whereas bleeding, nasal discharge were not significant. On comparing the symptoms after one week, nasal obstruction, mouth breathing, crusting and loss of smell had statistically significant values and bleeding and irritation of eyes were not present in both the groups. After one month when the symptoms were compared, none of them were statistically significant. CONCLUSION Nasal packing following septoplasty is thought to stabilise the remaining septum and prevent complications such as bleeding, septal haematoma, and formation of synechiae. Quilting sutures can effectively serve all these purposes. Also helps to avoid post-operative discomfort to the patient and decreases hospital stay. Hence packing can be reserved for special situations rather than using it in all cases.
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