<p class="abstract"><strong>Background:</strong> In selection of a graft tissue factors considered include its biological properties, probability of survival, its adequacy in size and ease of procurement<strong> </strong>The present study aims to preoperatively predict hearing improvement by paper patch test and compare with postoperative hearing improvement i.e. pre and post operatively hearing assessment.</p><p class="abstract"><strong>Methods:</strong> The study was conducted on 25 cases undergoing myringoplasty with Fascia lata and Temporalis fascia as a graft material among the patients fulfilling the standard criteria for myringoplasty i.e. pars tensa perforation, good cochlear reserve, dry ear and normal eustachian tube function were considered for surgery. Myringoplasty was done from post aural route for harvesting fascia temporalis graft &amp; from upper 1/3rd of thigh laterally to harvest fascia lata. Each case was followed up post operatively monthly for 3 months.  </p><p class="abstract"><strong>Results:</strong> Factors which influence graft take up are the size of perforation and lack of infection at the time of surgery and postoperative. Large perforations were difficult to repair as it took more time to heal. Surgery performed postaurally underlay technique using temporal fascia was associated with less morbidity, better uptake and lesser postoperative complications but permeatal route also serve similar purpose and does not affect the result of study significantly.</p><p class="abstract"><strong>Conclusions:</strong> This study compared both temporal fascia and fascia lata as graft materials for myringoplasty and proved that myringoplasty done by postaural underlay technique using temporal fascia holds best as per graft uptake, hearing improvement and postoperative complications when compared to fascia lata myringoplasty.</p>

Antibiotics are over-prescribed in low-and-middle-income countries, where the infection rate is high. The global paucity of standard treatment guidelines and reliable diagnose-specific prescription data from high-infection risk departments such as the otorhinolaryngology (ENT: ears, nose and throat) is a barrier to rationalize antibiotic use and combat antibiotic resistance. The study was conducted to present diagnose-specific antibiotic prescribing patterns of five years at ENT inpatient departments of two private-sector Indian hospitals. Data of all consecutive inpatients (n = 3527) were collected but analyzed for the inpatients aged >15 years (n = 2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses groups: surgical, non-surgical, chronic suppurative otitis media (CSOM), and others. Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% of patients in the clean surgery group and more than 75% in the viral and non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis (31%), where 90% of inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. This study highlights the inappropriate prescribing of antibiotics to patients of clean surgeries, viral infections, and non-infectious groups. The single-prophylactic dose of antibiotic for clean-contaminated surgeries was replaced by the prolonged empirical prescribing. The use of microbiology investigations was insignificant.

<p class="abstract"><strong>Background:</strong> The propensity for ossicular destruction is much greater in case of unsafe CSOM due to presence of cholesteatoma and/or granulations. Partial or total destruction of ossicles is seen in approximately 80% of patients with cholesteatoma, whereas in chronic otitis media without cholesteatom, ossicular chain erosion can be seen in approximately 20% cases.The present study aims to evaluate the clinical profile of patients of unsafe chronic suppurative otitis media with cholesteatoma and assesses patients on the basis of gadolinium enhanced T₁-T₂ weighted images of MRI.</p><p class="abstract"><strong>Methods:</strong> The study was conducted among patients who were fulfilling the criteria for unsafe CSOM i.e., retraction pocket in pars tensa, marginal perforation, perforation in pars flaccida, presence of granulation tissue, presence of polyp, blood stained discharge etc. were selected for the study. MRI was performed in all cases by using gadolinium enhanced T₁-T₂ sequences for diagnosis of cholesteatoma. Mastoidectomy was done to confirm the findings of MRI.  </p><p class="abstract"><strong>Results:</strong> In maximum number of cases perforation was found in attic region. Most common complication of disease is the ossicular chain erosion. In present study sensitivity was 84%, specificity was 100% and positive predictive value and negative predictive value were 100% and 66% respectively.</p><p class="abstract"><strong>Conclusions:</strong> It can be concluded that MRI can differentiate cholesteatoma from other inflammatory etiology. By using MRI with 1.5 or 3T unit a small cholesteatoma (even 2-3 mm) can be easily detected at its early stage and further complications can be prevented.</p>

Background Antibiotics are overprescribed in low-and-middle-income countries where the infection rate is high. The global paucity of standard treatment guidelines and reliable prescription data is a barrier to rationalise antibiotic use and combat antibiotic resistance. Moreover, there is a lack of diagnose-specific prescription data from high infection risk departments such as the otorhinolaryngology (ENT). The purpose of the study was to present diagnose-specific antibiotic prescribing patterns at ENT inpatient departments of a teaching hospital and a non-teaching hospital from Indian private healthcare sector. Methods Data of all consecutive inpatients at the department (n=3527) were collected for five years (2008-2013). Analyses were conducted for inpatients aged >15 years (n=2909) using the World Health Organization’s methodologies. Patient records were divided into four diagnoses (indication) groups, i.e., surgical, non-surgical, chronic suppurative otitis media (CSOM) and others. Results Of 2909 inpatients, 51% had surgical diagnoses. An average of 83% inpatients in the clean surgery group, 78% in viral infection and 75% in non-infectious groups were prescribed antibiotics. CSOM was the most common diagnosis at both settings (883/2909 inpatients), where nearly 90% inpatients were prescribed antibiotics. Overall, third-generation cephalosporins and fluoroquinolones were most commonly prescribed. Conclusions This study highlights prescribing antibiotic to the unindicated diagnosis groups, i.e., clean surgeries, viral infections, and non-infectious diagnoses. Recommended single-prophylactic dose of antibiotic was not prescribed for the majority of clean-contaminated surgeries. Prolonged empirical prescribing and insignificant use of the microbiology laboratory was evident in both settings. A meticulous analysis of clean surgery group highlighted the universal applicability issue of available global guidelines.