Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sized anterior and subtotal perforation of tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty two cases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group. Keywords: Anterior perforation; myringoplasty; subtotal perforation; ‘U’ flap.
Background: Myringoplasty done for anterior and subtotal perforation needs expertise and practice than conventional underlay myringoplasty. The objective of this study was to compare the graft uptake and postoperative hearing results between ‘U’ flap and conventional tympanomeatal flap technique in anterior and subtotal tympanic membrane perforation.Methods: Sixty three patients of age fifteen years and above with chronic otitis media mucosal type with any sizedanterior and subtotal perforationof tympanic membrane were randomly allocated for myringoplasty by lottery method. There were thirty one cases in ‘U’ flap group and thirty twocases in conventional tympanomeatal flap group. Graft uptake and hearing results were assessed after six weeks and results were compared within and between the groups.Results: Graft uptake rate was 90.3%(28/31) in‘U’ flap group and it was 87.5%(28/32) in conventional tympanomeatal flap group with no statistically significant difference (p= 0.772) between the two groups. The mean pre and post-operative air bone gap in ‘U’ flap group were 23.63dB±7.77dB; 13.26dB±5.50dB and that in the conventional tympanomeatal flap group were 20.88±9.88dB, 9.42dB±6.70dB respectively. There was no statistically significant difference in hearing results between the two groups (p= 0.504).Conclusions: The graft uptake rate and hearing results of ‘U’ flap group were comparable and showed no statistically significant difference to those of conventional tympanomeatal flap group.
Introduction: Coronavirus Disease 2019 (COVID-19), since its emergence, has spread rapidly as a pandemic causing massive loss of human life. This study aims to describe clinical severity of the disease in relation to age, mode of oxygen delivery and clinical outcome of patients admitted to a tertiary care center in Nepal. Methods: This was a descriptive cross-sectional study of data records of 130 COVID-19 patients 18 years and above admitted in Nepal Armed Police Force Hospital from April 2021 to June 2021 with Severe Acute Respiratory syndrome SARS-CoV-2 Reverse Transcriptase Polymerase Chain Reaction positive status. Ethical approval was obtained from Nepal Health research Council. Data were collected using structured proforma and analyzed using SPSS version 23. Results: Patients with severe illness (52/130) constituted 40% of the bulk of COVID-19 patients, 48 of them requiring intensive care. Among them, 38.5% required non-invasive ventilation and 32.7% were intubated during treatment. Severity of illness was variable among different age groups but mortality was high among severely ill patients, 19/52 (36.5%) and with increasing age. The overall mortality was 19/130 (14%) over the study period, all of which were among severely ill patients. Conclusions: Most of the clinically severe cases required Intensive Care Unit admission, the majority receiving oxygen therapy via non-invasive or invasive mechanical ventilation, with a high mortality rate. The number of severely ill COVID-19 patients was variable in different age groups. Mortality, however, was observed in severely ill patients only and proportionately increased in COVID-19 patients with advancing age.
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