exudates and Ear-Diseases

We conducted a retrospective observational study to determine the spectrum and antibiotic sensitivity pattern of organisms isolated in otorhinolaryngologic (ORL) infections. We reviewed the laboratory culture and sensitivity records of 4,909 patients-2,773 males (56.5%) and 2,136 females (43.5%), aged 2 to 90 years (mean: 45.3 ± 12.6)-who had been seen at two government hospitals in Malaysia. Of this group, 4,332 patients had a respiratory tract infection (88.2%), 206 had an ear infection (4.2%), 188 had a deep neck infection (3.8%), and 183 had an oropharyngeal infection (3.7%). The most common isolated organisms were Klebsiella spp, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus, methicillin-susceptible S aureus, coagulase-negative S aureus, and Acinetobacter baumannii. We also identified the antimicrobial susceptibility of these organisms. We conclude that since the spectrum of causative pathogens in some infections differs between tropical and nontropical areas of the world, tropical hospitals should not completely adopt the antibiotic guidelines for ORL infections that have been recommended for hospitals in nontropical regions. We hope that our review and analysis of local data will help practitioners in Malaysia develop an appropriate prescribing policy with respect to ORL pathogens and antimicrobial susceptibility. The goal is to reduce the morbidity and mortality associated with these infections.

Topics: Acinetobacter baumannii; Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Bacterial Infections; Child; Child, Preschool; Ear Diseases; Female; Hospitals; Humans; Klebsiella; Malaysia; Male; Methicillin-Resistant Staphylococcus aureus; Microbial Sensitivity Tests; Middle Aged; Neck; Oropharynx; Pseudomonas aeruginosa; Respiratory Tract Infections; Retrospective Studies; Young Adult

To determine the prevalence of mild hearing loss and its association with academic performance among primary school children.. A comparative cross sectional study was conducted on standard (grade) five school children in a state in Malaysia. Five schools were selected by using simple random sampling. There were three classes (A, B and C) of standard five in each school. Student's selection into these classes was made by respective school administration based on their final term examination in standard four. Class A was for the best academic achievers while class C was for the poorest. Ear examinations were done followed by pure tone audiometry for confirmation of the hearing status. In this study, mild hearing loss was defined as an average threshold of 20-39 dB at 0.5, 1, 2 and 4 kHz. Data analysis was done using SPSS Version 12.0 software. Chi-square test was used to determine the association between mild hearing loss and academic performance. The significant level was set at p=0.05.. From a total of 257 students, 234 have completed the examinations (response rate=91.0%). Fifty-three percent of them were boys while 47% were girls. A hundred and forty-nine (63.7%) of them were from class A while 85 (36.3%) were from class C. The prevalence of hearing loss in our school population was 15% (95% CI: 11.0-20.0%). Thirty-two (88.9%) of them were having conductive type. Out of the total, 38.9% were having problems in both ears. The students who have poor academic performance have been shown to be significantly associated with mild hearing loss (p<0.001).. There was a high prevalence of mild hearing loss among primary school children. This problem could affect their academic performance. Therefore, hearing assessment is highly recommended to be done on every child especially to those who have poor academic achievement.

Topics: Achievement; Child; Cross-Sectional Studies; Ear Diseases; Female; Hearing Loss, Bilateral; Hearing Loss, Conductive; Hearing Loss, Sensorineural; Hearing Loss, Unilateral; Hearing Tests; Humans; Malaysia; Male; Prevalence; Schools; Severity of Illness Index; Students

Lightning strike is a natural phenomenon with potentially devastating effects and represents one of the important causes of deaths from environmental phenomena. Almost every organ system may be affected as lightning current passes through the human body taking the shortest pathways between the contact points. A 10 years retrospective study (1996-2005) was conducted at University Hospital Kuala Lumpur (20 cases) also including cases during last 3 years from Hospital Tengku Ampuan Rahimah, Klang (7 cases) from the autopsy reports at Forensic Pathology Units of these 2 hospitals. Both these hospitals are attached to University of Malaya. There were 27 fatal cases of lightning strike with male preponderance(92.59%) and male to female ratio of 12.5:1. Majority of victims of lightning strike were from the age group between 30 and 39 years old. Most of the victims were foreign workers. Indonesians workers contributed to 59.26% of overall cases. Majority of them were construction workers who attributed i.e.11 of 27 cases (40.74%). Most of the victims were brought in dead (37.04%). In majority of the cases the lightning incidence occurred in the evenings, with the frequency of 15 of 27 cases (62.5%). The month of December represented with the highest number of cases (5 cases of 23 cases); 2004 had the highest incidence of lightning strike which was 5 (19.23%). Lightning strike incidence occurred when victims had taken shelter (25.9%) under trees or shades. Lightning strike in open areas occurred in 10 of 27 cases (37.0%). Head and neck were the most commonly affected sites with the incidence of 77.78% and 74% respectively in all the victims. Only 29.63% of the cases presented with ear bleeding.

Topics: Adolescent; Adult; Age Distribution; Child; Ear Diseases; Ethnicity; Female; Forensic Pathology; Hemorrhage; Humans; Incidence; Lightning Injuries; Malaysia; Male; Occupations; Retrospective Studies; Seasons; Sex Distribution; Time Factors; Young Adult

Endochondral pseudocyst of the auricle is an uncommon condition that affects predominantly Chinese males, with many reports studying this condition in homogenous Chinese populations. There have been few large-scale reports describing the features of this disease among the other Asian groups. In one of the largest series described to date, we report the epidemiological features, clinico-pathologic characteristics, and success of surgical treatment in 40 patients of different Asian groups presenting with pseudocyst of the auricle. Results showed a Chinese predominance (90 per cent), followed by Malays (five per cent) and Eurasians (five per cent). All had unilateral presentations apart from one patient. Most (55 per cent) presented within two weeks of auricular swelling. Few (10 per cent) had a history of trauma. The pseudocysts predominantly affected the concha (61 per cent). Surgery comprised excision of the anterior wall followed by local pressure application. Only 2.5 per cent had recurrence after surgery. These findings confirm earlier understood features of this disease while revealing some notable variations.

Topics: Adult; Anti-Infective Agents; China; Cysts; Ear Cartilage; Ear Deformities, Acquired; Ear Diseases; Female; Humans; Malaysia; Male; Middle Aged; Recurrence; Retrospective Studies; Singapore; Suction; Time Factors

To assess if children with Down's Syndrome have a higher prevalence of otological abnormality compared to their normal counterparts in Malaysia.. Thirty children with Down's Syndrome and normal children underwent otoscopic ear examination and Impedance test in the ENT outpatients clinic in University Hospital, Kuala Lumpur, Malaysia.. The study showed that children with Down's Syndrome had higher otological disorders. Forty four percent had impacted wax compared to 14.4% in normal children. Twenty one percent of ears in the study group had retracted drums compared to 6.6% of control. Fifteen percent of ears in the study group had middle ear effusion compared to 3.4% in controls, 55% had a type B tympanogram compared to 8.3% in controls and 73.4% had auditory canal stenosis compared to 14.4% in controls.. Children with Down's Syndrome, thus have a higher incidence of otological disorders.

Topics: Child; Child, Preschool; Down Syndrome; Ear Diseases; Humans; Infant; Malaysia

Two hundred Malaysian patients representing 227 ears with previously untreated cholesteatoma disease were analysed retrospectively in terms of i) type of disease, i.e. primary acquired attic defect or posterior superior retraction pocket and secondary acquired type cholesteatoma; ii) positive history of previous middle ear effusion, atelectasis or grommet insertion; and iii) likelihood of complications as initial presenting feature. The high 47.1% incidence of secondary acquired cholesteatoma disease in our patients contrasts with the predominance of primary acquired cholesteatoma in the Caucasian patient. Correlation of these two disease types with a positive history showed a significant positive association between the primary acquired group and a positive history; and conversely a significant negative association for the secondary acquired type. This supports a role for the retraction theory in primary acquired cholesteatoma but negates this theory in secondary acquired cholesteatoma. Secondary acquired cholesteatoma had a significantly higher (35.5%) complication rate against 15.8% in the primary acquired type (p = 0.001). This fact together with a 47.1% incidence of secondary acquired disease, low otolaryngologist population ratio and patient attitudes to disease account for the high total complication rate of 27.3%.

Topics: Adolescent; Adult; Child; Cholesteatoma; Ear Diseases; Humans; Malaysia; Otitis Media with Effusion; Prognosis; Pulmonary Atelectasis; Retrospective Studies

Topics: Animals; Child; Diptera; Ear Diseases; Female; Humans; Malaysia; Myiasis