Effects of ciprofloxacin or co-amoxicillin with and without antidepressants on behavioral deficit in rats induced with chronic suppurative otitis media.

Chronic suppurative otitis media (CSOM) is chronic infection of middle ear which is usually managed with antibiotic therapy. This infection may cause the depression and cognitive changes in patients. The aim of present study was to evaluate the effect of antibiotic (ciprofloxacin and co-amoxicillin) with antidepressant or without antidepressants (bromazepam and imipramine) at low doses on rats with induced with CSOM. Pseudomonas aeruginosa was used to induce CSOM by in rat ear (tympanic bulla). The rats were divided into eight groups having six animals in each group. Neuropharmacological activities and gross behavior were observed in open field activity, force swimming cage, maze test, light and dark activity box and traction test. Observations were noted weekly after the administration of ciprofloxacin (15.3mg/kg), co-amoxicillin (15.3mg/kg), imipramine (1.15mg/kg) and bromazepam (0.09mg/kg) intraperitoneally. The altered behavior and depression was observed in control positive but reverted back in groups maintained on antidepressants with antibiotics with significant improved locomotor activity, memory in memory cage, muscular co-ordination and body balance and decreased anxiety. On the other hand, groups treated with only antibiotics showed significant improvement only in force swimming and traction test at day 14. Therefore, the antidepressant effects of the drugs can be employed to attenuate stress and depression in patients with CSOM.

Accuracy and patient perceived difficulty of utilizing ototopical antibiotic therapy.

PURPOSE: To examine how patients self-administer ear drops, ascertain their perceived difficulty in performing the task and determine if they are able to deliver the correct dosage. MATERIALS AND METHODS: This is a prospective cohort study performed in an otology outpatient clinic with twenty-one subjects with a condition requiring ototopical antibiotics. The number of ear drops applied as well as skills performed during ear drop application was measured. Patient reported difficulty and confidence in application of ear drops data was also obtained. RESULTS: The mean number of drops applied was 2.91 ± 2.1 (target = 3 drops) with a large variance in drop application, range of 0.6 to 9.2 drops. If "correct dosage" is considered 85-115% of the intended dose, then almost half of patients, 47.6%, underdosed with 23.8% that over dosed. Patients reported that the average difficulty in applying drops to themselves was 3.6 (1 being easy and 10 being difficult). Patients reported a high confidence level in applying the correct dose of ear drops of 6.7 (1 being not confident and 10 being very confident). CONCLUSIONS: In our study of 21 patients self-administering ear drops, only 28.6% of patients were able to correctly apply the appropriate treatment dose, with almost half of patients underdosing. Questionnaire data indicated that most patients were unaware they were administering an incorrect dose. Inaccurate administration of ear drops could be problematic and lead to longer durations of symptoms, false treatment failures, and increased costs.

Clinimetric evaluation and clinical outcomes of the Dutch version of the Chronic Ear Survey.

BACKGROUND: To validate and evaluate the reliability of the Dutch version of the Chronic Ear Survey (CES) in patients suffering from Chronic Suppurative Otitis Media (CSOM) and to evaluate clinical outcomes of surgery using this questionnaire. METHODS: We developed the Dutch version of the CES (D-CES) using forward-backward translation of the original CES into the Dutch language. Next, patients with CSOM and controls completed the D-CES pre- and postoperatively. Internal consistency, test-retest reliability, known-group validity and convergent validity were evaluated. In addition to the D-CES, the Short Form 36 (SF-36) was administered to all participants to correlate D-CES data to quality of life. RESULTS: A total of 29 patients with CSOM scheduled for ear surgery were included. Our control group consisted of 26 patients scheduled for eye surgery, all without signs and symptoms of CSOM. Cronbachs' α of the complete questionnaire was 0.69. The Intraclass Correlation Coefficients (ICCs), reflecting test-retest reliability, ranged between 0.69 and 0.82. Scores differed significantly between CSOM patients and controls with substantial lower (more impaired) D-CES scores in the CSOM group. Duration of complaints preoperatively and the presence of a dry ear and/or improvement of hearing postoperatively all had a significant impact on D-CES improvement scores. Small to moderate correlations were found between D-CES subscales and matching subscales of the SF-36. CONCLUSION: The D-CES is an appropriate disease specific questionnaire to assess a patient's perceived functional health in CSOM.

[The evaluation of the quality of life in a healthy population with the use of the COMQ-12 questionnaire]. / Otsenka kachestva zhizni v zdorovoi populiatsii s pomoshch'iu oprosnika SOMQ-12.

The COMQ-12 questionnaire has been elaborated to evaluate the deterioration in the quality of life of the subjects suffering from chronic suppurative otitis media (CSOM) based on the reports of the patients themselves. This questionnaire is of special interest in that it allows to register the complaints of the patients stated by them in the order of priority beginning from those that are responsible for the most pronounced manifestations of the impairment in the quality of life. It, in turn, helps the medical practitioner to rationally organize the treatment of a concrete patient taking into consideration his or her individual expectations. At the current stage of the development and adaptation of the COMQ-12 questionnaire, the main emphasis is placed on the search for the possible range of the key scores and their normal values allowing to characterize the quality of life in the healthy population. The objective of the present work was to estimate the potential of the COMQ-12 questionnaire for the evaluation of the quality of life among the subjects having no signs of chronic suppurative otitis media. A total of 60 healthy volunteers were recruited for the study and asked to fill up the questionnaire. The following information was selected for the subsequent analysis: sex and age of the respondents, experience with having any ear-related problems other than those related to chronic suppurative otitis media in the course of the lifetime. The patients presenting with chronic suppurative otitis media were excluded from the study. The score values ranged from 0 to 14 among the entire set of the respondents (mean 3.55). The resulting score of the respondents' condition was 5 and less in 75% of the cases; it achieved 10 and less out of the possible maximum of 60 scores in 95% of the participants of the study. It is concluded that the application of the COMQ-12 questionnaire helps to concentrate the attention of the medical specialists on the subjects whose health condition is characterized by score 5 or less and motivates them to carry out the thorough and comprehensive analysis for the interpretation of the data in favour of or against the prescription of the surgical intervention taking into consideration the personal expectations of the patients.

A systematic review of patient-reported outcome measures for chronic suppurative otitis media.

OBJECTIVE: The purpose of this review was to systematically appraise the world literature to identify existing patient-reported outcome measures (PROMs) for the assessment of outcomes in patients with chronic suppurative otitis media, to verify the diversity of the individual questionnaire items, to report the methods employed to evaluate the questionnaires, and to identify areas for development in the future. DATA SOURCES: Embase (January 1980-November 2014), MEDLINE (January 1946-November 2014), Cumulative Index to Nursing and Allied Health Literature (January 1981-November 2014), and PsycINFO (January 1806-November 2014). REVIEW METHODS: A systematic literature search was independently undertaken by the two authors according to predefined inclusion and exclusion criteria. RESULTS: Nine original articles were identified, which overall outlined the evaluation of four different questionnaires. CONCLUSIONS: This systematic appraisal of the world literature has identified four PROM questionnaires for use in patients with chronic suppurative otitis media. All four questionnaires evaluate reliability and validity using different psychometric methods. The Chronic Ear Survey questionnaire has been most broadly evaluated and disseminated. All four questionnaires assess static health status. There are many advantages to developing a dynamic one-hit questionnaire to assess the health status of patients having undergone an intervention for chronic suppurative otitis media. LEVEL OF EVIDENCE: NA Laryngoscope, 126:1458-1463, 2016.

Knowledge, attitudes, beliefs and practices related to chronic suppurative otitis media and hearing impairment in Pokhara, Nepal.

BACKGROUND: Nepal has a high prevalence of chronic suppurative otitis media and hearing impairment. An improved understanding of patients' knowledge, attitudes, beliefs and practices is therefore important for effective healthcare planning and intervention. METHOD: Questionnaires designed to explore their current knowledge, attitudes, beliefs and practices were completed by 153 participants: 71 were affected by a known ear disease and 82 were unaffected. RESULTS: In the unaffected group, 31.7 per cent considered breast milk to be a risk factor for ear infection. Home remedies (e.g. leaf paste, oils, and urine and/or bodily fluids) had been used by 42.3 per cent of the affected group. Most participants (71.9 per cent) believed that society discriminates against those with hearing impairment. CONCLUSION: Knowledge deficits and false beliefs were found in both groups, along with a significant use of home remedies and a perception of discrimination against people with hearing impairment. These findings are relevant for healthcare providers and may aid the development of policy, interventions and public education initiatives.

General and disease-specific quality of life in patients with chronic suppurative otitis media--a prospective study.

BACKGROUND: Chronic suppurative otitis media (CSOM) is frequently associated with symptoms of inflammation like discharge from the ear or pain. In many cases, patients suffer from hearing loss causing communication problems and social withdrawal. The objective of this work was to collect prospective audiological data and data on general and disease-specific quality of life with validated quality of life measurement instruments to assess the impact of the disease on health-related quality of life (HR-QOL). METHODS: 121 patients were included in the study. Patients were clinically examined in the hospital before and 6 months after surgery including audiological testing. They filled in the quality of life questionnaires SF-36 and Chronic Otitis Media Outcome Test 15 (COMOT-15) pre-operatively and 6 and 12 months post-operatively, respectively. RESULTS: Complete data records from 90 patients were available for statistical analysis. Disease-specific HR-QOL in patients with CSOM improved after tympanoplasty in all the scales of the COMOT-15. There was no difference in HR-QOL assessment between patients with mesotympanic respectively epitympanic CSOM. However, we did find the outcome to be worse in patients who received revision surgery compared with those receiving primary surgery. Audiometric findings correlated very well with the subscale hearing function from the COMOT-15 questionnaire. General HR-QOL measured with the SF-36 was not significantly changed by tympanoplasty. CONCLUSIONS: Tympanoplasty did lead to a significant improvement of disease-specific HR-QOL in patients with CSOM while general HR-QOL did not change. Very well correlations were found between the subscale hearing function from the COMOT-15 questionnaire and audiological findings. Revision surgery seems to be a predictor for a worse outcome.

Subjective evaluation and overall satisfaction after tympanoplasty for chronic simple suppurative otitis media.

A questionnaire survey was conducted in 324 patients with chronic, simple, suppurative otitis media who had undergone tympanoplasty 6 months or more previously to investigate post-operative hearing, tinnitus, vertigo, occlusive feeling of the ear and otorrhea. In addition, the overall satisfaction with tympanoplasty was assessed by VAS value. Subjective hearing improvement was observed in 73.1% of the patients whose hearing was poor and in 50% of those whose hearing was good before the operation. The degree of satisfaction assessed by VAS value corresponded with the subjective hearing assessment. As to tinnitus, 66.2% of the patients became aware of the disappearance or alleviation of symptoms. In the case of patients who had tinnitus before the operation, the degree of awareness of tinnitus and the degree of satisfaction assessed by VAS value coincided. However, no changes in the VAS value were observed in those who did not have tinnitus before the operation. As for vertigo, 30.5% of the patients who had vertigo preoperatively became aware of the disappearance of the symptoms after the operation. The degree of satisfaction assessed by VAS value corresponded with the presence or absence, severity and frequency of vertigo. As to the fullness of the ear, alleviation of the symptoms was subjectively noted by 85.9% of the patients who had symptoms before the operation. The degree of satisfaction assessed by VAS value corresponded with the severity of the symptoms in those who had symptoms before the operation. As for otorrhea, the disappearance of the symptoms was subjectively noted by 85.5% of the patients who had otorrhea before the operation. The degree of satisfaction assessed by VAS value corresponded with the post-operative changes in otorrhea. Based on the above results, it was assumed that the patients placed greatest expectation on hearing improvement when they underwent tympanoplasty. VAS is considered a useful method to evaluate the degree of satisfaction of patients after surgery.