Comparison of Rate of Recurrence of Otitis Media with Effusion(Otorrhea) in Patients Treated by Myringotomy and Tympanostomy Tubes with Patients Treated by Additional Adenoidectomy

Background: To compare the frequency of recurrence of otitis media with effusion in patients treated by myringotomy and tympanostomy tube insertion with patients treated by adenoidectomy, myringotomy and tympanostomy tubes.Methods: In this comparative study patients with otitis media with effusion, who were selected for the study were divided into two groups . Patients in group A(n=52) underwent myringotomy and tympanostomy tubes, while in group B(n=50), the patients underwent adenoidectomy, myringotomy and tympanostomy tubes.There was history of OME of atleast 03 months which did not respond to medical treatment and nasal obstruction( snoring, mouth breathing). Patients with previous history of ENT surgery and acute infection were excluded. Myringotomy was done by giving radial or circumferential incision about 2 to 3 ml in tympanic membrane under microscope. Shepard’s ventilation tube was used as grommet in all cases. Patients were scheduled for follow up at 01, 02, and 06 months postoperatively to assess the otorrhea. The diagnosis of otorrhea was based on otoscopic visualization of discharge exuding through the tube lumen after gently cleaning the external auditory canal. Episodes of otorrhea were treated with oral antimicrobial drugs and if persistent then with ototopical medication. Final outcome of the study were documented at 06 monthsResults: Mean age of patients was 3.2 + 1.1 and 2.9 + 1.2 years in group A and B, respectively. Mean duration of illness was 3.8 + 1.2 and 4.1 + 1.1 months in group A and B respectively. Recurrence of disease was more commonly present in male patients, patients with greater duration of illness and in group A patients. There was significant difference in recurrence rate of the disease in both groups ( p-value= 0.0029<0.05). Age stratification indicates that the rate of recurrence dropped with advancing age in both groups. Gender stratification showed that recurrence of the disease is more commonly present in male patients in both groups. Recurrence rate was higher in patients with greater duration of illness in both groups.Conclusion: There was statistically significant difference( p-value= 0.0029<0.05) in the rate of recurrence of otitis media with effusion (otorrhea) among the two groups with fewer cases of recurrence in group B who underwent adenoidectomy, myringotomy and tympanostomy tubes

Patterns of prescription of antipsychotics in Qatar.

ObjectiveEven though all guidelines recommend generally against antipsychotic polypharmacy, antipsychotic polypharmacy appears to be a very common practice across the globe. This study aimed to examine the prescription patterns of antipsychotics in Qatar, in comparison with the international guidelines, and to scrutinize the sociodemographic and clinical features associated with antipsychotic polypharmacy.MethodsAll the medical records of all the inpatients and outpatients treated by antipsychotics at the Department of Psychiatry-Hamad Medical Corporation (HMC) in Doha, Qatar (between October 2012 and April 2014) were retrospectively analyzed. We retrieved the available sociodemographic data, psychiatric features, and details on the medication history.ResultsOur sample consisted of 537 individuals on antipsychotics (2/3 were male; mean age 33.8±10.2 years), prescribed for a psychotic disorder in 57%, a mood disorder in 9.3%, and various other diagnoses in 33.7%. About 55.9% received one antipsychotic, 29.6% received two antipsychotics, and 14.5% received more than two antipsychotics. Polypharmacy was associated with younger age (p = 0.025), being single (pConclusionsAntipsychotic polypharmacy appears to be quite common in Qatar, as it is the case in many other countries, in contrast with most international recommendations. Studies are needed to explore the reasons behind this disparity

Risk Factors of Metabolic Syndrome Among Patients Receiving Antipsychotics: A Retrospective Study

This study aimed to assess the differential effects of first-generation (FGA) and second-generation antipsychotics (SGA) on the prevalence of risk factors for metabolic syndrome among mentally ill patients in Qatar. We also wanted to check if there is proper adherence with the guidelines for prescribing antipsychotics and the monitoring of metabolic effects in this population. We collected the available retrospective data (socio-demographic, psychiatric, anthropometric, and metabolic measures) from the records of 439 patients maintained on antipsychotics. The majority were males, married, employed, having a psychotic disorder, and receiving SGA. Patients on SGA showed more obesity, higher BP, and more elevated triglycerides compared to those on FGA. The prevalence of the abnormal metabolic measures was high in this sample, but those on SGA showed a significantly higher prevalence of abnormal body mass index and BP. Obesity and hypertension were common in patients maintained on antipsychotics, especially those on SGA. Polypharmacy was common, and many metabolic measures were not monitored properly in those maintained on antipsychotics. More prospective studies with guided monitoring of the patients' clinical status and metabolic changes are needed to serve better this population of patients.Other Information Published in: Community Mental Health Journal License: https://creativecommons.org/licenses/by/4.0See article on publisher's website: http://dx.doi.org/10.1007/s10597-019-00537-y</p