EFFICACY OF ACETIC ACID VERSUS CIPROFLOXACIN EAR DROPS IN ACHIEVING DRY EARS IN CHRONIC SUPPURATIVE OTITIS MEDIA IN ADULT POPULATION OF ISLAMABAD, PAKISTAN: A NON-RANDOMIZED CONTROL TRIAL

Comparing the Efficacy of Acetic Acid vs Gentian Violet in Chronic Discharging Ears

Chronic suppurative otitis media is a prolonged and chronic condition. It is a prevalent bacterial infection in the field of otolaryngology that has substantial consequences. Prior to surgical intervention, it is crucial to implement medical treatment to make the ears dry in cases of chronic suppurative otitis media. The goal is to determine the most suitable agent for aural toileting in individuals with chronic suppurative otitis media by evaluating the outcomes of irrigation of acetic acid and gentian violet and determining the most suitable treatment. A randomized controlled study was done on 100 patients in a tertiary care center with a tubotympanic type of CSOM in the active phase. Patients were divided into 2 groups and toileting and irrigation were done with acetic acid in one group and with gentian violet in the other for 3 weeks. The comparison of treatment outcomes between the groups revealed a statistically significant difference, with acetic acid demonstrating superior treatment results compared to gentian violet. This was further confirmed by a statistically significant difference between the two groups in otologic scores at different time points, as a result of a considerably greater fall in scores in the acetic acid group. Regular antiseptic auditory cleaning and irrigation can help manage chronic suppurative otitis media. The process of healing is facilitated by modifying the pH of the ear canal, reducing inflammation, destroying biofilms, and removing exudates. Acetic acid appears to be more effective than gentian violet in treating the condition. Therefore, acetic acid alone or in conjunction with antibiotic ear drops, can be used for the treatment of chronic suppurative otitis media.

DISTRIBUTION OF HEPATITIS B INFECTED POPULATION BY SEX AND AGE GROUPS IN DISTRICT D.I.KHAN, PAKISTAN

Background: Significant morbidity and mortality is caused by untreated hepatitis B virus infection through cirrhosis and hepatocellular carcinoma. The objectives of our study were to determine distribution of hepatitis B infected population by sex and age groups in District D.I.Khan, Pakistan.Materials Methods: This cross-sectional study was done at District Health Office, D.I.Khan, Pakistan from January 30, 2021 to February 15, 2021. Data was collected for period from March 14, 2013 to January 28, 2021 for 2368 hepatitis B infected cases from population at risk consecutively. Sex and age groups were demographic variables. Data type was nominal for sex and ordinal for age groups. Distribution was analyzed by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were substantiated by chi-square goodness-of-fit test.Results: Out of 2368 hepatitis B infected population, 1670 (70.52%) were men 698(29.48%) women, and 562 (23.73%) were in age group 0-20 years, 1266 (53.46%) in 21-40 years, 462 (19.51%) in 41-60 years 78 (3.30%) in 60 years. Our distribution by sex (p.00001) and age groups (p.00001) were different than expected respectively.Conclusion: In our study, hepatitis B infection was more common in men than women and most common in age group 21-40 years, followed by 0-20 years, 41-60 years and 60 years. Our observed prevalence of hepatitis B infection in men was higher than expected in women it was lower than expected. Our observed prevalence in the four age groups was not similar to expected.

DISTRIBUTION OF DR-TB BY SEX, AGE GROUPS, OCCUPATION, PROVINCE, DIVISION, DISTRICT, TYPE OF DISEASE, TYPE OF DRUG RESISTANCE, TREATMENT REGIMEN AND OUTCOME OF TREATMENT IN DR-TB POPULATION IN D.I.KHAN DIVISION, PAKISTAN

Background: Drug-resistant tuberculosis (DR-TB) is the major cause of mortality worldwide. Our objectives were to determine the distribution of DR-TB by sex, age groups, occupation, province, division, district, type of disease, type of drug resistance, treatment regimen and outcome of treatment in DR-TB population in D.I.Khan Division, Pakistan.Materials Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan. A sample of 286 DR-TB patients was selected consecutively from population at risk. Sex, age groups, occupation, province, division and district were demographic while type of disease, type of drug resistance, treatment regimen and outcome of treatment were research variables. All variables being nominal were described by count, percentage cumulative percentage with 95% confidence interval for proportion. Distribution of DR-TB patients by all the ten variables were substantiated by chi-square goodness-of-fit test.Results: Out of 286 DR-TB patients, 123 (43%) were men and 163 (57%) women. DR-TB cases were most prevalent in age group 15-44 years 172 (60.14%), housewife 140 (48.95%), Khyber Pakhtunkhwa 175 (61.19%), D.I.Khan Division 178 (62.24%) and district 121 (42.31%). Most common type of disease, drug resistance and treatment regimen was pulmonary TB 282 (98.60%), MDR 273 (95.45%) and longer treatment (n=273 MDR-TB) 246 (90.11%) respectively. Treatment success rate was 161 (56.29%). The observed prevalence by occupation, province, division, district and type of disease in our sample was similar to expected prevalence in population (p.05 for all), while it was different from population by sex, age groups, type of drug resistance, regimen and treatment outcome (p.05 for all).Conclusion: The prevalence of DR-TB was higher in women, age group 15-44 years, housewife, Khyber Pakhtunkhwa and D.I.Khan Division and District. Most common type of disease, drug resistance and treatment regimen was pulmonary TB, MDR and longer treatment respectively. Treatment success rate was 56.29%. The observed prevalence by occupation, province, division, district and type of disease in sample was similar to population, while it was different by sex, age groups, type of drug resistance, regimen and treatment outcome.

PREVALENCE, DISTRIBUTION AND DETERMINANTS OF ESCHERICHIA COLI RESISTANCE TO CEFTRIAXONE IN ADULT INDOOR UTI POPULATION OF DISTRICT PESHAWAR, PAKISTAN

Background: Escherichia coliresistance to ceftriaxone in UTIs is an emerging health problem.Our objectives were to determine prevalence, distribution and determinants of E. coliresistance to ceftriaxone in adult indoor UTI population of District Peshawar, Pakistan. Materials & Methods:This cross-sectional study was conducted in Department of Medicine, Khyber Teaching Hospital, Peshawar, Pakistan from 1st January 2017 to 30th June 2017. 380 UTIs cases were selected from population at riskconsecutively.Sex and age groups were demographic, while presence of E. coli resistance to ceftriaxone was research variable. All variables were nominal.Prevalenceand distribution were analyzed by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were substantiated by chi-square goodness-of-fit and of association by chi-square test of association. Results: Out of 380 patients with UTI, 136 (35.80%) were men,244(64.20%) women, 262 (68.95%) in age group 18-45 years and 118 (31.05%) in age group 46-65 years. Frequency/ prevalence of E. coli resistance was 287/380 (75.53%, 95%CI 71.20-79.85). Out of 287 patients with E. coli resistance to ceftriaxone, 101 (26.58%) were men and 186 (48.95%) women, 198 (52.11%) in age group 18-45 years and 89 (23.42%) in age group 46-65 years. Our prevalence of E. coli resistance to ceftriaxone was higher than expected (p<.00001), our distribution by sex(p<.00125) and age groups (p<.00001) were different than expected. Presence of E. coli resistance to ceftriaxone was not associated to sex (p=.669333) and age groups (p=.975097). Conclusion:Prevalence of E. coli resistance to ceftriaxone in adult UTI population of District Peshawar, Pakistan was alarmingly high 75.53%. Prevalence was more in women than men and more in younger age group (18-45 years) than older age group (46-60 years) population.Overall prevalence of E. coli resistance to ceftriaxone was higher than expected. Distribution by sex showed higher prevalence than expected in men and lower than expected in women, and higher than expected in younger age group and lower than expected in older age group. Presence of E. coli resistance to ceftriaxone was not associated to sex and age groups respectively in adult UTI population of District Peshawar, Pakistan.

DISTRIBUTION OF DELIBERATE SELF-POISONING BY SOCIO-DEMOGRAPHIC FACTORS, PRECIPITATING EVENTS, TYPE OF SUBSTANCE AND MORTALITY IN POPULATION OF HAZARA DIVISION, PAKISTAN

Background: Deliberate self-poisoning is important cause of deaths in younger population. The objectives of this study were to determine the distribution of deliberate self-poisoning by 12 socio-demographic factors, precipitating events, type of substance and mortality in population of Hazara Division, Pakistan. Materials & Methods: This cross-sectional study was conducted in the Department of Medicine, Ayub Medical College, Abbottabad, Pakistan from October 9, 2017 to December 28, 2018. 102 deliberate self-poisoning patients were selected consecutively from population at risk. Variables were 12 socio-demographic factors, precipitating events, type of substance and mortality. All variables being categorical were described by count and percentage for sample and by confidence intervals for proportion for population at 95% confidence level. RESULTS: Deliberate self-poisoning cases (n=102) were higher in women 80.39%, in age group 18-25 years 54.90%, similar in urban 49.02% and rural 50.98%, higher in non-Pathan 74.51%, in married 57.84%, in joint family 79.41%, in up to matric education 85.29% and in housewives 52.94%, 4.90% with previous history of self-harm, 1.96% with family history of self-harm and higher in lower socioeconomic group 81.37%. The most common precipitating event was interpersonal difficulties with spouse, family members or friends 56.86%, while the most common type of substance was organophosphate 62.75%. Mortality was 3.92%. Conclusion: Deliberate self-poisoning was more prevalent in women, younger age group, married, joint family, educated up to matric, housewives and lower socioeconomic status. Family conflict was most common precipitating factor. Organophosphate was most common type of substance and mortality was high 3.92%.

PREVALENCE, DISTRIBUTION AND DETERMINANTS OF DEEP VEIN THROMBOSIS IN ADULT INDOOR STROKE POPULATION OF PESHAWAR DIVISION, PAKISTAN

Background: Stroke is a devastating public health problem worldwide, considered as the third leading cause of death in developed countries, and the leading cause of disability among adults. Deep vein thrombosis (DVT), including pulmonary embolism (PE) as a sequel, is a serious complication of various medical conditions including stroke. The purpose of this study was to determine frequency of deep vein thrombosis among patients presented with stroke. Materials and methods: This study was descriptive (cross-sectional) study, conducted in the Department of Neurology, Lady Reading Hospital, Peshawar over 6 months. In the study a total of 196 patients were observed. Base line investigations were done and ultrasound was carried out to diagnose deep vein thrombosis. All the laboratory investigations and ultrasound were done by single experience pathologist and sonologist having minimum of five years of experience respectively. Observation and examination was done by neurologist who was not aware about the study and data was recorded in a predesigned proforma. To control confounders and bias in the study results, strict exclusion criteria had been followed. Results: In this study mean age was 63 years with standard deviation ± 28.34. Forty two percent patients were male and 58% patients were female. More over 8% patients had deep vein thrombosis. Conclusion:Our study concludes that the frequency of deep vein thrombosis was 8% among patients presented with stroke.