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Kara A, Büyükcam A, Sütçü M, Sali E, Bozdemir ŞE, Kara M, İlarslan EÇ, Kaya C, Karakaşlılar S, Sönmez G, Kara SS, Bedir T, Albayrak E, Kara TT, Çelebi S, Öz FN, Karbuz A, Somer A, Alabaz D, Tezer H, Özdemir H, Çiftçi E. The effectiveness of topical 1% lidocaine with systemic oral analgesics for ear pain with acute otitis media. Int J Pediatr Otorhinolaryngol 2022; 156:111116. [PMID: 35325846 DOI: 10.1016/j.ijporl.2022.111116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Revised: 03/05/2022] [Accepted: 03/16/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND Acute otitis media (AOM) is one of the most common childhood infections. Ear pain, the main symptom of AOM, results in parents frequently seeking medical assistance for their children. The aim of this study was to compare the effectiveness of topical 1% lidocaine ear drops administered with oral analgesics with that of oral analgesics alone. METHODS This multicenter randomized, open-labeled study was conducted at 15 centers with 184 pediatric AOM patients with bilateral ear pain (aged 1-5 years) between May 1, 2016, and June 31, 2018. All patients received oral paracetamol or ibuprofen and topical 1% lidocaine, which was administered to each ear according to the randomization list. The ear pain score was evaluated within 48 h using the Face, Legs, Activity, Cry, and Consolability (FLACC) scale, and the patients were followed up for 10 days. RESULTS The median age was 31.8 months (min-max, 12-84.2 months). Of those patients enrolled, 22.3% received paracetamol, and 24.5% received paracetamol with lidocaine ear drops; 23.4% received ibuprofen, and 29.9% received ibuprofen with lidocaine ear drops. Lower pain scores were significantly measured at baseline and 10th minutes by a reduction 25% (RR 13.64, 95% CI 4.47-41.63, p = 0.001, RR 0.14, 95% CI 0.06-0.35, p = 0.001) and 50% (RR 4.76, 95% CI 1.63-13.87, p = 0.004, RR 0.14, 95% CI 0.05-0.4, p = 0.001) in the paracetamol and lidocaine versus paracetamol groups and the ibuprofen and lidocaine versus ibuprofen groups, respectively. No serious side effects were evident during follow-up. CONCLUSION This randomized study suggests that topical 1% lidocaine ear drops with paracetamol or ibuprofen seems to provide effective and rapid relief for children presenting with ear pain attributed to AOM.
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Affiliation(s)
- Ateş Kara
- Hacettepe Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Ayşe Büyükcam
- Hacettepe Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Murat Sütçü
- Konya Training Training and Research Hospital, Department of Pediatric Infectious Disease, Konya, Turkey.
| | - Enes Sali
- Şanlı Urfa Training and Research Hospital, Department of Pediatric Infectious Disease, Şanlıurfa, Turkey.
| | - Şefika Elmas Bozdemir
- Kayseri Training and Research Hospital, Department of Pediatric Infectious Disease, Kayseri, Turkey.
| | - Manolya Kara
- İstanbul Medical University, Department of Pediatric Infectious Disease, İstanbul, Turkey.
| | | | - Cemil Kaya
- Şanlıurfa Training and Research Hospital, Department of Pediatrics, Şanlıurfa, Turkey.
| | | | - Gülsüm Sönmez
- Çukurova Medical University, Department of Pediatric Infectious Disease, Adana, Turkey.
| | - Soner Sertan Kara
- Erzurum Regional Training and Research Hospital, Department of Pediatric Infectious Disease, Erzurum, Turkey.
| | - Tuğba Bedir
- Gazi Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Eda Albayrak
- Recep Tayip Erdoğan Medical University, Department of Pediatrics, Rize, Turkey.
| | - Tuğçe Tural Kara
- Ankara Training and Research Hospital, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Solmaz Çelebi
- Uludağ Medical University, Department of Pediatric Infectious Disease, Bursa, Turkey.
| | - Fatma Nur Öz
- Fırat Medical University, Department of Pediatric Infectious Disease, Elazığ, Turkey.
| | - Adem Karbuz
- Ok Meydanı Training and Research Hospital, Department of Pediatric Infectious Disease, İstanbul, Turkey.
| | - Ayper Somer
- Kayseri Training and Research Hospital, Department of Pediatric Infectious Disease, Kayseri, Turkey.
| | - Derya Alabaz
- Çukurova Medical University, Department of Pediatric Infectious Disease, Adana, Turkey.
| | - Hasan Tezer
- Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Halil Özdemir
- Ankara Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
| | - Ergin Çiftçi
- Ankara Medical University, Department of Pediatric Infectious Disease, Ankara, Turkey.
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Büyükcam A, Kara A, Bedir T, Gülhan B, Özdemir H, Sütçü M, Düzgöl M, Arslan A, Tekin T, Çelebi S, Kukul MG, Bayhan Gİ, Köşker M, Karbuz A, Çelik M, Kocabay Sütçü Z, Metin Ö, Karakaşlılar S, Dağlı A, Kara SS, Albayrak E, Kanık S, Tezer H, Parlakay A, Çiftci E, Somer A, Devrim İ, Kurugöl Z, Dinleyici EÇ, Atla P. Pediatricians' attitudes in management of acute otitis media and ear pain in Turkey. Int J Pediatr Otorhinolaryngol 2018; 107:14-20. [PMID: 29501295 DOI: 10.1016/j.ijporl.2018.01.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 01/15/2018] [Accepted: 01/17/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Acute otitis media (AOM) is predominantly a disease of childhood and one of the common reasons for prescribing antibiotics. Ear pain is the main symptom of AOM, with the result that parents frequently seek immediate medical assistance for their children. Antibiotic therapy for AOM does not provide symptomatic relief in the first 24 hours, and analgesics are commonly recommended for relieving the pain associated with AOM. The aims of the present study were to assess pediatricians' attitudes toward AOM and ear pain management in Turkey. METHODS This multicenter descriptive questionnaire study was conducted in 20 centers from different geographic locations in Turkey, with 977 pediatricians, between June 2015 and December 2016. The questionnaire comprised 20 questions focusing on the pediatricians' sociodemographic variables, experiences, and treatment related to AOM and ear pain. RESULTS Of the pediatricians, 58.2% were residents, 36.5% were specialists, and 4.3% were lecturers. Most participants were working in a university hospital (54.8%) or education and research hospital (32.2%). In general daily practice, the AOM diagnosis rates were between 6% and 20% in outpatient clinics, and 52.3% of the participants stated the patients complained about ear pain in pediatric clinics. The watchful waiting (WW) rate, as opposed to immediate antibiotic treatment, was 39.8% for all the pediatricians. The pediatric residents used the WW strategy less than the specialists and lecturers did (p = 0.004). The rates of the WW strategy were higher in outpatient clinics where AOM was commonly diagnosed (p < 0.001). The most common antibiotic prescribed for AOM was amoxicillin clavulanate (76.7%). The mean recommended treatment period for AOM was 9.3 ± 2.2 days. The choices for systemic ear pain treatment were acetaminophen (26.8%), ibuprofen (29.4%), and alternating between ibuprofen and acetaminophen (43.9%). Moreover, 34.6% of the participants recommended topical agents for otalgia. Topical agents were more commonly recommended by the pediatric residents than specialists or lecturers (p < 0.001). Finally, 58.3% of pediatricians had experiences of the parents' usage of a variety of herbal and folk remedies, such as breast milk or olive oil, for their children's ear pain. CONCLUSION Amoxicillin clavulanate was the most frequently prescribed antibiotic for AOM. WW was approved by the pediatricians, and having more AOM patients was a significant factor in the physicians' choice of WW; nevertheless, the WW rate was poor. Implementation of educational intervention strategies will help pediatricians in improving their compliance with evidence-based guidelines for AOM treatment. Otalgia is taken seriously by parents and pediatricians, and otalgia treatment seems to be well accepted in Turkey for providing symptomatic relief and enhancing the patients' quality of life.
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Affiliation(s)
- Ayşe Büyükcam
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey.
| | - Ateş Kara
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey
| | - Tuğba Bedir
- Gazi University, Pediatric Infection Department, Ankara, Turkey
| | - Belgin Gülhan
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Halil Özdemir
- Ankara University, Pediatric Infection Department, Ankara, Turkey
| | - Murat Sütçü
- İstanbul University, Pediatric Infection Department, İstanbul, Turkey
| | - Mine Düzgöl
- Behçet Uz Training and Research Hospital, Pediatric Infection Department, İzmir, Turkey
| | - Aslı Arslan
- Ege University, Department of Pediatrics, İzmir, Turkey
| | - Tuna Tekin
- Eskişehir University, Department of Pediatrics, Eskişehir, Turkey
| | - Solmaz Çelebi
- Uludağ University, Pediatric Infection Department, Bursa, Turkey
| | - Musa Gürel Kukul
- Hacettepe University, Pediatric Infection Department, Ankara, Turkey
| | | | - Muhammet Köşker
- Diyarbakır Children Hospital, Pediatric Infection Department Diyarbakır, Turkey
| | - Adem Karbuz
- Okmeydanı Training and Research Hospital, Pediatric Infection Department, İstanbul, Turkey
| | - Melda Çelik
- Keçiöğren Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Zümrüt Kocabay Sütçü
- Süleymaniye Maternity and Children Hospital, Department of Pediatrics, İstanbul, Turkey
| | - Özge Metin
- Konya Training and Research Hospital, Pediatric Infection Department, Konya, Turkey
| | | | | | - Soner Sertan Kara
- Erzurum Training and Research Hospital, Pediatric Infection Department, Erzurum, Turkey
| | - Eda Albayrak
- Recep Tayip Erdoğan University, Department of Pediatrics, Rize, Turkey
| | - Saliha Kanık
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Hasan Tezer
- Gazi University, Pediatric Infection Department, Ankara, Turkey
| | - Aslınur Parlakay
- Ankara Hematology Oncology Children's Training and Research Hospital, Pediatric Infection Department, Ankara, Turkey
| | - Ergin Çiftci
- Ankara University, Pediatric Infection Department, Ankara, Turkey
| | - Ayper Somer
- İstanbul University, Pediatric Infection Department, İstanbul, Turkey
| | - İlker Devrim
- Behçet Uz Training and Research Hospital, Pediatric Infection Department, İzmir, Turkey
| | - Zafer Kurugöl
- Ege University, Department of Pediatrics, İzmir, Turkey
| | | | - Pınar Atla
- Kırklareli State Hospital, Department of Pediatrics, Kırklareli, Turkey
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Kasapkara CS, Küçükçongar A, Boyunağa O, Bedir T, Oncü F, Hasanoğlu A, Tümer L. An extremely rare case: osteosclerotic metaphyseal dysplasia. Genet Couns 2013; 24:69-74. [PMID: 23610867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
OMD (osteosclerotic metaphyseal dysplasia) is a very rare sclerosing bone disorder, first described by G. Nishimura in two Japanese siblings in 1993 (6). We report the case of a 12-month-old male with hypotonia, developmental delay and sclerosis of the metaphyses and epiphyses of specific bones. This 36-week gestation boy was born to a 26 year old gravida 5 para 1 Turkish mother and a 27 year old nonconsanguineous father. Radiographic findings obtained during the hospital stay included bilateral symmetrical osteosclerosis of the metaphyseal portions of the long bones in the upper and lower extremities with osteopenic shafts. Narrow bands of metaphyseal osteosclerosis were detected in the short tubular bones of the hands and feet. Growing parts of bilateral scapula, iliac, pubic and ischial bones show sclerotic bands. In addition superior and inferior plates of vertebras, transverse processes of sacral vertebras, all visible epiphyses, carpal and tarsal bones also show sclerotic changes. The scalp was unaffected. Based on the clinical, radiographic, and laboratory findings, a diagnosis of OMD was made. We do not know any of the osteosclerotic bone disorder with changes including hypotonia, mental and motor developmental delay and metaphyseal sclerosis of the bones with a unique distribution except OMD. The syndrome is characterized by developmental delay of a progressive nature, hypotonia, elevated alkaline phosphatase, and late-onset spastic paraplegia 18 years ago. Our patient is the 4th case of OMD described in the literature share some clinical and radiological similarities with other three reported cases of osteosclerotic metaphyseal dysplasias.
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Affiliation(s)
- C S Kasapkara
- Gazi University Hospital, Pediatric Metabolism and Nutrition, Ankara, Turkey.
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