'Students sometimes have problems in deciding which universities they want to apply to.Suggest 3 factors that students should consider when applying to the universities.You may include some of the following aspect:
Courses offered and facilities.You should write at least 350 words.'
In our developed world today university education is no more a too-high-to-reach goal.Our higher education system is year after year offering a a lot of courses and facilities make students difficult to choose suitable university.Students also looked for available financial support which can support them in continue their study.
In the first place, let us look at first point. Obviously,there are many institute which offered same courses.Sometimes the students ambition and qualification are not suit with the course.There is still few of institute offered for critical and advance courses. So student have to look out for choice out of the country.This can influence in make a choice.
Second factor is, they have to compare which universities with the best facilities.
This can be including the transportation , library , cafe and so many more.There is an institute which still lack of facilities such as computer lab and shuttle bus. All of these will troublesome the students.
Financial support is the last but not least. Student really considered regarding this matter. Students who are come from poor family usually will face this problem.So it is important to enter the institute which have good financial support which is enough to pay their fees and need.
In conclusions, all of the factors troublesome the students in deciding their next institution of study. It was a lot more than to learn academically -it can do bucket load for their future.
Thursday, August 19, 2010
Wednesday, August 18, 2010
HIV ( Human Immunodeficiency Virus) MUST READ!!
What is HIV and AIDS?
HIV stands for Human Immunodeficiency Virus. HIV is a virus that takes over certain immune system cells to make many copies of itself. HIV causes slow but constant damage to the immune system.
AIDS stands for Acquired Immune Deficiency Syndrome. AIDS is the condition diagnosed when there are a group of related symptoms that are caused by advanced HIV infection or when someone has less than 200 CD4 cells (immune cells). AIDS makes the body vulnerable to life-threatening illnesses called opportunistic infections.
Normally, the human immune system is the body’s protection against bacteria, viruses, etc. It acts like a coat of armor. When HIV enters the body, it starts poking holes in the armor. Eventually, the armor becomes very weak and unable to protect the body. Once the armor is very weak or is gone, the person is said to have AIDS.
An AIDS diagnosis is generally made when either the body's protective T-cells drop below a certain level, or the HIV-positive individual begins to experience opportunistic infections. An opportunistic infection is an infection that would not be life-threatening to an otherwise healthy person. Oftentimes, it's these infections that are the cause of illness or death in HIV-positive individuals -- not the virus itself. If people do not get any treatment for HIV disease, it takes an average of 8-10 years to progress from HIV to AIDS.
HIV is transmitted through four body fluids: blood, semen (and precum), vaginal fluid, and breast milk.
In order to pass HIV from one person to another, HIV-infected fluid from one person needs to get into the bloodstream of another person. HIV is usually transmitted through sharing needles, unprotected anal, vaginal, and sometimes oral sex, and from mother to infant before or during delivery or while breastfeeding.
In order to pass HIV from one person to another, HIV-infected fluid from one person needs to get into the bloodstream of another person. HIV is usually transmitted through sharing needles, unprotected anal, vaginal, and sometimes oral sex, and from mother to infant before or during delivery or while breastfeeding.
Special note for HIV-positive mothers:
In developed countries like the U.S., formula feeding is strongly recommended over breastfeeding for babies of HIV-positive mothers. Whether choosing breastfeeding or formula, there should be little or no switching between the two, as doing so could put the child at a higher risk of contracting HIV, since baby formula can be harsh and weaken the lining of a baby's stomach, giving a path for HIV to enter the baby's bloodstream.
Becoming educated about HIV and understanding how it is transmitted is the first and perhaps most important way to prevent the spread of HIV. It is essential for people to make informed decisions about the level of risk they are willing to take, based on what is realistic for them.
Abstaining from sex and not sharing needles are the most effective ways for people to protect themselves from HIV and other sexually transmitted diseases (STDs). However, abstinence is not a realistic option for everyone.
Safer sex
When abstinence is not an option, the proper use of barrier protection such as latex or polyurethane condom (male or female) with a water based lubricant is the next best thing for vaginal or anal sex.
Note: Some water-based lubricants (including those already on some condoms) contain a spermicide called Nonoxynol-9 (N-9). Many people are allergic to N-9 and the resulting genital irritation can increase the risk of HIV and STD transmission by providing a direct entry point. You can test for a N-9 allergy by rubbing N-9 lubricant on the inside of the elbow the day before you plan to use the product for sex. If there is no irritation, there is likely no allergy.
The best way to reduce the risk of HIV transmission while performing oral sex is to maintain good oral hygiene. That, in addition to not flossing or brushing your teeth right before or after will also reduce the risk of transmission.
Performing oral sex on a woman ("go down", "eat pussy")
When performing oral sex on a woman, a dental dam or common kitchen plastic wrap can be used as a barrier to protect from HIV transmission. It covers the area you are performing oral sex on (vagina or anus). If you do not have a dental dam, you can also use a new, unused, non-lubricated or flavored condom by stretching it out and cutting it down the side, then stretching it out in the same way you would a dental dam or plastic wrap.
Performing oral sex on a man ("blowjob", "head")
In addition to good oral hygiene, proper use of a non-lubricated or flavored condom on a man can significantly decrease risk of HIV transmission. If a condom is not available or an option, not accepting semen into the mouth or spitting rather than swallowing will reduce the risk. You can also use the "harmonica method" by focusing on the shaft of the penis while avoiding the head.
Performing oral sex on the anus ("rimming", "eating ass")
For oral to anal contact, or rimming, a dental dam, plastic wrap, or a condom can be used in the same way described above under the heading “Performing Oral Sex on a Woman.” This can be a great barrier against not only HIV, but possible Hepatitis A exposure.
Receiving oral sex
Since HIV is not transmitted by saliva, there is generally no risk in receiving oral sex (unless there is a lot of blood in their mouth).
Most male condoms are made of latex. Since some people are allergic to latex (your doctor can test for it if you've ever experienced irritation from latex) there are also polyurethane condoms available. When used properly, both latex and polyurethane condoms are effective ways of significantly reducing the risk of HIV transmission.
Note: Lambskin (aka "natural") condoms will not protect against HIV or other sexually transmitted infections (STIs).
When using either latex or polyurethane condoms for vaginal or anal sex, water based lubricants on the outside of the condom will help to reduce friction that could cause the condom to tear. If desired, a small amount can be placed inside the tip of the condom as well.
Important Note: Use of oil based lubricants such as Vaseline can deteriorate latex condoms and significantly increase their chance of breaking. Oil based lubricants should only be used with polyurethane condoms.
When using a male condom
- Keep it fresh! Always store condoms in a cool dry place (not a wallet) and check the expiration date.
- Check it! Squeeze the package gently to make sure there are no punctures and be sure to not use your teeth to open the package. Your teeth could rip the condom!
- Heads Up! Unroll the condom a little before putting it on and make sure it's able to roll easily down the penis. Squeeze the tip (so semen can collect) and roll the condom from the tip of the penis all the way to the base. If uncircumcised, pull the foreskin back before putting the condom on.
- Don't Double Up! Be sure to never use more than one condom at a time. Doubling up can lead to friction and possibly the condom breaking. One condom is sufficient.
- Lube it Up! Apply lots of water based lubricant to the condom to prevent friction which could cause breakage.
- Take It Easy! After ejaculation (cumming), remove the penis from the vagina/anus/mouth while still erect and carefully unroll and remove the condom. Be careful to not spill any semen on your partner.
Never use a condom for more than one session. Always use a new condom each time you have sex, or when you switch from oral to vaginal or anal sex. This will reduce the risk of the condom breaking.
When using a female or reality condom
Although it is referred to as the female condom, it can be used by both men and women. For the female condom, make sure to put it into place before your partner's penis comes into contact with the vagina or anus. Once in place, carefully guide the penis into the condom, making sure to enter the condom and not outside of the condom's external rim.
For vaginal sex
- Press the inner ring between your fingers to narrow it and make it easier to insert.
- Hold the condom with its open end pointing down, and insert the closed end into the vagina, letting the wider end remain around the opening of the vagina (it's easier to insert if the knees are spread apart). You can also place the female condom on an erect penis or dildo to insert it.
- Push the condom up into the vagina, until it is just past the pubic bone (you can tell where the pubic bone is by curving the index finger when it has gone a couple inches into the vagina).
- When removing the female condom, squeeze the end, twist the condom to keep the semen inside, and pull out. DO NOT FLUSH.
For anal sex
- Remove the internal ring and place the condom on the partner's erect penis or a dildo.
- Use the penis/dildo to carefully insert the condom into the anus of the receptive partner.
- To remove, squeeze the end of the condom, twist to hold the semen inside and remove.
Tracheostomy
Definition
Among the oldest described surgical procedures, tracheotomy (also referred to as pharyngotomy, laryngotomy, and tracheostomy) consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea. The resulting stoma can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person tobreathe without the use of their nose or mouth. Both surgical and percutaneous techniques are widely used in current surgical practice.
Figure1 :Traquestomia
Among the oldest described surgical procedures, tracheotomy (also referred to as pharyngotomy, laryngotomy, and tracheostomy) consists of making an incision on the anterior aspect of the neck and opening a direct airway through an incision in the trachea. The resulting stoma can serve independently as an airway or as a site for a tracheostomy tube to be inserted; this tube allows a person tobreathe without the use of their nose or mouth. Both surgical and percutaneous techniques are widely used in current surgical practice.
Figure1 :Traquestomia
Indications
In the acute setting, indications for tracheotomy include such conditions as severe facial trauma, head and neck cancers, large congenital tumors of the head and neck (e.g., branchial cleft cyst), and acute angioedema and inflammation of the head and neck. In the context of failed orotracheal or nasotracheal intubation, either tracheotomy or cricothyrotomy may be performed. In the chronic setting, indications for tracheotomy include the need for long-term mechanical ventilation and tracheal toilet (e.g. comatose patients, or extensive surgery involving the head and neck).
Surgical Instrument
Tracheostomy tube
As with most other surgical procedures, some cases are more difficult than others. Surgery on children is more difficult because of their smaller size. Difficulties such as a short neck and bigger thyroid glands make the trachea hard to open. There are other difficulties with patients with irregular necks, the obese, and those with a large goitre. The many possible complications include hemorrhage, loss of airway, subcutaneous emphysema, wound infections, stomal cellulites, fracture of tracheal rings, poor placement of the tracheotomy tube, and bronchospasm".
By the late 19th century, some surgeons had become proficient in performing the tracheotomy. The main instruments used were:
“Two small scalpels, one short grooved director, a tenaculum, two aneurysm needles which may be used as retractors, one pair of artery forceps, haemostatic forceps, two pairs of dissecting forceps, a pair of scissors, a sharp-pointed tenotome, a pair of tracheal forceps, a tracheal dilator, tracheotomy tubes, ligatures, sponges, a flexible catheter, and feathers” Haemostatic forceps were used to control bleeding from separated vessels that were not ligatured because of the urgency of the operation. Generally, they were used to expose the trachea by clamping the isthmus thyroid gland on both sides. To open the trachea physically, a sharp-pointed tentome allowed the surgeon easily to place the ends into the opening of the trachea. The thin points permitted the doctor a better view of his incision. Tracheal dilators, such as the “Golding Bird”, were placed through the opening and then expanded by “turning the screw to which they are attached.” Tracheal forceps, as displayed on the right , were commonly used to extract foreign bodies from the larynx. The optimum tracheal tube at the time caused very little damage to the trachea and “mucus membrane”.
The best position for a tracheotomy was and still is one that forces the neck into the biggest prominence. Usually, the patient was laid on his back on a table with a cushion placed under his shoulders to prop him up. The arms were restrained to ensure they would not get in the way later The tools and techniques used today in tracheotomies have come a long way. The tracheotomy tube placed into the incision through the windpipe comes in various sizes, thus allowing a more comfortable fit and the ability to remove the tube in and out of the throat without disrupting support from a breathing machine. In today’s world general anesthesia is used when performing these surgeries, which makes it much more tolerable for the patient. Special tubes have always been created to assist people in their speech. With these unique speaking tubes, people can breathe and talk through these tubes. When they exhale the air passes through the tube and vocal cords, producing sound.
The tracheotomy underwent centuries of denial and rejection as well as much failure. Finally, in recent decades, it has become a commonly accepted, crucial, and successful surgery that has saved the lives of hundreds of thousands of patients.
Nursing Education Today
Vaccination competence of graduating public health nurse students.
BACKGROUND: Vaccination is a globally significant health prevention method implemented by health care professionals around the world. To date, however, there has been little research measuring vaccinators' vaccination competence. AIM: This paper evaluates the vaccination competence of graduating Finnish public health nurse students in order to develop teaching in vaccinators' basic and continuing education. METHODS: Data were collected using a structured instrument developed for this study. The participants were graduating public health nurse students (n=129). The measurement focused on the students' self-assessment of their vaccination competence using a Visual Analog Scale (VAS), whereas their vaccination knowledge was tested with a knowledge test. RESULTS: Students assessed their level of vaccination competence as high. According to the self-assessment, their best competence area was achieved in the outcome of the implementation of vaccination. The students' poorest competence area was displayed in their qualities as vaccinators. In the knowledge test, the students distinguished vaccination recommendations and common contraindications well, but managing an anaphylactic reaction as well as knowing the names of vaccines showed room for improvement. CONCLUSIONS: Vaccination competence can be measured by means of the structured instrument we developed. In Finland, more vaccination education in basic and continuing education is needed to maintain and develop vaccination competence.
http://pubget.com/search?q=issn:0260-6917&campaign=70216868&paperstore=true&gclid=CMverfrDwqMCFQxB6wodcHQJZw
BACKGROUND: Vaccination is a globally significant health prevention method implemented by health care professionals around the world. To date, however, there has been little research measuring vaccinators' vaccination competence. AIM: This paper evaluates the vaccination competence of graduating Finnish public health nurse students in order to develop teaching in vaccinators' basic and continuing education. METHODS: Data were collected using a structured instrument developed for this study. The participants were graduating public health nurse students (n=129). The measurement focused on the students' self-assessment of their vaccination competence using a Visual Analog Scale (VAS), whereas their vaccination knowledge was tested with a knowledge test. RESULTS: Students assessed their level of vaccination competence as high. According to the self-assessment, their best competence area was achieved in the outcome of the implementation of vaccination. The students' poorest competence area was displayed in their qualities as vaccinators. In the knowledge test, the students distinguished vaccination recommendations and common contraindications well, but managing an anaphylactic reaction as well as knowing the names of vaccines showed room for improvement. CONCLUSIONS: Vaccination competence can be measured by means of the structured instrument we developed. In Finland, more vaccination education in basic and continuing education is needed to maintain and develop vaccination competence.
http://pubget.com/search?q=issn:0260-6917&campaign=70216868&paperstore=true&gclid=CMverfrDwqMCFQxB6wodcHQJZw
1 Malaysia concept all about unity - Prime Minister
Prime Minister Datuk Seri Najib Tun Razak said that the 1Malaysia concept’s ultimate objective is to achieve national unity among its people. He said "In other words, 1Malaysia is a concept to foster unity in Malaysians of all races based on several important values which should become the practice of every Malaysian. 1Malaysia is a formula which serves as a prerequisite to ensure realisation of the country's aspiration to achieve developed nation status by 2020 if it is assimilated in the people and practised by society. If 'Bangsa Malaysia' (the Malaysian race) outlined in Vision 2020 is the ultimate objective of this journey, then 1Malaysia is the guide pointing the way towards that objective. As such, let not anyone feel apprehensive or suspicious and worried that the concept would deviate from what had been agreed to by our forefathers. In fact, 1Malaysia values and respects the ethnic identities of every community in Malaysia and regards them as assets to be proud of,"
He added that "This justice must take into account the different levels of progress of the races. As such, the government policies and constitutional provisions which safeguard the needy will continue to be implemented. The core elements of unity are, firstly, the attitude of acceptance among the races and the people, secondly, principles of nationhood based on the Federal Constitution and the Rukun Negara (National Ideology), and, thirdly, social justice,"
FLASHBACK: Prime Minister Datuk Seri Najib Razak and children miling around
a huge 1Malaysia logo during his visit
http://www.malaysiatoday.com/Latest-News/1malaysia-concept-all-about-unity-pm.html
He added that "This justice must take into account the different levels of progress of the races. As such, the government policies and constitutional provisions which safeguard the needy will continue to be implemented. The core elements of unity are, firstly, the attitude of acceptance among the races and the people, secondly, principles of nationhood based on the Federal Constitution and the Rukun Negara (National Ideology), and, thirdly, social justice,"
FLASHBACK: Prime Minister Datuk Seri Najib Razak and children miling around
a huge 1Malaysia logo during his visit
http://www.malaysiatoday.com/Latest-News/1malaysia-concept-all-about-unity-pm.html
'Gaza aims at Guinness Book of Record for largest Ramadhan lamp'
In the latest Guinness world book of record bid aimed at highlighting the Palestinian struggle a Gaza resident on Tuesday unveiled the "world's largest Ramadhan lamp."
The 10-metre (33 foot) high and 3.5 metre (11.5 feet) wide structure made out of wood and cloth was modelled on the lamps that adorn streets across the Muslim world during the festive fasting month.
"I am determined to set a Guinness world record in order to send a message to the world to break the siege on Gaza," Mustafa Massoud, 24, told AFP, adding that he had spent 400 dollars (300 euros) on materials to build the lamp.
He said he also hoped to send a message to rival Palestinian governments in Gaza and the West Bank to resolve their differences.
The attempt follows bids by the UN agency for Palestinian refugees (UNRWA) to set records for the most children bouncing basketballs and the most flying kites, events held last month.
The two feats were also aimed at attracting international attention to the plight of Palestinians in Gaza, which has been under a four-year Israeli and Egyptian blockade that has kept out all but vital goods.
Israel moved to ease the closures in June following a deadly raid on a Gaza-bound aid fleet that sparked international outrage, and these days allows in virtually all purely civilian goods.
It still prevents Gazans from exporting however, and strictly limits the movement of people in and out of the territory, which has been ruled by the militant Hamas movement since June 2007.
'Palestinians gather around a giant paper lantern'
Tuesday, August 17, 2010
Seasons In The Sun
Nothing much from us..just a simple lyrics for you to sing..
"Seasons In The Sun"
[Kian:]
Goodbye to you my trusted friend
We've known each other since we were nine or ten
Together we've climbed hills and trees
Learned of love and ABC's
Skinned our hearts and skinned our knees
[Bryan:]
Goodbye my friend it's hard to die
When all the birds are singing in the sky
Now that spring is in the air
Pretty girls are everywhere
Think of me and I'll be there
[All:]
We had joy we had fun we had seasons in the sun
But the hills that we climbed were just seasons out of time
[Shane:]
Goodbye Papa please pray for me
I was the black sheep of the family
You tried to teach me right from wrong
Too much wine and too much song
Wonder how I got along
[Mark:]
Goodbye papa it's hard to die
When all the birds are singing in the sky
Now that the spring is in the air
Little children everywhere
When you see them I'll be there
[All:]
We had joy we had fun we had seasons in the sun
But the wine and the song like the seasons have all gone
We had joy we had fun we had seasons in the sun
But the wine and the song like the seasons have all gone
[Nicky:]
Goodbye Michelle my little one
You gave me love and helped me find the sun
And every time that I was down
You would always come around
And get my feet back on the ground
[Shane:]
Goodbye Michelle it's hard to die
When all the birds are singing in the sky
Now that the spring is in the air
With the flowers everywhere
I wish that we could both be there
[All:]
We had joy we had fun we had seasons in the sun
But the hills that we climbed were just seasons out of time
We had joy we had fun we had seasons in the sun
But the wine and the song like the seasons have all gone
We had joy we had fun we had seasons in the sun
But the hills that we climbed were just seasons out of time
We had joy we had fun we had seasons in the sun
But the wine and the song like the seasons have all gone
The Middle Ear and Its Structures
Click on Image
The middle ear is a hollow chamber in the bone of the skull. It is separated from the outside world by a thin membrane about half-an-inch in diameter, the eardrum. The middle ear area is lined by the same kind of mucous membrane that lines nose and mouth. It is connected to the back of the nose, just above the soft upper portion of the mouth, by a narrow passage called the eustachian tube.
The eustachian tube lies closed until the swallowing movement pulls it open and allows fresh air to enter the middle ear. The fresh air is needed to replace oxygen that has been absorbed by the middle ear lining. The fresh air equalizes the middle ear pressure with the air pressure outside the head. Some people hear this burst of fresh air as a pop or click.
Suspended within the middle ear is a chain of three small bones, the ossicles, which conduct sound vibrations from the eardrum across the middle ear into the fluid-filled inner ear. Inside the inner ear these vibrations are converted to nerve signals that are carried by the auditory nerve to the brain.
The mastoid bone is an extension of the air space of the middle ear. It is made up of small interconnected air spaces similar to a honeycomb. Its function is not clear, but it is often involved in chronic ear infections. Within it lie the structures of the inner ear responsible for balance and facial expression.
Chronic Otitis Media (COM) is the term used to describe a variety of signs, symptoms, and physical findings that result from the long-term damage to the middle ear by infection an inflammation. This includes the following:
- Severe retraction or perforation of the eardrum (a hole in the eardrum)
- Scarring or erosion of the small, sound conducting bones of the middle ear
- Chronic or recurring drainage from the ear
- Inflammation causing erosion of the bony cover or the facial nerve, balance canals, or cochlea (hearing organ)
- Erosion of the bony borders of the middle ear or mastoid, resulting in infection spreading to the meninges (the coverings of the brain) or brain
- Presence of cholesteatoma
- Persistence of fluid behind an intact eardrum
If the eustachian tube becomes blocked by swelling or congestion in the nose and throat, by swelling of the mucous membrane in the middle ear, or by swelling of the mucous membrane of the eustachian tube itself, the air pressure in the middle ear cannot equalize properly. A negative pressure develops, and if the obstruction is prolonged, fluid may be drawn into the air space of the middle ear from the mucosa. This may occur with a cold or flu virus and is a common cause of ear infections in children (serous otitis media). Serous otitis media usually resolves without treatment, but may require a course of antibiotics or steroids. It is a common reason for placement of tubes in children and adults.
If the eustachian tube blockage persists, chronic changes in the tissue of the middle ear begin to occur. First, the mucous secretions become thicker, and therefore less likely to drain. Then the membranes themselves begin to thicken and become inflamed. The defense mechanisms of the eustachian tube and middle ear become compromised and bacteria normally present in the nose may enter the middle ear and cause a painful condition called acute otitis media.This responds to antibiotic treatment, but may require placement of tubes.
The negative pressure in the middle ear or alternating periods of negative, normal and positive pressure may deform the eardrum. In the long term, the eardrum may become severely distorted, thinned, or even perforated. These changes may cause hearing loss and a sensation of pressure. When there is a hole in the eardrum, the natural protection of the middle ear from the environment is lost. Water and bacteria entering the middle ear from the ear canal can cause inflammation and infection. Drainage from the ear is a sign of a perforation.
Inflammation and infection in time can cause erosion of the ossicles and the walls of the middle and inner ear. The patient may experience hearing loss, imbalance, or weakness of facial movement on the affected side. In rare instances, the infection may extend deeper into the head, causing meningitis or brain abscess.
Click on Image
A cholesteatoma, or skin cyst, is essentially skin in the wrong place. Epidermal skin from the ear canal or outside surface of the eardrum, like that on the back of the hand, does not belong in the middle ear. If it is trapped by a deformed eardrum or migrates through a perforation, it tends to grow out of control and can cause significant damage to the structures of the middle ear and mastoid.
Warning signs of chronic otitis media include:
- Persistent blockage of fullness of the ear
- Hearing loss
- Chronic ear drainage
- Development of balance problems
- Facial weakness
- Persistent deep ear pain or headache
- Fever
- confusion or sleepiness
- Drainage or swelling behind the ear
Chronic otitis media generally occurs gradually over many years in patients with longstanding or frequent ear trouble. However, it can occasionally develop over several months in a patient with no previous history of ear disease. Any of the above symptoms should prompt an evaluation by an ENT or otologist/neurotologist.
The first step in treating otitis media is a thorough evaluation by a physician. This will include a history and examination of the ear, nose, and throat. Depending on the individual situation, further testing will include a hearing test, tympanometry (a test that measures the pressure in the middle ear) and CT or MRI scan.
Treatment depends upon the stage of the disease. Initially, efforts to control the causes of eustachian tube obstruction, such as allergies or other head and neck infectious problems, may prevent progression of chronic otitis media. Uncomplicated chronic ear fluid is treated with antibiotics, steroids, and/or placement of ventilation tubes. Many children with chronic or recurrent ear infections have ventilation tubes inserted in their eardrums to allow normal air exchange in the middle ear until the eustachian tube matures.
Once the disease has progressed to the point of significant damage to the eardrum or ossicles, more intensive treatment is needed. If active infection is present in the form of ear drainage, antibiotic eardrops are prescribed. Occasionally, these may be supplemented with oral antibiotics.
Once the active infection is controlled, surgery is usually recommended. There are three objectives of surgery for COM:
- Eradication of the disease
- Remodeling of the middle ear and mastoid bone, located just behind the external ear, to prevent recurrence
- Preservation or improvement in hearing
Surgeries to achieve these objectives include tympanoplasty, mastoidectomy, or typanomastoidectomy. The ENT doctor or otologist makes an incision within the ear canal or behind the external ear. Part of the mastoid bone is then drilled away to gain access to the middle ear space. The abnormal tissues are removed. If possible, efforts are made to rebuild the eardrum and the sound-conducting bones. It is sometimes necessary, however, to complete the hearing reconstruction at a later date (a second stage) rather than at the same time as removal of the infected or damaged parts. Patients are usually discharged from the hospital on the same day or one day after surgery.
Healing after surgery takes several months. In 90 percent of cases, surgery is successful in repairing the eardrum and a dry, healthy ear results. Hearing improvement is more difficult to predict and varies greatly depending on the severity of the disease, including the presence of cholesteatoma, ossicular erosion, mastoid disease, and eustachian tube function. If a hearing reconstruction was performed, it will take several weeks and months for hearing to begin improving. During this time middle ear packing and fluids are being reabsorbed and scar tissue is being formed to help stiffen the bones. In addition, the eardrum thins out. These factors contribute to a gradual hearing improvement.Routine checkups by the physician are recommended at least yearly after the healing is complete, and in some cases may be required two or more times yearly to maintain adequate local hygiene.
Subscribe to:
Posts (Atom)