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Background: The Otitis media is an important and a highly prevalent disease of the middle ear and poses serious health problem world-wide especially in developing countries where large percentage of the population lacks specialized medical care. With a large number of patients frequently undergoing tympanoplasty for chronic suppurative otitis media (CSOM), it is important to assess the severity of the disease and predict the outcome of the surgical management. Materials and Methods: This was a prospective study of 90 cases of chronic otitis media, carried out over one year, who underwent various types of tympanoplasty, carried out in the Department of Ear, Nose, and Throat (ENT), Tertiary Care Teaching Hospital. The selection of cases was by convenience sampling method. All the cases of Chronic Otitis Media (COM), mucosal and squamous, in the age group of 10–80 years, irrespective of gender were included. Patients above 80 years, sensorineural or mixed hearing loss, COM with complications, any co morbid medical condition and unwilling patients were excluded. Result: The clinical profile of cases in present study. Almost all patients (97.8%) have complaint of on and off ear discharge followed by 91.1% cases having complaint of HOH followed by tinnitus (in 24.4% cases). In this study, 11.1% of the patients had active discharge. Maximum patients (48.9%) had ear dry for less than 3 months, rest had dry ear for more than 3 months. Three patients had history of trauma and no history of ear discharge. Ossicular involvement was seen in only 18.9% cases while in 81.1% cases, there was no ossicular involvement. In majority of cases (80%) middle ear mucosa was dry followed by wet mucosa in 13.3% cases. Total number of patients with score 1-3 (mild score) were 64.2%, with score 4-6 (moderate disease) were 27.1% and with score 7-12 (severe disease) were 8.7%. Conclusion: This study concludes that the MERI can be a useful tool in the preoperative evaluation in order to assess the probability of success of tympanoplasty. [ABSTRACT FROM AUTHOR]

Jack D Sobel,1 Navkiranjot Kaur,2 Nicole A Woznicki,1 Dina Boikov,1 Tina Aguin,3 Gurveer Gill,2 Robert A Akins21Division of Infectious Diseases, Wayne State University School of Medicine, Detroit, MI, USA; 2Department of Biochemistry, Microbiology, and Immunology, Wayne State University School of Medicine, Detroit MI, USA; 3Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USAPurpose: Oral metronidazole therapy is the standard of care for bacterial vaginosis (BV), yet it has alarming rates of recurrence and refractory responses among recurrent BV (RBV) patients. This study addresses whether high dose vaginal metronidazole therapy (HDM) is beneficial in RBV patients who fail after standard of care (SOC) therapy, whether diagnostic test scores proximal to the HDM predict clinical outcome, and whether menses, coitus, or race influences therapy outcome.Patients and methods: A total of 90 patients with RBV were given SOC and tracked 74 for up to 9 months. Refractory or recurrent patients (57) with symptomatic BV were given HDM and followed for up to 8 months. Patients were evaluated by Amsel criteria, Nugent score, and a qPCR assay that assesses the Lactobacillus content.Results: HDM achieved at least short-term remission in 68% of the patients who were refractory to or recurred after SOC and provided a 10-day increase in the mean duration of remission among patients who eventually recurred (p=0.027). Patients with prolonged dysbiosis (pH >5 or Amsel 4) before symptomatic recurrence were more likely to recur after subsequent HDM. Most recurrence happened within 10 days of menses, but sex in this cohort was not associated with clinical outcome. Mean diagnostic BV scores of African American patients in remission were inferior to scores of a small cohort of Caucasian patients in remission.Conclusion: Encouraging results obtained with HDM justify a prospective, randomized study to determine if follow-up HDM is beneficial among a broader cohort of women failing conventional oral metronidazole therapy.Keywords: nugent score, amsel criteria, LbRC, prognosis of bacterial vaginosis