title: Comparison of steroid antibiotic pack and 10% ichthammol glycerine pack in relieving pain of acute otitis externa in children.
abstract: OBJECTIVE
  This study was carried out with the objective of comparing clinical efficacy of 10% ichthammol glycerine (IG) pack with steroid-antibiotic pack for relieving pain in cases of acute otitis externa.
  
  
  METHODS
  A prospective quasi-randomized clinical trial was completely carried out in 65 patients at Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu. Patients of less or equal to 12 years of age and both gender presenting in our outpatient department from October 2008 to December 2009 and diagnosed to have acute otitis externa was evaluated. Six patients were excluded from the study because of not meeting the inclusion criteria. Alternately IG and steroid antibiotic packing were done. For steroid antibiotic group, we use betnovate-N, a combination of betnovate sodium phosphate 0.1% and neomycin sulphate 0.5%. Before packing was carried out, pain was assessed using Wong Baker Scale. Statistical analysis was done using "Z" test of mean to compare average number of pain score and visits in two different groups.
  
  
  RESULTS
  There were 33 patients in IG pack group and 32 patients in steroid antibiotic group. In less than 4 years, there were 30 children and in more than 4 years children, there were 35 children. There was male predominance in both the treatment groups and disease was most common in age group less than 4 years. There was statistical significant decrease in number of visits in steroid group in both children less than and more than 4 years. There was also significantly less pain in children with steroid antibiotic group.
  
  
  CONCLUSIONS
  Use of steroid antibiotic pack in children presenting with acute otitis externa causes earlier relief of pain as well as significantly lesser number of visits. Thus, steroid antibiotic pack is better than 10% ichthammol glycerine packs in relieving pain in acute otitis externa in children.
authors.affiliation: Department of ENT and Head and Neck Surgery, TU Teaching Hospital, Kathmandu, Nepal. drprakashadhikari@hotmail.com
authors.forename: Prakash
authors.initials: P
authors.lastname: Adhikari
authors.forename: Rishi
authors.initials: R
authors.lastname: Bhatta
authors.forename: Sukmit
authors.initials: S
authors.lastname: Bhandari
authors.forename: Manita
authors.initials: M
authors.lastname: Pyakurel Bhatta
mesh_terms: D000208:Acute Disease; D001624:Betamethasone Valerate / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004338:Drug Combinations; D005260:Female; D005500:Follow-Up Studies; D005990:Glycerol / Q000008:administration & dosage; D006801:Humans; D007223:Infant; D008297:Male; D009355:Neomycin / Q000008:administration & dosage*; D009390:Nepal; D010032:Otitis Externa / Q000175:diagnosis* / Q000188:drug therapy*; D010147:Pain Measurement; D011446:Prospective Studies; D000644:Quaternary Ammonium Compounds / Q000008:administration & dosage*; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D004338:Drug Combinations; D000644:Quaternary Ammonium Compounds; C032082:betamethasone 17-valerate, neomycin drug combination; D001624:Betamethasone Valerate; D009355:Neomycin; C089399:ichthammol; D005990:Glycerol