Categories
Ailmemts & Remedies

Ears Popping when Flying

Introduction:
The ear consists of three chambers:

English: The middle ear : 1)Eardrum 2)Ossicles...
English: The middle ear : 1)Eardrum 2)Ossicles 3)Eustachian tube 4)Tensor tympani Français : Oreille moyenne : 1)Tympan 2)Chaine ossiculaire 3)Trompe d’Eustache 4)Muscle du marteau (Photo credit: Wikipedia)

1 – skull
2 – ear canal
3 – pinna
4 – tympanum
5 – fenestra ovalis
6 – malleus
7 – incus
8 – stapes
9 – labyrinth
10 – cochlea
11 – auditory nerve
12 – eustachian tube

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•The outer ear canal which leads up to the ear drum.
•The middle ear chamber behind the drum which is filled with air.
•The very specialised inner ear.

The air in the middle ear is constantly being absorbed by the membranes that line the cavity, so the internal pressure can easily drop, putting tension on the tissues there. Fortunately, air is frequently resupplied to the middle ear during the process of swallowing.

Usually when you swallow, a small bubble of air passes from your throat or back of your nose, through a narrow tube known as the Eustachian tube which is usually closed, into your middle ear. As it does this, it makes a tiny click or popping sound.

This action keeps the air pressure on both sides of the eardrum about equal. If the air pressure isn’t equal, for example if the Eustachian tube isn’t working efficiently or if pressures suddenly change, the ear feels blocked or uncomfortable.

The pocket of air in the middle ear is particularly vulnerable to the changes in air pressure as you go up in a plane.

Click to see picture

The higher the plane, the lower the air pressure around you, although inside the cabin you’re protected, to some extent, from these pressure changes. Pressure in the middle ear remains higher until the Eustachian tube opens up to allow the pressure to equalise. Until this happens the relatively lower pressure outside the middle ear pulls the ear drum and tissues of the middle ear outwards, making them feel very uncomfortable.

The eardrum is stretched and can’t vibrate properly, so sounds become muffled. When the Eustachian tube opens, air travels out from the middle ear, making a popping noise as pressure equalises.

During the descent in a plane, the opposite happens as pressure builds up outside the ear, pushing the eardrum inwards.

Abnormal pressure can develop in the middle ear, pulling in or stretching the ear drum, when the Eustachian tube is blocked for other reasons – as the result of a bad cold, for example, or a nasal allergy – or because it’s narrow as a result of childhood ear infections.

Treatment and recovery:
Flyers often experience what is referred to as ear barotrauma or airplane ear. This condition is caused by the change in pressure between the inside and outside of the eardrum that causes the eustachian tubes inside the ear to swell. The popping noise in your ear is the sound of the eustachian tube opening. There are some simple tips that can be used to pop your ears in an effort to ease the pain and discomfort associated with airplane ear.
The following can help to relieve the problem:

•Swallowing activates the muscle that opens the Eustachian tube, and you swallow more often when chewing gum or sucking sweets so try this just before and during descent.
•Yawning is an even stronger activator of the muscles.
•Avoid sleeping during descent, because you may not be swallowing often enough to keep up with the pressure changes.

The most forceful way to unblock your ears is to pinch your nostrils, take in a mouthful of air and use your cheek and throat muscles to force the air into the back of your nose, as if you were trying to blow your thumb and fingers off your nostrils. You may have to repeat this several times before your ears pop.

Decongestants shrink internal membranes and make your ears pop more easily. Ask your pharmacist for advice. However, you should avoid making a habit of using nasal sprays, because after a few days they may cause more congestion than they relieve.

Few more Tips to releave :

Eat Candy or Chew Gum
One of the easiest ways to pop your ears is to chew a piece of gum or suck on a piece of hard candy. This forces your ears to pop on purpose by allowing the muscles around your eustachian tube to open. The movement of the jaw equalizes the pressure between the inside and outside of the eardrum upon the opening of the eustachian tube.

Ear Plugs
Purchase earplugs that are specifically designed for flying. The earplugs restrict the flow of air into your inner ear, allowing it more time to keep up with the rapid change in pressure. Earplugs can be purchased at your local pharmacy or drug store.

Breathing
There is a special way you can breathe to release the pressure in your ears while flying. Inhale, and then gently exhale while holding the nostrils closed and the mouth shut. Repeat several times, especially during descent, to equalize the pressure between your ears and the airplane cabin.

Use A Decongestant
Purchase an oral or nasal spray decongestant. A decongestant can be used before, during, or after the flight to relieve any built-up nasal congestion, and to open the eustachian tube. For best results, use a spray decongestant 30 minutes prior to landing. If is best to take an oral decongestant 30 minutes to an hour prior to your plane taking off.

Tips For Babies
The best way to control the change in pressure between the inside and outside of a baby’s eardrum is to have the child suck on a bottle or pacifier during take off and landing. It is also important to make sure that a baby does not sleep during descent.

To learn few more Tips You may click to see :How to Keep My Ears From Popping While Flying

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.bbc.co.uk/health/physical_health/conditions/earspopping.shtml
http://www.eustachian-tube.net/EUSTACHIAN-TUBE.html
http://www.ehow.com/list_6821346_tips-pop-ears-flying.html

http://commons.wikimedia.org/wiki/File:Ear-anatomy.png

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Categories
Ailmemts & Remedies

Ear Infection

Alternative Names: Otitis media – acute; Infection – inner ear; Middle ear infection – acute
………………...CLICK & SEE
Definition:
Ear infections are one of the most common reasons parents take their children to the doctor. While there are different types of ear infections, the most common is called otitis media, which means an inflammation and infection of the middle ear. The middle ear is located just behind the eardrum.

There are two types of ear infection…Acute & Cronic.

The term “acute” refers to a short and painful episode. An ear infection that lasts a long time or comes and goes is called chronic otitis media.

You may click to learn more about ear infection:

Symptoms
An acute ear infection causes pain (earache). In infants, the clearest sign is often irritability and inconsolable crying. Many infants and children develop a fever or have trouble sleeping. Parents often think that tugging on the ear is a symptom of an ear infection, but studies have shown that the same number of children going to the doctor tug on the ear whether or not the ear is infected.

CLICK & SEE:->

Common Ear Infection

Acute Ear Infection

Cronic Ear Infection

Ear Infection of Bone

Other possible symptoms include:
*Fullness in the ear
*Feeling of general illness
*Vomiting
*Diarrhea
*Hearing loss in the affected ear
*The child may have symptoms of a cold, or the ear infection may start shortly after having a cold.

All acute ear infections include fluid behind the eardrum. You can use an electronic ear monitor, such as EarCheck, to detect this fluid at home. The device is available at pharmacies.

Possible Causes:
Ear infections are common in infants and children in part because their eustachian tubes become clogged easily. For each ear, a eustachian tube runs from the middle ear to the back of the throat. Its purpose is to drain fluid and bacteria that normally occurs in the middle ear. If the eustachian tube becomes blocked, fluid can build up and become infected.
Anything that causes the eustachian tubes and upper airways to become inflamed or irritated, or cause more fluids to be produced, can lead to a blocked eustachian tube. These include:

*Colds and sinus infections
*Allergies
*Tobacco smoke or other irritants
*Infected or overgrown adenoids
*Excess mucus and saliva produced during teething

Ear infections are also more likely if a child spends a lot of time drinking from a sippy cup or bottle while lying on his or her back. Contrary to popular opinion, getting water in the ears will not cause an acute ear infection, unless the eardrum has a hole from a previous episode.

Ear infections occur most frequently in the winter. An ear infection is not itself contagious, but a cold may spread among children and cause some of them to get ear infections.

Risk factors:

*Not being breast-fed
*Recent ear infection
*Recent illness of any type (lowers resistance of the body to infection)
*Day care (especially with more than 6 children)
*Pacifier use
*Genetic factors (susceptibility to infection may run in families)
*Changes in altitude or climate
*Cold climate
*Sudden change of weather

Diagnosis:

Signs and tests
The doctor will ask questions about whether your child (or you) have had ear infections in the past and will want you to describe the current symptoms, including whether your child has had any symptoms of a cold or allergies recently. Your doctor will examine your child’s throat, sinuses, head, neck, and lungs.

Using an instrument called an otoscope, the doctor will look inside your child’s ears. If infected, there may be areas of dullness or redness or there may be air bubbles or fluid behind the eardrum. The fluid may be bloody or purulent (filled with pus). The physician will also check for any sign of perforation (hole or holes) in the eardrum.

A hearing test may be recommended if your child has had persistent (chronic and recurrent) ear infections

Modern  Treatment
The goals for treating ear infections include relieving pain, curing the infection, preventing complications, and preventing recurrent ear infections. Most ear infections will safely clear up on their own without antibiotics. Often, treating the pain and allowing the body time to heal itself is all that is needed:

*Apply a warm cloth or warm water bottle.
*Use over-the-counter pain relief drops for ears.
*Take over-the counter medications for pain or fever, like ibuprofen or acetaminophen. DO NOT give aspirin to children.
*Use prescription ear drops to relieve pain.

ANTIBIOTICS
Some ear infections require antibiotics to clear the infection and to prevent them from becoming worse. This is more likely if the child is under age 2, has a fever, is acting sick (beyond just the ear), or is not improving over 24 to 48 hours.

However, for several years there was a tendency to over-prescribe antibiotics, leading to the increasing numbers of bacteria that are resistant to these drugs. Joint guidelines from the American Academy of Pediatrics and the American Academy of Family Physicians are aimed at using antibiotics for ear infections when they are most needed. If the antibiotics do not seem to be working within 48 to 72 hours, contact your doctor to consider switching to a stronger antibiotic. Usually there is no benefit to more than two, or at the most three, rounds of appropriate antibiotics.

SURGERY
If there is fluid in the middle ear and the condition persists, even with antibiotic treatment, a healthcare provider may recommend myringotomy (surgical opening of the eardrum) to relieve pressure and allow drainage of the fluid. This may or may not involve the insertion of tympanostomy tubes (often referred to as ear tubes). In this procedure, a tiny tube is inserted into the eardrum, keeping open a small hole that allows air to get in so fluids can drain more easily down the eustachian tube. Tympanostomy tube insertion is done under general anesthesia. Usually the tubes fall out by themselves. Those that don’t may be removed in your doctor’s office.

If the adenoids are enlarged, surgical removal may be considered, especially if you have chronic, recurrent ear infections. Removing tonsils does not seem to help with ear infections.

ALTERNATIVE TREATMENT:
Click to see:
Alternative Treatment for Ear Infections :
Alternative to Tubes for Ear Infection Treatment:
Natural Cures For an Ear Infection – More Than Home Remedies:

Prognosis:
Ear infections are curable with treatment but may recur. They are not life threatening but may be quite painful.

Prevention:
What can kids do to prevent ear infections? You can avoid places where people are smoking, for one. Cigarette smoke can keep your eustachian tubes from working properly.
You can reduce your child’s risk of ear infections with the following practices:

*Wash hands and toys frequently. Also, day care with 6 or fewer children can lessen your child’s chances of getting a cold or similar infection. This leads to fewer ear infections.
*Avoid pacifiers, especially at daycare.
*Breastfeed — this makes a child much less prone to ear infections. But, if bottle feeding, hold your infant in an upright, seated position.
*Don’t expose your child to secondhand smoke.
*The pneumococcal vaccine prevents infections from the organism that most commonly causes acute ear infections and many respiratory infections.
*Some evidence suggests that xylitol, a natural sweetener, may reduce ear infections.
*Avoid overusing antibiotics.

Click to see:
Taking Care of Your Ears;
What’s Earwax?;
What’s Hearing Loss?

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://kidshealth.org/kid/ill_injure/sick/ear_infection.html
http://healthtools.aarp.org/adamcontent/ear-infection-acute?CMP=KNC-360i-GOOGLE-HEA&HBX_OU=50&HBX_PK=ear_infection_acute
http://health.nytimes.com/health/guides/disease/ear-infection-acute/overview.html

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Health Quaries

Some Health Quaries & Answers

Q: I have terrible dreams every night when I feel I am falling over a mountain or am locked in a box. I don’t feel refreshed when I wake up. I am also drowsy all day.

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A: No one knows exactly why people dream, where dreams originate, what they mean or what the purpose of dreaming is for the body or the mind. But we do know that dreams are strongly associated with REM (Rapid Eye Movement) sleep. This can be picked up by an EEG (electroencephalogram) which records electrical signals in the brain. REM shows up as typical wave patterns. During an average lifespan, a human being spends about six years’ time dreaming. This works out to almost two hours each night. Most dreams last for only 5-20 minutes.

One way to sleep well is to go for a 45-minute walk half an hour after dinner, and then drink a cup of warm milk before going to bed.

I suspect cancer :
Q: My father has been taking aryuvedic medicine for his arthritis. He has developed black patches on his skin and tongue. I am afraid it is cancer.

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A: Cancer of the tongue is more likely to appear as a painless white patch or a nodule. Black patches on the skin and tongue are probably due to consumption of metals like silver, gold, mercury and lead which are present in Aryuvedic medications. These metals are not eliminated from the body. The concentration builds up and they get deposited in the bones and muscles. It is advisable to stop the medications and see an allopathic physician. If necessary, have a biopsy done to rule out cancer.

That unrelieved feeling:
Q: I have problem moving my bowels. I never manage to finish the business before leaving for work. The whole day I feel the “urge” but cannot evacuate as I do not use the office toilet, which is unhygienic.

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A: Constipation, especially long standing, can be due to improper diet lacking in sufficient fibre and fluids. It may also be due to a disease process like thyroid malfunction or a block in the intestine. In your case the former seems more likely as you have suffered for years and your health does not seem to have deteriorated in any way.

If there is no disease process (ascertained by a medical evaluation), try increasing water intake to three litres a day and eating 4-6 helpings of fruit and vegetables. If this does not work, you can try 2tsp isabgol husk in a glass of water at night to increase the bulk in your food. Walking for 45 minutes a day and doing abdominal exercises will help tone your muscles. This in turn will help regulate your bowels. Also try getting up earlier so that you can spend time in the toilet without tension and anxiety.

Otitis media
Q: My five-year-old daughter has enlarged adenoids (I don’t know what that is) and because of that (according to the paediatrician) she has frequent attacks of middle ear infection. She has been advised pneumococcal vaccine. Is it necessary?

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A: Adenoids are paired structures situated at the back of the throat, close to the opening of the middle ear into the throat. With bacterial and viral infections they can also get enlarged, the condition being called otitis media. They can block the opening of the middle ear and cause unequal pressures, build up of secretions and ear ache, eventually leading to infections.

Two common bacterial organisms causing ear infection are the H. influenza and pneumococcus. Immunisation against H. influenza is given with DPT/HepB at six weeks, 10 weeks and 14 weeks of age as part of the recommended extended immunisation schedule. Prevanar (against pneumococcus) can be given at the same time. If this is missed, Pneumo 23 can be given after the age of two years. The vaccines are safe.

Vaporising mosquito repellents can lead to allergic swelling of the adenoids. Use of a feeding bottle while sleeping, particularly at night, compounds the problem. These two factors should be removed, otherwise the infections will self perpetuate despite immunisation.

High BP at youth
Q: I am 26 years old and have hypertension, which is well controlled. I also have anxiety. I am on medications which I want to discontinue.

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A: You are too young to have hypertension. This needs to be evaluated as there are several correctable diseases that cause secondary hypertension. Continue the medications at present and try to consult an endocrinologist or nephrologist to evaluate the hypertension and hopefully find a cause. Meanwhile, to reduce anxiety, try jogging for 40 minutes a day and practise meditation or yoga regularly.

Sources: The Telegraph (Kolkata, India)

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Categories
Ailmemts & Remedies

Acute Otitis Media in Children

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The most common cause of earache in children is acute otitis media, which is caused by infection in the middle children are at risk because eustachian tubes, which connect the middle ear to the throat, are small and become obstructed easily. Acute otitis media is often part of a respiratory tract infection, such as the common cold. The infection causes inflammation that may block one of the eustachian tubes, causing a buildup in the middle ear that may get infected with bacteria.
1.Normal
2.Abnormal……..(1)
The part of the ear that we can see is called the outer ear. It is connected to an external canal, which is then separated from the structures of the middle ear by a thin drum like membrane called the eardrum (tympanic membrane). The middle ear is filled with air and is connected to the back of the nose by a tube like canal called the eustachian tube. The other parts beyond the middle ear are the inner ear (cochlea, semicircular canal) and the auditory nerves (carries messages to the brain).

CLICK & SEE

Otitis Media refers to an infection of the middle ear that normally follows the flu or a cold. OM can affect people at any age, but it is more common in children under the age 7.

About 1 in 5 children under age 4 has one episode of acute otitis media each year. the condition is more common in children whose parents smoke. It is also common in children of eskimo or native american descent and may run in families, suggesting a genetic factor. The condition is less common in children over the age of 8.

What are the sympotms?
Symptoms usually develop rapidly over several hours. a very young child may have difficulty locating the pain, and the only symptoms may be fever and vomiting. In older children, the symptoms may be more specific and include:

*20-40% of the cases of bacterial infections may have little or no symptoms.
*In infants, there is irritability, poor feeding, or loss of appetite may be the only symptoms for the first few months.
*In cases without bacterial infection, there may be a mild decrease in hearing or a feeling of heaviness in the ear.
*In most cases of acute OM there is:
flu, cold, sinus, throat, allergies, and earaches.
*The bone behind the ear (Mastoid bone) may hurt if it is pressed.
*Decreased hearing
*Fever may or may not be present
*If the eardrum is punctured, fluid may leak out (otorrhea)
*Hearing loss and spread of the infection to other site (brain, facial nerves and mastoid bone) can occur
* Earache.
*Tugging or rubbing the painful ear.
*Temporary impaired hearing in the affected ear.
Left untreated, the eardrum may rupture, relieving the pain but causing a discharge of blood and pus. Recurrent infections in the middle ear may cause chronic secretory otitis media.

Probable Causes:
Conditions such as a Common Cold (caused by a virus), sinuses, throat infections, allergies to tree pollen, mold spores, and mites can irritate the eustachian (E) tube and weaken its normal defenses.

Once the defenses of the eustachian tube is compromised, it is prone to invasion by bacteria, which then climb up to the air filled middle ear chamber and cause an infection. This results in fluid build up, earaches, and other symptoms.

Bacteria responsible for OM are:

Pneumococci (30-35%)
Haemophilus Influenza (20-25%)
Moraxella catarrhalis (10-15%)
Group A streptococci and Staphylococcus species (1-3%)
Up to 30% of cases of OM occur without any Bacterial infections

*Structural abnormalities of the ear or an E-tube present at birth

*Previous history of OM

*Family history of OM, especially in a sibling

*Second hand tobacco smoke

*Day care

*Allergies

*Sinus infections

*Throat infections

*Formula feeding

 

Method of Diagnosis::
Medical history and a physical examination is the first step
There may be facial pain (over the sinuses), nasal (nose) congestion, sore, red throat if allergies exist, or a sinus infection may be present.
There may be enlarged Lymph glands (pea size nodes) in the neck
The mastoid bone may hurt if doctor presses on it.
The doctor will use a special light (otoscope) to look into the ear canal, where he will see the ear drum bulging out (fluid behind it), moving poorly, or have a tear and the middle ear where fluid is leaking into the external canal.

The fluid that may have leaked out can be collected by a sterile cotton swab, and sent to the laboratory so they can identify the cause and type of the bacteria (takes 24-48 hours).

Hearing can be tested by a specialist called an audiologist.
Risk Involvement:
*Males more than females
*Ear trauma or previous ear surgery
Modern Treatment:
* Usually treated on an outpatient basis except for infants under 2 years of age with high fever.
*If not too sick, use Auralgan drops (eases the pain) and Tylenol (pain and fever) by mouth, and observe closely for the first 2-3 days.
*If symptoms persist for more than 48-72 hours, or the patient is sick, consider antibiotics.
*Antibiotics such as Amoxicillin are given by mouth for up to 10 days (or until the bacteria is identified).
*If there are 3 or more OM’s in 6 months, or 4 or more in one year, then antibiotics may be needed for up to 6 months.
*In cases where there is persistent fluid (Effusion) in the middle ear without bacteria (consider Allergy), antibiotics do not help, and Antihistamines (Claritin) or decongestants such as Entex can be tried.
*In allergic OM, where medications do not help, one may consider consulting with an allergy and Immunology doctor.
*In cases where middle ear effusion is present for more than 4 months in both ears, or more than 6 months in one ear, or, if hearing is affected (greater than 25 decibels), surgery may need to be done.
*Recurrent bacterial OM (more than 2-3) while on antibiotics may also benefit from surgery.
*An ENT (ears, nose, throat) doctor will perform all necessary surgeries.
*Surgeries include drainage of the middle ear fluid via a tiny tube (tympanostomy tube).
*The tube may be placed for days, weeks, months, or in some cases, permanently.
*A good diet that is full of vegetables, fruits, fish, and low in animal products (beef, pork, etc.) and fats may help to prevent future infections.
*Try breast-feeding your baby
*Stop smoking, especially around your children and animals.
What might be done?
You should consult you child’s doctor if liquid is discharged from the ear or if the earache last more than a few hours. he or she will examine your child’s ears and may blow air into the affected ear using a special instrument to check that the eardrum is moving normally. Acute otitis media can clear up without treatment; however, the doctor will probably prescribe antibiotics if he or she suspects that a bacterial infection is present. to relieve discomfort, acetaminophen may be recommended. After a few days, your doctor will reexamine you child.

Symptoms usually clear up in a few days with appropriate treatment. a ruptured eardrum should heal within a few weeks. In some children, hearing is affected for more than 3 months until the fluid in the ear disappears.

Research: Otitis Media

Acute Otitis Media in Children — Current Concepts

Acute Otitis Media treatment & Prevention

Healing Otitis Media Through Homeopathy

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.

Reources:

http://www.ecureme.com/emyhealth/data/Serous_Otitis_Media.asp
http://www.charak.com/DiseasePage.asp?thx=1&id=339

Categories
Ailmemts & Remedies Pediatric

Oh, that earache!

Ear infections frequently develop in children and is one of the commonest infections in childhood. A staggering 75 per cent of children have at least one episode of ear pain and infection by the time they reach the age of three.

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Most ear infections occur when the weather changes or if there is an infection going around in school.
Most ear infections are acute and are accompanied by excruciating pain, and occur when the weather changes or if there is an infection “going around” in school. Although the child may not to be able to accurately express or localise the discomfort, most parents suspect there is an earache because the child has fever and pulls or tugs at the ear. Sometimes, however, it manifests itself only with unexplained irritability or continuous nerve-wracking screaming. Hapless parents cannot localise the symptoms and are forced to seek emergency medical care.

Most ear infections start innocuously as a viral infection with fever, a runny nose and irritability. There is a three-pronged connection among the nose, throat and the middle ear. As long as all the connections are open, there is very little chance of an ear infection despite an upper respiratory infection. If any connection is blocked, pressure and secretions build up behind the ear drum, causing pain. Later, these secretions can remain stagnant in the middle ear and lead to an infection.

Ear infections often settle by themselves with symptomatic treatment. Frequent (two-hourly) administration of saline nose drops unblocks the nose. Paracetamol administered as dispersible tablets, drops or suspension (10-15mg/kg/dose) every four to six hours reduces the pain and fever. A mild anti-histamine syrup dries up the secretions. Sometimes, anaesthetic (not antibiotic) eardrops may be required to ease the pain. But the technique of administration is very important for the drops to be effective. The child should be placed on a flat surface, not on a pillow or on the lap. The affected ear should face upwards. The outer ear should then be gently pulled upwards and the drops administered. This will not help with the infection but will definitely ease the pain.

About 80 per cent of the antibiotics used worldwide are prescribed for “colds, coughs and ear infections”. They do not work against viral infections, nor do they shorten the course of the disease or prevent progress to a bacterial infection. A wait and watch policy for viral ear infections helps avoid the unnecessary use of antibiotics.

It is advisable, however, to consult a paediatrician immediately if the child is less than six months old, or has some other complicating illness.

If the pain and fever persist even after 72 hours, a secondary bacterial infection may have occurred. This needs appropriate antibiotics in the correct dose and duration. The medication should not be stopped just because the child looks better. Nor should the same antibiotic be purchased OTC (over the counter) and be self administered for a subsequent infection.

Children are more likely to develop recurrent ear infection

* If the early feeding is improper. Breast milk protects from infection, especially during the first six months of life.

* If the head is not raised while feeding. A prone position or placing a bottle of milk in a sleeping baby’s mouth may lead to an ear infection.

* If solids are force fed to an uncooperative child while lying down.

There is also a marked increase in the number of ear infections in children exposed to cigarette smoke. Most ear infections subside with no sequalae.

Certain cases of acute infection require urgent attention —

* When there is a suspicion of short-term mild hearing loss. This can persist if the fluid in the ear does not clear.

* If the infection becomes chronic, leading to damage to the bones and other structures in the middle ear. This can lead to permanent hearing loss.

* If the infection spreads to the mastoid, a bone behind the ear.

* Eventually, pus may extend into the brain and cause abscesses.

Surgery may have to be considered if the infection becomes chronic, with persistent effusions from both ears for three months or from one ear for six months. There are two procedures — myringectomy or tympanostomy, whereby a tube may have to be inserted into the ear drum.

A hole in the ear drum may need to be closed with a skin patch. Eventually, the tonsils and adenoids may need to be removed.

Two of the common bacteria causing ear infections belong to the Pneumococcal and H Influenzae groups. The Hib and pneumococcal vaccines, if administered to children, reduce the incidence of ear infections.

This is because the vaccine incidentally lends immunity against 55 per cent of the organisms that cause an ear infection. These vaccines also have a multiplier effect — they increase herd immunity, that is, they protect other children and elders in the community against bronchitis, pneumonia and ear infections caused by these common organisms.

From: Dr Gita Mathai’s writing (Telegraph ,Kolkata,India)

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