Browsing by Author "Bagale, Gyanendra"
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Publication Clinical Response to Amoxicillin among Children with Acute Suppurative Otitis Media(Nepal Health Research Council, 2025) Joshi, Deepa; Nepal, Ajit; Shrestha, Namita; Rajbhandari, Piyush; Bagale, Gyanendra; Chapagain, Saroj; Dhakal, SrijanaAbstract: Background: Acute Suppurative Otitis Media(ASOM) is a very common disease of childhood caused by various bacteria and viruses. Amoxicillin is used as first line antibiotics in the community setting as well as hospital setting. Methods: This is a hospital based prospective observational cross-sectional study. All cases of ASOM of patients under 14 years presenting to the Patan Hospital with duration of less than 6weeks were included in the study. Ear discharge was collected using sterile cotton swab using aseptic precautions and sent to the Department of Microbiology for further processing. The children were treated with amoxicillin (80mg/kg/day) with maximum dose not exceeding 3g/day and follow up was done after 1 week of antibiotic therapy for clinical responsiveness. Results: Out of 32 cases, 13 cases showed no growth of organism in the culture sensitivity reports. Among remaining 19 cases, 9 were sensitive and 10 were resistant to amoxicillin. Coagulase negative Staphylococcus (7) was the most common organism grown in the laboratory followed by Staphylococcus aureus (4) and Klebsiella pneumoniae (4). Chloramphenicol, linezolid, clindamycin and trimethoprim-sulphamethoxazole were the most common antibiotics sensitive to the organisms grown besides amoxicillin. Out of total 32 patients, 31 were responsive to high dose amoxicillin at the end of 1 week. Conclusions: Oral amoxicillin in high doses is effective in the treatment of ASOM in children.Publication Comparison of Recovery Rate of Otomycosis using One-Percent Gentian Violet and One-Percent Clotrimazole Topical Treatment(Nepal Health Research Council, 2024) Dhakal, Srijana; Bagale, Gyanendra; Nepal, Ajit; Yadav, Deepak; Khadka, Chetan; Joshi, DeepaBackground: Otomycosis is a fungal infection of external auditory canal with worldwide prevalence of 9% to 30%. Treatment includes elimination of predisposing factor, thorough canal cleaning and topical or systemic antifungal agents. Clotrimazole is a specific topical antifungal agent with effectiveness varying from 95% to 100%. Gentian violet is an aniline dye and its use as antifungal has been mentioned in literature with effectiveness up to 80%. This study was aimed at comparing the effectiveness of these two commonly used treatments in otomycosis.This is a conducted in Department of ENT-HNS, Patan Academy of Health Sciences, Lalitpur, Nepal over one-year period after approval from institutional review committee. Patients with otomycosis were randomized into arm A and arm B group. Arm A patients were treated with one percent clotrimazole topical drops. Patients in Arm B were treated with application of one percent Gentian Violet paint. Effectiveness was measured on the basis of clinical response and recovery at end of second week. Data analysis was done with Epi Info application. Chi-square test was used and p-value less than 0.05 was considered significant. Results: Total 90 patients were treated for otomycosis over one year. Recovery was better in clotrimazole group at second week i.e., 86.84% vs 71.43%. Conclusions: Clotrimazole was more effective in treatment of otomycosis compared to Gentian Violet paint, though the result was not statistically significant. Keywords: Antifungal agent; external auditory canal; otalgia.