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JOURNAL APPRAISAL. Que , Mary Harmony Rivera, Joanna Grace Sioco , Demetrio Roberto. Clinical SITUATION. Increasing number of children in the community with impacted cerumen Finding cost-effective means of addressing this problem. Research Question.
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JOURNAL APPRAISAL Que, Mary Harmony Rivera, Joanna Grace Sioco, Demetrio Roberto
Clinical SITUATION • Increasing number of children in the community with impacted cerumen • Finding cost-effective means of addressing this problem
ResearchQuestion Among children with impacted cerumen, is the application of water as a softening agent effective in clearing the ear canal (using a randomized control trial)?
A quasi-randomised controlled trialof water as a quick softening agent of persistent earwax in general practice A Journal Article on Therapeutics
METHOD • Population: • Patients with persistent earwax (more than 75% obstruction after 5 attempts of syringing) • Intervention group: 22 patients • Control group: 20 patients
METHOD • Water (room temp) dropped at affected ear until ear is full and canal covered with a wad of cotton • left for 15 minutes in the waiting area of an actual patient encounter • Irrigation with 100cc syringe • Olive oil dropped on affected ear until ear is full and covered with a wad of cotton • Done every night for 3 days before patient encounter • Irrigation with 100cc syringe Intervention -water Control -mineral oil
Validity • Was it Randomized? Was randomization concealed? • The patients were randomised into an intervention group (n = 22, year of birth was even) and control group (n = 20, year of birth was odd). • Intervention Group – drops of water for 15mins. • Control Group – oil at night for 3 days
Results of the Study • Intervention group: 3.0 ((95% CI = 2.4 to 3.6) • Control group: 2.4 (95% CI = 1.7 to 3.1). • The difference between these means (0.6; 95% CI = -0.3 to 1.5) • P value: 0.18 (not statistically significant)
Applicability • Water can be an alternative softener for impacted cerumen. • Water is very accessible and not costly(can be more practical than spending for oil) • Though syryinging is not the most preferable method by otolaryngologist, the practice can be considered generally safe to apply