Comparison of boric acid and combination drug of polymyxin, neomycin and hydrocortisone (Polymyxin NH) in the treatment of acute otitis externa

Acute otitis externa is an inflammation of the external auditory canal known as “swimmer's ear”. Direct costs including medical treatment, painkillers, antibiotics, steroids or both and indirect costs are also remarkable. Aim: The aim of this study was to compare the effect of boric acid and polymyxin, neomycin and hydrocortisone composition in the treatment of acute otitis externa. Materials and Methods: This randomized clinical trial was carried out on 80 patients aged more than 17-year-old who were referred to Kashani hospital clinic with a diagnosis of acute otitis externa by otolaryngologist. The patients were randomly allocated to two groups (A: Boric acid and B: polymyxin NH ear drops) and Painkiller was prescribed and administered orally for all patients and in the presence of fever, cellulitis around the ears and neck adenopathy, broad-spectrum systemic antibiotics were used besides topical treatment. Symptoms of patients who were evaluated by a physician includes pain, discharge from the ear, swelling of the ear canal, auricle swelling, tenderness, and ear itching. In addition, pain was evaluated in patients and was recorded by Macgill Pain Questionnaire, in the first, third, seventh and tenth days. Results: Results showed that itching on third day (p=0.007) and swelling of the ear canal in the examination of the third day (p=0.006) and the seventh day (p=0.001) in the polymyxin NH group is more than those of boric acid group. Overall mean pain based on McGill questionnaire was 11.10±1.49 in boric acid group in the examination on the first day and was 4.05±0.22 in the examination on the tenth day and in the polymyxin NH group, it was 10.9±0.99 on the first day and 4.20±0.40 on the tenth day. In both groups, pain relief was the same and there was no significant difference between two groups (p=0.075) Conclusion: The findings of this study showed slight differences in the effectiveness of the boric acid drug and combination of polymyxin, neomycin and hydrocortisone in the treatment of patients with acute otitis externa that is clinically of significance and considerable

Relationship between serous otitis media and its risk factors in primary school students in Shahrekord

زمینه و هدف: اوتیت میانی سروز یکی از علل اصلی نارسایی شنوایی در کودکان بوده و یکی از عوارض جدی آن کاهش شنوایی دائمی می باشد. این مطالعه با هدف تعیین فراوانی این بیماری در کودکان دبستانی شهرکرد و تعیین ارتباط آن با آلرژی، سابقه آلرژی در خانواده، شکاف کام، عفونت اخیر گوش، استعمال سیگار در منزل، میزان تحصیلات والدین، نحوه تغذیه دوران شیرخوارگی، وزن هنگام تولد، سینوزیت، بزرگی آدنوئید، جنس، سن و تعداد فرزندان خانواده در کودکان فوق انجام گردید. روش بررسی: در این مطالعه توصیفی - تحلیلی تعداد 1017 دانش آموز مقاطع ابتدایی مورد مطالعه قرار گرفتند. برای هر دانش آموز پرسشنامه ای حاوی اطلاعات فردی، ریسک فاکتورها و معاینات انجام شده که از قبل توسط محقق تهیه شده بود به کمک والدین تکمیل گردید و سپس تمام آنها توسط پزشک عمومی مورد معاینه گوش، حلق و بینی قرار گرفتند و موارد مشکوک جهت معاینه مجدد تخصصی و انجام تمپانومتری به منظور تشخیص قطعی نزد متخصص گوش، حلق و بینی فرستاده شدند. یافته ها: میزان فراوانی اوتیت سروز 5/1 در جمعیت مورد مطالعه بود. بین میزان فراوانی اوتیت میانی سروز و آلرژی، بزرگی آدنوئید، سابقه آلرژی در خانواده و عفونت اخیر گوش رابطه معنی دار آماری به دست آمد (05/0

Study of Effect of Household Parental Smoking on Development of Acute Otitis Media in Children Under 12 Years.

BACKGROUND & AIM High prevalence of acute otitis media (AOM) in children represents a combination of the factors developing eustachian tube dysfunction and higher susceptibility to upper respiratory tract infections in children. This disease is relatively prevalent in Iran and much cost is spent annually to treat it. This study investigated the effect of household parental smoking on development of AOM in children under 12 years. METHODS In this case-control study all patients under the age of 12 years with AOM referring an ENT clinic in Shahrekord, southwest Iran between April 2014 and August 2014 were enrolled by convenience sampling. This study included two groups. Group 1 (G1) was exposed to parental smoking at home and group 2 (G2) was not. For the patients, a questionnaire of demographic data such as age and gender, the disease symptoms, parents' education level, history of respiratory diseases, allergy, surgery (adenoidectomy, tonsillectomy, and tympanostomy), and household smoking was filled out by a specialist through interview. RESULTS In this study, 250 children 1-12 years with AOM, 145 in G1 and 105 in G2, were investigated. Clinical symptoms including fever (p=0.001) and hearing loss (p=0.014) were significantly more frequent in the children of G1 than G2, and otalgia, discharge, and tinnitus were similarly frequent in the two groups (p>0.05). Also, eardrum inflammation was more frequent in G1 than G2, with no significant difference (p>0.05). AOM was reported 70.3% in G1, which was higher than 26.7% reported in G2 (p=0.001). Also, asthma, recurrent ear pain, enlargement of the tonsils, and respiratory problems were more frequent in G1 than G2 (p<0.05). CONCLUSIONS Parental smoking was a risk factor for AOM and respiratory problems and therefore the parents are recommended to avoid smoking near children to reduce the likelihood of AOM development and exacerbation in children

Effects of Oral Gabapentin, Local Bupivacaine and Intravenous Pethidine on Post Tonsillectomy Pain

Introduction: Tonsillectomy is one of the most common surgeries performed worldwide. Post-operative pain arising from tonsillectomy is one of the earliest complications that can postpone oral nutrition and increase the hospitalization period. Administration of opioids via injection is usually preferred to relieve pain in these patients. However, the side effects of this approach prompted us to seek alternative treatments. In this study, the effectiveness of oral gabapentin is compared with an intravenous (IV) injection of pethidine and a local injection of bupivacaine in the control of pain after tonsillectomy. Materials and Methods: This clinical trial was performed on 7-15 year-old patients who were candidates for tonsillectomy at Shahrekord Kashani hospital from 2012–2013. The patients were divided into three groups at random. Group 1 was give 20 mg/kg oral gabapentin 1 hour before anesthesia. In Group 2, 2.5 ml bupivacaine 0.25% was injected into each tonsil bed by a surgeon. In Group 3,1 mg/kg pethidine was injected intravenously after intubation. To assess postoperative pain, the Oucher scale was used in recovery as well as 3,6,12, and 24 hours after surgery. Results: The pain score was lowest in the gabapentin group and highest in the bupivacaine group during the study. The pain score in the gabapentin group was significantly lower than that in the bupivacaine group (P<0.05). No statistically significant difference was found between the pain score of the Pethidine group and that of the Bupivacaine group (P>0.05). Conclusion: Gabapentin, with its antihyperalgesic properties and other unknown properties, is a convenient drug for controlling pain following tonsillectomy

Comparison of the effect of amoxicillin and cefriaxone in treatment of acute otitis media in children under 6 years old

زمینه و هدف: اوتیت میانی حاد یکی از شایع ترین بیماری های دوران کودکی است. عوارض بیماری شامل عفونت مزمن گوش میانی، فلج عصب فاسیال، لابیرنتیت، کری حسی - عصبی و عوارض داخل جمجمه ای می باشد. درمان بیماری با آنتی بیوتیک مناسب باعث پیشگیری از عوارض آن و نیز کاهش دوره بیماری می گردد. لذا این مطالعه با هدف مقایسه اثر درمانی آموکسی سیلین و سفتریاکسون در این بیماریانجام گرفت. روش بررسی: در یک کارآزمایی بالینی تعداد 160 نفر از کودکان زیر 6 سال مبتلا به اوتیت میانی حاد از بین مراجعه کنندگان به کلینیک انتخاب و به طور تصادفی به دو گروه 80 نفری تقسیم شدند. گروه اول با آموکسی سیلین خوراکی 50 تا 80 میلی گرم به ازاء هر کیلوگرم وزن بدن روزانه به مدت 10 روز و گروه دوم با 50 میلی گرم سفتریاکسون به ازاء هر کیلوگرم وزن بدن به صورت تک دوز درمان شدند. جهت پیگیری و ارزیابی پاسخ به درمان دو هفته و چهار هفته بعد از شروع درمان بیماران مجدداً معاینه شدند. برای مقایسه دو گروه از آزمون کای اسکوار استفاده شد. یافته ها: فراوانی بیماری در پسرها 8/58 و در دخترها 2/41 و بیشترین فراوانی در سن 2 سالگی به دست آمد. نتایج حاصله نشانگر اثر یکسان دو روش درمانی و برابر 80 بهبودی می باشد (05/0p>). بین ریسک فاکتورهای بیماری و میزان بهبودی رابطه ای یافت نشد. نتیجه گیری: با توجه به نتایج این مطالعه که نشانگر اثر یکسان و مطلوب دو روش درمانی در بهبودی اوتیت میانی حاد است هنوز آموکسی سیلین داروی مؤثر و مناسبی در درمان این بیماری می باشد

Nasopharyngeal Mixed Tumor: A Case Report

Salivary glands tumors account for less than 5% off all neoplasm in the head and neck. Pleomorphic adenoma is the most common type. Those typically arise in the palate, rarely found in the nasopharynx and nasopharyngeal tumors are usually malignant. Here we report a rare case in 61-year-old woman, who had progressive nasal obstruction for about 6 months, without any disease in the nose, but had a round nasopharyngeal mass and pathologic diagnosis as pleomorphic adenoma. Nasopharyngeal pleomorphic adenoma is a rare tumor

Honey versus diphenhydramine for post-tonsillectomy pain relief in pediatric cases: a randomized clinical trial.

INTRODUCTION Tonsillectomy is one of the most common surgeries done worldwide and often the first one a child sustains. Pain relief after tonsillectomy is helpful for oral feeding after surgery. Acetaminophen and diphenhydramine have been conventionally used for reducing pain. This study was conducted to compare the effect of honey and diphehydramine on pain relief after tonsillectomy. MATERIALS AND METHODS For this randomized clinical trial study, 120 patients of 5 to 12 years undergoing tonsillectomy were recruited. The patients were divided into four groups randomly. After tonsillectomy and beginning of eating, Group A took 5cc honey alone every hour, Group B was given 5 cc 50% honey (mixed with water) every hour, group C was treated with 1mg/kg diphenhydramine every 6 hours and group D was observed without any intervention. In all patients, severity of the pain was evaluated by ocher questionnaire at recovery, and 3, 6, 12 and 24 hours after surgery. The data were analyzed using ANOVA and the repeated measures ANOVA (SPSS version 17). RESULTS The repeated ANOVA showed a significant decreasing trend of pain scores during the study for both pain scales (p 0.05). No statistically significant difference in pain was detected among the groups. CONCLUSION Although honey can help the pain decrease, more research is supported for confirmation of this effect

The effect of oral dextrometorphan and placebo on the postoperative pain severity of adenotonsillectomy

زمینه و هدف: از مسائل مورد تعقیب در علم پزشکی نوین تسکین درد بعد از اعمال جراحی می باشد. درمان دارویی درد حاد پس از جراحی از طریق یکسری رژیم های دارویی از جمله اپیوئیدها و داروهای ضد التهابی غیر استروئیدی (NSAID) انجام می گیرد. عوارض جانبی این داروها باعث شده تا محققین به فکر جانشینی برای آنها باشند. هدف این مطالعه بررسی مقایسه اثر دکسترومتورفان خوراکی با در مقایسه پلاسبو بر شدت درد بعد از عمل جراحی آدنوتانسیلکتومی در بیماران 12-3 ساله بوده است. روش بررسی: در این مطالعه کارآزمایی بالینی 160 کودک 12-3 سال کاندید عمل جراحی آدنوتانسیلکتومی به صورت در دسترس انتخاب و بصورت تصادفی به چهار گروه مساوی 40 نفره تقسیم شدند. 2 ساعت قبل از عمل به بیماران گروه اول و دوم، mg/Kg 5/0 شربت دکسترومتورفان خوراکی و به گروه های سوم و چهارم پلاسبو داده شد. پس از عمل جراحی و بعد از انتقال بیمار به بخش تا 24 ساعت بعد از عمل به گروه های اول و سوم mg/Kg5/0 دکسترومتورفان و به گروه های دوم و چهارم پلاسبو داده شد. شــــدت درد هر 6 ساعت بر اساس جدول Oucher، ارزیابی شد. داده ها با استفاده از آزمون های آماری کای دو و آنالیز واریانس مشاهدات تکرار شده مورد تجزیه و تحلیل آماری قرار گرفت. یافته ها: در تمام گروه ها، بیشترین شدت درد در بدو ورود به بخش و کمترین شدت درد در 24 ساعت بعد از عمل بود. شدت درد در همه گروه ها با سن رابطه معکوس داشت (05/0

Parathyroid adenoma completely impacted within the thyroid gland: A case report

Ectopic parathyroid adenoma can be seen in various locations. Sometimes ultrasound and even fine needle aspiration studies cannot distinguish this lesion from thyroid lesions. A 29-year-old woman with a prominent nodule of left thyroid lobe was referred to surgical department. Thyroid function test were normal. She had no family history of parathyroid disease, other endocrine disease, and any other malignancies and had received no radiation. Ultrasonography revealed a solid and hypoechoic mass, 25x20 mm in size, with a regular shape and contour without calcification in the inferior of left lobe of the thyroid gland. For definite diagnosis, immunohistochemistry study of the lesion with three markers was done. Finally, PTH marker was positive in cytoplasms of cells so parathyroid adenoma was confirmed. Fine needle aspiration of the nodule was suspicious for follicular neoplasm; however, postoperative histopathology and immunohistochemistry revealed a parathyroid adenoma. Ultrasonography may be helpful to identify localized thyroid lesions especially in parathyroid adenom

Comparison of Efficacy and Side Effects of Azithromycin and Co-Amoxiclav in the Treatment of Acute Sinusitis in Adults: A Randomized Clinical Trial

Background: Regarding high prevalence of common cold and sinusitis in Chaharmahal and Bakhtiari Province and the lack of studies on patients referring hospitals in this province, this study was conducted to determine and compare the efficacy and side effects of azithromycin and co-amoxiclav. Methods: This study was a double-blinded randomized clinical trial. The study population of this clinical trial was consisted of 90 patients with acute sinusitis aged 12-65 years. At least two major criteria or one major criterion and two minor criteria with duration of at least 7 days and at most 28 days, were some of the sinusitis diagnostic criteria for inclusion of the patients into the study. The patients were examined for symptoms prior to and twice after the treatment. The treatment was administration with 500 mg azithromycin tablet per day for three days in group 1 (G1) and 625 mg co-amoxiclav tablet every 8 h for 10 days in group 2 (G2). The data were analyzed by repeated measures analysis of variance, independent t-test, and chi-square in Stata software and P < 0.05 was considered significant. Results: Mean±Standard deviation age of all patients was 32.14±9.91 years. Out of 90 participants in the study, 50 (55.56%) were male and the rest were female. The patients’ symptoms were quantitatively similar in the two groups (22.3±2 and 22.2±1.9 in G1 and G2, respectively) prior to the intervention. The score at second examination decreased to 3.7±2.1 in G1 and to 9.4±2.7 in G2, significantly different from that prior to intervention and between the two groups (P<0.001). Although the score decreased in the two groups at third examination, it was not significant in the two groups (P=0.652). The cure rate in azithromycin group was derived 87.5% and 88%, and in co-amoxiclav group 32.4% and 83.3% at the days 5 and 10 of treatment, respectively. The most prevalent side effects in the two groups were diarrhea and nausea. The prevalence of diarrhea was obtained 21% and 33% in G1 and G2, respectively. Conclusion: No significant difference in side effects was seen between the two groups. Although the cure was faster in the patients treated with azithromycin than those treated with co-amoxiclav, co-amoxiclav is still considered as adequately working against acute sinusitis bacterial pathogens. In view of this efficacy, co-amoxiclav seems to lead to no drug resistance and could be used to treat the patients