ABSTRACT
Pharyngeal infection with Group A Beta-Haemolytic Streptococci [GABHS] is a common threat to the paediatric and young population. The control of this alarming infection can possibly reduce the risk of contraction of rheumatic heart disease [RHD]. One hundred RHD patients [Group I] were studied together with 200" heart free, throat free" low risk patients [Group II] and 100 patients with GABHS pharyngo-tonsillitis [Group III]. Group I showed high susceptibility to carry GABHS than Group II. Tonsillectomy lowered the risk of contracting GABHS by 2.5 - 2.6 times as compared to Long Acting Penicillin [LAP]. In Group III 76% of GABHS were resistant to penicillin due to the presence of beta-lactamase producing organisms [BLPO]. In the absence of BLPO, LAP was found to be as effective as tonsillectomy in protecting from GABHS. Anti-BLPO combination therapy or cefuroxime ought to be the drugs of choice in the treatment of acute bacterial pharyngitis and tonsillitis. Repeated cultures of BLPO after acute pharyngo-tonsillitis is suggested as a new indication for tonsillectomy
Subject(s)
Humans , Male , Female , Streptococcal Infections , Tonsillectomy , Penicillins , Penicillin ResistanceABSTRACT
Few studies dealt with the iotrogenic damage of the chorda tymapni during ear surgery. In these studies the number of patients were small and the methods were inadequate to draw a solid conclusion. In the present study gusatory functions of the chorda tympani were measured under strict criteria in 50 patients coming for ear surgery. Serial concentrations of NaCI [salty taste], surcose [sweet taste], HCI [bitter taste] and Urea [sour taste] were applied to the ipsilateral tongue on the operated side. Patients were divided into group A, where the nerve was stretched and group B where the nerve was transected four patterns of changes were observed to occur to the taste thershold. Group A exhibited mostly pattern four [no change]. In 92-96% of group B pattern three [evaluation of thershold with no return to normal value] was observed with no response to maximum concentration. The change in the thershold became stable in the majority of the cases after the first month postoperatively and onwards. On the contrary to the objective measurements patients did not feel subjective loss of the taste sensation in 84% cases with transected chorda tympani. In the present study the normal thersholds for different tastes was measured. To our knowledge, this was not previously achieved for an otological group of patients. No gustatory deficiencies were observed before surgery for all cases with chronic suppurative otitis media. Also, the study showed four newly recognised different patterns of changes in the taste thershold after injury to the chorda tympani. It explained the general concensus among ear surgeons that unilateral injury to the chorda tympani should not be alarming