[Adenoid tissue: a comparative bacteriological study]

Adenoid hypertrophy and its complications such as otitis media and sinusitis are common problems in childhood. Rapic and appropriate detection of interfering microorganisms in chronic nasopharyngitis is very important for better medical and surgical interventions. The aims of this study were to detect major core adenoidal microorganisms and to compare similarity of pernasal and oropharyngeal cultures with adenoidal culture, and also to compare bacteriological resistance in patients with and without complications. In this descriptive study, 50 patients with adenoid hypertrophy and chronic nasopharyngitis were recruited and divided into 2 groups: group I [n=25] with complications such as otitis media with effusion and group II [n=25] without complication. All patients underwent adenoidectomy. A pressure equalizing tube was inserted for patients in group I. The smear and culture specimens were collected for bacteriological study. After 26 months of prospective bacteriological study on 50 patients with adenoidal enlargement, major results were as follow: the most common adenoidal growing microorganisms in two groups of patients, in decreasing frequency were hemophilus influenza. Type B beta hemolytic streptococcus and staphylococcus auresus. Pernasal smear and culture results were more similar than oropharyngeal results to core adenoidal cultures [p<0.01]. 70.1% of adenoidal microorganisms in group I patients and 21.2% in group II patients were resistant to ordinary antibiotics [without anti-betalactamase activity] [P<0.0001]. For better medical management of chronic nasopharyngitis [pre and/or post adenoidectomy], were recommend that in antibiotic selection, the hemophilus influenza type B should be considered as the major growing organism. Pernasal culturing is more appropriate for detection of interfering microorganisms. In complicated patients [cases or otitis media with effusion and /or sinusitis] it is advisable to use more potent antibiotics with anti-betalactamase activity. For infection control in non-complicated patients, use of ordinary antibiotics can reduce the resistance to potent antibiotics in general population

comparative study between three topical treatments in patients with chronic suppurative otitis media

Chronic suppurative otitis media [CSOM] is a common ear disease with potential intra and extracranial complications. The control of infection is very important for prevention of its consequences. The aim of this study was to compare three topical treatment modalities in patients with this disease. A randomized clinical trial was performed on three groups of CSOM patients with active otorrhea but without cholesteatoma, otomycosis or ear polyps. They were treated with three different topical drug regimens: group I [combined therapy, 61 patients] with acetic acid 1.5% solution and ciprofloxacin 0.3%; group II [acid therapy, 30 patients], with acetic acid 1.5% solution; and group III [antibiotic therapy, 30 patients] with ciprofloxacin 0.3%. All patients were followed weekly for 4 weeks and results compared with chi-square and fisher tests. At the end of second week, the infection was controlled in 95.1% of patients in group I, which was statistically greater than other two groups 50%, 73.3% respectively [p<0.0001]. The response rate to topical therapy was also more than other group in group I patients, after one week of treatment [p<0.001]. In accordance with the ethical principles, 15 patients of group II and 8 patients of group III, with treatment failure, were also underwent combined therapy, which 100% of these patients in the group II and 87.5% of them in the group III, responded to treatment after two weeks. According to our findings, the combined topical therapy with acetic acid and ciprofloxacin is an effective and quick treatment method for control of infection and otorrhea in patients with CSOM

[Anticardiolipin antibody in type I diabetic patients]

Type 1 diabetes mellitus is an autoimmune disorder which is associated with different organ specific autontibodies including anticardiolipin antibody [ACLA]. The association of ACLA with diabetes has not been widely reported. The aim of this study was to determine the prevalence of ACLA IgG and IgM and evaluation of their possible association with other auto-antibodies, duration of disease and status of control of blood glucose in type 1 diabetes patients. In a cross sectional study, 48 patients with type 1 diabetes in Bandar Abbas were compared with 41 age and sex matched healthy persons for the presence of ACLA [IgG and IgM], Rheumatoid Factor [RF] and Anti Nuclear Antibody. The mean age of diabetic patients was 20/5 +/- 10 years. High titers of ACLA [IgG and/or IgM] were more common in type 1 diabetic patients than in healthy controls [18% vs. 0%, p<0.01] with no significant difference between males and females [4 and 12% respectively]. Unlike ACLA IgG, the mean value of serum ACLA IgM was significantly higher in type 1 diabetic patients than in controls [6.8 +/- 2.8 vs. 4.5 +/- 2.4 GPLU/ml]. Among type 1 diabetic patients, those with high titers of ACLA [ACLA+] were older and had higher age of onset of diabetes than those with normal titers, but there were no difference in duration of diabetes or level of HbA1c between them. No significant difference was observed in the prevalence of ACLA+or the mean values of ACLA IgG and IgM between recently [<1 years] and previously [>1 years] diagnosed diabetic patients. ACLA+patients were also more likely to show positive RF than the ACLA-group[25 vs. 0%]. The relatively high prevalence of ACLA [+] in type 1 diabetic patients and its association with other autoantibodies may reflect an abnormal immunologic response in some stages of type 1 diabetes. ACLA might be added to the list of autoantibodies that should be measured in type 1 diabetes patients