Comparison of pain after radiofrequency tonsillectomy compared with conventional tonsillectomy: a pilot study.

Tonsillectomy results in a severe sore throat, especially in the first few days, until the exposed and inflamed muscle becomes covered with regenerated mucosa. There are a variety of techniques of tonsillectomy including monopolar and bipolar diathermy, blunt dissection, and most recently radiofrequency tonsil ablation and coblation. The objective of the present study was to assess the postoperative pharyngeal or ear pain of radiofrequency tonsillectomy and compared with traditional blunt dissection tonsillectomy with loop ligation hemostasis.

Treatment of the common cold.

BACKGROUND: Common colds are usually treated by the patients themselves with over-the-counter (OTC) cold medications. Many cough and cold remedies are available and sold freely without prescription. The authors conducted a study to compare the efficacy, adverse effects, the quality of life (QOL) and the patient's opinion and appreciation on the drugs (POD) between Dayquil/Nyquil and Actifed DM plus paracetamol syrup. METHOD: In this prospective, investigator-blinded clinical trial, 120 patients, aged between 15 and 60 years old, with common colds within 72 hours, who accepted the trial and gave informed written consent, were randomized into two treatment groups. One patient was excluded due to evidence of bacterial infection. Fifty-nine patients were treated with Dayquil/Nyquil (D/N group), while the other 60 patients had Actifed DM plus paracetamol (ADM/P group) for three days. On day 1 the patient's demographic data (sex, age, body weight, blood pressure, co-existing diseases/conditions, drug use, and allergy to any drugs), the most prominent symptoms and its duration were recorded. All patients were screened for bacterial infection by physical examination, complete blood count and sinus radiographs. The symptoms (nasal obstruction, rhinorrhea, sneezing, cough, sore throat, fever and headache) and signs (injected nasal mucosa, nasal discharge and pharyngeal discharge) were scored, based on 4-point scale (0 to 3), on days 1 and 4. Changing of the symptoms and QOL were recorded on the diary card. The patient's opinion and appreciation on the drugs (POD) was assessed on day 4. The effectiveness (the ability to lessen the symptoms and signs), QOL and POD between two treatments were compared. RESULTS: The demographic data between the two groups were similar. The four most common prominent symptoms of common colds in our series were cough (47.9%), sore throat (26.17%), rhinorrhea (8.4%) and headache (8.4%). However, both treatments were equally effective in lessening the symptoms (P = 0.426) and signs (P = 0.716) of common cold from days 1 to 4. The adverse effects were significantly higher in ADM/P group than in D/N group (p = 0.006). In contrast, QOL in terms of alertness, freshness and sound sleep improved from day 1 to day 3 in both treatments, but the overall day-3 score was significantly higher in the D/N group than the ADM/P group (1.85 +/- 1.83; 1.25 +/- 1.94: p = 0.024). POD in terms of convenience, flavour of drug, effectiveness of the drug and a need to repeat the drug assessed on day 4, was also significantly higher in the D/N group than the ADM/P group (10.68 +/- 2.56; 8.92 +/- 2.27: p < 0.001). CONCLUSION: Dayquil/Nyquil are as effective as Actifed DM plus paracetamol in controlling the symptoms and signs of the common cold, but have fewer adverse effects. The quality of life assessed during the use of the drugs was significantly higher in the Dayquil/Nyquil group, and according to the patients, they prefered Dayquil/Nyquil more than Actifed DM plus paracetamol.

Eosinophilic mucin rhinosinusitis: terminology and clinicopathological presentation.

Many terms related to allergic fungal rhinosinusitis (AFRS) such as eosinophilic mucin rhinosinusitis (EMRS), eosinophilic fungal rhinosinusitis (EFRS), and AFRS-like syndrome have been proposed. The authors define EMRS as patients with rhinosinusitis who demonstrate eosinophilic mucin on histopathological examination. EMRS patients who demonstrate fungal hyphae within the mucin are diagnosed as having EFRS and those who cannot demonstrate fungal hyphae within the mucin are diagnosed as having EFRS-like syndrome. EFRS patients who demonstrate an allergic response to the fungi are diagnosed as having AFRS and those who cannot demonstrate any allergic responses to the fungi are diagnosed as having non-allergic fungal rhinosinusitis (NAFRS). In the United States, the prevalence of AFRS in chronic rhinosinusitis patients who require surgery is 5-10 per cent. However, the prevalence of AFRS in Thailand is not known because AFRS has never been reported and studied in Thailand. This study shows the clinical and pathological entities of patients with EMRS in King Chulalongkorn Memorial Hospital from July 2001 to July 2002. From a total of two hundred and fourteen rhinosinusitis patients who required surgery, six were diagnosed as having EMRS. Two of six EMRS patients were diagnosed as having EFRS (both of them were also diagnosed as having AFRS) and four patients were diagnosed as having EFRS-like syndrome. In this study, the prevalence of AFRS is much less than in the United States because of the limited understanding of this disease, the lack of commercially available antigens for dematiaceous fungi, and the lack of awareness and knowledge of pathologists to diagnose eosinophilic mucin and fungi within the mucin. The terms related to AFRS are also discussed in this study.

A comparative study of the side effects between pseudoephedrine in Loratadine plus Pseudoephedrine Sulfate Repetabs Tables and loratadine + pseudoephedrine tablet in treatment of allergic rhinitis in Thai patients.

The objective of the study was to evaluate the adverse reactions of Loratadine plus Pseudoephedrine Sulfate Repetabs Tables (LTD+PSE Repetabs) (Loratadine 5 mg + Pseudoephedrine 120 mg) twice daily with that of loratadine (5 mg) twice daily and pseudoephedrine (60 mg) quarter daily in the treatment of patients with allergic rhinitis. The study was designed as an investigator-blind, parallel group study. In this study, 56 patients were equally separated into 2 groups and treated for 14 days with either LTD+PSE Repetabs or loratadine + pseudoephedrine tablet. Both groups were comparable in age, gender, weight; baseline systolic blood pressure, diastolic blood pressure and pulse rate. The change of systolic blood pressure, diastolic blood pressure, and pulse rate did not reach clinical significance throughout the study period. There was no significant difference in occurrences of insomnia, palpitation, mouth dryness and anxiety. However, the incidence of patients with tremor at day 14 in the loratadine + pseudoephedrine tablet group was significantly higher than the LTD+PSE Repetabs group (39% vs 10.7%, p-value = 0.03). Furthermore, one patient in the loratadine + pseudoephedrine tablet group had to discontinue medication at day 7 due to insomnia. In conclusion, LTD+PSE Repetabs is well tolerated and has fewer adverse effects when compared to the loratadine + pseudoephedrine tablet.