A multi-center observation of the therapeutic efficacy of Bencycloquidium bromide in the treatment of seasonal allergic rhinitis with predominant symptoms of rhinorrhea / 临床耳鼻咽喉头颈外科杂志

Objective:To observe the efficacy and safety of the M receptor antagonist Bencycloquidium bromide nasal spray in treatment of seasonal allergic rhinitis with runny nose as the main symptom. Methods:From August 2021 to September 2021, 134 patients with seasonal allergic rhinitis were enrolled in the otolaryngology Outpatient Department of Peking University Third Hospital, First Affiliated Hospital of Harbin Medical University and China-Japanese Friendship Hospital of Jilin University, including 71 males and 63 females, with a median age of 38 years. TNSS score and visual analogue scale（VAS） of total nasal symptoms were observed during 2 weeks of treatment with Bencycloquidium bromide nasal spray. Results:TNSS score decreased from （8.89±3.31） on day 0 to （3.71±2.51） on day 14（P<0.001）, VAS score of nasal symptoms decreased from （24.86±7.40） on day 0 to （6.84±5.94） on day 14（P<0.001）, VAS score of rhinorrhoea decreased from （6.88±2.06） on day 0 to （1.91±1.81） on day 14（P<0.001）. Rhinoconjunctivitis quality of life questionnaire（RQLQ） score decreased from （94.63±33.35） on day 0 to （44.95±32.28） on day 14（P<0.001）. The incidence of adverse reaction was low and no serious adverse events occurred during the whole experiment. Conclusion:Bencycloquidium bromide nasal spray has significant efficacy and good safety in the treatment of seasonal allergic rhinitis.

effect of olopatadine 0.1% ophthalmic solution on ocular and nasal symptoms in patients with seasonal allergic rhino- conjunctivitis

To evaluate the effect of olopatadine 0.1% ophthalmic solution twice daily on ocular and nasal symptoms in patients with seasonal allergic rhino-conjunctivitis. This study was conducted at the Ophthalmology and ear, nose and throat [ENT] clinics on patients with seasonal allergic rhino-conjunctivitis during spring and early summer seasons [March to end of June] in 2010 at Princess Haya Al Hussein hospital in the south of Jordan and in 2011 at Prince Rashid Bin Al Hassan hospital in the north of Jordan. The patients were divided randomly into 2 groups; group A [50 patients] received Olopatadine 0.1% ophthalmic solution [Patanol] twice daily, group B [51 patients] received placebo in the form of balanced salt solution. All patients attended ENT and Ophthalmology clinics weekly for 2 visits; they were reviewed regarding the improvement of ocular symptoms [itching, redness and lacrimation] and nasal symptoms [sneezing, itchy nose and runny nose]. In those patients who received Olopatadine 0.1% ophthalmic solution, after two weeks 98%, 98% and 90% of them showed satisfactory improvement according to a scale of 1 to 5 marked by the patients for itching, lacrimation and redness respectively compared to 14%, 12% and 6% in group B respectively [P-value <0.05]. Regarding nasal symptoms 90%, 84% and 78% of patients in group A showed satisfactory improvement regarding sneezing, running nose and nasal itching respectively compared to 8%, 16% and 10% in group B [P-value <0.05]. The treatment of ocular allergy positively impacts nasal symptoms. The use of ocular solution of Olopatadine 0.1% ophthalmic solution twice daily has an excellent effect on ocular symptoms and good effect on nasal symptoms, this effect was more significant at two weeks of treatment. Olopatadine 0.1% ophthalmic solution is a well-tolerated drug and may be considered as a primary treatment for patients with seasonal allergic rhino-conjunctivitis

Antihistamines quality of life studies to assess the efficacy and safety in allergic rhinitis in Punjab, India

Allergic rhinitis impairs social life, but it is not known whether quality of life may be improved when patient are treated with H 1 blockers. The present study evaluated the comparative efficacy and safety of cetirizine, loratidine and astemizole in patients of allergic rhinitis. The design was open, randomized, parallel group comparison of three active treatment groups over a six week period. Sixty patients of either sex in the age group of 16 - 45 years, suffering from allergic rhinitis were selected randomly. The effect of cetirizine, loratidine and astemizole were observed on various parameters i.e., sneezing, nasal obstruction, watering of eyes, sedation and overall well being of the patients over a period of six weeks. The Visual Analogue Scale [VAS] was utilized as a quantitative measure of symptom relief. An improvement in patient's discomfort as assessed by VAS was observed in all treatment groups, with cetirizine 10mg daily being significantly more effective than loratidine 10mg and astemizole 10mg. Cetirizine resulted in a significant reduction in sneezing and nasal obstruction as compared to loratidine and astemizole [p<0.05]. Cetirizine and loratidine both were equally efficacious in relieving watering of eyes but cetirizine as well as loratidine were more efficacious as compared to astemizole [p<0.05]. Sedation was found to be maximum with cetirizine followed by astemizole and loratidine over six weeks of study period. Cetirizine has been found to be most effective in relieving the symptoms of allergic rhinitis followed by loratidine and astemizole and it can also improve quality of life for patients with allergic rhinitis

Efectividad del extracto estandarizado de hojas de petasites hybridus (tesalin®) en el tratamiento de la rinitis alérgica / Effectiveness of the standardized extract of leaves of petasites hybridus (tesalin®) in the treatment of allergic rhinitis

La rinitis alérgica es una patología frecuente, de alto impacto social, y alteración de la calidad de vida, lo que conlleva al cambio frecuente de la medicación, y al uso de más de un medicamento, sin el control adecuado de la sintomatología. Se evaluó la evolución de los síntomas clínicos en 927 pacientes con historia de rinitis alérgica perenne y estacional sintomática, sin indicación de antibioticoterapia en las dos semanas previas al tratamiento con Extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®). Los síntomas de la rinitis alérgica fueron registrados en la visitas a sus médicos los días 0, 7, 14 y 28 después de iniciar el tratamiento. Los pacientes con Extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®) una tableta dos o tres veces al día durante 28 días, se permitió cualquier otra medicación concomitante excepto antimicrobianos. El análisis de efectividad y tolerancia fue realizado por el médico y paciente. Para el médico, el porcentaje de pacientes que se encontraban totalmente libres de síntomas, o éstos eran muy leves,fue de 94.71%, mientras que para los pacientes fue de 95.90%, con una excelente correlación entre ambas opiniones. La tolerancia fue buena para el médico (90.70%) y para el paciente (94,47%) (p 0.95). El extracto estandarizado de hojas de Petasites Hybridus Ze339 (Tesalin®) resultó efectivo y seguro en el tratamiento de los síntomas de la rinitis alérgica no complicada

Allergic rhinitis is a common condition, high social impact, and impaired quality of life, which leads to frequent change of medication, and the use of more than one drug, without adequate control of symptoms. We evaluated the evolution of clinical symptoms in 927 patients with a history of seasonal allergic rhinitis and symptomatic, with no indication of antibiotic therapy in the two weeks before, that receiving standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®). The symptoms of allergicrhinitis were recorded in the visits to their doctors on days 0, 7, 14 and 28 after starting treatment. Patients were treated with standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®) one tablet two or three times a day for 28 days, allowed any concomitant medication except antibiotics. The effectiveness and tolerance analysis was performed by both the physician and patient. For physicians, the percentage of patients who were completely free of symptoms it was very mild, was of 94.71%, while for the patients was 95.90%, with an excellent correlation between both. Tolerance was good for the doctor (90.70%) and patients (94.47%) (P 0.95). The standarized extract of leaves of Petasites Hybridus Ze339 (Tesalin®) is effective and safe in treating the symptoms of allergic rhinitis is not complicated

Anticuerpo monoclonal anti-inmunoglobulina E en el tratamiento de la rinitis alérgica / Anti-immunoblobulin E monoclonal antibody in the treatment of allergic rhinitis

La rinitis alérgica (RA) es una enfermedad con alta incidencia a nivel mundial, sus síntomas están directamente relacionados con la exposición a un alérgeno ambiental que desencadena una cascada inflamatoria mediada por inmunoglobulina E. El tratamiento convencional actual de la RA consta del control ambiental, farmacoterapia e inmunoterapia; la reciente aparición de los anticuerpos monoclonales para el manejo de las enfermedades alérgicas parece ser prometedora. Estudios han demostrado que el Omalizumab, un anticuerpo monoclonal humanizado anti IgE, es capaz de modificar la respuesta inflamatoria dependiente de IgE, constituyéndose en una posible alternativa al manejo de la RA.

Allergic rhinitis (AR) is a disease with global high prevalence, its symptoms are directly related to environmental exposure to an allergen that triggers an inflammatory cascade mediated by Immunoglobulin E. The current standard treatment of AR consists of environmental control, pharmacotherapy and immunotherapy; the recent emergence of Monoclonal Antibodies for the management of allergic diseases appears promising. Studies have shown that Omalizumab, an anti-IgE humanized monoclonal antibody, is capable of modify the inflammatory IgE-dependent response, becoming a possible alternative to the management of AR.

Co-administration of Chenopodium album allergens and CpG oligodeoxy- nucleotides effects on peripheral blood mononuclear cells of patients with allergic rhinitis treated with intranasal corticosteroids and antihistamines

Allergic Rhinitis [AR] is one of the most common chronic diseases in the developed countries. This study was performed to investigate the effect of CpG-ODN in alteration of T-helper [Th]l/Th2 balance of patients with AR treated with intranasal corticosteroids [INCs] and antihistamines. Peripheral blood mononuclear cells [PBMCs] of 20 patients with AR were isolated before and after 45 days therapy. Cytokine production [IL-4, IL-10, IL-13, IFN-gamma] and specific Ch.a IgE in response to CpG co-administration of natural chenopodium album [CpG/Ch.a] or recombinant Ch.a [CpG/rCh.a] allergen were investigated in supernatants.of cultured PBMCs using ELISA Intracellular IL-10 was also assessed in CD4[+] cells using flow cytometry. Significant increase in production of IFN-y and IL-10 and decrease in production of IL-4 were found in supernatants of cultured PBMCs activated with CPG/ch.a and CPG/rch.a. of both CpG/Ch.a and CpG/rCh.a compared to allergens alone, before and after therapy. After therapy, IFN-gamma production with CpG/Ch.a was significantly increased in comparison with before [237 vs. 44 pg/ml, p=0.001]. IFN-gamma and IL-10 production with CpG/rCh.a was significantly increased after therapy compared to before [407.6 vs. 109 pg/ml, p=0.0l for IFN- gamma; 171.7 vs. 52.6 pg/ml, p=0.008 for IL-10], whilst IL-4 was significantly decreased [2.1 vs. 5.8 pg/ml, p=0.02]. Intracellular IL-10 expression was also significantly increased in response to either CpG/Ch.a or CpG/rCh.a that showed intracellular assay could be more sensitive than ELISA. Also, treatment with intranasal corticosteroids and antihistamines could enhance this CpG effect, in vitro

O impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais / The impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents

OBJETIVO: Detectar o impacto do tratamento fonoaudiológico no controle da asma e da rinite alérgica em crianças e adolescentes respiradores orais. MÉTODOS: Trata-se de um estudo quase-experimental; foram randomizados 24 pacientes com asma, rinite alérgica e respiração oral, idade de 6 a 15 anos. Todos os pacientes usavam dipropionato beclometasona inalação oral. No momento em que aceitaram participar da pesquisa, a inalação oral foi substituída pela inalação exclusivamente nasal na inspiração e, após 1 mês, associou-se ao tratamento fonoaudiológico em metade dos pacientes. Esses receberam 16 sessões de tratamento fonoaudiológico em 8 semanas, além do dipropionato de beclometasona inalação exclusivamente nasal (grupo DBF). O grupo de comparação recebeu somente dipropionato beclometasona inalação exclusivamente nasal (grupo DBI). Os dois grupos foram avaliados em cinco tempos. Utilizou-se o escore clínico da rinite alérgica, da asma, o protocolo de avaliação miofuncional orofacial adaptado de Marchesan (2003), a observação dos responsáveis, dados de espirometria, de pico de fluxo inspiratório e de pico de fluxo expiratório. RESULTADOS: Houve melhora significativa do grupo DBF: escores clínicos da asma no tempo 5 (p = 0,046); valores do pico de fluxo inspiratório no tempo 4 (p = 0,030); pico de fluxo expiratório no tempo 3 (p = 0,008); modo respiratório e postura de lábios (p = 0,000) a partir do tempo 3; observação dos responsáveis, no tempo 2, tempo 4 e tempo 5 (p = 0,010; p = 0,027; p = 0,030). CONCLUSÕES: O tratamento fonoaudiológico associado ao dipropionato beclometasona por inalação exclusivamente nasal promoveu um controle clínico e funcional mais precoce e duradouro da asma, da rinite alérgica e da respiração oral entre os grupos estudados.

OBJECTIVE: To determine the impact of speech therapy on asthma and allergic rhinitis control in mouth breathing children and adolescents. METHODS: This was a quasi-experimental randomized study of 24 mouth breathing patients with asthma and allergic rhinitis, aged from 6 to 15 years. All patients were taking beclomethasone diproprionate through oral inhalation at the start of the study. At enrollment on the study, oral inhalation was substituted with exclusively nasal inhalation and 1 month later half of the patients began speech therapy. They attended 16 speech therapy sessions in 8 weeks and continued taking beclomethasone dipropionate through exclusively nasal inhalation (BDT group). The comparison group received only beclomethasone diproprionate through exclusively nasal inhalation (BDI group). Both groups were assessed five times. Clinical scores were calculated for allergic rhinitis and asthma, an adapted version of the Marchesan orofacial myofunctional assessment protocol was applied, and parents/guardians' observations were recorded, in addition to spirometry measurements of peak inspiratory and peak expiratory flow. RESULTS: There were significant improvements in the BDT group: clinical asthma score at T5 (p = 0.046); peak inspiratory flow at T4 (p = 0.030); peak expiratory flow at T3 (p = 0.008); breathing mode and lip position (p = 0.000) from T3 onwards; and parents/guardians' observations at T2, T4, and T5 (p = 0.010; p = 0.027; p = 0.030). CONCLUSIONS: Speech therapy in combination with beclomethasone diproprionate through exclusively nasal inhalation resulted in earlier and longer-lasting clinical and functional control of asthma, allergic rhinitis, and mouth breathing than was achieved in the group that only took beclomethasone diproprionate.

Circadian rhythms: chronotherapeutic study of non sedating antihistamines in treating allergic Rhinitis

The first aim of this study is to determine if there is circadian rhythm variation in persistent allergic rhinitis symptoms. The second aim is to evaluate the role of morning vs. evening non-sedating antihistamine therapy in achieving the improvement of these symptoms. One hundred patient suffering from allergic rhinitis symptoms were included in this study. A questionnaire regarding allergic rhinitis symptom was filled for each patient. Five symptoms [nasal itching, runny nose, nasal blockage, sneezing and eye symptoms] were graded from 0 to 3 [no, mild, moderate and sever respectively] with total symptom score equals 15. This questionnaire was filled before therapy. The patients were randomly divided into two groups, one group received non-sedating antihistamine once daily [cetirizine hydrochloride 10 mg or desloratidine 5 mg] at morning [AM-group] and the other one received the same antihistamine at evening [PM-group]. The same questionnaire was filled again after 2 weeks for each patient. Both Binomial Method and Kolmogorov-Smirnov Test [non-parametric tests] indicate that there was a significant difference between the total scores of symptoms at morning [AM] and night [PM]. P-Value of any of the two tests was less than 0.05. Using Spearman Rank Correlation, any symptom tends to lower its intensity during night. After treatment, using Kolmogorov-Smirnov test, TSS in PM-group is very significantly lower than that of AM-group. The adverse events were comparable in both groups and also comparable for cetirizine and desloratidine. The commonest side effects were gastro-intestinal upset [nausea and abdominal discomfort] in 13 patients [13%] and headache in 11 patients [11%]. The present study confirmed the morning versus evening variation of allergic rhinitis symptoms. The symptoms were more worse in the early morning. Giving antihistamine medication at night has a better therapeutic outcome in most of the patients. However, the timing of treatment must be individualized to each patient according to his own symptoms' circadian rhythm

Montelukast in pediatric asthma management.

Leukotriene modifiers (receptor antagonist and biosynthesis inhibitor) represent the first mediator specific therapeutic option for asthma. Montelukast, a leukotriene receptor antagonist is the only such agent approved for use in pediatric patients. Montelukast modifies action of leukotrienes, which are the most potent bronchoconstrictors, by blocking Cysteinyl leukotriene receptors. Systemic drug like mountelukast can reach lower airways and improves the peripheral functions which play a crucial role in the evolution of asthma. Review of existing literature showed that montelukast compared to placebo has proven clinical efficacy in better control of day time asthma symptoms, percentage of symptom free days, need for rescue drugs and improvement in FEV 1. Studies also demonstrated improvement in airway inflammation as indicated by reduction in fractional exhaled nitric oxide, a marker of inflammation. Studies comparing low dose inhaled corticosteroids (ICS) with montelukast are limited in children and conclude that it is not superior to ICS. For moderate to severe persistent asthma, montelukast has been compared with long acting beta agonists (LABA) as an add-on therapy to ICS, montelukast was less efficacious and less cost-effective. It has beneficial effects in exercise induced asthma and aspirin-sensitive asthma. Montelukast has onset of action within one hour. Patient satisfaction and compliance was better with montelukast than inhaled anti-inflammatory agents due to oral, once a day administration. The recommended doses of montelukast in asthma are- children 1-5 years: 4 mg chewable tablet, children 6-14 years: 5mg chewable tablet, ADULTS: 10mg tablet; administered once daily. The drug is well tolerated. Based on the presently available data montelukast may be an alternative treatment for mild persistent asthma as monotherapy where ICS cannot be administered. It is also an alternative to LABA as an add-on therapy to ICS for moderate to severe persistent asthma. The other indications for use of montelukast include: allergic rhinitis, exercise induced bronchoconstriction and aspirin-induced asthma.

Evaluation of six years allergen immunotherapy in allergic rhinitis and allergic asthma

Allergen immunotherapy involves the administration of gradually increasing quantities of specific allergens to patients with IgE-mediated conditions until a dose is reached that is effective in reducing disease severity from natural exposure. In the present study we evaluated a period of six years immunotherapy allergic rhinitis and allergic asthma patients with positive skin prick test of common aeroallergen. The immunotherapy was performed on 156 patients. One hundred twenty of the cases were allergic rhinitis [80%], 29 cases had allergic asthma and 7 cases were mixed [4.5%]. 70% in allergic rhinitis group, 75% in allergic asthma group and 42.8% in mixed group completely improved. Immunotherapy, an older therapeutic method, has now been updated, and with appropriate indications, precautions and methods, has been clearly shown to be effective in the treatment of allergic rhinitis and in some cases of asthma and insect hypersensitivity

The efficacy and safety of 30 mg fexofenadine HCl bid in pediatric patients with allergic rhinitis.

Allergic rhinitis is one of the most common chronic disorders in children. It is also one of the most common causes of absence from school. This study reports on the efficacy and safety of a twice-daily oral dose of fexofenadine HCl 30 mg in Asian children aged 6-11 years diagnosed with seasonal or perennial allergic rhinitis. A total of 100 children with a history of allergic rhinitis for more than one year and a positive prick skin test response to at least one of the common aeroallergens in Thailand were enrolled in this multi-center, open-label, non comparative study. The severity of individual symptoms such as sneezing, rhinitis, etc. and adverse events were recorded in diary cards by the patients in form of scores as well as by the investigator at each visit. The total symptom score (TSS) with or without blocked nose at baseline, week 1 and week 2 was recorded. The TSS was defined as the sum of the individual symptom scores except for the nasal blockage score, as nasal blockage was not expected to respond to antihistamine treatment. Only patients with a total symptom score > or = 6 were included in the study. There was a statistically significant improvement at p < 0.01 for the TSS with or without blocked nose and for each symptom score such as blocked nose, sneezing, rhinorrhea, itchy nose/palate and/or throat, and itchy/watery/red eyes from baseline to week 1 and week 2. Additionally, there was a statistically significant improvement between week 1 and week 2 for itchy nose/palate and/or throat and itchy/watery/red eyes (p < 0.05). The Kappa measure of agreement was statistically significant at p < 0.001 between investigator's and patient's/parent's assessment, indicating the same degree of satisfaction with the overall effectiveness of the treatment. Fexofenadine 30 mg bid is effective in reducing the total symptom score of allergic rhinitis including blocked nose and is generally well tolerated. It is not cardiotoxic and is safe for pediatric patients as young as 6 years of age.

Montelukast in general pediatric practices.

Allergic diseases, e.g., allergic rhinitis, atopic dermatitis and asthma, are common problems in children. Researches on the pathogenesis of allergic diseases have led to the development of new specific antiinflammatory medications, including Montelukast, which blocks the interaction of cysteinyl leukotrienes to their receptors and resulting downstream events. Several studies have demonstrated the effect of regular Montelukast therapy on asthma, allergic rhinitis, viral-induced wheezing in bronchiolitis and chronic rhinitis symptoms. Evidence base medicine now shows that Montelukast can be used as a monotherapy in mild persistent asthma and can be an add-on drug to inhaled corticosteroid (ICS) in moderate to severe persistent asthma. Even in allergic rhinitis, Montelukast has a role in controlling rhinitis symptoms. Montelukast demonstrated a safety profile similar to placebo and more safety than ICS. Moreover Montelukast can improve quality of life in patients with asthma and comorbid allergic rhinitis.

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.

Efficacy of nimesulide alone and in combination with cetirizine in acute allergic rhinitis.

OBJECTIVE: To study the effect of cetirizine and nimesulide given alone and in combination in allergic rhinitis. METHOD: A double blind, double dummy, randomised, parallel controlled clinical study in three groups consisting of 18 patients each suffering from allergic rhinitis was conducted. Group A was given nimesulide alone (100 mg BD), Group B received combination (nimesulide 100 mg + cetirizine 10 mg) and Group C was given cetirizine alone (10 mg) for one week. The efficacy of each treatment in reducing nasal stuffiness, nasal discharge, itching nose and watery eyes was assessed at base line (day 0), on days four and eight of treatment. Patients used diary cards twice daily to rate symptom severity on a four point scale. RESULTS: Nimesulide and cetirizine alone could decrease nasal discharge, nasal stuffiness and sneezing significantly in allergic rhinitis patients by day four. Cetirizine was more effective in relieving nasal discharge and sneezing compared to nimesulide. By combining cetirizine and nimesulide four symptoms of allergic rhinitis, i.e., nasal discharge, nasal stuffiness, sneezing and watery eyes decreased significantly. CONCLUSION: Present study has shown that nimesulide alone could decrease three symptoms of allergic rhinitis like certirizine and combination of cetirizine (anti-histaminic) and nimesulide (anti-inflammatory) exerts synergistic action in reducing symptoms in patients of allergic rhinitis.

Pattern of disease and treatment of allergic rhinitis in Karachi

This study was conducted on 100 patients visiting Jinnah Postgraduate Medical Centre Karachi, over a period of three years [1996 to 1999] to gain an insight in the problem of nosed allergy in Karachi It was found that perennial rhinitis is more common in Karachi and the response to treatment with antihistamines and local steroid was much better as compared to antihistamines alone

The changing face of antihistamines and cardiac adverse drug reactions: a clinical perspective.

Recent times have witnessed a qualitative shift in the recognition and management of adverse drug effects. Many of them occur in organs that are unconnected to the primary target of pharmacological action. Out of these, cardiac side-effects have drawn particular attention because of their potential to cause death. Starting with the early observations on antibiotics such as macrolides, followed by fluoroquinolones and others, the focus has now shifted to the antihistamine class of drugs which are used extensively by patients all over the world, thanks to the ever increasing levels of environmental pollution. The occurrence of prolonged QTc interval following treatment with terfenadine leading to ventricular tachycardia of torsades de points variety with a potentially fatal outcome has forced many regulatory authorities of the world to clamp a ban the use of this drug. Alerted by these developments, studies on a new member, followed by fluoroquinolones and others, the focus has now shifted to the antihistamine class of drugs which are used extensively by patients all over the world, thanks to the ever incresing levels of envrionmental pollution. The occurrence of prolonged QTc interval following treatment with terfenadine leading to ventricular tachycardia of torsades de points variety with a potentially fatal outcome has forced many regulatory authorities of the world to clamp a ban use of this drug. Alerted by these developments, studies on a new member of non-sedating antihistamine class viz, fexofenadine, have been reviewed especially because of the structural similarity between terfenadine and fexofenadine. It is now clear that despite the closeness of its chemical structure to terfenadine fexofenadine behaves in a different manner and does not affect the electrophysiology of the heart muscle tissue, as proved by data from extensive clinical trials as well as membrane models in vitro. Interestingly, the solitary false alarm that was sounded on the drug by a group of workers in the Netherlands was later rectified by the same group. Clinically speaking, the cardiovascular safety of fexofenadine has been convincingly demonstrated at various dose levels and various time intervals, alone and together with other drugs of potential toxigenicity. All things put together, it appears reasonable to conclude that fexofenadine is free from cardiovascular ADRs of clinical significance. It could also be concluded that cardiac side-effects of antihistamines is not a class effect.

comparative study of 20 / silver nitrate and galvanic cautry for the treatment of allergic rhinitis

To compare the results of 20% silver nitrate and galvanic cautry for the treatment of allergic rhinitis. SETTING: ENT department Mayo Hospital, Lahore: DESIGN: Retrospective study. PATIENTS AND METHODS: This study was conducted on 100 patients of allergic rhinitis with age range of 16 years to 50 years from Oct 1992 to Oct 1995. Taking into consideration the morbidity and beneficial effects of using 20% silver nitrate cautry and galvanic cautry for the treatment of allergic rhinitis detailed results are studied. 20% silver nitrate cautry is far superior than galvanic cautry for the treatment of allergic rhinitis