[ comparative evaluation of the effects of new antihistaminic drugs [loratadine and claritin] in treatment of allergic rhinitis]

Allergic rhinitis is one of the most important diseases that occurs commonly in east IRAN specially northeast, Khorasan. Approximately 10-15% of general population suffers from it. One of the best methods of treatment of allergic rhinitis, that is the most usual, is the usage of classic antihistaminic drugs [such asChlorpheniramine], but their side effects, specially somnolence and malaise, made a few patients to discontinue such treatment. More than a decade has showed that the Non Sedating Anti Histaminic Drugs [Terfenadin, Astemizole andLoratadine] are free from these side effects and do not show the CNS and anticholinergic disorders. The evaluation of their efficacy in the epidemiology of IRAN, beside the comparison of generic products with the registrated ones, is the main goal of this research. In this clinical study, the efficacy and adverse reactions of the Loratadine and its registratedproduct called Claritin are compared with Chlorpheniramine on 90 patients. It has been performed in northeast IRANand the study is a kind of double blind, prospective studies. 30 patients have received Chlorpheniramine, as the same for Loratadine and Claritin. Then the results are compared with each other by Chi- square test. According to results and the P. value for each controlled sign and symptoms, it seems that all the three drugs act effectively in this setting. On the other hand, there is a suitable growth in their efficacy from Chlorpheniraminetoward Loratadine and then Claritin. Also for the side effects, there is a meaningful difference in somenolence, headache, giddiness and xerostomia between Chlorpheniramine with the others and also a decline in these side effects from Loratadine toward Claritin. The results suggest that in the geographic condition of IRAN, Loratadine and specially Claritin can be use as the powerful and effective nonsedating antihistamines that do not cross the blood brain barrier to show adverse disorders and will be a successful treatment of Allergic rhinitis in the first line, specially in patients who are sensitive to other antihistaminic drugs. Claritin due to acceptable clinical efficacy and lower side effects is preferred toLoratadine and makes the drug managers to pay more attention to quality improvement of the generic products

correlation between vitiligo and hearing losse

To determine the correlation between vitiligo and hearing loss. Fifty patients with active vitiligo and forty healthy subjects were included in this case control study. Pure tone thresholds were determined at frequencies between 250 and 8000Hz. We compared the results in control and patients group by use of chi-square test. M/F ratio was 10:40 in the patients group and 10:30 in the control group. Mean age in patients and control groups was 22 and 22.6 years old respectively. The mean hearing threshold in patients was 19.5 +/- 5.7 and 10 +/- 5.7 in control groups. High frequency sensor neural hearing loss was seen in 19 out of 50 patients [38%], whereas no hearing loss was observed in the control group [X[2]=19.26, P<0.001]. Bilateral, right ear and left ear involvement were 63.1%, 26.3% and 10.6% respectively. Statistical difference between bilateral and unilateral involvement was significant [P<0.05]. No conductive hearing loss was seen in the control and patients groups. Vitiligo, Which is a type of pigmentary disorder, seems to be an effective factor in hearing loss. The mechanism for this condition might be the absence of the preventive function of melanin - containing cells in the inner ear

Results of aerobic culture and antibiogram in 105 patients with acute bacterial pharyngitis

To study throat culture and antibiogram results in treatment of acute pharyngitis. 105 Patients with acute phartngitis were included in this prospective study. From all of the patients throat culture and gram-stained smear were provided. Antibiogram was done in patients with posit throat culture. 63 Patients of 105 patients [59%] gave negative throat culture and gram stained smear from pharyngeal secretions. 20 Patients [19%] have positive throat culture and gram stained smear. 12 Patients [12%] have positive throat culture and negative gram stained smear. Therefore 32 patients [31%] of 105 patients have bacterial pharyngitis. Fever, pharyngeal and tonsillar purulent exudates and adenopathy in patients with positive throat [31%] was more common than patients with negative throat cultures [69%]. The most common cause of bacterial pharyngitis was group A betahemolytic streptococcus. Antibiogram findings revealed that bacterial pharyngitis such as streptococcal, staphylococcal and pneumococcal were completely resistant penicillin, Amoxicillin and Ampicillin that are used routinely in out patient clinics, and on the other hand were sensitive to unusual antibiotics in treatment of acute bacterial pharyngitis. Including Doxycicline, Vancomycin and Erythromycin and they are better alternatives

[Lingual thyroid-Report of three cases and review of literature]

Lingual thyroid is a developmental congenital abnormality with a reported incidence ranging from 1:10 to 1:100,000. It is characterized by the failure of the thyroid gland, or remnants, to descend from is embryologic site of origin of the foramen cecum to its usual pretraceal position

Clinical Presentation: we reported three patients with diagnosis of lingual thyroid during the years 1371 - 1381. One patient a 23 years old male presented with dysphangia and oral bleeding during solid ingestion from 7 year ago. Other patient a 47 years old female presented with intermitant oral bleeding, dyspnea and snoring during sleep from 20 years ago. Third patient a 16 years old female presented with sore throat and articulation disorders from 2 months ago

Intervention: thyroid scan with iodine 123 showed high uptake zone in the base of tongue without activity in the normal thyroid bed. The patients were operated with transhyoid anterior pharyngotomy approach and pathology revealed normal thyroid tissue

Conclusion: definitive diagnosis of lingual thyroid is on based on iodine 123 thyroid scan. When the mass is causing functional impairment, suppressive doses of thyroid hormones may be sufficient; when it is not, total excision should be considered