role of Human papilloma virus [HPV] genotyping in recurrent respiratory papillomatosis in Rasoul Akram Hospital

The most common laryngeal mass in children is recurrent respiratory papillomatosis [RRP]. Studies have attempted to correlate viral typing and its aggressiveness. 29 patients with histologically confirmed RRP enrolled in adjuvant therapies. Patients underwent several surgical interventions. HPV genotyping demonstrated 45% HPV-6 and 55% HPV-11. The mean age at the first surgical intervention was 52.39 months [SD=102.28] [range from 4 months to 426 months]. The mean number of surgical intervention was 10.39 [SD=7.76] [range from 2 to 30]. The mean time of surgical intervals was 4.63 months [SD=4.02] [range from 2 to 24 months]. In fourteen patients [48%] tracheotomy was done. All patients who had tracheotomy received alpha-interferon. One of our cases was a male who had pulmonary extension with HPV-6. A review of patients with RRP was regarding to HPV genotyping and need for adjuvant therapy and tracheostomy. Mean number of surgical procedure was 10/40 and nearly fourteen patients [48%] need to tracheotomy. The clinical differences between HPV6 and HPV11 disease may not be accurately predictable. Patients with less age and with HPV-11 seemed to have more severe problems, but these differences were not statistically significant which needs much more investigations for reasonable starting point of evaluation for these differences

[Effect of the extract of dried hedera helix leaves on respiratory tract mucociliary system]

Respiratory tract is continuously exposed to environmental pollutants, respiratory pathogens and dispersed toxins in the air. Respiratory tract clearance through mucociliary system is the main defensive mechanism in the upper and lower airways. Various studies demonstrated the effectiveness of herbal drugs, however little studies conducted about mechanism of action of these drugs. In this prospective case-series, saccharin test as a measure of mucociliary clearance time, was conducted on 40 subsequently healthy volunteers presenting to otolaryngology clinic of Firoozgar Hospital. Time between placing saccharin over nasal mucosa to sensation of sweet flavor in the pharynx was recorded. Saccharin test was re-performed after administration of 3 doses of 7.5 cc of Prospan syrup. Data were analyzed by Wilcoxon signed ranked test and SPSS V.16. In this study 32 patients [80%] were male and 8 were female [20%] with mean age of 38.4 +/- 12.07 years. Mean of time between "placing saccharin on nasal mucosa" to "sensation of sweet flavor in the pharynx" was 15.55 +/- 3.67 minutes before Prospan administration and 10.31 +/- 4.94 minutes after 3 doses of Prospan. Average reduction in the time of sweet sensation in the pharynx was 5.23 +/- 3.7 minutes. This study in conjunction with preliminary studies regarding the effectiveness of the extract of dried Hedera helix leaves on respiratory symptoms shows that "improvement in the function of mucociliary system" is one of the main mechanisms of actions of this drug