Is it Necessary to initiate antibiotic therapy in children with pharyngitis?

Streptococcuscus Beta Hemolytic Group A is the most important pathogen causing which may lead to purulent and non purulent angina. Rheumatic fever is the most important complication that is the cause of 30% to 40% of cardiac disease and disablement. This study was performed to evaluate prevalence of Streptococcuscus Beta Hemolytic Group A and estimate role of clinical findings in children with Streptococcuscus angina diagnosis. antibiotic resistance was also assessed evaluated in the patients with bacterial pharyngitis. Throat culture was performed on 104 patients referred to Amiralmomenin hospital of Semnan at the age range of 5 to 15 years having angina without begin on antibiotic treatment after the completion of the questionnaire. A frequency of 1% have been assessed for Streptococcuscus Beta Hemolytic Group A, coagulase -positive Staphylococci and non-group A Streptococcuscus frequencies were 10.6% and 17.3% respectively. 100% of patients had pharyngeal erythema, 72% had fever, 55% had exudates and 52% had cervical adenopathy. The diagnosed Streptococcuscus was sensitive against penicillin, erythromycin and amoxicillin and resistant against cotrimoxazole. In examining Staphylococcus aureus antibiotic-resistance, only 40% of cases were sensitive to clindamycin and 40% were also sensitive to vancomycin. Very low frequency of group A Streptococcuscus has undermined the routine use of antibiotic and show that the clinical based diagnosis alone is not reliable and rational use of antibiotics requires the use of other diagnostic methods such as throat culture and rapid antigen test [RATs]. Also in analyzing coagulase -positive Staphylococci antibiotic resistance, we can see increased cases of resistance against neomycin and clindamycin which indicates the necessity of rational treatment of patients afflicted by strep to coccal infections

[Effects of intra-oral intake of different concentrations of sucrose on biobehavioral pain response to immunizations in infants]

An uncontrolled pain in infants can lead to permanent damage of the components of cognitive growth and development and change in response to painful stimuli. The aim of this study was to compare the effect of oral sucrose%20 and%50 on biobehavioural pain response to hepatitis B virus [HBV] vaccine injection in term newborns. In this triple blind clinical trial study, which was performed in Semnan Amir-Al-Momenin Hospital, 91 term infants were selected and randomly divided into three groups. Two minutes prior to immunization with HBV vaccine by intramuscular injection, 2 ml of 20% or 50% sucrose solution was given to the infants in, experimental groups, while, the infants in the control group were orally received only 2 ml of sterile distilled water. The pain response was measured by using Neonatal Infant Pain Scale [NIPS] tools before the administration of sucrose, immediately after injection and 5 min after injection. The results showed that the administration of 50% sucrose significantly reduces pain response in newborns immediately and 5 minutes after HBV vaccination [P < 0.05]. But the administration of 20% sucrose was effective only 5 minutes after HBV vaccine injection. The administration of 50% sucrose can effectviley reduce the pain due to HBV vaccination in infants.