Botulinum toxin type A on an intranasal sponge for chronic allergic rhinitis: randomized clinical trial

In this study, we examined the effect of botulinum toxin A [BTA] on chronic allergic rhinitis [CAR]. We tested the effects of BTA, applied to an intranasal sponge, on patients who had CAR for a minimum of three years and had been treated unsuccessfully with conventional medications. The study was an interventional case-control single-blind randomized clinical trial. Forty-four male and female CAR patients who were referred to Tehran's Saee and Pasargad Hospitals, and Saadat-Abaad, Sarv and Karimkhan Clinics in 2012; aged 20-40 years were selected on the basis of inclusion and exclusion criteria. The subjects were randomly assigned to the intervention [n=22] or control group [n=22]. The intervention group received BTA [100 IU/ml; Dysport], on a 5 cm nasal sponge retained in each nasal cavity for 30 minutes. The control group received normal saline. The groups were evaluated by the same examiner. Pre- and post-tests [1, 3, 6, and 12 weeks] were performed according to the authors' pre-designed checklist, the validity and reliability of which was previously established. The symptoms scored from none [0] to severe [10] at the test points. The statistical analysis was conducted with SPSS-19, with a significance level of 0.05. Based on ANOVA, there was a significant difference [P<0.05] in symptomatic relief between the intervention and control groups. No marked adverse effects were observed during the study. An intranasal 5 cm sponge impregnated with 100 IU/ml BTA, retained in each nasal cavity for 30 minutes, may alleviate CAR symptoms with no significant adverse effects

Pattern of psychotropic drug prescription in the elderly with chronic schizophrenia

Psychotropic drug use in the elderly with chronic schizophrenia is an important issue in the field of psychiatry. The main goal of this study was to clarify the pattern of such drug use in these patients, in order to consider such therapy plan and focus on its cost attributing measures, for a more reasonable quality of care program. In this descriptive study, participants included 52 elderly patients at Tehran's Razi Mental Hospital who had chronic schizophrenia in the residual phase. Selected patients were taking at least two psychotropic drugs equivalent to 500mg Chlorpromazine. We prepared the list of the drugs used by completing the pre-designed questionnaire charts. Data were analyzed with SPSS 17. In one case [1.92%] the entries were Risperidone, Chlorpromazine, Fluphenazine Decanoate, and Thiothixene]. In 11 cases [21.2%] there were three entries and in 40 cases [76.8%] there were two. The Chlorpromazine equivalent dose in each group ranged from the lowest dose [750. mg] to the highest [5600. mg]. The highest Chlorpromazine dose [5600. mg] equivalent per milligram belonged to the four entries of [Risperidone, Chlorpromazine, Fluphenazine Decanoate and Thiothixene]. The lowest Chlorpromazine dose [750. mg] was seen in 3 entries of Risperidone, Chlorpromazine and Fluphenazine Decanoate. There was a high prevalence of using more than two psychotropic medications from the first atypical antipsychotic category. Less frequently, the second and the third typical antipsychotics were used. We recommend further research into more feasible patterns of psychotropic prescriptions, lowering the amount of medication use and considering their cost-benefits in the elderly with chronic schizophrenia

Young male's post appendectomy complication of pulmonary thromboembolism

The main goal of this report was to share with clinicians an atypical presentation of pulmonary thromboembolism [PTE] in a young male's post-appendectomy, whom he had no significant predisposing factors for such disease. The case also introduced for re-examining the challenges of PTE clinical manifestations which may mimic other differential diagnosis. PTE is an abrupt blockage of the pulmonary artery by a thrombus. Such thrombus is generated by a blood clot which has been formed, separated and migrated from the leg and/or pelvic veins toward the lung. The lung tissue's circulation is impaired which later episode results hypoxia and infarction. These events initiate a set of PTE clinical manifestations