Efficacy of spiramycin as an alternative to amoxicillin in the treatment of acute upper respiratory tract infections.

This study compared the efficacy of spiramycin with that of amoxicillin in treating patients with acute community-acquired upper respiratory tract infections (URTIs). The study was an open, randomised, comparative parallel design and patients received either spiramycin 3 MIU (2 tablets, 500mg or 1.5 MIU per tablet) twice daily after meals, i.e. 6 MIU/day for 7 days or amoxicillin (500 mg/capsule) 1 capsule three times daily after meals, i.e. 1500 mg/day for 7 days. Patients attending the ENT outpatient clinic at Siriraj Hospital in Bangkok for treatment of acute URTIs were included in the study after giving their informed consent. Eligible patients comprised those aged 18 years and over, of either gender, who had at least two of the following symptoms: fever (>/=38 degrees C oral), nasal discharge/obstruction, sore throat, cough and/or hoarseness of voice that did not require parenteral drug therapy or hospitalisation. A total of 99 patients were included in this study, 49 patients received spiramycin and 50 received amoxicillin. Of the 45 assessed patients treated with spiramycin, 40 were judged by the investigators as a 'success' (89%), and five were judged a 'non-success' (11%), compared with 48 assessed patients in the amoxicillin group where 40 patients were classified as a 'success' (83.3%) and 8 were judged a 'non-success' (16.7%). No statistically significant differences between treatments were demonstrated regarding the overall efficacy of treatment. This study demonstrated that the prescribed regimens of spiramycin and amoxicillin were similarly effective in the treatment of adult acute URTIs. The tolerability of both drugs was also similar. Furthermore, it was noted that the convenient twice-daily dosage regimen of spiramycin may allow better patient compliance.

Osteoblastoma of the ethmoid sinus in a nine-year-old child--an unusual occurrence.

Osteoblastoma is a benign bone tumor which is common in the vertebral column and long bone of the extremities. The paranasal sinus involvement is rare. We reported a case of benign osteoblastoma of the ethmoid sinus in a nine-year-old boy who presented with exophthalmos. The tumor had aggressive growth with cranial base involvement. Radiologic finding was a mottled soft tissue mass with sclerotic margin. Histologic features were the presence of osteoblast, small trabeculae of woven bone and rich vascular fibrous stroma. Differential diagnoses consist of various kinds of fibro osseous lesions; the closest one is osteoid osteoma. Surgery is the treatment of choice, external ethmoidectomy with lateral rhinotomy was performed in this case. Recurrence is common according to previous reports. Previous literature were reviewed and discussed.

The first naso-sinus laboratory for cadaver preparation in Thailand.

The first naso-sinus laboratory has been set up in Siriraj Hospital for better training of rhinosurgeons. The specimens used for practice operation are the entire nasal cavities with all paranasal sinuses, taken from cadavers and preserved in 95% ethanol. The "Siriraj" sinus holder is specially designed and constructed to hold various sizes of specimens. It is made of plastic board and stainless steel screws; it is an inexpensive and simple device which can be afforded by every centre. With this naso-sinus laboratory, ENT residents and rhinosurgeons can achieve their skills in performing nasal endoscopy, endoscopic or microscopical sinus surgery and all kinds of sinus operations at their convenience.

Epstein-Barr virus serological markers for nasopharyngeal carcinoma in Thailand.

The present study reports on the prevalence of specific IgA and IgG antibodies to EBV viral capsid antigen in nasopharyngeal carcinoma (NPC) patients with different histological types of carcinoma and their age-matched controls by the indirect immunofluorescence test, using the B-95-8 lymphoblastoid cell line as source of viral capsid antigen. EBV specific IgG was found in almost all the study cases, and antibody titers were significantly higher in the NPC patients than in non-cancer controls. GMT of anti-EBV IgG in NPC patients, patients with other malignant diseases, and those with non-malignant diseases were 371.5, 97.7 and 35.5, respectively. Anti-EBV specific IgA was more specific to NPC than was IgG, and was present in 86.5% (83 of 96) cases of NPC patients, 6.6% (2 of 30) of patients with other cancers, and 3.1% (3 of 97) cases of non-malignant diseases. A weak correlation between level of anti-EBV IgA in NPC patients was observed (r = 0.3). EBV IgA was found in all histological types of NPC, ie, WHO types 1, 2 and 3, but WHO type 1 was rare among NPC patients in Thailand. Use of anti-EBV IgA for monitoring cancer therapy is to be further investigated.