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Background and purpose: Ëar infection in one of the common problem of ËNT specialists and the general physicians. Ëxternal otitis is a painfull inflammation of external auditory metus and earlob. Ôtitis can be of infectious and noninfectious type, or both. The infection is caused by bacteria and fungi. Prevalence of external otitis is quite more in summer than in winter season. Due to climatic condition of Mazandaran province and it’s closure to Çaspian Sea, tourist spots of beaches and using of swimming pools, we decided to study the etiological agents of external otitis in summer of 1999.
Materials and methods: The samples were collected from the patients who were diagnosed clinically as external otitis. Çollection of the sample was performed by two sterile swabs wetted in sterile saline and kept in sterile plugged tube, transferred to laboratory as soon as possible to culture in proper media. The patients were visited by a consulted physician also the questionnaires were filled and wet mount with 10% KÔH and one smear for staining were prepared from the samples to identify fungi and bacteri respectively. Âlso the sample was inoculated on blood agar and McÇonky agar incubated for 24 hours and was followed by the biochemical tests to identify the species of bacteria. Meanwhile the same sample was inoculated on saborauds dextrose agar incubated for 48 houres to identify fungi and finally the identification of the species was done by macroscopic characteristics.
Results: Ïn this study out of 101 (59 females and 42 males) cases suspected to have external otitis, 39(38.6%) and 23(22.8%) cases were of bacterial and fungal infections respectively and 16(15.2%) cases were of both bacterial and fungal infections. Most of the patients were in the third and fourth decade. X2 test showed significant relationship between the occurrence of otomycosis and gender of the patients (p<00.5) while there was not significant relationship between bacterial otitis and gender of patients. Ïn 22.7% of cases no organism was isolated, but in same patients the normal flora of skin (Staph epidermidis Çorynebacteria and non hemolytic Streptococci) were isolated. The most common isolated bacteria was Pseudomonas aeroginosa in 37(36.6%) cases and the most common isolated fungi were as following: Âspergilus niger in 10(9.9%) cases, yeast species in 9(8.9%) cases and Âspergilus fumigatus in 5(5%)cases.
Çonclusion: Ïn this study it was found that the clinical symptoms of otomycosis were same as of bacterial otitis but with less severity, but pruritis and stuffiness was more marked in otomycosis than bacterial otitis. So due to similarity of clinical symptoms, it is recommended that the laboratory investigations be carried out to identify the causative agent before treatment begins.

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Background and purpose: The most common complication of acute otitis media (ÂÔM) is otitis media with effusion (ÔMË) in children. Ït’s definite cause is not known. Persistant otitis media for more than three months inspite of an appropriate course of antibiotic therapy, requires myringotomy to avoid probable complications. The purpose of this study is to evaluate the effect of oral prednisolone (1mg/kg body weight) on resolution of ÔMË in children before a surgical attempt.
Materials and Methods: This experimental study was conducted on 49 patients with ÔMË for more than three months (approved by audiotympanometry) inspite of a two course broad spectrum antibiolic therapy. Ëxperimental group with 25 patients were treated with prednisolone in the dose of 1mg/kg/day for 10 days, and conrol group received only placebo for the same period. Statistical analysis was done using X2 test and clinical follow up was done for 2 week to 6 months.
Results: Ôut of 25 patient in experimental group, 22(88%) of them had a resolusion of ÔMË, while in control group, out of 25 patients, the rate of resolusion was only 8(33.3%). The difference between two groups was statistically significant (P=0.0002, X= 13.19) and recurrence was not seen during the follow ups.
Çonclusion: Âccording to the results obtained, Ït is recommended that a 10 days prednisolone therapy be tried in patients with ÔMË for more than three months duration, before a surgical attempt, if patient does not have any specific contra- indication for steroids therapy.

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Background and purpose: There are many anatomical variations in nasal cavity and paransal sinuses that interfere with proper drainage and ventilation of these sinuses and predispose the patients to chronic and recurrent sinusitis as well as some complications during FËSS. Ïn this study we evaluated the prevalence of these variations in patients referred to Bina medical imaging center.
Materials and methods: This study was a case series form. Two milimeters ÇT cuts were perfomed in patients paranasal sinuses. Patients with history of nasal and paranasal surgery were excluded from the study. Ëach ÇT was interpreted by two radiologist and the data recorded.
Result: 300 Patients (61% male and 39% female) were included in the study. The majority of the patients were in the third and fourth decades. The main results were: mucosal swelling 7%, closed ÔMÇ 45.6%, pan sinusitis 17.3%, pneumatization of uncinate process 2.6%, chonca bollusa 35%, Huller cell 11.3% .
Çonclusions: There are variations in the structure of paranasal sinuses and in order to prevent sinustitis and its complications, detailed evaluation of paranasal sinuse structure before FËSS is recommended.

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Background and Purpose: The obstruction of the upper respiratotri for tract (URT) is one of the most important reasons patients recurrent referral to the ENT clinic. Adentonsilar hypertrophy is almost common reason of the upper respiratory tract obstruction, and it will cause some changes in lung volumes and also in blood gases. The purpose of this study was to determine the effects of tonsillectomy on respiratory symptoms and arterial blood oxygen saturation.
Materials and Methods: In a clinical trials study, in a pre and post operative manner, 62, 2-14 years old children were imposed to adentonsilectomy in an easy sampling way. The respiratory symttoms such as: snoring, dyspnea, feeling airway obstruction, mouth breathing and oxygen saturated hemogolobin condition (Spo2), prior to surgery and one month after operation, has been studied and recorded. The results were Compared with paired t-test.
Results: In a preoperative manner, 80% of patients had mouth breathing symptom and mouth dryness which were reduad? to 10% after surgery. Spo2 measurement had no significont difference before and after surgery, and, it was in a normal range.
Conclusion: The correction of respiratory obstruction due to adenotansil ar hypertrophy does not make any changes in arterial blood oxygen. The surgery which is used for correction of these obstruction, whill just improve the clinical respiratory symtoms such as snoring and mouth breathing.

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Background and purpose: The pharmaceutical excipients can be incompatible with drug or other excipients. Thus, for each material, compatibility with formulation components and packaging materials should be examined. The dissolution of a drug has an important role in its bioavailability. Any change in the physico-chemical properties can result in changes in the drug release, and furthermore in its bioavailability. In order to overcome such changes, it is necessary to determine the storage conditions required for obtaining a desired drug release. The aim of this study was to investigate the effects of time and environmental factors on the physical properties of piroxicam tablets. Materials and methods: Piroxicam tablets were prepared by the direct compression method and using different excipients. After conducting some initial tests, these tablets were subjected in different temperatures and humidities for six months. Drug release and disintegration time were analyzed in periods of study (baseline, 3, and 6 months). DSC (differential scanning calorimeter) and FTIR (fourier transform infrared) were used to determine the possible interactions between drug and excipients. Results: The results of drug release from different formulations after 3 and 6 months storage in 25° C /60% RH and 40° C /75% RH showed statistically significant difference among various times. Under all storage conditions piroxicam tablets showed an increase in disintegration time. DSC and FTIR did not show any interaction between formulation ingredients. Conclusion: The results of dissolution and disintegration time showed that keeping piroxicam tablets for three and six months in different conditions caused significant changes in the drug release and disintegration time. Moreover, no change was observed in the physical stability of tablets.