Comparison of 40% trichloroacetic acid and cryotherapy for the treatment of plantar warts: A single-blind, randomized clinical trial.

Plantar warts can cause pain near the toes and the sole of the foot and may result in referral for treatment. This study was aimed at comparing 40% trichloroacetic acid (TCA) and cryotherapy (Cryo) for the treatment of plantar warts. This single-blind, randomized clinical trial was performed on 60 subjects presenting with plantar wart in Sabzevar, Iran in 2018. The first intervention group was treated with 40% TCA in four sessions within 4 weeks. The second intervention group was treated with Cryo using liquid nitrogen in four sessions within 8 weeks. The mean (SD) age of subjects was 20.16 ± 5.96 years and 68.33% (n = 41) were male. Although the resolution rate of warts in the TCA 40% group was greater than the Cryo group, there was no statistical association found between the two groups by adjusting age, sex, and basal time (P = .648). Findings suggest that although 40% TCA was almost as effective as Cryo in the treatment of plantar warts, considering the lower adverse effects of TCA 40% group as compared to the Cryo group, it could be a proper alternative.

Disseminated Bacillus Calmette-Guerin infection after BCG vaccination.

The BCG is administered to all the newborns at birth in Iran. Systemic adverse reactions to BCG vaccine such as osteomyelitis and disseminated BCG infection are rare. This is a retrospective study of 15 cases <72 months who were admitted with systemic syndrome compatible with disseminated mycobacterial disease during 2004-07. Disseminated BCG disease occurred in eight children younger than 6-months old and 12 patient younger than 12-months old. Twelve patients were male. Nine of 15 patients had well known primary immune deficiency disorders including severe combined immunodeficiency, chronic granulomatous disease; cell mediated immune defect and HIV infection. Nine (60%) cases had good response to four anti-mycobacterial drug therapy and interferon gamma. Disseminated BCG disease is a rare but devastating complication of BCG vaccination that should be considered in the appropriate clinical setting. Severe immune-compromised infants are at greatest risk and they respond poorly to standard therapies.

A new clinical scoring system for adenoid hypertrophy in children.

INTRODUCTION: Chronic nasal obstruction due to adenoid hypertrophy is a very common disorder. Although the clinical assessment of adenoid hypertrophy is essential, its real value in young children is difficult to evaluate. The purpose of this prospective study was to validate a simple clinical score to predict the severity of adenoid obstruction and to evaluate the relationship between this method of clinical scoring with radiography and nasopharyngeal endoscopy. MATERIALS AND METHODS: Ninety symptomatic children were enrolled into this study. The clinical score included difficulty of breathing during sleep, apnea, and snoring. We investigated the relationship between clinical scoring, nasal endoscopy, and radiographic findings. RESULTS: The clinical score correlated very well with endoscopic findings (P<0.000), but the correlation between the clinical score and radiologic findings (P>0.05) and endoscopic findings and imaging (P>0.05) was weak.  CONCLUSION: Clinical findings could be used to select children for adenoidectomy, especially when endoscopic examination is not available or cannot be performed.

The effect of lithium chloride on WIN 55,212-2-induced tolerance in isolated guinea pig ileum.

Tolerance to most of the cannabinoid effects has been reported, either in humans or in other species. Pharmacodynamic properties of these agents are perceived to be responsible for this phenomenon. The effect of lithium was examined on tolerance to WIN 55,212-2, a synthetic cannabinoid, in guinea pig ileum, a functional model to examine the mode of action of cannabinoids. Ileum strips were mounted in bath containing 37 degrees C Tyrode, under 0.5 g resting tension. The pulses were delivered, via platinum electrode, to the tissue and subsequent twitches were recorded using PowerLab system. WIN 55,212-2 could inhibit electrically stimulated twitches of guinea pig ileum in a dose dependent manner (pD(2)=8.56+/-0.41). Tolerance to this effect could be induced by incubating isolated ileum for 4h with WIN 55,212-2 (3 x IC(50)) (pD(2)=6.36+/-0.26, degree of tolerance: 159.32) (P<0.01). Lithium (1mM) could interfere with the development of this cannabinoid-induced tolerance and restores the sensitivity of ileum to inhibitory action of WIN 55,212-2 either when strips were exposed to lithium chloride during 4h incubation period (pD(2)=7.26+/-0.39) (P>0.05 versus non-tolerant group) (degree of tolerance: 20.28), or when lithium was added immediately before examining the inhibitory action of WIN 55,212-2 (pD(2)=8.09+/-0.33) (P<0.05 versus corresponding tolerant group) (degree of tolerance: 2.96). Upon these results, it appears reasonable to consider an interventional role for lithium which may be able to break the chain of development and/or expression of tolerance to WIN 55,212-2 in this experimental model.