Treatment of acute tonsillo-pharyngitis: a comparative study of spiramycin and erythromycin.

A comparative study was carried out to determine the clinical efficacy of spiramycin and erythromycin in the treatment of acute tonsillo-pharyngitis. Patients were allocated at random to receive either 500 mg spiramycin 3-times daily for 3 days or 500 mg erythromycin 3-times daily for 5 days. Details were recorded daily by patients of subjective complaints such as fever, sore throat and difficulty in swallowing, and objective signs and symptoms of inflammation were assessed by the physician before and after treatment. Results were analyzed for 32 patients in each group and showed both treatments resulted in a rapid relief of their clinical condition in over 90% of patients. Although all patients showed marked improvements, a few still complained of symptoms at the end of the treatment period. Neither treatment regimen proved adequate for the eradication of the initial pathogen identified from throat swab cultures and leucocytosis persisted in at least 1 patient in each group. Seven patients on erythromycin complained of nausea and/or epigastric pain and 1 patient on spiramycin had urticaria.

Studies on hearing loss in a community with endemic cretinism in Central Java, Indonesia.

An audiometric study was carried out in a community of 642 subjects severly affected by endemic goitre and cretinism. Hearing loss was measured in 34 out of 41 subjects diagnosed as cretins, 92 normal subjects aged 5-20 years from the same community and 54 subjects (also of 5-20 years) living in a nearby control area without endemic goitre. The excess number of hearing defects in the endemic area seems to be entirely due to the process that leads to cretinism. There is no reason to describe deafness and deafmutism in an area with severe endemic goitre as a separate entity. The hearing defect showed a definite greater loss in the higher frequencies than in the lower frequencies and was found in 92% of the cretins. Deafmutism was present in 5, a loss of more than 60 db in 8, a loss of 40-60 db in 10 cretins. A loss of 20-30 db was found in 2.2% of normal subjects in the endemic area and 1.8% of those living in the control area. It is concluded that audiometry is a simple and significant test to establish the presence of the neurological form of endemic cretinism, which is the most prevalent form in most endemias. The differential diagnosis and pathogenesis of the described hearing defect are discussed.