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PubMed2005

[Can the administration of large doses of vitamin C have a harmful effect?].

Vitamin C in its pure form or as a component of multivitamin and combined drugs belongs to the over-the-counter drugs that are available not only at the chemist's but in retail shops as well. Intensive promotion of the advantages of vitamin C as the compound that augments immunity to all sorts of infections, accelerates recovery, eliminates the symptoms of common cold and flu-like diseases, and contributes to general well-being, is of great importance to its intake in quantities far exceeding the recommended dietary allowance. Moreover, the subjects who simultaneously take several anti-common cold drugs are not aware of the fact that almost each of them contains ascorbic acid. Among numerous reports concerning positive effect of vitamin C as antioxidant and free radicals scavenger, there are also those pointing at its potentially pernicious effect. Vitamin C, especially in the doses exceeding daily recommended dietary allowance may result in oxalate crystallization, formation of advanced glycation end products and even exert prooxidant effect.

Animals↗
PubMed2005

Knowledge, attitudes, and reported practices among obstetrician-gynecologists in the USA regarding antibiotic prescribing for upper respiratory tract infections.

BACKGROUND: Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic use among primary care providers. METHODS: An anonymous questionnaire asking about the treatment of URIs was sent to 1031 obstetrician-gynecologists. RESULTS: The overall response rate was 46%. The majority of respondents (92%) were aware of the relationship between antibiotic use and antibiotic resistance, and respondents estimated that 5% of their patients had URI symptoms at their office visits. Overall, 56% of respondents reported that they would prescribe an antibiotic for uncomplicated bronchitis and 43% for the common cold. OB/GYNs with the fewest years of experience were less likely than those with the most years of experience to report prescribing for uncomplicated bronchitis (Odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23 to 0.91) or the common cold (OR 0.44, CI 0.22 to 0.89). The majority of respondents (60%) believed that most patients wanted an antibiotic for URI symptoms, with male OB/GYNs being more likely than female OB/GYNs (OR 2.1, CI 1.2 to 3.8) to hold this belief. Both male OB/GYNs (OR 1.9, CI 1.1 to 3.4) and rural practitioners (OR 2.1, CI 1.1 to 4.0) were more likely to believe that it was hard to withhold antibiotics for URI symptoms because other physicians prescribe antibiotics for these symptoms. OB/GYNs who believed that postgraduate training prepared them well for primary care management were more likely than those who did not (OR 2.1, CI 1.1 to 4.2) to believe that they could reduce antibiotic prescribing without reducing patient satisfaction. CONCLUSION: Multiple demographic factors affect attitudes and reported practices regarding antibiotic prescribing. However, in view of the low proportion of office visits for URIs, an OB/GYN-specific program is not warranted.

Adult↗
PubMed2003

Relative bioavailability and bioequivalence of a newly developed fixed combination sachet of acetylsalicylic acid and pseudoephedrine compared with a preliminary combination.

Acetylsalicylic acid (ASA) and pseudoephedrine (PSE) are often administered together for the treatment of symptoms of the common cold, i.e., nasal congestion, runny nose, sore throat and headache. Based on this fact we developed a fixed combination of 500 mg ASA and 30 mg PSE, the recommended doses for both drugs for treating symptoms of the common cold, as granulate to be dissolved in water for administration. The purpose of this open, randomized, three-factorial (three-treatment, three-period, six-sequence) Latin Square clinical study was to investigate the relative bioavailability of ASA and PSE as well as the establishment of bioequivalence after single administration of the fixed combination (final formulation for approval) of 500 mg ASA/30 mg PSE*HCl and the preliminary formulation of this combination. Pharmacokinetic characteristics AUC(norm) and C(max,norm) of ASA, its metabolite SA, and PSE, were determined as measure of rate and extent of absorption of the two formulations. The treatment ratios final/preliminary formulation and their corresponding 90% confidence intervals were calculated to establish bioequivalence. Additionally, descriptive statistics were calculated for the parameters t(max), t((1/2)), and mean residence time (MRT). In total, data from 18 healthy male volunteers were included in the pharmacokinetic evaluation. The primary target parameters were analyzed using an analysis of variance (ANOVA) after logarithmic transformation of the data. Confidence intervals of 90% were calculated for the geometric means of ratios using the mean square error term of the ANOVA. Bioequivalence criteria were fulfilled for AUC(norm) and C(max,norm). Geometric means of individual ratios of AUC(norm) and of C(max,norm) showed equal bioavailability of the new formulation compared with the preliminary. Furthermore, a relative bioavailability of approximately 100% of the preliminary formulation was shown for the newly developed formulation for all parameters. The parameters t(max), t((1/2)), and MRT showed comparable results for ASA, SA, and PSE, respectively, in both formulations. The supplementary evaluation for the non-normalized original parameters AUC and C(max) also revealed bioequivalence. For the newly developed formulation, the arithmetic means of the parameters AUC and C(max) for PSE were 1040.66 mg/h*l and 134.52 mg/l, for SA 142.28 mg/h*l and 30.34 mg/l, respectively. The median t(max) values were 0.67 h for PSE and 0.92 h for SA. Both treatments were safe and well tolerated.

Administration, Oral↗
PubMed2003

[The efficacy and problems with influenza vaccination among hospital workers].

PURPOSE: The purposes of this study were: (1) to assess the therapeutic and side effects of influenza vaccination during a winter season by comparison of vaccinated and non-vaccinated subjects; and (2) to survey their willingness to receive vaccination in the future based on their experience with the present vaccination. METHOD: The subjects were 185 vaccinated hospital workers and 450 unvaccinated city office workers. We explained to the first group the desirability of receiving vaccination for the purpose of preventing in-hospital infections and received informed consent before administering influenza vaccinations. There were five subjects who did not receive any vaccination due to strong side effects from previous vaccinations or who did not give consent. We then examined the therapeutic and side effects of the vaccination with the vaccinated subjects. A questionnaire was also filled out by both groups of subjects regarding their physical condition and whether they wished to receive vaccination in the future. In this study, the criterion for influenza was a fever of 38.5 degrees C or higher while common cold was concluded with a fever under 38.5 degrees C. RESULTS AND DISCUSSION: The percentage of subjects who subsequently developed influenza symptoms was 13.2% for the vaccinated group whereas that for the unvaccinated group was 33.2%. The difference was significant (P < 0.01). There was no significant difference in the frequency of common cold symptoms between the two groups. According to the vaccinated group's self-report (through the questionnaire; n = 159), 16 subjects (10%) suffered some kind of side effects after the vaccination. In terms of their desire to receive vaccination the following year, in the vaccinated group, 25% of those who reported side effects wanted vaccination the following year whereas 86% of those who did not report side effects wanted vaccination. The difference was significant (P < 0.01). CONCLUSION: The significantly lower percentage of vaccinated subjects with influenza symptoms may have been due to the vaccination effect. The prevalence of side effects (10%) was rather low. Although a relatively high percentage of the vaccinated subjects wished to receive vaccination in the following year, the breakdown indicated that only a small number of those with side effects wanted furture vaccination. Even among those with no side effect, there were some (9.1%) who did not desire vaccination in the future. Thus, there seems to be a need for further education regarding the importance of preventing influenza through vaccination.

Adult↗
PubMed2004

In vitro activity of expanded-spectrum pyridazinyl oxime ethers related to pirodavir: novel capsid-binding inhibitors with potent antipicornavirus activity.

Picornaviruses (PV) include human rhinovirus (HRV), the primary cause of the common cold, and the enteroviruses (EV), which cause serious diseases such as poliomyelitis, meningoencephalitis, and systemic neonatal disease. Although no compounds for PV infections have been approved in the United States, pirodavir was one of the most promising capsid-binding compounds to show efficacy in human clinical trials for chemoprophylaxis of the common cold. Susceptibility to hydrolysis precluded its use as an oral agent. We have developed orally bioavailable pyridazinyl oxime ethers that are as potent as pirodavir. Compounds BTA39 and BTA188 inhibited a total of 56 HRV laboratory strains and three clinical isolates as determined by neutral red uptake assay. At concentrations of <100 nM, BTA39 inhibited 69% of the HRV serotypes and isolates evaluated, BTA188 inhibited 75%, and pirodavir inhibited 59% of the serotypes and isolates. The 50% inhibitory concentrations (IC(50)s) for the two compounds ranged from 0.5 nM to 6,701 nM. The compounds also inhibited EV, including coxsackie A and B viruses (IC(50) = 773 to 3,608 nM) and echoviruses (IC(50) = 193 to 5,155 nM). BTA39 only inhibited poliovirus strain WM-1 at 204 nM, and BTA188 only inhibited poliovirus strain Chat at 82 nM. EV 71 was inhibited by BTA39 and BTA188, with IC(50)s of 1 and 82 nM, respectively. Both compounds were relatively nontoxic in actively growing cells (50% cytotoxic doses, >/=4,588 nM). These data suggest that these oxime ethers warrant further investigation as potential agents for treating selected PV infections.

Animals↗
PubMed2004

Deadly viral syndrome mimics.

Upper respiratory tract infections (ie, "the common cold") have several hundred causes, the most common of which include rhino-virus, coronavirus, and respiratory syncytial virus. The clinical presentation varies with symptoms. Every emergency department, no matter what the demographics, cares for patients with this constellation of symptoms. Emergency physicians examine, diagnose, and treat these disorders frequently. With increasing burdens being placed on emergency physicians, it is possible to assume a diagnosis of upper respiratory tract infection without generating a complete differential diagnosis. The challenge is to identify and recognize the distinctions between an innocuous upper respiratory tract infection and a life-threatening disease "mimic" or entities. This article discusses some of these life-threatening mimics.

Common Cold↗
PubMed1963

CHIMPANZEE KIDNEY TISSUE CULTURES FOR GROWTH AND ISOLATION OF VIRUSES.

Dick, Elliot C. (University of Wisconsin, Madison). Chimpanzee kidney tissue cultures for growth and isolation of viruses. J. Bacteriol. 86:573-576. 1963.-Chimpanzee kidney tissue cultures were employed for propagation of several laboratory strains of viruses that commonly inhabit the respiratory and intestinal tracts, or both, and for isolation of viruses from throat washings of persons with common colds and tonsillitis-pharyngitis. This tissue culture host was found to support the growth of approximately the same viruses as do Rhesus monkey kidney tissue cultures, with two exceptions: (i) chimpanzee kidney tissue culture was much more susceptible to herpes simplex infection, and (ii) cytopathic effects were not produced by either "M" or "H" strains of muriviruses (common cold viruses). The presence of adventitious viruses in some uninoculated chimpanzee kidney tissue cultures is suspected.

Animals↗
PubMed1978

Viral causes of sensorineural hearing loss.

Many viruses, even the common cold, are capable of producing sensorineural hearing loss. Treatment so far available is ineffective in correcting these losses. However, as the technology of vaccination advances, it is hoped that these can be prevented. Poliomyelitis and smallpox have been virtually eliminated from this country. Measles, rubella, and mumps are coming under control. Perhaps in the future we will be able to completely control influenza and the common cold and thus prevent many of the sensorineural hearing losses that we see today.

Cochlea↗
PubMed1996

-Clinical features of 10 cases of tuberculous meningitis--with special reference to patient's delay and doctor's delay.

We retrospectively evaluated the clinical findings of 10 cases of tuberculous meningitis who had been admitted to our department from 1987 to 1994. Four patients were male and six were female. All of them were Japanese, and their age ranged from 17 to 74 years old. Regarding the patient's delay, nine patients visited a doctor in 1 to 20 days after the onset of headache, and one patient visited a doctor in 14 days after the onset of general malaise. It is suggested that the patient's delay could not be longer than 3 weeks because of progressively worsening symptoms of tuberculous meningitis such as severe headache and fever. The time interval between the first contact of the patient to a doctor and the commencement of antituberculous therapy (doctor's delay), ranged from 14 to 66 days. When the diagnosis of meningitis was obtained based on the findings of the cerebrospinal fluid (CSF), focal neurological signs including psychological symptoms, cranial nerve palsies and seizure were noted besides meningeal signs or the disturbance of consciousness in 4 patients. The CSF revealed an increase in cell counts with mononuclear cell dominance in 9 patients, but the findings typical for tuberculous meningitis such as increase in total protein content and a decrease in glucose concentration were obtained in only 5 patients. Mycobacterium tuberculosis had not been detected in all cases when the antituberculous chemotherapy was started. Later, it was found to be positive in the CSF sample from only three patients by culture or polymerase chain reaction (PCR) method. When the antituberculous therapy was completed, meningitis was cured without remaining any symptom or sign in all patients. All patients had no active pulmonary tuberculosis when the meningitis was diagnosed, and only one of them had sequels of lung tuberculosis. Four patients had the past history of tuberculosis, and 1 had the familial history of pulmonary tuberculosis. At the first contact to a doctor, seven patients were diagnosed as having common cold or headache related with fever because of the lack of typical signs of meningitis. Similarly three other patients were initially diagnosed as having meningitis due to viral infection or unknown etiology. In summary, it was difficult to obtain the solid diagnosis of tuberculous meningitis at the initial stage of this disease, since the symptoms and signs at its onset often similar to those of common cold or non-specific headache. Therefore, when we see the patients with subacute onset of headache and fever followed by the meningeal signs, tuberculous meningitis should always be included in the list of diseases requiring differential diagnosis. In addition, when tuberculous meningitis is suspected, the antituberculous therapy should be started without any delay.

Adolescent↗
PubMed1989

[Health effects of volcanic air pollution--an analysis of the national health insurance].

Using the national health insurance bills covering the one-year period from January through December 1987, the morbidity figures for respiratory diseases, conjunctivitis and dermatitis were compared among four local districts; Ushine, Kaikata, Kunugibaru and Shinjo, in the city of Tarumizu. The former two districts are 10 km south-east of Mt. Sakurajima supposedly experience higher volcanic ash exposure compared to the latter two located 10 to 15 km from this volcano. Results obtained are as follows; 1) Age-adjusted rates of patients' consultations and existing patients were apparently higher in the Ushine and Kaikata districts than in the Kunugibaru and Shinjo districts for non-infectious or infectious respiratory diseases and the common cold. For the rates of other diagnostic categories of disease, i.e., rhinitis, other respiratory diseases, conjunctivitis and dermatitis, a difference between the district was not clearly noted. These figures are suggestive of an association of volcanic air pollution with an increased number of outpatient consultations for respiratory problems. 2) Variations of monthly clinical consultations for patients with diagnoses of non-infectious or infectious respiratory diseases and the common cold showed a seasonality, being highest in winter and lowest in summer, while another seasonality, highest in summer and lowest in winter, was proved in the variation of monthly clinical consultations for patients with dermatitis. Few or no stable seasonalities were shown in the variations of monthly clinical consultations for patients with the other diseases, studied, rhinitis, other respiratory diseases and conjunctivitis. In addition, the variations in the monthly averages of sulfur dioxide concentrations showed a stable seasonality with the highest peak in winter and the lowest in summer but there was no stable seasonality in the monthly variations of total suspended particles at the place in Arimura for which air pollution data were available. These facts suggest that in the area exposed to volcanic air pollution, the seasonal variation in the number of monthly clinical consultations for respiratory problems is partly modified by the exposure levels of sulfur dioxide rather than total suspended particles, although no adjustments were made for climatologic factors. 3) A few patients diagnosed as having "pneumoconiosis" were found in the Ushine and Kaikata districts. However, it is difficult to interpret these cases without information about occupational and other risk factors for the development of pneumoconiosis.

Adolescent↗
PubMed2004

Physician behaviour for antimicrobial prescribing for paediatric upper respiratory tract infections: a survey in general practice in Trinidad, West Indies.

BACKGROUND: Upper respiratory tract infections (URTIs) are among the most frequent reasons for physician office visits in paediatrics. Despite their predominant viral aetiology, URTIs continue to be treated with antimicrobials. We explored general practitioners' (GPs) prescribing behaviour for antimicrobials in children (< or = 16 years) with URTIs in Trinidad, using the guidelines from the Centers for Disease Control and Prevention (CDC) as a reference. METHODS: A cross-sectional study was conducted on 92 consenting GPs from the 109 contacted in Central and East Trinidad, between January to June 2003. Using a pilot-tested questionnaire, GPs identified the 5 most frequent URTIs they see in office and reported on their antimicrobial prescribing practices for these URTIs to trained research students. RESULTS: The 5 most frequent URTIs presenting in children in general practice, are the common cold, pharyngitis, tonsillitis, sinusitis and acute otitis media (AOM) in rank order. GPs prescribe at least 25 different antibiotics for these URTIs with significant associations for amoxicillin, co-amoxiclav, cefaclor, cefuroxime, erythromycin, clarithromycin and azithromycin (p < 0.001). Amoxicillin alone or with clavulanate was the most frequently prescribed antibiotic for all URTIs. Prescribing variations from the CDC recommendations were observed for all URTIs except for AOM (50%), the most common condition for antibiotics. Doctors practicing for >30 years were more likely to prescribe antibiotics for the common cold (p = 0.014). Severity (95.7%) and duration of illness (82.5%) influenced doctors' prescribing and over prescribing in general practice was attributed to parent demands (75%) and concern for secondary bacterial infections (70%). Physicians do not request laboratory investigations primarily because they are unnecessary (86%) and the waiting time for results is too long (51%). CONCLUSIONS: Antibiotics are over prescribed for paediatric URTIs in Trinidad and amoxicillin with co-amoxiclav were preferentially prescribed. Except for AOM, GPs' prescribing varied from the CDC guidelines for drug and duration. Physicians recognise antibiotics are overused and consider parents expecting antibiotics and a concern for secondary bacterial infections are prescribing pressures. Guidelines to manage URTIs, ongoing surveillance programs for antibiotic resistance, public health education on non-antibiotic strategies, and postgraduate education for rational pharmacotherapy in general practice would decrease inappropriate antibiotic use in URTIs.

Journal Article↗
PubMed2003

[Effects of H1 blocker and inhaled corticosteroids on asthmatic patients with allergic rhinitis].

OBJECTIVE: To evaluate the therapeutic effects of H(1) blocker in combination with low dose inhaled corticosteroid on allergic asthma. METHODS: A multi-center, double blind, randomized, placebo control study was conducted in 67 patients with mild to moderate allergic asthma. Patients were randomized to receive either Loratadine 10 mg or placebo twice a day on the basis of inhaled beclomethasone dipropionate (400 microg/d for 14 days, then reduced to 200 microg/d) for 5.3 +/- 1.3 months. Symptom scores of asthma, frequencies of episode of rhinitis and common cold and doses of inhaled Salbutamol as rescue drug were recorded. Bronchial hyperresponsiveness (PD(20) FEV(1) in response to Histamine) and serum ICAM-1 and VCAM-1 were measured before and after the treatment. RESULTS: After treatment, there was much better improvement in symptom score (2.4 +/- 0.9 vs 3.1 +/- 0.9, P < 0.01), symptomatic days due to rhinitis (4.0 +/- 1.2 d/week vs 1.9 +/- 0.9 d/week, P < 0.001), episode of common cold symptom (0.8 +/- 0.5 time vs 1.1 +/- 0.4 time, P < 0.001), average doses of inhaled beta(2) agonist as rescue medication (2.6 +/- 0.9 puff/week vs 3.7 +/- 0.8 puff/week, P < 0.001) and bronchial responsiveness (P < 0.05) in Loratadine group as compared with the control group. However, there was no significant change in serum ICAM-1 and VCAM-1 levels after treatment in both groups (P > 0.05). CONCLUSIONS: On the basis of low dose inhaled corticosteroid, orally administered Loratadine significantly improves the therapeutic efficacy of asthma in patients with allergic asthma and rhinitis.

Administration, Inhalation↗
PubMed2002

[Study on risk factors of cryptorchidism].

OBJECTIVE: Cryptorchidism is the most common urogenital congenital malformations in males, which increases male infertility and testicular tumors. It is necessary to identify its risk factors. METHODS: A hospital-based case-control study was conducted. Cases were 99 boys with cryptorchidism with two matched controls per case were randomly selected. Both cases and controls were interviewed with a uniformed questionnaire by face to face. Conditional logistic regression model was used for univariable and multivariate analysis by SAS6.12 computer software was used to estimate odds ratios (OR) and their 95 per cent confidence internals (95% CI). RESULTS: Multiple conditional logistic regression analysis showed that cryptorchidism was positively associated with maternal common cold accompanied fever in the first trimester (OR = 9.37, 95% CI: 2.25 - 39.09), with threatened abortion in the first and/or second trimester (OR = 4.66, 95% CI: 2.02 - 10.74), maternal preeclampsia during pregnancy (OR = 16.33, 95% CI: 1.40 - 191.20), paternal exposure to pesticides occupationally (OR = 12.79, 95% CI: 2.90 - 56.43), neonatal low birth weight (OR = 5.77, 95% CI: 1.39 - 23.98), and maternal age under 24 years (OR = 2.89, 95% CI: 1.29 - 4.06). CONCLUSIONS: The risk factors of cryptorchidism were maternal common cold accompanied fever in the first trimester, threatened abortion in the first and/or second trimester, maternal preeclampsia during pregnancy, paternal exposure to pesticides occupationally, neonatal low birth weight, maternal age under 24 years.

Case-Control Studies↗
PubMed2003

Changing use of antibiotics in community-based outpatient practice, 1991-1999.

BACKGROUND: Judicious use of antibiotics can slow the spread of antimicrobial resistance. However, overall patterns of antibiotic use among ambulatory patients are not well understood. OBJECTIVE: To study patterns of outpatient antibiotic use in the United States, focusing on broad-spectrum antibiotics. DESIGN: Cross-sectional survey in three 2-year periods (1991-1992, 1994-1995, and 1998-1999). SETTING: The National Ambulatory Medical Care Survey, a nationally representative sample of community-based outpatient visits. PATIENTS: Patients visiting community-based outpatient clinics. MEASUREMENTS: Rates of overall antibiotic use and use of broad-spectrum antibiotics (azithromycin and clarithromycin, quinolones, amoxicillin-clavulanate, and second- and third-generation cephalosporins). All comparisons were made between the first study period (1991-1992) and the final study period (1998-1999). RESULTS: Between 1991-1992 and 1998-1999, antibiotics were used less frequently to treat acute respiratory tract infections, such as the common cold and pharyngitis. However, use of broad-spectrum agents increased from 24% to 48% of antibiotic prescriptions in adults (P < 0.001) and from 23% to 40% in children (P < 0.001). Use of broad-spectrum antibiotics increased across many conditions, increasing two- to threefold as a percentage of total antibiotic use for a variety of diagnoses in both adults and children. By 1998-1999, 22% of adult and 14% of pediatric prescriptions for broad-spectrum antibiotics were for the common cold, unspecified upper respiratory tract infections, and acute bronchitis, conditions that are primarily viral. CONCLUSIONS: Antibiotic use in ambulatory patients is decreasing in the United States. However, physicians are increasingly turning to expensive, broad-spectrum agents, even when there is little clinical rationale for their use.

Adult↗
PubMedDate not supplied

Surveillance for low-level malaria.

Due to good detection and control, malaria has reached very low levels in China with the result that existing methods of surveillance, taking blood slides from all fever cases and those with a common cold, are finding very few malaria cases among the millions of persons examined. Passive case detection agents in areas of moderate and low endemicity in Hubei Province, China, were instructed to indicate on the form associated with each slide whether the patient was considered to be a clinical case of malaria (group 1), was thought to have malaria but did not have all the features (group 2), had fever alone and was not thought to be a case of malaria (group 3), or merely had a common cold (group 4). In the low endemic area (slide positivity rate 0.23%), only 5 cases in group 3 and 4 in group 2 were detected per 10,000 examinations. It is recommended that these categories be discontinued in malarious areas of low endemicity, to encourage greater efficiency in detecting cases in groups 1 and 2. In the moderately endemic area, with a slide positivity rate of 4.19%, all categories, including group 4, were considered valuable for detecting malaria cases.

Adolescent↗
PubMed1979

[The antiallergic effect of Balkis. A rhino-manometric study].

The antiallergic and decongestive effects of the common cold preparation Balkis was tested by rhinomanometry in human volunteers usually suffering from allergic rhinitis after oral treatment. The nasal irritation in these patients was induced by administration of the specific allergen. This kind of test is especially appropriate for the control of drugs in cases of ordinary colds, as the test conditions are reproducible in symptomatically similar cases. The rhinomanometrical control of the respiratory resistance was carried out before and after an allergenic exposal as well as before and after administration of Balkis and allergenic exposal in 30 patients (17 females, 13 males; 9-49 years old). It is shown that Balkis had a good to satisfactory antiallergic effect in 67% of all cases. In 33% of the cases the antiallergic effect was not evident. This result confirms objectively the good antiallergic effect of this common cold preparation by oral administration. Balkis was well tolerated in all of the 30 patients. The symptoms of slight fatigue which appeared in 1/3 of all cases were only transitory.

Chlorpheniramine↗
PubMed1994

Mothers' perceptions of severe pneumonia in their own children: a controlled study in Pakistan.

In 1992, 320 mothers were interviewed in a Rawalpindi hospital to identify which of the signs and symptoms they saw in their own children were most consistently linked with a clinical diagnosis of pneumonia as opposed to common cold. A related goal was to determine whether mothers could correctly judge the actual presence or absence of two major pneumonia signs--fast breathing and chest indrawing. The mothers were predominantly poor and 43% were illiterate. The study sample was composed of four matched groups: (1) mothers of 80 children with pneumonia, most with severe disease, interviewed after the child was referred to the ward; (2) mothers of 80 such children interviewed in the outpatient clinic prior to any discussion of the pneumonia diagnosis; (3) mothers of 80 children with common cold; and (4) mothers of 80 'well' children. Results showed that when mothers were interviewed in the clinic, their perception that a child had fast breathing and/or chest indrawing was highly correlated with pneumonia (sensitivity 64%, specificity 90%). Mothers were even more likely to say that a child had these signs after the pneumonia diagnosis had been conveyed, suggesting that interaction with doctors influenced their views. Fast breathing was better recognized than chest indrawing, and accurate diagnosis of both signs was better among mothers having prior experience with childhood pneumonia. The data suggest that even in the absence of formal ARI education, a majority of Pakistani mothers attending hospitals in indigent areas can recognize these two signs in their own children. However, the seriousness of the signs and their connection with pneumonia should be stressed in education campaigns since a high percentage of children had chest indrawing (a late sign of severe disease) by the time they were brought to the hospital.

Adolescent↗
PubMed2002

Voluntary control of cough.

Cough is normally referred to a reflex mediated by control centres in the respiratory areas of the brainstem. However, there is much experimental information that indicates that human cough is under voluntary control and that higher centres such as the cerebral cortex have an important role in both initiating and inhibiting cough. Studies on acute cough associated with common cold, and capsaicin induced cough have demonstrated that human cough can be voluntarily inhibited and often abolished. Further evidence for some role of consciousness in the control of cough comes from studies that show that cough is inhibited or abolished during sleep and with light anaesthesia. This paper discusses the historical development of the brainstem 'cough centre' and discusses the experimental evidence on the voluntary control of cough in man. A cough model demonstrating the voluntary and reflex control of cough in man is proposed. A hypothesis is proposed that cough associated with common cold is a mixture of both reflex and voluntary cough.

Consciousness↗