Background Acute otitis media (AOM) is very common in children. In spite of spontaneously relief, some cases suffer from the recurrence and other complications occurring after AOM. Animal studies have proved that persistence of leukotrienes in the middle ear may play a role in the development of AOM. Based on this statement, treatment with leukotriene modifiers may be effective in the treatment of OM. The aim of this study was to examine the effect of adjunction of montelukast to antibacterial agents in treatment of AOM. Materials and Methods One hundred patients aged 2-6 years were randomly divided into two groups. One of the groups (53%) were treated with "amoxicillin alone", 80-90 mg/kg amoxicillin for 10 days, and the other group (47%), received "amoxicillin and montelukast" 5 mg per day orally for 10 days. Patients were evaluated for resolution and complications of AOM at 2 post enrollment visits (days 2-4 and 10-14). Results The patient followed-up for one month and results showed that, treatment with montelukast had beneficial effects on resolution of AOM. In monotherapy (amoxicillin alone) group, 66% of patients and in the montelukast (amoxicillin and montelukast) group, 85. 1% were treated. Conclusion In this study, the montelukast receiving group showed a better response to treatment. Based on this and previous studies, it is recommended to consider the role of inflammatory mediators in AOM. Prescribing montelukast and other leukotriene receptor antagonists may have benefits for the patients.

Introduction: The Ministry of Health and Medical Education of Iran, and similar institutions in many other countries, advises physicians to use current guidelines for the diagnosis and treatment of acute otitis media (AOM). However, there has been no evaluation of the effectiveness of such guidelines or whether physicians in Iran adhere to them. Thus, as laryngologists are the most important group of people who interact with patients with AOM, the aim of this study was to evaluate the attitude of laryngologists to the established guidelines.Materials and Methods: A total of 120 anonymous surveys were mailed to 120 otolaryngologists in Tehran, Iran, to evaluate the patterns of diagnosis and treatment of AOM used by these physicians. The survey included questions regarding the otolaryngologists’ age, gender, place of work, and attitude towards diagnosis and treatment of AOM.Results: Sixty-two completed surveys were received, for a response rate of 51%. There was no significant difference between respondents to these surveys according to sex, age, practice setting, graduation year, or the number of patients with AOM seen each month.Conclusion: Our study adds new insights to the previous literature on the use of guidelines in the management of AOM. We can now assess the impact of guidelines on the usual practice of physicians in evidenced-based management of AOM.

Background: Acute otitis media (AOM) is a common disease in children and consists one- third if visits in pediatrics clinics. The most common form of AOM is otitis media with effusion (OME) usually happens during the first two years of life. After an attack of AOM, the middle ear effusion remains after 1, 2 and 3 months in 40%, 20% and 10% of children respectively. The risk of OME is depending on antimicrobial treatments. Therefore we decided to investigate the rate of OME following AOM in children after two types of treatment including coamoxiclave and ceftriaxone.Methods: In this study 90 patients aged between 6 months to 11 years were entered. All cases were visitedas outpatient in 22 Bahman and Arya Hospitals of Islamic Azad University of Mashhad. After acomplete physical exam, a questionnaire based on patient's details and clinical findings was completed.Based on the table of random number, a series of numbers were chosen and the patients were treated with one of antibiotics (co-amoxiclaveor ceftriaxone) randomly. At the end of treatment period, another clinical examination and a tympanometry were performed for all cases.Finding: Fifty four patients (56 ears) had OME from a total of 108 ears with AOM. Based on type B tympamometry, the rate of occurrence of OME in children who received co-amoxiclave was about32% and in those who treated with ceftriaxone was 73.18% (P=0.001).This study showed that presence of smoker parentshad significant effect in occurrence of OME (P=0.03); But age, gender, history of AOM and history of allergy didn’t have significant effect in occurrence of OME in either group.Conclusion: Co-amoxiclave is more suggested for children with AOM, furthermore this treatment is more effective in patients with presence of a smoker parent.

Colitis-associated colorectal cancer (CAC) is a serious condition driven by chronic inflammation in the colon, representing a significant challenge in both preventative and therapeutic contexts. Apis mellifera intermissa venom has shown promising therapeutic potential in various disease models, particularly those involving inflammation and tumorigenesis. This study evaluates the therapeutic effects of venom derived from honeybees native to Algeria on the progression of CAC in azoxymethane (AOM)-treated mice. A total of 28 male mice were randomly allocated into four groups (n=7 per group): a control group received a tap drinking water, an AOM group (10 mg AOM /kg body weight), a bee venom group (0.76 mg/kg body weight), and a combined bee venom + AOM group. CAC was induced in mice by a single intraperitoneal injection (i.p) of AOM, and a high-fat diet (45% fat by diet weight) for two weeks. The potential therapeutic effect was evaluated by administering bee venom intraperitoneally on a daily basis for two weeks. AOM significantly reduced body weight, food and water intake while increasing colon weight. Hematological analysis revealed significant reductions in red blood cells (RBC), hemoglobin (HGB), and hematocrit (HCT), coupled with increased white blood cell counts, mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH). Elevated serum C-reactive protein (CRP) levels further confirmed systemic inflammation. Macroscopic examination and histopathological analyses of the colon revealed extensive pathological changes in the AOM group, including severe mucosal inflammation, necrotic epithelial damage, and substantial immune cell infiltration. Noteworthy, co-treatment with bee venom effectively mitigated these pathological alterations. Bee venom significantly restored hematological profiles by improving RBC count, HGB, and HCT levels while reducing the elevated WBC count, MCV, and MCH values. CRP levels were significantly reduced, reflecting the anti-inflammatory effects of the venom. Also, macroscopic evaluations demonstrated the preservation of colon morphology, while histopathological assessments revealed an improved epithelial integrity with fewer signs of necrosis and cellular atypia. These findings suggest that Apis mellifera intermissa venom holds potential as an adjunct therapeutic agent for suppressing CAC progression, warranting further investigation into its underlying mechanisms and clinical applicability.