Septilin in Otolaryngology

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1 (The Indian Practitioner, (984):, 045) Septilin in Otolaryngology N. Luley, Reader and Head of the Department of E.N.T. and V. Kalbande, Student, E.N.T. Department., Indira Gandhi Medical College, Nagpur. INTRODUCTION Septilin is an Ayurvedic preparation which contains antibacterial and anti-inflammatory principles. Septilin has been reported by Behl and Tripathi to stimulate phagocytosis. Cahn and Hirsh 2 demonstrated the presence of an antibacterial protein, phagocytin, in the cytoplasmic granules of polymorphs. Phagocytin has an antibacterial effect on both gram-positive and gram-negative organisms. Septilin produces a rise in the phagocytic coefficient, which corresponds with clinical coefficient, which corresponds with clinical improvement in chronic infections resistant to the commonly used broad-spectrum antibiotics. Septilin improves the defence mechanism of the body. Septilin is excellently tolerated and can be given for prolonged periods without developing drug resistance or untoward reactions. Similar observations have also been made by Gadre, 3 Lakshmipathi, 4 Vishwakarma 5 and Sheth. 6 MATERIAL AND METHODS This study on Septilin was conducted at the Dept. of E.N.T., Indira Gandhi Medical College, Nagpur from September 983 to February 984. In all, 82 patients attending the E.N.T. Out-patients Dept. were included in this study. Out of these, 00 patients completed a 3 weeks course of drug treatment and only they were evaluated. The patients selected were having tonsillopharyngitis, chronic suppurative otitis media or chronic maxillary sinusitis. All the patients had also taken other drugs in the past without much improvement. In some cases swabs of the throat, ear and nose were taken for culture and sensitivity tests before starting Septilin treatment. The same bacteriological examinations were repeated after completion of treatment. Each patient was reviewed after a week and the progress was noted, depending on the improvement in signs and symptoms. The results were classified into four groups, i.e. Very Good, Good, Fair and Poor. OBSERVATIONS Out of the 00 patients, 57% were females and 43% males. The maximum number of patients (47%) were in the 2-30 age group. The youngest patient was 5 years old and the oldest 60.

2 Table : Showing the age and sex incidence Age group Total no. of patients Male Female 0 to 0 years 2 2 to 20 years to 30 years to 40 years to 50 years Above 50 years Total In tonsillitis and pharyngitis In 60 patients with tonsillitis and pharyngitis the commonest symptom was discomfort in the throat which was present in all cases and showed improvement in 50% of them. Dryness of the throat improved in 89%, halitosis in 86%, pain in the throat in 62% and sticky secretions disappeared in 63% of cases. Table 2: Showing signs and symptoms in tonsillopharyngitis before and after treatment. Discomfort in the throat (50%) 2. Pain in the throat (62%) 3. Sticky secretions 22 4 (63%) 4. Dryness (89%) 5. Halitosis (86%) Signs. Congestion (63%) 2. Follicles 3 25 (8%) 3. Post-nasal secretions (80%) 4. Fever 8 8 (00%) In chronic suppurative otitis media Out of the 25 cases of chronic suppurative otitis media, the ears became dry in 7 patients (68%). Improvement in other signs and symptoms included headache (00%), foul smell (7%) and deafness (24%). There was no change in the tympanic membrane perforations. Table 3: Showing signs and symptoms in chronic suppurative otitis media before and after treatment. Ear discharge 25 7 (68%) Mucoid (5) () (73%) Mucopurulent (4) (2) (50%) Purulent (6) (4) (67%) 2. Foul smell 7 5 (7%) 3. Headache 3 3 (00%) 4. Deafness 25 6 (24%) Conductive (22) (6) (27%) Mixed (3) 5. Tympanic membrane perforations 25 Central (9) Subtotal (3) Total (3) In chronic maxillary sinusitis

3 Fifteen cases of chronic maxillary sinusitis completed the treatment. Table 4 shows significant improvement in sinus tenderness in 00%, headache in 87% and nasal discharge in 80% of cases. Reduction in the size of the inferior turbinate, though in only 50% of cases, is also significant. More prolonged treatment would seem necessary in these cases. Table 4: Showing signs and symptoms in chronic maxillary sinusitis before and after treatment. Headache 5 3 (87%) 2. Nasal obstruction 3 0 (77%) 3. Nasal discharge 0 8 (80%) 4. Post-nasal discharge 5 3 (60%) 5. Foul smell 4 3 (75%) 6. Deviated nasal septum 7 7. Sinus tenderness 9 9 (00%) 8. Hypertrophy of the inferior turbinate 8 4 (50%) Bacteriological examinations Before treatment, bacteriological examinations and sensitivity tests were done in 25 cases. After treatment they showed sterile cultures in 9 cases (76%) and no change in 6 cases (24%). Table 5 shows the details. Table 5: Bacteriological examinations Sl. Diagnosis Before treatment No. of After treatment No. Micro-organisms found Sensitive to patients Swab sterile No change. Tonsillo-pharyngitis (5 cases) 2. Chronic suppurative otitis media (5 cases) 3. Chronic maxillary sinusitis (5 cases) Gram +ve cocci P. Gram ve bacilli Gram +ve cocci P. Gram ve cocci P E. Total P. = Pencillin, = Ampicillin, = Streptomycin, = Gentamycin, E. = Erythromycin DOSAGE The dosages employed were as follows: (a) In adults - 2 tablets, t.i.d. (b) In children - tablet, t.i.d. Therapy was continued for 3 weeks in all the patients. Only in 8 cases was the treatment continued for 5 weeks. Clinical improvement was noticed in 34 cases from the st week, 33 cases from the 2nd week and 8 cases from the 3rd week.

4 No other antibacterial agents were used during the trial. Only in some cases antihistaminics, gargles and nasal decongestants were employed as required. RESULTS The following criteria were used to assess the results: (i) Very good - when there are subjective improvement, disappearance of signs and the swab became negative. (ii) Good when there was subjective improvement, partial improvement in signs and the swab became negative. (iii) Fair when there was only subjective improvement. (iv) Poor - no change seen. As Table 6 reveals, Very Good results were seen in 6%, Good in 6%, Fair in 9% and Poor in 4% of cases. Table 6: Showing the results Very good Good Fair Poor Total Tonsillo-pharyngitis Chronic suppurative otitis media Chronic maxillary sinusitis Total no. of patients 6 (6%) 6 (6%) 9 (9%) 4 (4%) 00 (00%) SUMMARY. The main aim of our study was to establish an effective alternative to common antibiotics which are used extensively in spite of their higher cost and toxic side-effects. Both these important factors decide the course of treatment in the majority of cases in our country. Septilin is an antibacterial agent which is economical and does not cause any side-effects even after prolonged administration in full doses (2 tablets t.i.d.). 2. Our study comprised 00 patients suffering from various E.N.T. infections. Forty-three were males and 57 females. 3. There were 60 cases with tonsillitis and pharyngitis, 25 with chronic suppurative otitis media and 5 with chronic maxillary sinusitis. 4. In adults, the dosage of Septilin was 2 tablets t.i.d. In children it was tablet t.i.d. Therapy was continued for 3 weeks in all patients. 5. The result were as follows: (i) Very good 6% of cases (ii) Good 6% of cases (iii) Fair 9% of cases (iv) Poor 4% of cases The cases in our study had taken other chemotherapeutic agents previously without much relief. In such resistant cases, a cure rate of 67%, (i and ii above) for Septilin is really noteworthy. 6. The significant improvement in signs and symptoms in tonsillitis, pharyngitis, chronic suppurative otitis media and chronic maxillary sinusitis proves the efficacy of Septilin.

5 ACKNOWLEDGEMENT We are thankful to the Dean, Indira Gandhi Medical College and Supt. General Hospital, Nagpur, the Prof. of Microbiology and The Himalaya Drug Co., Bombay for helping us to conduct this study. REFERENCES. Behl, P.N. and Tripathi, R.L., Aspects of Allergy and Applied Immunology (975): VIII, Cohn, Z. and Hirsch, J., J. exp. med. (960): 2, pp. 983 and Gadre, K.C., Shah, H. and Dehnugara (Miss), P., Probe (964): 3, Lakshmipathi, and Venugopal Rao, B., J. Ind. med. Assoc. (962): 4, Vishwakarma, K., Probe (979): 2, Sheth, Shantilal, C., Tibrewala, N., Warerkar, U.R. and Karande, V., J. Ind. med. Prof. (959): 5, 2767.

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